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  • Thank everyone
  • Work in the notion that you are tracking activity against a competency framework. Also, physician learning should be measured!
  • This is an image of the Baltimore Fire of 1904. It wiped out 80 city blocks. Calls went to Philadelphia and DC fire departments, but they couldn’t use Baltimore hydrants because the connections weren’t standardized. Standards for connecting fire hoses and hydrants went into effect as a result of this disaster.
  • Bob Galbraith will be discussing a project called Trusted Agent that applies…
  • How many have heard of SCORM? How many have used it?
  • It turns out that healthcare is not alone in facing training challenges. DoD would buy a new fighter plane, they would also purchase training for that plane. By the time the training was delivered, it was out of date, it didn’t run on their system, and they had to pay for the expense of creating a whole new course. Training needed to be faster and cheaper.
  • Difficult to keep track of, no required connection with area of practice, little impact on behavior
  • Bob Galbraith will be discussing a project called Trusted Agent that applies…

PPT PPT Presentation Transcript

  • MedBiquitous Orientation Valerie Smothers MedBiquitous MedBiquitous Annual Conference May 13, 2008
  • Objectives
    • At the conclusion of the workshop, participants will be able to:
    • Describe the benefits of standards in healthcare education and competence assessment.
    • Identify opportunities for participating in the standards development process.
  • Before we start
    • How many are planning to attend Virtual Patients in a Nutshell at 11?
  • Overview
    • Introductions
    • What is MedBiquitous?
    • Why standards?
    • Major Activities
    • Summary
    • How to participate
  • Introductions
  • What is MedBiquitous?
  • MedBiquitous Mission
    • To advance healthcare education through technology standards that promote professional competence, collaboration, and better patient care.
    • Not-for-profit, member-driven, standards development organization
  • The Fragmented Healthcare Industry Universities Societies Certifying Boards Licensing Boards Government Publishers Industry Accrediting Bodies ?
  • How it all started… And it kept growing…
  • MedBiquitous: Technology Standards for Healthcare Education
    • 74 member organizations
    • 7 Working Groups
    • ANSI process
      • Openness
      • Transparency
      • Consensus
      • Due process
    • Work with leading organizations that can drive adoption
    Professional Profile Learning Objects Activity Reporting Competencies Virtual Patients Metrics Point of Care Learning
  • ANSI Accredited Standards Developer
    • MedBiquitous develops information technology (XML) standards for:
    • Healthcare education and training
    • Healthcare professional competence assessment, certification, and licensure
    • Healthcare professional and scientific publications
    • Healthcare professional online communities and portals
  • MedBiquitous Goals
    • Better tracking and evaluation of professional education and certification activities
    • Easier discovery of relevant education and information resources when and where needed
    • Interoperability and sharing of high quality online education
    • Coordination and tracking of competence assessment data
  • Identify gaps in competency Identify relevant resources Identify learner Track accomplishments <Competencies> <lom>
    • John Doe’s Portfolio
    • CME
    • Course 1
    • Course 2
    • Course 3
    Learner Portfolio <ActivityReport> <Member>
    • What is the correct answer?
    • Choice 1
    • Choice 2
    • Choice 3
    • Choice 4
    Self-assessment
    • General Competencies in Family Practice
    • Competency 1
    • Competency 2
    • Competency 3
    Competencies QI CME Certifying board Licensing board
  • MedBiquitous Process
    • Approves new standards projects
    • Meets via telco, in person
    • Develops specifications
    • Consensus body
    • Votes
    • Final approval
    Working groups Standards committee ANSI Executive committee
  • Working Groups
    • Professional Profile
      • Standard for describing a healthcare professional
      • Credentials verification, administration, identification
    • Competencies
      • Standard for describing competency framework
      • Working with IEEE
    • Learning Objects
      • Healthcare LOM (describing learning activities)
      • SCORM for Healthcare (running e-learning)
  • Working Groups
    • Virtual Patient
      • Standards for interactive computer programs that simulate real life clinical scenarios
    • Activity Report
      • Tracking CE/MoC activities
    • Metrics
      • Aggregate evaluation data
    • Point of Care Learning
      • Integration with clinical systems
      • Tracking needs assessment and inquiry data
  • Working Group Meetings
    • Activity Report WG Thur, 3:30 PM
    • Competency WG Thur, 12 PM
    • Learning Objects WG, Thur, 7:30 AM
    • Metrics WG Thur, 12 PM
    • Point of Care Learning WG Thur, 7:30 AM
    • Professional Profile Thur, 3:30 PM
    • Virtual Patient WG Today, 3:30 PM
  • Why standards?
  • Why standards?
    • Activity
      • You are designing your own searchable cookbook for all of the recipes you download from the internet.
      • Develop a data structure for a cooking recipe. Describe some of the benefits of having this standard.
  • Why standards?
    • To facilitate exchange of data and resources
    • To enable collaboration
    • To create economies and networks of scale
  •  
  • Your Challenges
    • Activity
    • What information exchange, coordination, or integration challenges do you have?
    • 5 min
  • Major Activities
  • Coordinating Professional Healthcare
    • Professional Profile
      • Coordinating clinician data
    • Competencies
      • Coordinating competency data
  • Professional Profile Working Group
    • Mission: to develop XML standards and Web services descriptions to enable the exchange of clinician profile information across organizations and systems
  • Participants
    • Mike Zarski, American Osteopathic Association, Chair
    • Archana Aida, American Board of Pediatrics
    • Skip Bartolanzo, American Board of Pediatrics
    • Tom Brantigan, TMA Resources
    • Annette Van Veen Gippe, American Osteopathic Association
    • David Hooper, Federation of State Medical Boards
    • Jim Jahrling, American Board of Medical Specialties
    • Paul Jolly, Association of American Medical Colleges
    • Don Jones, American College of Chest Physicians
    • Laura Martin, American Board of Pediatrics
    • Joe O’Conner, Educational Comission for Foreign Medical Graduates
    • Monica Quiroz, American Medical Association
    • Kelly Reddick, American Board of Pediatrics
    • Michael Rowan, Learn Something
    • Pam Shellner, American Association of Critical-Care Nurses
    • Cyndi Streun, Federation of State Medical Boards
    • Howard Tanzman, American College of Surgeons
    • Todd Tischendorf, CECity
    • Toby Vandermark
  • Professional Profile Use Case
    • Common format for exchanging information about healthcare professionals
      • Contact
      • Education
      • Training
      • Certification
      • License
      • Disciplinary action
      • Academic appointments
      • Memberships
    • Facilitates cross- organization collaboration
  • Benefits
    • Faster to process standardized data
    • Faster to develop new applications
    • Easier to work with partner organizations
    • Able to automate many business processes
    • Users: ABMS, AOA for faster credentialing
  • Status of Professional Profile
    • Undergoing Public Review Complete
      • Ballot complete
    • Standards Implementation
      • Clinician credentialing
      • Data collection
    • Developing implementation guide and services documentation
    Working groups Standards committee ANSI Executive committee
  • Competencies
    • Competency = any educational objective or educational outcome that results from knowledge, skills, or beliefs.
  • Competencies Working Group
    • Co-chairs: Rosalyn Scott, MD and Tim Willett, MD
    • Mission: develop a standardized framework to represent competency data
    • Existing work: IEEE Learning Technology Standards Committee (LTSC) has convened a Competency study group
  • Uses for a Competency Standard
    • Allow learners to track their accomplishments against a list of relevant competencies
    • Enable educators to see how their curriculum fits into a competency framework
    • Enable content developers to tie educational activities to a competency framework
  •  
  • Coordinating in Primary Care
    • Activity
    • Exchanging membership data
    • Promoting a core curriculum
    • 7 min
  • Finding Educational Activities and Content
    • Healthcare Learning Object Metadata (Healthcare LOM)
      • Finding learning activities
  • Healthcare Learning Object Metadata (LOM)
    • Metadata Definition: the data that describes a resource.
      • Example: card catalog information for a book: author, title, publication date, topic, etc.
    • Problem: many organizations use completely different metadata schemes.
      • Example: keyword = “Renal Failure” vs. Topic = “Renal Failure”
  • Healthcare LOM Working Group Mission
    • To develop XML and Web services standards to enable interoperability, accessibility and reusability of Web-based medical learning content.
  • Healthcare LOM Uses Health Education Title: Aresenic Toxicity Keyword: Environmental medicine, MeSH D019550 Target audience: Physician, registered nurse Credits:: CME 1.5 AMA PRA Category 1; CNE 1.7 contact hours Database B Title: Preventing sports injuries Target audience: Patient
  • Healthcare LOM Uses CE Evaluation Interdisciplinary teams Evidence based practice Quality improve-ment Inform-atics Patient centered care
  • Learning Objects Working Group
    • Morgan Bantly, Department of Veterans Affairs , Chair
    • Patti Abbott, Johns Hopkins University
    • Trupti Bakrania, St George's University of London
    • Ravi Teja Bhupatiraju, Oregon Health and Sciences University
    • Gabrielle Campbell, Association of American Medical Colleges
    • Chris Candler, M.D., Association of American Medical Colleges
    • Dawn Carroll, Department of Veterans Affairs
    • David Davies, Ph.D., University of Warwick 
    • Nancy Davis, Ph.D., National Institute for Quality Improvement and Education
    • Sharon Dennis, M.S., HEAL
    • Shona Dippie, HEAL
    • Rachel Ellaway, Northern Ontario School of Medicine
    • Nancy Gathany, Centers for Disease Control and Prevention
    • Stuart Gilman, M.D., Department of Veterans Affairs
    • William Hersh, M.D., Oregon Health and Sciences University
    • Lorena Hitchens, HighWire Press
    • Julie Lambla, American Association of Critical-Care Nurses
    • Tao Le, M.D., Johns Hopkins University
    • Joy Leffler, WEMOVE
    • Ross Martin, M.D., Pfizer
    • Jim Martino, Ph.D., Johns Hopkins University
    • Sandra McIntyre, M.Ed., HEAL
    • Don O'Guin, Pfizer
    • Jennifer Ott, Healthstream
    • Beth Powell, Centers for Disease Control and Prevention
    • Andrew Rabin, CECity
    • Mike Rowan, LearnSomething
    • Chris Rueger, Healthstream
    • Deborah Sher, Department of Veterans Affairs
    • Damon Silver, HighWire Press
    • Carl Singer, CECity
    • Sebastian Uijtdehaage, Ph.D., HEAL
    • David Ward, American Association of Critical-Care Nurses
    • Walter Wolyniec, Boehringer Ingelheim
    • Dan Rehak, Ph.D.
    • Jorge Ruiz, M.D., University of Miami
    • Charles Willis, American Gatroenterological Association
  • Healthcare LOM Structure
  • Healthcare LOM Structure
  • Benefits
    • Save money – don’t reinvent, reuse
    • Improve access to content – internally or across organizations
    • Use content in innovative ways
    • Users – HEAL, MedEdPortal, VA
    • Ballot complete - In ANSI review
  • Break – 10 minutes
  • Sharing and Reuse of Educational Resources
    • SCORM for Healthcare
      • Self-directed Web-based learning
    • Virtual Patients
      • Web-based simulations of clinical encounters
    • S hareable
    • C ontent
    • O bject
    • R eference
    • M odel
    SCORM
    • An e-learning model that enables accessibility , reuse , and interoperability of learning objects and tracking of learner progress.
    • Standards for running, packaging, and describing learning content
    • Broad international adoption
  • SCORM for Healthcare
    • Profile of SCORM
    • Leverages extensions to SCORM metadata called Healthcare Learning Object Metadata (Healthcare LOM)
    • Developed by MedBiquitous
    • All SCORM for Healthcare content is conformant with SCORM
  • Challenges in Defense Training
    • Content not portable / interoperable
    • Content monolithic and not easily updated
    • Content cannot be shared
  • Goals of SCORM This year’s course on asthma will run on the LMS you buy next year. Will continue to function as systems are upgraded. Durable Module run in one LMS can be shared with other organizations and run on their systems. Can function in multiple hardware/software environments. Interoperable Module on effects of radiation exposure can be included in multiple courses. Independent of learning context. Can be used for multiple situations. Reusable Searching an education repository for hemorrhagic fever brings relevant results. Easily discovered and located. Accessible Example Definition SCORM Content is…
  • Status of SCORM for Healthcare
    • Draft specification available
    • Users – VA co-developing content in conjunctions with other government agencies
  • Virtual Patients
    • Definition: An interactive computer simulation of real-life clinical scenarios for the purpose of medical training, education, or assessment.
    • Several schools are developing
    • Very costly to create
    • No common framework that would allow these virtual patients to be shared across systems
  •  
  • Virtual Patient Working Group Mission
    • To develop XML standards and Web services requirements to enable interoperability, accessibility and reusability of Web-based virtual patient learning content.
  • Virtual Patients Working Group
    • Soeren Huwendiek, University of Heidelberg
    • Patrik Jonsson, Karolinska Institute
    • Peter Kant, University of Pittsburgh
    • Joy Leffler, WE MOVE
    • Sandra McIntyre, M.Ed., HEAL
    • Dick Moberg, Moberg Research
    • Beth Powell, Centers for Disease Control
    • Narain Ramluchumun, St. George's University of London
    • Kathie Rose, National Board of Medical Examiners
    • Deborah Sher, Department of Veterans Affairs
    • Arnold Somasunderam, St. George's University of London
    • Chris Toth, University of Pittsburgh
    • Dan Walker, Tufts University
    • Pat Youngblood, Stanford
    • Nabil Zary, Karolinska Institute
    • Grace Huang, M.D., Harvard University
    • Carol Kamin, University of Colorado
    • Yanko Michea, M.D., University of Connecticut
    • Nancy Posel, McGill
    • Dan Rehak, Ph.D.
    • Gurjeet Shokar, University of Texas Medical Branch
    • Scott Stern, University of Chicago
    • Kevin Souza, University of California, San Francisco
    • Marc Triola, M.D., New York University
    • Rachel Ellaway, Co-chair
    • JB McGee, Co-chair
    • Spenser Aden, Healthstream
    • Susan Albright, Tufts University
    • Ben Azan, MedBiquitous
    • Dmitriy Babinchenko, University of Pittsburgh
    • Chara Balasubramaniam, St. George's University of London
    • Matthias Bauch, University Children's Hospital Heidelberg
    • Linda Bell, American Association of Critical-Care Nurses
    • Chris Candler, M.D., Association of American Medical Colleges
    • Emily Conradi, St. George's University of London
    • David Davies, Ph.D., University of Warwick
    • Parvati Dev, Stanford University
    • Jeroen Donkers, University of Maastricht
    • Shona Dippie, HEAL
    • Uno Fors, D.D.S., Ph.D., Karolinska Institute
    • Robert Galbraith, M.D., National Board of Medical Examiners
    • Dennis Glenn, American Board of Surgery
    • Michael Hagen, American Board of Family Medicine
    • Frank Hess, University of Heidelberg
    • Jörn Heid, University of Heidelberg
    • Matthias Holzer, University of Munich
  • Virtual Patient Architcture
    • Component based approach
    • Enables sharing and reuse of entire virtual patient or components
    • Engaging and relevant
    • Provides feedback on practice
    • Hewlett funded grant for VP player (Tufts)
    • Basis of eViP project
  • The MVP Architecture SCORM package
    • VP Working Group accomplishments
      • Draft schemas available
      • Draft data and player specifications available
      • Being implemented by several universities
    • Benefits:
    • scale costly virtual patient development across institutions
    • Users:
    • EViP participants, Tufts, U of Pittsburgh, NYU, Northern Ontario School of Medicine
    VP Working Group Status
  • Reusing Content
    • Activity
    • Some have referred to educational materials as “legos” that may be reconfigured to form a variety of useful educational resources.
    • What are the various ways that the following resources may be used, alone or in combination with other resources?
    • 5 min
  • Video of an Abnormal Gait Brain MRI Brain Tissue Labeled Diagram of the Nervous System
  • Tracking and Evaluation of Learning Activities
    • Activity Report
      • Tracking CE and certification activities across organizations
    • Point of Care Learning
      • Tracking clinical questions, resources searched, and application to practice
    • Medical Education Metrics
      • Reporting aggregate evaluation data
  • Activity Report Working Group
    • Mission: develop XML standards and Web services requirements and descriptions to enable tracking of the learning and certification activities of physicians and other healthcare professionals.
  • Participants
    • Toby Vandemark, Chair
    • Spencer Aden, Healthstream
    • Archana Aida, American Board of Pediatrics
    • Dawn Ainger, Genova Technologies
    • Mary Pat Aust, American Association of Critical-Care Nurses
    • Skip Bartolanzo, American Board of Pediatrics
    • Ray Everngam, CTSNet
    • Scott Foutz, American Academy of Pediatrics
    • Cyndi Grimes, Medscape
    • Monica Hanks, American Association of Critical-Care Nurses
    • Jeanette Harmon, American Medical Association
    • Lorena Hitchens, HighWire Press
    • Rachel Makleff, American Thoracic Society
    • Laura Martin, AMerican Board of Pediatrics
    • Spencer Moore, Radiological Society of North America
    • Christie Morales, American Heart Association
    • Bryan Pawlak, American Osteopathis Association
    • Monica Quiroz, American Medical Association
    • Kelly Reddick, American Board of Pediatrics
    • Shelly Rodrigues, California Academy of Family Physicians
    • Barb Rosenthal, American Board of Medical Specialties
    • Mike Rowan, LearnSomething
    • Taranmg Shah, American Osteopathic Association
    • Carl Singer, CE City
    • Leah Wang, Medscape
    • Scott Weber, Med-IQ
    • Todd Tischendorf, CE City
    • Mike Zarski, American Osteopathis Association
    • Edward Kennedy, Accreditation Council for Continuing Medical Education
    • Charles Willis, American Gastroenterological Association
  • Current Problems with CE Tracking and Measurement
    • We aren’t tracking CE
    • We don’t help the learner assess gaps
    • We can’t tell if CE matches learner’s practice-based needs
    • We don’t measure CE value consistently
    • We don’t verify claimed credits for certification or licensure
  • Reporting and Tracking CE/MoC Provider A Provider B Dr. John Doe’s CE Tracker A: Asthma Management .5 cr B: Bronchodialators .5 cr A: Pain Management .5 cr Report to Board <xml> Activity report CE Tracker <xml> Activity report
  • Benefits
    • Enables centralized tracking of CE and Certification activities
    • Increases accountability of all parties
    • Reduces administrative burden on professional
  • Status of Activity Report
    • Schema, spec, and servivces available
    • ABP and AAP are piloting the use of the standard for use in MOC
    • American Heart using for integration w/HighWire and others
    • Mesdcape, AOA, and CECity piloting use for CE certificates
    • RSNA using for centralizing radiology ce data
    Working groups Standards committee ANSI Executive committee
  • Point of Care Learning Working Group
    • Mission: to develop XML standards and guidelines to support offering clinicians learning at the point of care, tracking point of care learning, and using point of care learning data for needs assessment.
  • Participants
    • Jabin White, Silverchair, Chair
    • Nick Ackerson, Thomson
    • Michelle Adams, American Academy of Dermatology
    • Zalman Agus, M.D., University of Pennsylvania
    • Dawn Ainger, Genova Technologies
    • Scott Bradbury, American Academy of Pediatrics
    • Ron Carovano. METI
    • Bill Deluise, Wiley
    • Nancy Davis, Ph.D., National Institute for Quality Improvement and Education
    • Tom Godden, Wolters Kluwer
    • Cyndi Grimes, Medscape
    • Irina Laghidze, Moberg Research
    • Matt Lewis, Boehringer Ingelheim
    • Rachel Makleff, American Thoracic Society
    • J.B. McGee , M.D., University of Pittsburgh
    • Dick Moberg, Moberg Research
    • Kevin O'Hara, Healthstream
    • Jerry Osheroff, M.D., Thomson
    • Mellie Pouwels, Radiological Society of North America
    • Andrew Rabin, CECity
    • Deborah Samuel, American Academy of Pediatrics
    • Danette Somers, Wiley
    • Robert Stern, MedPage Today
    • Walter Wolyniec, Boehringer Ingelheim
    • Beverly Wood, M.D., American Academy of Pediatrics
    • Jake Zarnegar, Silverchair
    • Laird Kelly, RSi
    • Paul Martin, eeds
    • Charles Willis, American Gastroenterological Association
  • Point of Care Learning Uses
    • Common format for exchanging point of care learning activity data
      • Clinical question
      • Search parameters
      • Resource used
      • Application to practice
    • Allows providers to collect data for credit and needs assessment
    • Draft specification and schema
    • Piloted by U Penn and MedPage Today
    POC System ? CME Provider Transcript
  • MEMS: Medical Education Metrics
    • Technology standard for core evaluation data
    • Users
      • Educators want best practices, ability to compare
      • Funders want to measure reach and efficacy
      • Accreditors want to measure success of activity and provider
  • MEMS Data
    • Activity Description
      • What’s being evaluated
    • Participant Activity Evaluation
      • What did participants think
    • Participation Metrics
      • How many people participated
    • Learner Demographics
  • Metrics Working Group
    • Mission: to develop XML standards and Web services requirements and descriptions for the exchange of aggregate evaluation data and other key metrics for health professions education.
  • Metrics Participants
    • Linda Casebeer, Outcomes, Inc., Co-Chair
    • Francis Kwakwa, RSNA, Co-Chair
    • Robin Bay, WEMOVE
    • Craig Bowen, Ph.D., Johns Hopkins University
    • David Cook, M.D. Mayo Clinic
    • Bill Deluise, Wiley
    • Ray Everngam, CTSNet
    • Michael Fordis, M.D., Baylor College of Medicine
    • Stuart Gilman, M.D., Department of Veterans Affairs
    • Monica Hanks, American Association of Critical-Care Nurses
    • Sean Hayes, Ph.D., AXDEV Group
    • Jack Kues, Ph.D., University of Cincinnati
    • Tao Le, M.D., Johns Hopkins University
    • Matt Lewis, MPA, Boehringer Ingelheim
    • Jackie Mayhew, Pfizer
    • Suzanne Murray, Ph.D., AXDEV Group
    • Kevin O'Hara, Healthstream
    • Veronica O'Quinn, METI
    • Mellie Pouwels, Radiological Society of North America
    • Andrew Rabin, CECity
    • Michael Saxton, M.Ed., Pfizer
    • Hillary Schmidt, Ph.D., Sanofi-Aventis
    • Donna Schoonover, Department of Veterans Affairs
    • Scott Weber, Med-IQ
    • Walter Wolyniec, Boehringer Ingelheim
    • Edward Kennedy, Accreditation Council for Continuing Medical Education
    • James Lesit, Alliance for Continuing Medical Education
    • Tim Willet, M.D., CRI Critical Care Education Network
    • Ross Martin, M.D., Bearing Point
  • MEMS Use Case Program Evaluation Dashboard Online activities Jointly sponsored activities Journal-based ce In person activities Outcomes DB
  • MEMS Status
    • Flexibility of instruments
    • Draft specification and schema
    • Developing survey item specification
    • Moving to higher levels of evaluation
  • Exchanging CE Data
    • Activity
    • Streamlining CME Reporting and Administration
    • 10 min
  • Summary
  • MedBiquitous Goals
    • Better tracking and evaluation of professional education and certification activities
      • Activity Report
      • Point of Care Learning
      • Medical Education Metrics
    • Easier discovery of relevant education and information resources when and where needed
      • Healthcare LOM
  • MedBiquitous Goals
    • Interoperability and sharing of high quality online education
      • SCORM for Healthcare
      • Virtual Patients
    • Coordination and tracking of competence assessment data
      • Professional Profile
      • Competencies
  • Back to your challenges
    • Can existing standards address any of the challenges you face?
    • Are there needs for other standards?
  • Questions for you
    • Are standards a good idea?
    • Should you develop them within your own organization?
    • What are the benefits of standards to your organization?
  • How to Participate
  • Working Group Meetings
    • Activity Report WG Thur, 3:30 PM
    • Competency WG Thur, 12 PM
    • Learning Objects WG, Thur, 7:30 AM
    • Metrics WG Thur, 12 PM
    • Point of Care Learning WG Thur, 7:30 AM
    • Professional Profile Thur, 3:30 PM
    • Virtual Patient WG Today, 3:30 PM
  • Contact
    • Valerie Smothers [email_address]