#acehp12 preconference - Emerging Technology and Medical Education
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#acehp12 preconference - Emerging Technology and Medical Education

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These are the slides with which I opened the 2012 Alliance meeting Emerging Technologies Pre-Conference

These are the slides with which I opened the 2012 Alliance meeting Emerging Technologies Pre-Conference

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  • http://www.commonwealthfund.org/News/News-Releases/2010/Jun/~/media/Images/Publications/Fund%20Report/2010/jun/MM2010l.gif
  • http://www.commonwealthfund.org/News/News-Releases/2010/Jun/~/media/Images/Publications/Fund%20Report/2010/jun/MM2010l.gif
  •   http://www.healthcarereportcard.illinois.gov/maps
  •   http://www.healthcarereportcard.illinois.gov/maps
  • http://www.watsonblogs.org/ramachandran/image11.jpg
  • Lets take a minute or two to ground the arguments that I make and to align them with the powers-that-be because if we are going to make the changes that the ‘leaders of the healthcare community’ have been debating for years we need a story to tell our corporate leadership. What I will try to do in the next 35-40 minutes is to lay out that story for you. Each of you will have to fit in your local evidence in the right places, but we may be able to leave w/ an agreement on where our current systems fail and a defensible vision of what our grant making models could look like and how we can lead change in the way CE is implemented and integrated in the US…but don’t lose the basic premise: how good is the enemy of great…and in the current climate we no longer have the luxury of being good enough – we need to accelerate changes in healthcare quality or get out of the road of those who are trying to do so.
  • Spoken word – antiquity Movable type 1000 China – 1450 europe Newspapers early- 1600’s Radio: 1890’s Marconi TV: 1920-30’s 36 Olympic games. Commercially available since the late 1930s, the television set has become common in homes, businesses and institutions, particularly as a source of entertainment and news. Since the 1970s the availability of video cassettes, laserdiscs, DVDs and now Blu-ray Discs, have resulted in the television set frequently being used for viewing recorded as well as broadcast material. Overhead The U.S. Army in 1945 was the first to use it in quantity for training as World War II wound down. It began to be widely used in schools and businesses in the late 1950s and early 1960s. Slide projectors were common in the 1950s to the 1970s as a form of entertainment; family members and friends would gather to view slideshows. Compact Cassette – late-1950
  • Myspace 2002 Linkedin 2003 Delicious 2003 Facebook 2004 Flickr 2004 Youtube 2005 Twitter 2006 Slideshare 2006 UStream 2007
  • [1] Administrative Letter-Waiver of Documentation of Consent: Physician Survey #8702685.0 Protocol(-2-04-2011) [2] Davis, F.D. (1989), “Perceived usefulness, perceived ease of use, and user acceptance of information technology”, MIS Quarterly 13(3): 319-340.
  • Title: Physician Adoption and Use of Social Media to Share Medical Knowledge with Other Physicians Authors: Molly Wasko, PhD; Bryan Vartabedian, MD, FAAP; Robert S. Miller, MD, FACP; Desirae Freiherr, MS; Debi Susalka; Mazi Abdolrasulnia, PhD†; and Brian S. McGowan, PhD† † Dr. McGowan and Dr. Abdolrasulnia share senior author responsibilities Background: Recent advances in information and communication technologies (ICTs), especially Web 2.0 technologies, have significantly expanded the ways in which physicians can share medical knowledge with one another. With the growing demand for more meaningful use of IT in healthcare, more research is needed on physician adoption and use of ICTs as collaborative tools to synthesize, share and contribute knowledge. Objectives: The objectives of this research were to (1) study the adoption and use of 13 of the most commonly used ICT applications to share medical knowledge with other physicians (texting, email, podcasting, blogs, wikis, RSS feeds, cell phone apps, iTunes, Facebook, LinkedIn, Twitter, YouTube and restricted online communities (e.g. SERMO)); (2) compare the number of users who claim that they “Will Never Use” these ICTs with the number of users that are “Current Users”; and (3) examine whether there are important differences between two physician practices: oncologists and primary care physicians (PCPs). Methods: We surveyed 491* practicing clinicians across the United States: 191 oncologists and 300 PCPs. The survey was designed to capture data about the distribution of physicians currently using the different types of technologies and to assess physicians’ intentions to adopt the technologies by non-users. The percentage of physicians across the categories were assessed (not aware of this application, will never use, unlikely to use within 3 months, not sure, likely to use within 3 months, very likely to use within 3 months, and current user). Comparisons across technologies, and between oncologists and PCPs were examined. Results: A total of 491 (27%) of 1800 eligible participants responded. Respondents were least likely to be aware of RSS feeds (22%) and LinkedIn (14.3%). Email is the most widely used (70.5%), followed by restricted online communities (51.5%), texting (39.5%) and cell phone apps (35.6%). The technologies with the lowest percentage of adoption were RSS feeds (5.5%), Twitter (6.7%), LinkedIn (10.4%) and blogs (10.6%). In terms of non-adoption, physicians responded that they will never adopt Twitter (32.6%), Facebook (21%), blogs (21%) and YouTube (20.8%). Only 1% of physicians claim they will never use email. Restricted online communities, such as SERMO, have widespread awareness and usage among physicians. In comparing oncologists with PCPs, overall, PCPs were less likely to be non-adopters across all technologies. Oncologists who have already adopted the technology were more likely than PCPs to adopt email, podcasting, texting, restricted online communities, RSS feeds and cell phone apps. PCPs were more likely to have adopted YouTube, Twitter, LinkedIn, iTunes, Wikis, Facebook and blogs. This suggests that PCPs have been earlier adopters of social media technologies, while oncologists have been earlier adopters of more traditional, uni-directional communication technologies. While Twitter adoption was lowest and had the highest physician skepticism, the 6.7% adoption rate is not that different from the current percentage of US adults who have adopted Twitter (8.7%). Conclusions: Physician adoption of different ICTs varies widely and appears to covary with type of practice, with PCPs being more open to new technologies in general, and more likely to use technologies typically referred to as “social media.” Oncologists were more skeptical adopters overall, but were more likely to have adopted technologies used for knowledge dissemination/broadcasting over sharing/collaboration. These technologies have received wider adoption (more users than non-adopters) than social media technologies overall. Healthcare IT systems that incorporate technologies such as email, restricted online communities, cell phone apps, iTunes and wikis may have wider adoption by physicians. PCPs are less likely to be technology skeptics. Overall, fewer PCPs reported that they would never adopt a technology than oncologists across all technologies. However, oncologists who have already adopted the technology were more likely than PCPs to adopt email, podcasting, texting, restricted online communities, RSS feeds and cell phone apps. PCPs were more likely to have adopted YouTube, Twitter, LinkedIn, iTunes, Wikis, Facebook and blogs, indicating that PCPs have been earlier adopters of social media technologies, while oncologists have been earlier adopters of more traditional, uni-directional communication technologies. Although Twitter ranked the lowest in terms of adoption, at an overall adoption rate of 6.7% of respondents indicating current users, this is not that much different from the US adult population, which at the time of this study was approximately 8.7%. This study was supported by Pfizer, Inc. *Note: 491 respondents included 6 respondents who were classified as “other” based on degree. The “other” category included 5 respondents in the oncology sample and one respondent  in the PCP sample.
  • Title: Physician Adoption and Use of Social Media to Share Medical Knowledge with Other Physicians Authors: Molly Wasko, PhD; Bryan Vartabedian, MD, FAAP; Robert S. Miller, MD, FACP; Desirae Freiherr, MS; Debi Susalka; Mazi Abdolrasulnia, PhD†; and Brian S. McGowan, PhD† † Dr. McGowan and Dr. Abdolrasulnia share senior author responsibilities Background: Recent advances in information and communication technologies (ICTs), especially Web 2.0 technologies, have significantly expanded the ways in which physicians can share medical knowledge with one another. With the growing demand for more meaningful use of IT in healthcare, more research is needed on physician adoption and use of ICTs as collaborative tools to synthesize, share and contribute knowledge. Objectives: The objectives of this research were to (1) study the adoption and use of 13 of the most commonly used ICT applications to share medical knowledge with other physicians (texting, email, podcasting, blogs, wikis, RSS feeds, cell phone apps, iTunes, Facebook, LinkedIn, Twitter, YouTube and restricted online communities (e.g. SERMO)); (2) compare the number of users who claim that they “Will Never Use” these ICTs with the number of users that are “Current Users”; and (3) examine whether there are important differences between two physician practices: oncologists and primary care physicians (PCPs). Methods: We surveyed 491* practicing clinicians across the United States: 191 oncologists and 300 PCPs. The survey was designed to capture data about the distribution of physicians currently using the different types of technologies and to assess physicians’ intentions to adopt the technologies by non-users. The percentage of physicians across the categories were assessed (not aware of this application, will never use, unlikely to use within 3 months, not sure, likely to use within 3 months, very likely to use within 3 months, and current user). Comparisons across technologies, and between oncologists and PCPs were examined. Results: A total of 491 (27%) of 1800 eligible participants responded. Respondents were least likely to be aware of RSS feeds (22%) and LinkedIn (14.3%). Email is the most widely used (70.5%), followed by restricted online communities (51.5%), texting (39.5%) and cell phone apps (35.6%). The technologies with the lowest percentage of adoption were RSS feeds (5.5%), Twitter (6.7%), LinkedIn (10.4%) and blogs (10.6%). In terms of non-adoption, physicians responded that they will never adopt Twitter (32.6%), Facebook (21%), blogs (21%) and YouTube (20.8%). Only 1% of physicians claim they will never use email. Restricted online communities, such as SERMO, have widespread awareness and usage among physicians. In comparing oncologists with PCPs, overall, PCPs were less likely to be non-adopters across all technologies. Oncologists who have already adopted the technology were more likely than PCPs to adopt email, podcasting, texting, restricted online communities, RSS feeds and cell phone apps. PCPs were more likely to have adopted YouTube, Twitter, LinkedIn, iTunes, Wikis, Facebook and blogs. This suggests that PCPs have been earlier adopters of social media technologies, while oncologists have been earlier adopters of more traditional, uni-directional communication technologies. While Twitter adoption was lowest and had the highest physician skepticism, the 6.7% adoption rate is not that different from the current percentage of US adults who have adopted Twitter (8.7%). Conclusions: Physician adoption of different ICTs varies widely and appears to covary with type of practice, with PCPs being more open to new technologies in general, and more likely to use technologies typically referred to as “social media.” Oncologists were more skeptical adopters overall, but were more likely to have adopted technologies used for knowledge dissemination/broadcasting over sharing/collaboration. These technologies have received wider adoption (more users than non-adopters) than social media technologies overall. Healthcare IT systems that incorporate technologies such as email, restricted online communities, cell phone apps, iTunes and wikis may have wider adoption by physicians. PCPs are less likely to be technology skeptics. Overall, fewer PCPs reported that they would never adopt a technology than oncologists across all technologies. However, oncologists who have already adopted the technology were more likely than PCPs to adopt email, podcasting, texting, restricted online communities, RSS feeds and cell phone apps. PCPs were more likely to have adopted YouTube, Twitter, LinkedIn, iTunes, Wikis, Facebook and blogs, indicating that PCPs have been earlier adopters of social media technologies, while oncologists have been earlier adopters of more traditional, uni-directional communication technologies. Although Twitter ranked the lowest in terms of adoption, at an overall adoption rate of 6.7% of respondents indicating current users, this is not that much different from the US adult population, which at the time of this study was approximately 8.7%. This study was supported by Pfizer, Inc. *Note: 491 respondents included 6 respondents who were classified as “other” based on degree. The “other” category included 5 respondents in the oncology sample and one respondent  in the PCP sample.
  • Digital - networked - open - fast - cheap - out-of-control…but look at the faces of those that are not part of the event…those that are not connected.
  • Remote participation Backchannel discussion Amplification Socialization Alternative Formats

Transcript

  • 1. Technology and Medical Education Brian S. McGowan, Ph.D. Education and Technology Consultant Consult Columnist, Social Media Connections Medical Meetings, A MeetingsNet Magazine
  • 2. Technology and Medical Education
    • Blog: www.cmeadvocate.com
    • Twitter: @BrianSMcGowan
      • Curator : #SoMeCME & #socialQI
      • Founder: #CMEchat (W’s 11amET)
      • Contributor: #Meded chat (Th4PM and 9PMET)
    • YouTube: http://www.youtube.com/user/Briansmcgowan
    • Slideshare: http://www.slideshare.net/cmeadvocate
    • LinkedIn: http://www.linkedin.com/in/cmeadvocate
      • Member : Alliance for CME Group; CME Group…
      • Manager : MAACME
    • MededMOOC: Founding member
    • Quora: http://www.quora.com/Brian-S-McGowan-PhD
    • G+: http://bit.ly/McBrian
  • 3. A Story with Four Acts
    • Act 1: Why are we talking about technology?
    • Act 2: What technology are we talking about?
    • Act 3: What do we mean by ‘use’? (learners)
    • Act 4: What do we mean by ‘use’? (CME pros)
  • 4. Act 1: Why are we talking about technology?
  • 5. Where Does the US Rank in Quality?
  • 6. http://www.rand.org/content/dam/rand/ww/external/health/projects/qdart/images/predominantly_hispanic_areas_low_ldl_testing_rates.jpg
  • 7. http://www.rand.org/content/dam/rand/www/external/health/projects/qdart/images/predominantly_hispanic_areas_low_ldl_testing_rates.jpg
  • 8. http://www.rand.org/content/dam/rand/www/external/health/projects/qdart/images/predominantly_hispanic_areas_low_ldl_testing_rates.jpg
  • 9. http://trace.wisc.edu/docs/function-aging/pics/graying.gif
  • 10.  
  • 11. http://trace.wisc.edu/docs/function-aging/pics/graying.gif
  • 12.
    • The [education] system as it is structured today is so deeply flawed that it cannot properly support the development of health professionals…this has left health professionals unprepared to perform at the highest levels…
    http://jama.ama-assn.org/content/303/8/716.full
  • 13. Act 1: Driving Hypothesis
    • Without new strategies for medical education the bottleneck in information flow will grow and the healthcare system will fail… embracing technology is a necessary solution .
  • 14. Act 2: What technology are we talking about?
  • 15. Roadmap From Technology to Improvement Digital Networked Open Fast Cheap Out of Control Crowd Light Desire networked weather
  • 16. Digital, Networked, Open
  • 17. Evolution of Traditional Media Broadcasting Archiving Teaching 2000 1900 1800 1700 1600 1500 1400
  • 18. Revolution of Social Media - 2000  Networking, Sharing, and Learning
  • 19. What does this look like? http://bit.ly/txvpUP http://youtu.be/dbPqOdYYDeQ Jonathan Chu, LXD
  • 20. Act 2: What technology are we talking about?
    • Digital, networked, and open solutions
    • Keep an open mind:
      • Does it solve a problem?
      • Does it prevent a problem from occurring?
      • Does it motivate, facilitate, or trigger new behaviors?
      • Does it leverage the power of the community?
  • 21. Act 3: What do we mean by ‘use’? (learners)
  • 22. Inconsistent Data of Docs Using SoMe 2% Twitter 4% Facebook Sermo 2010 PeerView 2010 MCM 2010; unpublished Do you use ____ professionally?
  • 23. Inconsistent Data of Docs Using SoMe
  • 24. Inconsistent Data of Docs Using SoMe
  • 25. Defining ‘Social Media’
    • Social media is defined as internet-based applications which allow for the creation and exchange of user-generated content and includes services such as social networking, professional online communities, wikis, blogs, and microblogging.
  • 26. Defining ‘Use’ in Medicine
    • Hypothesis:
    • There are 3 ways that HCPs ‘use’ social media:
      • To treat – engaging directly w/ patients about care
      • To teach – providing timely & credible education
      • To learn – sharing of medical information/knowledge
    TO TREAT TO TEACH TO LEARN Bucket 1 Bucket 2 Bucket 3
  • 27. Defining ‘Meaningful Use’ TO TREAT TO TEACH TO LEARN Bucket 1 Bucket 2 Bucket 3 Care Info Info
  • 28. Act 3. Part B: What have we really learned about learning?
  • 29. Measuring Bucket Three - ‘Meaningful Use’
    • Sharing medical knowledge is defined as the exchange of information, advice, ideas, reports and scientific discoveries with other physicians in the medical community.
    To Learn Bucket 3
  • 30. Collaborators Robert S. Miller, MD, FACP Clinical Associate Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Oncology Medical Information Officer Johns Hopkins University School of Medicine Bryan Vartabedian, MD, FAAP Assistant Professor of Pediatrics Baylor College of Medicine Molly Wasko, PhD Associate Professor and Chair University of Alabama at Birmingham School of Business Mazi Abdolrasulnia, PhD Debi Susalka Desirae Freiherr Kevin Pho, MD Lawrence Sherman, FACME Joseph Kim, MD This research was funded by Pfizer, Inc.
  • 31. Methods/Framework
    • Planning:
    • Conducted a review of previously published literature
    • Received input from advisory board of physicians with social media expertise
    • Received approval from the Western Institutional Review Board [1]
    • Utilized the Technology Acceptance Model [2] (TAM) theoretical framework as a model
    • Survey distribution
    • Survey distributed via email to a random sample of practicing oncologists and primary care physicians in the United States.
    • Survey data was collected during March of 2011 from a total of 186 U.S. oncologists and 299 U.S. primary care physicians (response rate ~ 30%)
    [1] Administrative Letter-Waiver of Documentation of Consent: Physician Survey #8702685.0 Protocol(-2-04-2011) [2] Davis, F.D. (1989), “Perceived usefulness, perceived ease of use, and user acceptance of information technology”, MIS Quarterly 13(3): 319-340. Study conducted between November 2010 and March 2011
  • 32. Technology Acceptance Model (TAM) Davis, F. D. (1989), "Perceived usefulness, perceived ease of use, and user acceptance of information technology", MIS Quarterly 13(3): 319–340 External factors Perceived Usefulness Perceived Ease of Use Attitude Behavioral Intention to use Technology Use
  • 33. Meaningful Use of SoMe for Learning
    • Medicine 2.0
  • 34. Survey Sample Demographics Demographic Characteristics Oncology n = 186 Primary Care n = 299 Degree MD/DO 100% 100% Years since graduation from medical school Mean/St. dev. 24 years/10 24 years/9 Percent Male 75% 72% Patients seen per week Mean/St.dev. 100 patients/56 124 patients/73 Practice Location Urban Suburban Rural 47% 44% 9% 23% 60% 17% Practice Setting Solo Practice Group Practice Medical School Non-Government Hospital 12% 68% 9% 5% 34% 60% 1% 3% Major professional activity Direct patient care 97% 98%
  • 35. Physician Adoption and Use of Social Media to Share Medical Knowledge with Other Physicians
  • 36. Physician Adoption and Use of Social Media to Share Medical Knowledge with Other Physicians All Docs = 491
  • 37. Primary Care Physicians Oncologists Many x’s a week 41% 28% 35% 31%
  • 38. “… A BENEFICIAL USE OF TIME” “… A SOURCE OF HIGH QUALITY INFORMATION”
  • 39. Perceived Benefits of Using Social Media
  • 40. Perceived Barriers to Using Social Media
  • 41. Act 3: Data on Meaningful Use
    • Physicians are increasingly turning to social media to support their learning.
    • Fewer than 1 in 5 physicians have negative attitudes toward these new channels.
    • More than half of physicians feel these new channels improve their performance.
  • 42. Act 4: What do we mean by ‘use’? (CME professionals)
  • 43. Defining ‘Use’ in CME Profession
    • Hypothesis:
    • There are 3 ways that HCPs ‘use’ social media:
      • To teach – supporting our CME programs
      • To learn– supporting our professional development
      • To advocate – amplifying the voice of CME advocacy
    To Teach To Learn To Advocate Bucket 1 Bucket 2 Bucket 3
  • 44. Bucket 1: To Teach
    • 50% of healthcare providers have used Wikipedia in practice 1
    • 51% of Docs are using online professional communities
    • 66% of Docs expect their professional online activity to increase over the next 12-18 months 2
    1 http://bit.ly/3sQVb 2 http://bit.ly/bAjrXu By not adopting social media, we are failing to stop information-seeking HCPs from relying on less credible and less regulated sources of medical information.
  • 45. Bucket 2: To Learn
    • The learning and quality-improvement communities outside of CME are actively engaging in social media.
    • By delaying adoption of social media, we are ignoring readily available best practices used by other forms of adult education.
    • Blogs enable community leaders to communicate ideas and best practices.
    • Staff can use google alerts to learn about the latest trends in their profession.
    • Staff can share using micro-blogging.
    • Staff can social bookmarking to archive important information.
    • Collaborative workspaces enable teams to share documents, screens, photos, files, and presentations.
    • Sharing is simplified (virtual teams).
    • Staff can search for experts who have the skills necessary to address needs.
    http://www.astd.org/lc/2010/0510_medved American Society of Training and Development
  • 46. Bucket 3: To Advocate
    • SoMe = the quickest, simplest, and most cost-effective channel for sharing these successes.
    • By ignoring social media, we’re missing the opportunity to share all of our success stories in an easily accessible channel that keeps up with the fast-pace of modern news cycles and new media.
  • 47. CME Pros are unsure about social media “ Describe your use of these technologies to support learning…”
  • 48. Leaving Us Two Groups of People… … the impact of “networked weather”
  • 49. Impact On Our Educational Meetings:
    • Remote participation
    • Backchannel convo
    • Amplification
    • Socialization
    • New Formats
  • 50. Impact On Our CPD #CMEchat #MededMOOC
  • 51. CME Pros are using other technologies “ What other types of CE online learning does your organization provide”
  • 52. What areas of technology in CME most interests you?
  • 53. Please select the device(s) you intend to have on-hand to the Pre-Conf
  • 54. CME Pros Perceived Barriers to Adopting New Technology
  • 55. “ What do you want to learn in this session?” - 4 themes emerged -
    • What is new and how to use each type of technology.
    • What are the latest trends in technology for CME/CE events?
    • How to augment my CME program with new modalities
    • Cost effective ways to integrate technology to learning.
  • 56. Act 4: The CME Community
    • Can use new channels for teaching, learning, or advocacy
      • We have no data on learning and advocacy…
    • Fewer than 1 in 5 CME professional have integrated social media into their programs
    • More than 1 in 3 CME professional are unlikely to integrate social media into their programs in the near future