3-D barcodes for information resources…Online communities of practice…Mobile devices….Video….Apps for decision support….Collaborative evaluation for ongoing quality improvement, demonstration of efficacy, and formative input
Piloting the process of technology enabled academic detailing
Piloting the process of technology enabled academic detailing: Lessons for integrationCordeiro, J., Novak Lauscher, H., Amari, E., Newton, L., Chong, X, and Ho, K. eHealth Strategy Office, Faculty of Medicine, UBC
Physician Academic Detailer (Pharmacist) TEAD• BC Provincial Academic Detailing (PAD) service provides: • Academic detailing for family practice physicians and other health care professionals • Balanced, evidence-informed drug information on best prescribing practices• Technology enabled academic detailing (TEAD) utilizes technology, like web-conferencing, to help facilitate academic detailing sessions. PURPOSE OF PILOT STUDY 1. To test the implementation of TEAD in a real context 2. To identify areas of strength and improvement in TEAD
Participants were recruited from across the 5 regional B.C. health authorities andincluded: • Nine (9) academic detailing pharmacists • Eighteen (18) family practice physicians• Physicians were contactedthrough email and invited totrial a TEAD session with anacademic detailer to test thetechnology and the process ofTEAD.
• The academic detailers were trained to use the web-conferencing technology.• A process for booking and conducting TEAD sessions was developed.• Interested physicians were matched up with the academic detailers in their healthauthorities.• In total, eighteen TEAD sessions were scheduled.
Of the 18 physicians who participated: • 58% of physicians were 55 years of age or older, 25% were between 45-54 55-64 years of age, and 17% were between 45-54 35-44 years of age. 35-44 • Average of 28.7 years experience in practice Male • 85% were male, and 15% female Female • 85% had no previous online session experienceData was collected from all users- both the academic detailers and the physicians. • Academic detailers: Online post-session surveys and focus group • Physicians: Online post-session surveys and follow-up telephone interviews
Satisfaction with Pilot Sessions 5 4.5 4 3.5Score 3 Academic Detailer Physician 2.5 2 1.5 1 Likelihood of Uptake Web Conferencing Tool Content Physician Engagement Global Satisfaction Upon completing pilot TEAD sessions, the academic detailers and physicians completed online post-session surveys. Five satisfaction areas were included: • Likelihood of uptake • Satisfaction with the web conferencing tool (WebEx) • Detailing content • Engagement/ participation of the physician in the session • Global satisfaction The largest differences between the physician and academic detailer groups were satisfaction with the web conferencing tool (WebEx), perception of engagement, and global satisfaction.
Engagement During the Session 5.00 4.50 4.00 3.50Score 3.00 Academic Detailer Physician 2.50 2.00 1.50 1.00 1 2 3 4 5 6 7 8 9 10 11 12 13 Academic Detailer and Physician Pairs • Discussion-based delivery (versus didactic presentation) is integral to achieving learning outcomes of academic detailing sessions. • Comparatively, physicians were more satisfied with the amount of participation they were afforded in TEAD sessions than academic detailers were with physician participation, although, both groups showed high satisfaction with engagement on average.
Webconferencing Tool 5.00 4.50 4.00 3.50Score 3.00 Academic Detailer Physician 2.50 2.00 1.50 1.00 1 2 3 4 5 6 7 8 9 10 11 12 13 Academic Detailer and Physician Pairs • The physicians were more satisfied with the web conferencing tool than academic detailers as a way of connecting for the session. • In the academic detailer focus group, this difference was attributed to the extra responsibility academic detailers have to ensure that the technology is working properly.
Global Satisfaction 5 4.5 4 3.5Score 3 Academic Detailer 2.5 Physician 2 1.5 1 1 2 3 4 5 6 7 8 9 10 11 12 13 Academic Detailer and Physician Pairs • Overall satisfaction with TEAD sessions was high for the physicians, showing that TEAD as a service is appealing to this target group. • However adding technology to the way academic detailing information is delivered poses challenges unique to the academic detailers by way of in session engagement strategies and ensuring the technology is functioning properly.
• In individual interviews, the physicians mentioned…• Using technology for receiving education… • Flexibility in the scheduling was the biggest benefit. The ability to schedule the session in their own time and do the session from home created a relaxed and receptive educational environment. • Presentation method was clear and effective for presenting the clinical detailing content. • Lessons for using the technology… • Clear and simple audiovisuals should be used when delivering the clinical content online. • Give more control of the online meeting window should be given to the learners so they can move between slides, pages and documents. • Send electronic copies of materials which learners can print or save for later.
• In a focus group, the academic detailers discussed…• Using technology for delivering academic detailing… • Feelings of limited interaction using the web conferencing tool. • Differences in the dynamics and flow of the session when doing TEAD. • Changing some content and materials to optimize display online.• Lessons for technological support… • A variety of modes of support has been used to work through technical problems and adapt/ generated solutions. • Modification and help with navigating conventional IT systems is required for TEAD, as it is a novel and innovative program. • A Contingency Plan was developed to ensure alternatives are offered to physicians in a timely manner when any technical problems emerge during scheduled sessions.
Physician Academic Detailer (Pharmacist) TEAD1. Even though the two groups of users have a different perspectives, TEAD can be efficient for physicians and pharmacists alike.2. Additional strategies, such as using a webcam to help foster interactivity, need to be developed and implemented to aid in engagement.3. A clear contingency plan is needed for when “the technology doesn’t work.”4. Technology can be used to enable and extend the reach of academic detailing in many ways (e.g., online community, mobile devices, apps for decision support, 3D barcodes for info resources…).
Physicians Academic Detailers (Pharmacists) The physician-pharmacist relationship is the heart of academic detailing.TEAD is more than an online version of a face-to-face session – current and emerging technologies offer many ways to support the relationship.
The TEAD project team would like to thank: • BC PAD academic detailers • Participating physician • Pharmaceutical Services Division, BC Ministry of Health for fundingFor more information about the BC PAD Service visit: www.bcpad.caFor more information about the eHealth Strategy Office: Or visit http://ehealth.med.ubc.ca/