Piloting the process of technology
   enabled academic detailing:
      Lessons for integration
Cordeiro, J., Novak Lauscher, H., Amari, E.,
    Newton, L., Chong, X, and Ho, K.
 eHealth Strategy Office, Faculty of Medicine, UBC
Background:
  Piloting the
Process of TEAD
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
Approach:
     Engaging
    physicians
       and
academic detailers
Participants were recruited from across the 5 regional B.C. health authorities and
included:
   • Nine (9) academic detailing pharmacists
   • Eighteen (18) family practice physicians




• Physicians were contacted
through email and invited to
trial a TEAD session with an
academic detailer to test the
technology and the process of
TEAD.
• 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 health
authorities.
• 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
      experience

Data 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
Results:
By the Numbers
Satisfaction with Pilot Sessions
          5

        4.5

          4

        3.5
Score




          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

        3.50
Score




        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

        3.50
Score




        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

        3.5
Score




         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.
Results:
Conversations with
 the Participants
• 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.
Conclusions:
A Discussion of
 the Findings
Physician                                       Academic Detailer (Pharmacist)
                                        TEAD




1. 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.
Additional
Information:
 Other pieces
The TEAD project team would like to thank:
  • BC PAD academic detailers
  • Participating physician
  • Pharmaceutical Services Division, BC Ministry of Health for funding

For more information about the BC PAD Service visit: www.bcpad.ca




For more information about the eHealth Strategy Office:

                         Or visit http://ehealth.med.ubc.ca/

Piloting the process of technology enabled academic detailing

  • 1.
    Piloting the processof technology enabled academic detailing: Lessons for integration Cordeiro, J., Novak Lauscher, H., Amari, E., Newton, L., Chong, X, and Ho, K. eHealth Strategy Office, Faculty of Medicine, UBC
  • 2.
    Background: Pilotingthe Process of TEAD
  • 3.
    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
  • 4.
    Approach: Engaging physicians and academic detailers
  • 5.
    Participants were recruitedfrom across the 5 regional B.C. health authorities and included: • Nine (9) academic detailing pharmacists • Eighteen (18) family practice physicians • Physicians were contacted through email and invited to trial a TEAD session with an academic detailer to test the technology and the process of TEAD.
  • 6.
    • The academicdetailers 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 health authorities. • In total, eighteen TEAD sessions were scheduled.
  • 7.
    Of the 18physicians 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 experience Data 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
  • 8.
  • 9.
    Satisfaction with PilotSessions 5 4.5 4 3.5 Score 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.
  • 10.
    Engagement During theSession 5.00 4.50 4.00 3.50 Score 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.
  • 11.
    Webconferencing Tool 5.00 4.50 4.00 3.50 Score 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.
  • 12.
    Global Satisfaction 5 4.5 4 3.5 Score 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.
  • 13.
  • 14.
    • In individualinterviews, 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.
  • 15.
    • In afocus 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.
  • 16.
  • 17.
    Physician Academic Detailer (Pharmacist) TEAD 1. 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…).
  • 18.
    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.
  • 19.
  • 20.
    The TEAD projectteam would like to thank: • BC PAD academic detailers • Participating physician • Pharmaceutical Services Division, BC Ministry of Health for funding For more information about the BC PAD Service visit: www.bcpad.ca For more information about the eHealth Strategy Office: Or visit http://ehealth.med.ubc.ca/

Editor's Notes

  • #19 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