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- 1. Action Plan Telemedicine Programme for Health Professionals in a Developing Country University College London, 31 May 2012 Maryam Hasan
- 2. Outline Background of Telemedicine Anaesthesia 4 Iraq – Ongoing Telemedicine event for Iraq Literature Review – Research question Literature Review – Methodology Literature Review – Findings Action Plan
- 3. Telemedicine •Broad definition • Distance Healthcare HP Education (UK) •Technology Education Treatment • Telemedicine in Continuing Medical HP Patient Education (IRAQ) (IRAQ) •Assumptions and limitations
- 4. Anaesthesia 4 Iraq DISTANCE HEALTHCARE EDUCATION EVENTS AND ONLINE CPD 4
- 5. Literature Review Action Plan Research Question: Learning Objectives: “What are the barriers to 1. What is telemedicine? wide-scale and 2. Telemedicine Benefits. sustainable 3. Telemedicine projects in CME implementation of a and methods. telemedicine 4. What are their barriers and videoconferencing challenges to implementation? programme in Iraq?” 5. What are the recommended solutions?
- 6. Literature Review Action Plan Search Strategy: Terms: Telemedicine (topic) AND developing country (topic) AND continuing medical education Databases: Electronic: Medline, Ovid, CINAHL, ERIC, Cochrane Hand-search Grey literature Other: key person interviews, contact authors, reference lists, Inclusion and exclusion criteria
- 7. Literature Review Action Plan Barriers / Challenges •Lack of data & difficult outcome •Time-zone measures •Language •Communication Infrastructure & •Attendance Political will •Costs •HP attitudes & pedagogical shift
- 8. Literature Review Action Plan Telemedicine 4 Iraq Launch Current Programme (Oct. 2009) (Nov. 2012) • Site – Iraq • Population – Postgraduate medical doctors • Design –Lectures/discussion/online CPD Journal • Prospected Audience Size – 250 • Time Frames (Gantt chart) – Sponsorship (March- April), d/c with Iraq counterparts (ongoing), Speakers (UCLH, St. George’s), Slides completed and submitted to organisers, Rehearsal, launch (Nov. 2012)
- 9. Literature Review Action Plan Telemedicine 4 Iraq Launch Current Programme (Oct. 2009) (Nov. 2012) • Budget – Polycom technologies, room hire • Organisational structure– Job descriptions • Feedback – MCQs and feedback forms • Expected Outcomes • Limitations • Ethical considerations
- 10. Thank You! Maryam.hasan.11@live.ucl.ac.uk References • Bajpai (2012) Telemedicine: A review. URL: • Wootton, R., Craig, J., and Patterson, P. http://www.webmedcentral.com/wmcpdf/Ar (1999) Introduction to Telemedicine, Royal ticle_WMC002847.pdf Society of Medicine, London., Chapter 1 • Anaesthesia4Iraq website: • Wootton, R., and Bonnardot, L. (2010) ‘In www.anaesthesia4iraq.com what circumstances is telemedicine appropriate in the developing world?’, • Cochrane Library (2012) Telemedicine URL: Journal of the Royal Society of Medicine, Vol. http://www.thecochranelibrary.com/details/ 1, no. 537 collection/806797/Telemedicine.html • Wootton, R., and Zanaboni, P. (2012) ‘Adoption of telemedicine: from pilot stage to routine delivery’, BMC Medical Informatics and Decision Making
Editor's Notes
- My dissertation topic is on a literature review and AP for a Telemedicine Programme for Health Professionals in a Developing Country. In this specific Action Plan I focus on Iraq.
- Travel costs, time and can deliver education to more than one professional at a time.by engaging developed and developing world in healthcare education, discussion and allow for support links to develop between hcp’s in developed to developingGrowing importance of cme.Distance learning, online learning in cme is more established than undergraduate.
- Travel costs, time and can deliver education to more than one professional at a time.by engaging developed and developing world in healthcare education, discussion and allow for support links to develop between hcp’s in developed to developingGrowing importance of cme.Distance learning, online learning in cme is more established than undergraduate.
- This Case Study is central to my dissertation. The results of this series of lectures was very positive which inspired me to research more about telemedicine, but there were also challenges we faced as well, which is why I wanted to develop and propose this action plan to improve on it.
- So in the literature review component, I wanted to explore the challenges and barriers to wide-scale implentation of a telemedicine programme in a developing country context. To help me answer this I outlined learning objectives… LO 3: tm and cme methods: videoconferencing vs other methods store-and-forward like email.So the research question is specific to my action plan, but what I actually found was that there was very limited literature about anything similar in Iraq, so I branched it out to developing world and developing country, to include papers from countries in from a similar region.
- Telemedicine, e-health, e-medicine, telehealth, telecare, distance healthcare education, videoconferencing, distance learning, tele-education + healthcare or medicineElectronic:Web of Knowledge (Medline and Web of Science). Ovid, CINAHL, Proquest, Sage, Wiley, ERIC, HMIC, Cochrane, LISA. Hand-search: Journal of Telemedicine and Telecare. Telemedicine journal and e-health, international journal of medical informatics.Grey literature: Google scholar, Google, blogs Inclusion: Tele-subspecialties. Undergrad, Postgrad, CME. Education/support between colleagues. V/C and email. English. Exclusion: Telemedicine to patient. Developed country? Old (pre-1999). so I branched it out to developing world and developing country, to include papers from countries in from a similar region.This is my search strategy... Telemedicine has many sysnonymous terms, in fact a systematic review of telemedicine published this year found 104 different peer-reviewed definitions of telemedicine which just shows how widely contested and difficult it is to find a single definition! This is unfortunate for me, because it means I have to search all of these terms. The databases are all these journals, found through a preliminary search through similar articles/systematic reviews/google-ing.To beign with, I want to include spefici medical specialty training that uses distance learning. After scanning titles and abstracts, I’m only including postgraduateStudies, descriptive, theoretical.Postgraduate healthcare professionals, doctors.TM project: store and forward (e-mail) and interactive (videoconferencing).Outcome measures: Primary: Improved learning outcomes (pass rates), participant satisfaction, Secondary: cost-effectiveness, other benefits.
- So, now moving on to the findings of the search strategy: what are the barriers and challenges to widescale implementation of TMMajor: the nature of the intervention is difficult to measure the outcome variables, therefore difficult to analyse cost-effectiveness, the lack of data written up of TM projects is also an issue, the communication infrastructure of the recipient country, HP attitudes and resistance to this method of teaching is also a major barrier.Minor: Time zone, language, attendance and costs.Then I connclude from Lit Rv & also write how this will have implications for AP“I have done”The practical barriers we experience were cost mainly. A few of the barriers seen in the literature also seemed familiar to my own experience. I grouped them into big and small. As my experience was specific to Iraq, a lot of the same challenges and barriers were similar to other developing and wartorn countries. After presenting at the THE conference here in UCL, the most common comments was the communication infrastructure, some rural areas don’t have an online connection, videoconferencing would need quite a high min standard of bandwidth. Someone brought up the attitude to learning in developing countries. That videoconferencing isn’t needed, you don’t need interaction to open up access to education, it would just be cheaper to provide online resource access, that would save money. However the counter argument there is the benefits to engaging with colleagues and interaction that may enhance learning and learning outcomes. BandwidthThe need to be interactive
- Limitations of telemedicine: technology is not perfect