Whats up Doc Using Information Technology to Share

“What’s up Doc? ”: Using Information Technology to Share Evidence. Based Medicine in a Residency Family Medicine Education Consortium Cleveland, Ohio | 9. 28. 2012 Marco Cornelio, M. D. & Stephen Martin, M. D. , Ed. M. Barre Family Health Center Department of Family Medicine and Community Health University of Massachusetts Medical School

We have no actual or potential conflict of interest

ACGME. Common Program Requirements. July 2011. www. acgme. org/acgmeweb/Programand. Institutional. Guidelines/Medical. Accreditation/ Family. Medicine. aspx Lifelong Learning Text

Text Atul Gawande. Annals of Medicine. “The Learning Cure, ” The New Yorker, January 28, 2002. p. 52 -61.

Challenges in Lifelong Learning Too Much Information

Institute of Medicine. (2012). Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. (M. Smith, R. Saunders, L. Stuckhardt, & J. M. Mc. Ginnis, Eds. ). Washington, D. C. : Committee on the Learning a. Health Care System in America; Institute of Medicine. Information Overload

Challenges in Lifelong Learning Too Much Information Filtering Problem

Filtering Problem … Getting information that is important and relevant to practice

Challenges in Lifelong Learning Too Much Information Filtering Problem Dissemination/Implementation Problem

Green, L. W. , Ottoson, J. M. , García, C. , & Hiatt, R. a. (2009). Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annual review of public health, 30, 151– 74. doi: 10. 1146/annurev. publhealth. 031308. 100049

Institute of Medicine. (2012). Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. (M. Smith, R. Saunders, L. Stuckhardt, & J. M. Mc. Ginnis, Eds. ). Washington, D. C. : Committee on the Learning Health Care System in America; Institute of Medicine. Implementing Clinical Knowledge into Clinical Practice

Lenfant, Claude. “Clinical Research to Clinical Practice -- Lost in Translation? N Engl J Med 2003; 349: 868 -874. Cabana, M. D. (1999). Why Don’t Physicians Follow Clinical Practice Guidelines? ; A Framework for Improvement. JAMA. The Journal of the American Medical Association, 282(15), 1458 -1465.

Challenges in Lifelong Learning Too Much Information Filtering Problem Dissemination/Implementation Problem Quality

Hamilton, M. (2002). EBM: unmasking the ugly truth. BMJ (Clinical research ed. ), 325(7378), 1496 -8.

Challenges in Lifelong Learning Too Much Information Filtering Problem Dissemination/Implementation Problem Quality Organization Problem

Keeping Information Organized

Past Approaches to Lifelong Learning Ad Hoc

Past Approaches to Lifelong Learning Ad Hoc CME/Conferences

Past Approaches to Lifelong Learning Ha. Forsetlund, L. , et al. (2009) Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane database of systematic reviews. (Oniline), (2), CD 003030. doi: 10. 1002/14651858. CD 003030. pub 2

Past Approaches to Lifelong Learning Ad Hoc CME/Conferences Journal Club

Past Approaches to Lifelong Learning: Outcomes Outcome = Clinical practice dictated by third party payers

Our Approach: “What’s up Doc? ”

“What’s up Doc? ”: Upsides Trusted colleagues filter recent information

“What’s up Doc? ”: Upsides Trusted colleagues filter recent information Brings relevant information directly and frequently

“What’s up Doc? ”: Upsides Trusted colleagues filter recent information Brings relevant information directly and frequently Concise

“What’s up Doc? ”: Upsides Trusted colleagues filter recent information Brings relevant information directly and frequently Concise Asynchronous, always available

“What’s up Doc? ”: Upsides Trusted colleagues filter recent information Brings relevant information directly and frequently Concise Asynchronous, always available Allows for discussion

“What’s up Doc? ”: Upsides Trusted colleagues filter recent information Brings relevant information directly and frequently Concise Asynchronous, always available Allows for discussion Allows for system implementation

“What’s up Doc? ”: Downsides Local

“What’s up Doc? ”: Downsides Local Requires time and motivation

“What’s up Doc? ”: Downsides Local Requires time and motivation Focus on breadth not depth

“What’s up Doc? ”: Downsides Local Requires time and motivation Focus on breadth not depth Sustainable

Use of Push Technology TRIP Database Journal Watch Health News Review Medscape Evidence Updates New England Journal of Medicine Email

Journal. Watch

Evidence. Updates

Evidence. Updates

Medscape

TRIP Database

NEJM E-Mail Updates

Health. News. Review

E-Mail Collection of Journal Articles

Overcoming the Organization Problem

Evernote

“What’s Up Doc” Sample the Experience

Discussion: “What’s up Doc? ” Take 5 minutes and record your thoughts about how the “What’s Up Doc? ” session went. Ñ Did it feel useful? ÑCan you imagine running it at your residency? ÑHow would you change it? Ñ

Discussion: Evernote What are your thoughts about Evernote? Ñ Is it a helpful organizational tool? Ñ Can you imagine it being used in your residency? Ñ Can you imagine it being used in another way? Ñ Are there other electronic tools that you use or heard about? Ñ

Access to a shared WUD Evernote Username: umasswud Evernote Password: umasswud For access to our WUD Evernote Username: bfhc Evernote Password: 3556321

References ACGME. Common Program Requirements. July 2011. www. acgme. org/acgmeweb/Programand. Institutional. Guidelines/Medical. Accreditation/Family. Medicine. aspx Atul Gawande. Annals of Medicine. “The Learning Cure, ” The New Yorker, January 28, 2002. p. 52 -61. Slotnick, H. B. (2000). Physicians’ learning strategies. Chest, 118(2 Suppl), 18 S– 23 S. doi: 10. 1378/chest. 118. 2 Institute of Medicine. (2012). Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. (M. Smith, R. Saunders, L. Stuckhardt, & J. M. Mc. Ginnis, Eds. ). Washington, D. C. : Committee on the Learning Health Care System in America; Institute of Medicine. Green, L. W. , Ottoson, J. M. , García, C. , & Hiatt, R. a. (2009). Diffusion theory and knowledge dissemination, utilization, and integration in public health. Annual review of public health, 30, 151– 74. doi: 10. 1146/annurev. publhealth. 031308. 100049 Lenfant, Claude. “Clinical Research to Clinical Practice -- Lost in Translation? N Engl J Med 2003; 349: 868 -874. Cabana, M. D. (1999). Why Don’t Physicians Follow Clinical Practice Guidelines? ; A Framework for Improvement. JAMA. The Journal of the American Medical Association, 282(15), 1458 -1465. Hamilton, M. (2002). EBM: unmasking the ugly truth. BMJ (Clinical research ed. ), 325(7378), 1496 -8. Forsetlund, L. , et al. (2009) Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane database of systematic reviews. (Oniline), (2), CD 003030. doi: 10. 1002/14651858. CD 003030. pub 2