Electronic Community of Practice: Seamless Interprofessional Learning and Practice towards Patient Centred Care. Ho K. eHealth week 2010 (Barcelona: CCIB Convention Centre; 2010)

1. electronic Community of Practice:
Supporting Interprofessional Learning &
Practice
WoHIT eHealth 2010 Barcelona
March 15-18, 2010
Kendall Ho, Executive Director, TEKTIC
Director, eHealth Strategy Office
Associate Professor of Emergency Medicine
University of British Columbia, Canada

2. Greetings
from
Vancouver,
Canada

3. What makes a GREAT piano?
• Purity of each note
• Depth/warmth
• Connectivity/Harmony
between notes

4. Health Professionals & Patient Centred Care

5. Health Teams
Advantages Challenges
• Complementary skills • Shared understanding?
• Coordinated pt care • Duplication of care
• Increase compliance • Conflicting advice
• Avoid adverse events • Care gaps: errors
• Mutual consultations • “Turf wars”
• Time saving • Increased time spent

6. Learning together?

7. Electronic Community of Practice
(eCOP)?
• Social learning and shared
sociocultural practices when
people who share common
goals interact*
• Newcomers enter and
acquire sociocultural
practices of a community*
• Enabled by I.T.
*Rogoff, Lave, Wanger

8. What eCoP is *NOT*…
• Team: structured, tasks (vs informal)
• Task force: timed (vs evolution)
• Board: top down (vs “grassroots”)
• Assembly line: sequenced (vs flexible)
• Orchestra: restricted by size or talents (vs growth
and mentorship)

9. eCoP: Components
Synchronous: Asynchronous:
•Videoconferencing
•Multimedia posting
•Interactive sessions
•Blogs
•Live chats
•Discussion boards
•WebEx, Elluminate,
Tanberg… •Wiki-documents

10. B.C. Statistics
B.C. Spain
944,736 km2 499,542 km2
4.2 M pop’n 46 M pop’n
~175,000
~9,000 MDs
MDs

11. Challenges: Medications Use
• Large number of new medications
• MDs: keeping up is difficult
• Time to learn: premium
• Commercial detailing: double edge
Useful, new “evidence based information”
Knowledge vs “sell”

12. Technology Enabled AD
using information and communication technologies (e.g.
Internet, computer, personal digital assistants) to conduct AD.

13. Key Findings
OVERALL TEAD & AD
• Majority: • MDs:
Lack AD experience Equally effective
• MDs: AD: personal interaction
unbiased, tailored drug info TEAD/AD: 49 vs 81 min
• PharmDs: TEAD + webcam 1st
BOTH
Enjoyed MD interactions • PharmDs
• Gain practice insights AD: read MDs’ reactions
AD/TEAD: same content
• Form eCoP
Medication prescribing
Evidence based medicine
Just in time information

14. Challenge: Emergency
• Best practices vs urban/rural variations
• Complex & dynamic practice contexts
• Interprofessional collaboration vital
Health administrators/policy makers
Health professionals

15. Translating CPG into Practice: E2E through IHI
*EB *EB *EB order Agreed Optimal patient
CPG inquiries sets indicators outcome
*EB = Evidence Based
Result
IHI Improvement
Process model
People
E2E Communities of
Practice

16. E2E: Results
• 40 EDs: MDs, nurses, administrators
• 3 learning forums
• Identify priority topics:
Sepsis
Triage
• Develop joint measurement indicators
• Grant: rigorous evaluation x 3 years

17. eCoP: Conditions for Success
• Mutual respect of community members
• Flexibility and adaptability
• Accountability
• Ability to table and deal with conflicts
• Sharing successes and mistakes

18. Communal Learning: eCoP
• Through health vision, togetherness
• Through evaluation, mutual understanding
• Through collaboration, transformative change

19. Contact Information
eHealth Strategy Office
Faculty of Medicine, UBC, Vancouver, Canada
MISSION: IT to enable education, service,
research and knowledge translation
Kendall Ho: Director & Associate Professor, Emergency Medicine
Kendall.Ho@ubc.ca
www.eHealth.med.ubc.ca
Facebook: Kendall Ho