30.6.08

"Renovating" Medical Education: Web/Gaming Tech & NextGen Med School Coursework

Question of the Week:

As the old guard of physicians nears retirement (some will remain engaged with practices well into their 7th, 8th or even 9th decades), is the influx of new healers modernizing the manner in which medical education is delivered?

There are two answers, depending on your perspective and position in the system:

1. Yes. Slowly but surely, a few schools are integrating web and gaming tech into medical education.
  • Or, even more promising, a single-session, 2 hour intro class on EHR use at the University of South Florida Health in Tampa.
  • ""While there’s a general move toward technology training, the formal education around EHRs has been lacking, contends Michael Ehlert, M.D., national president at the American Medical Student Association, Reston, Va. “There are some places that have done a good job. But most schools are just scratching the surface (Health Data Management). ""

  • For now, students aren't tested on the material, only one EHR vendor is used, and it's near impossible to do the gaping chasm that is the current confused EHR/PHR market justice in 2 hours...it'd probably take at least 2 weeks.
  • Even so, this is a step in the right direction. I'd love to find out who the "new administrator" is who made this course happen. Better yet, I'd like to take the course. Still better yet, I'd like to bring a complementary course on engaging patients in the healthcare conversation via EHRs/PHRs (how do I talk to a patient about using these things?) to USFH. If this post somehow finds its way into the mailbox of a USFH administrator, please contact me.

2. No, or at least, not fast enough.
  • Medical students are graduating without seeing web and social networking tools utilized as part of the formal curriculum. To teach medical stuff. Much less to teach how to interact with increasingly web-savvy e-patients who may know more about the PHR market than docs do.
  • The good news: they'll figure it out themselves and start well-read blogs, like Graham at Over My Med Body. Then they'll graduate, and that knowledge goes with them from med school out into the 'real world' of medical practice. Now who's teaching the next round of McDreamys?
  • The bad news: if we don't give them the tools in coursework training, they'll have to use their own spare time (which someone may have told me was scarce during med school) to bring HIT to administrators and create concept courses to teach peers AND administrators/fellow physicians, as Berci Mesko has done with his presentations on Second Life in medicine/health 2.0.
If we're working towards a more consumer-centric, patient-directed system, the educational component of such a revision must not be neglected.

And med students desperately need this kind of information and training included in curricula, NOW. As in next semester. As in 2 months from TODAY.

Not 3 years from now after lengthy Board meetings, celebratory approval, news releases, additional tenure-track positions secured and outside consulting agencies engaged.

After all, CMS/Medicare will run a 1-year pilot program testing PHRs in North Carolina (The Medical Quack).

But who's going to pay for docs to be trained on how to use the PHRs CMS decides to utilize?

Since Uncle Sam is already cutting docs' pay a bracing 10.6 percent, it seems an especially cruel twist to tell those in NC that they'll need to learn to incorporate PHRs into an already time-crunched, tech-deficient day.

And how are the schools going to find money to teach these courses?

"One reason medical schools might not offer formal EHR training is because they don’t have the money or resources to support it, Eichenwald-Maki says. She suggests organizations apply for grants or look for partnership opportunities with other schools so they can find a way to bring EHRs into the classroom (Health Data Management)."

Vanderbilt constructed their own proprietary system from scratch. I have a friend who selected Vanderbilt over an uppercrust NY school (hey DM, good choice).

Here's where it pays to utilize collaborative hives of dispersed global innovators with an interest in augmenting the current system *cough* *cough.*

I'm not advocating for med curricular anarchy here - but rather the addition of new, catalyzing lectures and courses that speed up the reaction time from first exposure to formation of a new compound - consumer-centric care.

If you can't beat 'em, join 'em. Berci Mesko, Ted Eytan, some Nexthealth.NL folks and I will be working on concept courses/lecture series to 'renovate' medical education.

This initiative was just born Friday, so give us some time. Like 2 weeks (we need the VCWear shirt that snarks "We Move Quick"). Better yet, give us some ideas. Some thoughts. Some emotions. Some complaints.

If you're just going into med school, what do you want to learn about how to interact with patients? What types of HIT and social web tech would you like to integrate into practical training?

If you're just getting out of med school, what was your medical education missing? How could courses have been augmented? Do you want to know what docs, interns, residents, med students are doing and saying on the social web? How physicians are using blogs? How different strata of healthcare professionals are using webmedia to connect?


We're working to set up a social networking site now, or feel free to Twitter any of us (@jenmccabegorman, @NCurse, @tedeytan) for more info.

Much of what we're thinking revolves around our own experiences (positive and negative) with the system, in several countries:

1. Ted Eytan, physician, blogger, new Kaiser patient, strong consumer-centric advocate - US.

2. Berci Mesko, medical student, blogger, lecturer, HIT & genomics guru, strong web-based medical education advocate - Hungary.

There are admitted gaps in our knowledge (US med school student? European physician?), so if you're interested join us in kicking ideas around online.

Some conceptual questions tickling my gray matter to frame course coverage include:
  • What are we failing to do as providers when we fail to integrate cocreation and maintenance of a personal health narrative into the practical, formulized scope of care delivery?
  • What value are we NOT adding to care intersections by neglecting to utilize HIT and the social web in practice?
  • Patients are finding patients and sharing personal health narrative (use of term, storytelling, people think in concepts not definitions - reason we go from spoken storytelling to written word - meaning is always created with CONTEXT (also semantic web implications) and VALUE arises from that meaning, often then commercialized).
  • Where others "are" on their personal health narrative helps us revise our own. What online tools (Patients Like Me, Organized Wisdom, CarePages, Diabetes Mine, etc.) are helping us share and speed up the evolution of consumer-centric care?
  • Where are physicians interacting with patients at the participatory, patient-directed care level (if anywhere?) and how can we create more spaces and practices for physicians and patients to share in the responsibility of determining what's next for each invididuals personal health narrative?

1 comment:

Brandon said...

Jen,

This post was an excellent read; well researched, very thorough, and entertaining.

It actually won the Scrubby Award on redscrubs.com for this week, and that's quite an honor!

You can check out the post here:
http://redscrubs.com/2008/07/redscrubs-weekly-wrap-up-7-11-08/

Make sure to email or call us so we can get you the pair of scrubs that you won.

Sincerely and congratulations,

Brandon Wood
brandon@redscrubs.com