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

Academic Detailer (Pharmacist)PhysicianTEAD

• 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

physiciansand

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.

Male

Female

Of the 18 physicians who participated:

• 58% of physicians were 55 years of age

or older, 25% were between 45-54

years of age, and 17% were between

35-44 years of age.

• Average of 28.7 years experience in

practice

• 85% were male, and 15% 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

55-64

45-54

35-44

Results: By the Numbers

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1.5

2

2.5

3

3.5

4

4.5

5

Likelihood of Uptake Web Conferencing Tool Content Physician Engagement Global Satisfaction

Sco

reSatisfaction with Pilot Sessions

Academic Detailer

Physician

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.

1.00

1.50

2.00

2.50

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3.50

4.00

4.50

5.00

1 2 3 4 5 6 7 8 9 10 11 12 13

Sco

reEngagement During the Session

Academic Detailer

Physician

• 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.

Academic Detailer and Physician Pairs

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1.50

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5.00

1 2 3 4 5 6 7 8 9 10 11 12 13

Sco

re

Webconferencing Tool

Academic Detailer

Physician

• 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.

Academic Detailer and Physician Pairs

1

1.5

2

2.5

3

3.5

4

4.5

5

1 2 3 4 5 6 7 8 9 10 11 12 13

Sco

re

Global Satisfaction

Academic Detailer

Physician

• 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.

Academic Detailer and Physician Pairs

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

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…).

Academic Detailer (Pharmacist)PhysicianTEAD

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/