Online Mul)ple Sclerosis educa)onal programs
A General Prac))oner’s view
Liliana Laranjo
MD, MPH PhD student
2nd ECTRIMS Focused Workshop Lisbon, 7 March 2014
MS is not a frequent disease in General Prac)ce
In Portugal, the average number of
MS pa)ents in a GP’s list is ≈1
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Implica.ons
Lack of experience:
…Diagnosis
…Follow-‐up
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Further complicated by:
-‐ Difficulty contac)ng Neurologists
-‐ Limited access to certain exams
In Portugal, a head MRI is 100x more expensive when ordered by a GP than in the Hospital
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Importance of the GP in MS:
-‐ Diagnosis (gatekeeping role)
-‐ Longitudinal care
-‐ Help the pa)ent navigate the health care system
-‐ Pa)ent and family support
-‐ Holis)c view
-‐ Care coordina)on between all health care professionals
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
Health informa.on technology
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Electronic Health records
-‐ Care coordina)on
-‐ Safety
-‐ Clinical decision support
-‐ Improved care management
Health Informa)cs in the cloud (Braunstein M, 2013)
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
Personal Health Records – A guide for Clinicians (Al-‐Ubaydli, 2011)
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Personal Health records
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
‘Physicians, especially those in primary care, were frustrated when
demands for greater quan)ty of care limited the )me they could spend with each pa)ent, detrac)ng from the quality of care in some cases.’
Friedberg M et al. Factors Affec)ng Physician Professional Sa)sfac)on and Their Implica)ons for Pa)ent Care, Health Systems, and Health Policy
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
‘Electronic health records were a
source of both promise and frustra)on, with major concerns about
interoperability between systems and with the
amount of physician )me involved in data entry.’
Friedberg M et al. Factors Affec)ng Physician Professional Sa)sfac)on and Their Implica)ons for Pa)ent Care, Health Systems, and Health Policy
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
1. Social media
2. GP – Neurologist interac)on
3. Educa)onal programmes
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
1. Social media
2. GP – Neurologist interac)on
3. Educa)onal programmes
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
Social media
Physicians should be able to advise pa)ents regarding:
• Good informa)on sites (HON code)
• Danger of erroneous health informa)on online
• Online social networks for social support
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Social media – online social networks for pa.ents
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
Social media for physicians
(e.g medical community sites; physician mailing lists)
• Informa)on and knowledge exchange
• Share clinical cases
• Benefit from the collec)ve wisdom of the network
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
1. Social media
2. GP -‐ Neurologist interac.on
3. Educa)onal programmes
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
GP – Neurologist interac.on:
-‐ Facilitated communica)on (e.g. secure email, EHR)
-‐ Bilateral informa)on exchange
-‐ Telemedicine
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
1. Social media
2. GP – Neurologist interac)on
3. Educa.onal programmes
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
Educa.onal programmes:
-‐ Unbiased, industry-‐free
-‐ Evidence-‐based
-‐ Asynchronous
-‐ Focused on the specific needs and role of the GP in MS (e.g. community-‐based care; pa)ent and family support, common complica)ons and
comorbidi)es; care coordina)on)
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view
HIT -‐ benefits Opportuni)es & challenges HIT -‐ limita)ons MS in General
Prac)ce Conclusion
The role of GPs in MS care can be leveraged by HIT:
• Social media
• Web-‐enabled communica)on between GPs and Neurologists
• Online educa)onal programmes
Before adding more technology to the life of over-‐burdened physicians, cost-‐
effec)veness should be demonstrated
[email protected] @LilianaLaranjo
“Medicine has built on a long history of innova)on, from the stethoscope (…) to
magne)c resonance imaging (…)
Doctors have embraced each new technology to advance pa)ent care.
But nothing has changed clinical prac)ce more fundamentally than one recent
innova)on: the internet.”
Online Mul)ple Sclerosis educa)onal programs -‐ A General Prac))oner’s view