networked intelligence in eds across canada caep 2016
TRANSCRIPT
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Networked intelligence in EDs across CanadaPatrick Archambault, MD, MSc, FRCPCClinician-scientist FRQS Junior 2 (CISSS-CA, Hôtel-Dieu de Lévis)Assistant professeur, DMFMU and Anesthesia, Université Laval
@patarchambault
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Financial disclosuresNoneResearch projects funded by CIHR, FRQS, CMPA, KT Canada
Partners
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Plan
1. What are social networks ?
2. What are communities of practice ?
3. What communication tools are used?
4. Why would we want to use wikis?
5. Research program on wikis
6. Future: Semantic web
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4Recent history in information sharing
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Knowledge sharingWeb 1.0: Single knowledge hubs
Web 2.0: distributed networked knowledge sharing
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Social networks are growing
• ER docs are increasingly connected
• Social networks allow us to share knowledge more openly and faster
Infographic created by Ivor Kovic @ivorkovic
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Social networks• Social network = set of social actors
(individuals/organizations) with interactions
• Diffusion of innovations theory focuses on the spread and use of ideas from one actor to another
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John Stuart Mill“ Placing humans in contact with persons dissimilar to themselves is one of the primary sources of progress (1909) ”
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Communities of practice• Lave and Wenger coined the term while
studying apprenticeship as a learning model• “Informal group of peers/practionners that
have a common sense of purpose, a common need to resolve an issue, and/or a common need develop expertise, knowledge or innovation”
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Elements of a CoP• Community-Domain-Place to meet• Shared domain of knowledge
• Explicit knowledge (know what to do)• Tacit knowledge (know-how; experience)• There is no knowledge outside of people, only
information.
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Web and CoPs• Web has extended the reach beyond local
CoP• Expands the possibilities for community
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Virtual EM communities of practice• CanadiEM• SGEM• ALiEM• #FOAMed• The Rounds• Sermo
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Honeycomb modelEach social media have different functions
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Kietzmann et al 2012
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Build a collaborative environment• Find and connect with experts• Find and connect with peers• Identify the needs of your community• Social media can support your needs• Identity (Facebook)• Conversation (Blog)• Sharing (wikis)
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What is a wiki?
• Webpage content• User-generated• Edited by whoever
has access• Synthesis of
information
• Open wiki (Wikipedia)
• Closed wiki (WikEM)
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Why use a wiki?
16Archambault et al http://www.jmir.org/2013/10/e210/
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A wiki for KT ?
KTools support evidence based decision making:
• Care protocols• Order sets• Decision aids
Archambault et al http://www.researchprotocols.org/2015/1/e21/Archambault et al http://medinform.jmir.org/2016/2/e18/Plaisance et al http://www.researchprotocols.org/2016/1/e24/
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WikiTrauma research programProject A Wikis and Collaborative Writing Applications in Health Care: A Scoping Review: positive
potential but strong evidence is lacking (scoping review JMIR, 2013) + (protocole Cochrane, 2014)
Project B Healthcare professionals' intentions to use wiki-based reminders to promote best practices in trauma care (mixed methods survey): strong intention among health professionals to use a wiki, but there is a need for training about how to use a wiki.(manuscrit JMIR 2012) + (pre/post case study, Medicine 2.0) + (Quebec provincial survey)
Project C Development of a theory based intervention to increase use of wiki-based reminders promoting best practices in trauma care: created an online training course (Wiki101)(CIHR planning meeting May 2014)
Project D Implementation and Evaluation of a Wiki Involving Multiple Stakeholders Including Patients in the Promotion of Best Practices in Trauma Care (currently ongoing)(Funded by CMPA 2014)
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WikiTrauma: ongoing experiment
To edit a page
Archambault et al 2015 http://www.researchprotocols.org/2015/1/e21/
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Protocol published JMIR ResProtoc, 2015
http://www.researchprotocols.org/2015/1/e21/
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Wikis for KT: summary• Wikis have interesting potential for KT• Savings by reducing duplication? • Continuous quality improvement?• Improved interprofessional collaboration?• Improved collaboration between hospitals? • More research is needed
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Future of the Web• Semantic Web
technology will allow human-readable web pages to become machine-readable by adding metadata
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Examples of Semantic Web • Cochrane’s Linked Data project • HealthData.gov
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Semantic wiki database• Semantic wiki database could allow sharing
and reuse of information on larger scale• Linked knowledge tools would facilitate
distributed intelligence and continuous system learning
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Semantic Web• Automation• Data fusion• Continual learning• Compounding (as data accumulates)• Contextualisation (linking content to context)
25http://nofilmschool.com/2010/05/web-3-0-now-were-just-talking-semantics
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The future?
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Tim Berners-Lee:
“If we end up developing all the things I can image, we will have failed.”
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More about wikis in healthcarehttp://medinform.jmir.org/2016/2/e18/http://www.researchprotocols.org/2016/1/e24/http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9821394&fileId=S1481803514000499http://www.researchprotocols.org/2015/1/e21/http://www.jmir.org/2013/10/e210/http://www.jmir.org/2011/4/e114/http://www.ncbi.nlm.nih.gov/pubmed/22515985http://www.jmir.org/2015/2/e48/http://www.jmir.org/2011/1/e14/ 28