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Gurprit Randhawa



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  • OS12 - Expanding Digital Competencies Through Education (ID 18)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 6/06/2017, 10:30 AM - 12:00 PM, Room 206B
    • OS12.06 - Strategic Integration of an Educational EHR into Health Informatics Curriculum (ID 127)

      Gurprit Randhawa, Victoria/CA

      • Abstract
      • Slides

      Purpose/Objectives: To support the effective design, development, implementation, use and optimization of electronic health records (EHR), there is a considerable need for Health Informatics (HI) students to have hands-on experience and training with using EHRs. However, many HI students in Canada have very limited exposure to EHRs in the classroom/laboratory setting. This lack of exposure results in student challenges with developing HI competencies that are pre-requisites for other courses, co-op work terms, and eventually the workplace. Consequently, HI students may feel inadequately prepared to design, develop, implement, and support EHRs as graduates. The integration of an educational EHR into HI curriculum is central to develop fully students' HI core competencies related to the health sciences. To meet this need, McMaster University procured an educational EHR for its Health Informatics and Health Information Management (HIM) diploma programs.

      Methodology/Approach: To introduce the educational EHR to its HI and HIM Course Developers and Instructors, McMaster University organized a vendor-led training session with hands-on homework. The teaching team was provided the opportunity and option to use the educational EHR in their respective courses. As a part of the course redesign efforts for HTH 105: Information Systems and Technology, the educational EHR was adopted by the course developer and instructor for integration into the course curriculum. A three-hour scavenger hunt activity using the education EHR was included as a pre-requisite for the course. Relevant hands-on activities were included as weekly learning activities, providing 1-3 hours of weekly hands-on exposure to the educational EHR. Students were also provided supplementary activities to gain additional practice with using the EHR.

      Finding/Results: Nearly all HTH 105 students (n=21/22, 95%) have adopted the educational EHR, completed the course pre-requisite EHR activities, and are completing the weekly hands-on EHR activities for the course. However, students have encountered a number of technical challenges with initial installation of the EHR and co-signing EHR notes (the instructor was not listed as a co-signer by the EHR vendor). The American-centric build of the EHR is also one limitation of the system. Nevertheless, the implementation challenges were presented as a learning opportunity for students to gain an understanding of the common issues faced during EHR implementation. Many students expressed the value they realized in "applying theory in practice" through use of the EHR. Evaluation and monitoring of the benefits and limitations of the educational EHR is ongoing until the end of the course (December 2016).

      Conclusion/Implication/Recommendations: With the introduction of hands-on exposure to the educational EHR, HTH 105 students at McMaster University have experienced an EHR's features, learned how clinical and administrative data is inputted and retrieved, observed its workflows, evaluated its usability, and made recommendations for system improvements. These skills are foundational to the development of health sciences core competencies for HI students. Educational EHRs should be integrated strategically into other HI courses and programs across Canada to support the applied learning of HI students. Further, there is a need to develop a Canadian educational EHR to achieve this vision.

      140 Character Summary: McMaster University's lessons learned will help inform the strategic integration of educational EHRs into HI curriculum across Canada.

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  • OS26 - Creating Effective Health Care Platforms for the Future (ID 31)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical and Executive
    • Presentations: 1
    • Coordinates: 6/07/2017, 10:30 AM - 12:00 PM, Room 202AB
    • OS26.04 - Strategic Capacity Building for Clinical Informatics: A 2020 Vision (ID 180)

      Gurprit Randhawa, Victoria/CA

      • Abstract
      • Slides

      Purpose/Objectives: To support the use and optimization of health information systems, there is a considerable need for Health Informatics (HI) professionals specialized in Clinical Informatics (i.e., Clinical Informaticists) in Canada and across the globe. However, there is currently a high shortage of Clinical Informaticists. To address this, there is a need "to broaden the skills of current clinical professionals to better support them in Clinical Informatics roles" (HI/HIM Report, 2014, p. 67). In 2014, five Canadian HI and health information management organizations identified that the upgrading of Clinical Informatics skills of clinical professionals is a priority for human resources planning until 2019 (HI/HIM Report). Although the development of Clinical Informatics skills is being introduced into clinical curricula/training, there "continues to be a significant gap in the availability of skill broadening resources for incumbent clinical professionals" (HI/HIM Report, 2014, p. 67). Capacity building in Clinical Informatics is central to addressing this gap to fully realize the quality, accessibility, and productivity benefits of health information systems. To build capacity for Clinical Informatics in Canada, there is a critical need to examine the individual and organizational levels to (a) build on the existing knowledge and skills of clinical professionals and (b) foster an environment of continuous learning and adapting to change for Clinical Informaticists.

      Methodology/Approach: In 2014, Island Health created the Department of Clinical Improvements and Informatics to support clinicians and physicians with clinical change management and the integration of computing and biomedical technologies into practice to ensure system usability and adoption. The Clinical Improvements & Informatics team initially included six Clinical Informaticists. To support the implementation of an integrated electronic health record across the organization, Island Health significantly invested in the development of a strong organizational structure for Clinical Informatics, including a 2020 vision and intensive strategy for supporting the initial and continuous professional development of Clinical Informaticists.

      Finding/Results: From 2014-2016, Island Health's Department of Clinical Improvements and Informatics has grown to a team of over 30 full-time Nurse Informaticists, Allied Health Informaticists, and Clinical Informatics Specialists. Currently, the majority of these Clinical Informaticists have limited education and training in Clinical Informatics. To build on the existing knowledge and skills of the Clinical Informatics team, Island Health has developed a multi-faceted strategy to meet the initial and continual learning needs of Clinical Informaticists, which includes: (a) tailored education/training sessions from COACH: Canada's Health Informatics Association and study/review sessions to prepare the Clinical Informaticists for the Certified Professional in Healthcare Information and Management Systems - Canada (CPHIMS-CA) credential, (b) monthly professional development learning sessions, and (c) Clinical Informatics practice reflection journals.

      Conclusion/Implication/Recommendations: The past, present, and future work for developing capacity for Clinical Informatics at Island Health has significant implications for developing a national vision and model for Clinical Informatics capacity building to fully realize the benefits of health information systems. Island Health's barriers, facilitators, and lessons learned for developing capacity for Clinical Informatics will help inform the strategic thinking and planning of Clinical Informatics in other Canadian health care organizations.

      140 Character Summary: Island Health's lessons learned will help inform the development of a national vision and model for Clinical Informatics capacity building.

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  • OS30 - Novel Education Models (ID 35)

    • Event: e-Health 2017 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical
    • Presentations: 1
    • Coordinates: 6/07/2017, 10:30 AM - 12:00 PM, Room 205B
    • OS30.03 - A Conceptual Model for Increasing EMR Use Through End-User Support (ID 128)

      Gurprit Randhawa, Victoria/CA

      • Abstract
      • Slides

      Purpose/Objectives: The adoption and use of electronic medical records (EMR) is a priority for the Canadian health care system. Improved provider effectiveness and health outcomes require better adoption of advanced EMR features by primary care physicians (PCP). However, the majority of PCPs do not fully adopt these advanced features. The literature widely suggests that end-user support (EUS) is a critical success factor for increasing EMR use (i.e., overall use of all EMR features). EUS is any information or activity that is intended to help physicians solve problems with and better utilize their EMR. However, many PCPs must learn the true capabilities of their EMR with little effective EUS. Existing research in EUS is limited and is inconsistently described and measured, which impedes efforts to improve EUS quality and EMR use. Additional research on the relationship between EUS and EMR use is also required.

      Methodology/Approach: To explore the relationship between EUS and EMR use, the EMR End-User Support (EMR-EUS) model (Figure 1) was developed following a review of conceptual and theoretical frameworks related to technology adoption/use and EUS. <img alt="emr eus model.jpg" annotation="" id="image://20" src="https://cpaper.ctimeetingtech.com/deliver_media_imagick.php?congress=ehealth2017&auth_hash=ebce521215e673e27ff09ab2bcf92f383ba4fe03&id=20&width=350&height=350&download=0" title="emr eus model.jpg" /> Figure 1. EMR End-User Support (EMR-EUS) Model The EMR-EUS Model is based on Venkatesh et al.’s (2003) Unified Theory of Acceptance and Use of Technology (UTAUT) and Shachak et al.’s (2011) theoretical framework for describing and characterizing EUS for Health Information Technology (HIT). The UTAUT model is a widely-cited, comprehensive model that was developed following a meta-analysis of eight theories of technology acceptance and use. The theoretical model by Shachak et al. (2011) was developed based on a scoping review of the literature. Together, these two models were amalgamated to create the EMR-EUS model.

      Finding/Results: The EMR-EUS model contains seven EUS components that affect EMR use by PCPs (highlighted in yellow in Figure 1). These include: (a) one core construct (facilitating conditions), (b) four antecedents of facilitating conditions, and (c) two moderators. “EMR use behaviour” is the key outcome of this conceptual model. The aforementioned antecedents exert equal influence on facilitating conditions, and facilitating conditions directly impacts EMR use behaviour.

      Conclusion/Implication/Recommendations: This presentation contributes a conceptual model for exploring the relationship between EUS and EMR use that is based on existing technology adoption/use theories in the literature. This model may be applied by researchers, practitioners, or decision-makers to design EUS interventions and examine their effects on EMR use. Additional research is needed to test this conceptual model.

      140 Character Summary: Researchers, practitioners, or decision-makers can use the EMR-EUS model to explore the relationship between end-user support and EMR use.

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