PT Hacker: Using Technology to Make You a Better PTA Program of Collaboration and Innovation

2009 APTA Annual Conference

Baltimore, MD

Eric Robertson, PT, DPT Tim Noteboom, PT, PhD

HACKER: DEFINED

(′hak·ər) (computer science) A person who uses a computer system without a specific, constructive purpose or without proper authorization.

1. A person who enjoys exploring the details of programmable systems and how to stretch their capabilities

6. An expert or enthusiast of any kind. One might be an astronomy hacker, for example.

7. One who enjoys the intellectual challenge of creatively overcoming or circumventing limitations. http://www.answers.com/hacker

About Me: Eric

•Physical Therapist•Orthopaedics & Manual Therapy

•Assistant Professor,•Medical College of Georgia

•Interest in Web Technology & EBP•Blogger

About Me: Tim•Director, Department of Post-Professional Programs@ Regis University

•Board Certified in Sports PT

•Interest in EBP & Web Technology

Our Mission

1. Identify organizational challenges in the area of efficiency and productivity.

2. Explore Web 2.0 and Medicine 2.0 principles and concepts.

3. Review the latest web tools related to work efficiency, evidence based practice, and collaborative innovation.

4. Case Examples: Provide case examples of various solutions to improve work efficiency, evidence-based practice, collaborative enterprise, and practice management.

Our Navigation Plan1. Overview of Web 2.0

Concepts and Introduction

2. Barriers and Blockades: Personal and Professional Productivity Killers

3. Web 2.0 Tools and Solutions with Select Product Demos

4. Case Examples of Innovation and Collaboration

“Evidence-based medicine practice is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.”

Sackett, D.L. et al. (1996) Evidence based medicine: what it is and what it isn't. BMJ 312 (7023), 13 January, 71-72).

EBP Time Barriers

•Busy Clinic

•More and more evidence

•Only enough time to read a few articles

• Productivity• Billable Time• Family Life

Without enough TIME, the concept of EBP Fails!

How is Knowledge Gained?

“Web 2.0 is not a fad, but is changing the way patients and physicians interact.”

Web 2.0 A New, Interactive Web ExperienceGuistini D. How Web 2.0 is Changing Medicine. BMJ 333(7582): 1283-84. (December 2006).

Sharing of Ideas Collaboration Communication Interaction!

INTERACTION!

Disruptive InnovationsDevelopment of new technologies can cause a reduction in innovation. We would like to minimize this!

DISRUPTIVE INNOVATIONS…

“...it is often entirely rational for incumbent companies to ignore disruptive innovations, since they compare so badly with existing technologies or products, and the deceptively small market available for a disruptive innovation is often very small compared to the market for the established technology.”

http://en.wikipedia.org/wiki/Disruptive_technology

Vic Gundotra, Google VP of Engineering at Google I/O, 2009

Web 1.0•Pull Information•One -way•Stand alone / Firewalls•E-mail Alerts & ListservsWeb 2.0•Open Source•Collaboration•Syndicate / Push Information•Liberation of Information

Web 2.0 in a Nutshell• Make Sites Sticky• Notification of updated content (feeds)

Web 2.0

The Past… Now…

Characteristics:

Web 2.0 …•Applications without software…it lives on

the web

•Users add value

•Social networking aspect

•User-friendly interface

HEALTH 2.0 MEDICINE 2.0

Copyright 2007 by Scott Shreeve, MD. Made available under the Creative Commons Non-Commercial Attribution 2.5 License

Health 2.0

• Light-weight definition:• "The use of social software…to

promote collaboration between patients…medical professionals, and other stakeholders in health"

Sources: 1. Adapted from Jane Sarasohn-Kahn's "Wisdom of Patients" report, by Matthew Holt, Last updated June 6, 2008 2. Eysenbach, Gunther. Medicine 2.0 Congress Website launched (and: Definition of Medicine 2.0 / Health 2.0). Posted at:

Gunther Eysenbach's random research rants (Blog). URL: http://gunther-eysenbach.blogspot.com/2008/03/medicine-20-congress-website-launched.html.

Adapted from Wikipedia.com: http://en.wikipedia.org/wiki/Health_2.0

Use of Web 2.0 Tools in Healthcare

Use Role Example Users

Staying Informed

Stay up to date on latest developments in a field

RSS, Podcasts, Search Tools

Health Professionals, Public

Education Delivery of professional and continuing education

E-Learning, Web Seminars, Distance-based, podcasts

Health Professionals

Collaboration and Practice

Decision making in daily practice, collaborative research

Wikis, literature searches, shared documents

Health Professionals

Managing a Condition

Information related to condition and treatment options

Multiple Public

BARRIERS AND BLOCKADES

Personal and Professional Productivity Killers

The Clinician

Keep up with evidence?

Access Continuing Ed?

Tap into the profession’s collective knowledge from often remote locations?

Peer-to-Peer interactions?

The Private Practice

Facilitate Training?

Synchronize Policies?

Efficiency in Process?

Branding and Marketing?

Does individualism have a place in Web 2.0?

The StudentStudents have changed radically

They are no longer the people our educational system was designed to teach

Have grown up in a digital age

Digital immigrant teachers speak a different language

The Educator

Regis Faculty comment:

“I just visit the Internet, my students live there”

Barriers:

•Prioritization – Update content or add technology?

•Lack of knowledge

•Lack of support

•Effectiveness of technology?

•Learning a new language•Accent still evident

Digital Immigrants

•Early innovators•Early adopters

Digital Settlers

•The only world they ever knew…

Digital Natives

Immigrants and Natives

• Immigrant Teachers• Slow controlled release

of information from limited sources

• Step by step• One thing at a time• Independent individual

focus• Serious• Linear/sequential access• Text primary• Deferred

gratification/reward• Teach “just in case”• Curriculum guide/tests

• Native Students• Receive information

quickly from multiple sources

• Parallel processing• Multi-tasking• Simultaneous

network/collaborate• Fun/games• Random access• Visuals/sound

primary• Instant

gratification/reward• Learn “just in time”• Relevant and useful

WEB TOOLS AND APPSPersonal and Professional Productivity Boosters

Intentional and Reflective Learning• Blogs & Wikis vs. Traditional CMS

• Collaborative nature promotes higher levels of learning

• Much more than a copy machine

• Learning as a goal• Web 2.0 tools can foster this• Contribute to content• Collaboration• Open for peer-review

Important Collaborative Tools

• Blogs• Allow Self-Directed Learning, provoke discussion, chronology of content

• Wikis• Moderated, Various Quality of Information, useful for organization of

information, from the Hawaiian word for “quick” referencing easy edits.

• Podcasts / Videos• PT Journal Podcast Series, PT Student Videos of CPR’s

• File Sharing / Tagging / Pictures / etc.• NEJM: Pictures in Medicine, social bookmarking

• Searching and Push Technologies• Power Searches, RSS Feeds

• Social Networks / Crowdsourcing• Facebook, TWITTER!, e-patients

THE AVERAGE GOOGLE USER NEVER USES MORE THAN 3% OF THE CAPACITY OF GOOGLE’S TOOLS.

3%

Other Ways to Use Google

• See Appointments• Streamline Scheduling• Increase the collective

knowledge!

Organizational

Calendaring

POWER SEARCHING

Become a Power Google User

Search operators, file type filters, quality info!

Google Reader!

RSS

RSS

►Originated in late 90’s from Netscape Corp.

►Widespread use Nov 2002, New York Times

►a.k.a. XML, RSS 2.0, Atom, or just “Feed”

RSS

►Coding format used to publish web pages with

frequently updated content.

RSS

►Permits continuous instant alerting to the latest ideas

RSS

►Requires an AGGREGATOR to display the Feeds

…like an inbox for the web.

RSS Made Simple

http://www.commoncraft.com/

And now for a demo…

NYT has tons of feeds!

Why not use e-mail alerts?

CASE STUDIESExamples of Collaboration and Innovation

Resources as assets

Extend use of learning resources beyond the time of

the course

Regis TDPT Courses

Student Resource Site

Student Resource Site

Students have ongoing access

How should a work team develop new program?

Solution:Use wiki to develop collaborative site

PB Works wiki softwarewww.pbworks.com

Links to easily created pages

Content generation by team

Who edited and when?

How can students apply knowledge to create new content?

Solution:Use wiki/YouTube for student assignments

Power of Amazon.com is not in online products but in the collective sharing of experience

CLINICAL IMPLEMENTATION

How small clinics can leverage technology

One Organization’s Example

Needs• Communication• Schedules

• Distribute training & information

• Standardized reports

• Collect, share research

Solutions• Blog, Twitter• Synchronized calendars

across platforms

• Wiki/content management system for document archival and distribution

• Google Docs• Key products: Adobe

Reader, Evernote/Zotero

http://www.adobe.com/products/acrobatconnect/demo/

Examples

• Orientation of new students in TDPT program– Advisor presents Powerpoint & answers

questions

• Meeting with distance TDPT faculty• Problem-solving computer issues• Recording Fellow presentations• Recording screen-shot tutorials

REFERENCING WITH ZOTERO

It’s like an Easy Button!

Let’s give a try…..

Clinician @ APTA: “I’m thinking about attending a session by Tim Flynn. I wonder what research he has published?”

Solution: Use Zotero to access reference information for all or most recent publication, and view during or after his presentation.

Clinician @ AAOMPT: “Huh?”

ZOTERO DEMOIt’s is an Easy Button!

Physio-pedia.com

•Taking it to the next level

•World-wide Evidence-based Encyclopedia written by, and for Physical Therapists

•Can serve as a turn key wiki for PT educators.

A resource for clinicians, instructors and students!

• Where have all the textbooks gone?

• Student-generated content • Instructor-generated Content

Currently being utilized by instructors and students from:• Medical College of Georgia, School of Allied Health Science• Evidence In Motion, Orthopaedic Residency• Royal College of Surgeons in Ireland, School of Physiotherapy• University of Hertfordshire, School of Health and Emergency

Professions

Twitter.com/EricRobertsonTwitter.com/tnoteboom

Just WHAT, will we use Twitter for?

•Microblogging•On-the-go communication•Crowdsourcing•Patient interactions?

MANAGING YOUR IDENTITY

Considerations of a Personal and Professional Brand

Dangers of Social Media and Web Apps?

Some fears reflect personal comfort, some reflect misinformation, others…just need to be accepted.

Managing Your Online Identity

1. Have a Message

2. Spread the Message

3. Be Consistent

!!!Who do you really want to see this pic?

http://lifehacker.com/357460/manage-your-online-reputation

5 Fool-Proof Ways to Stay Out of Trouble for Your Posts

1. Get Permission

2. Be Nice

3. Manage the Permissions of Your Medium

4. “Will I Offend Anyone?”

5. Create Alerts for Your Stuff

My Strategy:

•RSS (Google Reader)•Set up Searches and Filters

Get Information

•Google Docs•Wikis•Web Meetings

Collaborate

•Blog•Social SitesShare

Your Strategy?

• Determine your bottlenecks and issues

• Find the application to solve it

• Learn to use each tool in depth…– (though don’t spend too much time learning!)– Example: Learn how to search Gmail efficiently,

or learn how to Jott to Google Calendar

• Colleagues: Ask and Share!

Elegant Solutions

Simple Solutions….

A coordinated web strategy for professional development.

THE INTERNET IS EVERYWHERE…

IT’S PART OF OUR LIVES…

DEPART FROM ANCIENT SYSTEMS OF LEARNING AND STORAGE…

MODERN STORAGE SOLUTIONS

INVESTIGATE

ENCOURAGE

EXPLORE

A MUCH RICHER LEARNING EXPERIENCE…

The World’s Information at your…

FINGERTIPS!

THANK YOU!Go Explore!

Eric Robertson, PT, DPT Tim Noteboom, PT, PhD

2009 APTA Annual Conference

Baltimore, MD

REFERENCES AND ATTRIBUTIONS

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