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A Second Life for Wearable Activity Trackers

[Guest post by Lisa Gualtieri]

I was given a Fitbit and, in tiny print on the package insert, it said to recycle responsibly. It turns out that there is really no way to do that – even wine corks can be recycled but not wearables. My exploration of this led me in many directions, including The Product Stewardship Institute and the complicated recycling websites of many cities and towns. My conclusion to date is that most wearables are thrown in a drawer. As a researcher, I wanted to learn more so I have a survey at http://goo.gl/forms/AyftXiB7N6  which I would be most grateful if you take and pass along to friends and colleagues. The incentive is a drawing for an Apple Watch.

The other side of this research is that I am curious how wearables can help people who want or need to increase their fitness but don’t know about them or can’t afford them. I have pilots planned with the YMCA of Central MA in Fitchburg and I hope to either receive a donation of wearables for the pilot or use reburbished ones we collect as part of http://RecycleHealth.com.

The survey is a helpful way of learning about feasibility of this!

I want to conclude by saying that one of invitations I most enjoyed was to present a keynote on The Future of Consumer Health to the Mid-Atlantic Chapter of the Medical Library Association in Richmond in 2011. I love this picture of “Girls with Pearls” – my pearls were a loan for the picture. Would “Women with Wearables” have the same charm?

Girls with Pearls

Guest post by:
Lisa Gualtieri, PhD, ScM
Assistant Professor
Tufts University School of Medicine
Department of Public Health and Community Medicine
Email: lisa.gualtieri@tufts.edu

Twitter: http://twitter.com/lisagualtieri
Blog on health: http://lisagualtieri.com

Certificate in Digital Health Communication

7th Tufts Summer Institute on Digital Strategies for Health Communication offered July 19-24, 2015

Learning Self-Advocacy Skills to Navigate the Healthcare System

[Guest post by Beverly Doolan and Ashley Conley]

Using video as a teaching medium is one way to reach low literacy audiences and to engage community members in a visual learning opportunity. Developed by the Greater Nashua Public Health Region’s (GNPHR) Access to Health Care workgroup, the “My Health. My Care.” video series and toolkit provide simple tools for navigating healthcare systems. The series was locally produced, and included participation from the area’s two acute care hospitals and other major medical providers, local public libraries, community members, United Way, Marketplace Assistance groups and other supportive service organizations. The project includes four 5-7 minute videos that discuss communicating with healthcare providers, insurance, billing, how to prepare for medical appointments and how to stay healthy. Healthcare providers from regional healthcare partners are featured in the videos. Educational materials were developed to accompany the videos including a brochure that highlights key concepts from the videos, templates for organizations that would like to hold a film screening and a health resources flier for the greater Nashua area. The toolkit of all materials is available on the City of Nashua website so that other regions can use or adapt the materials for their area: http://bit.ly/MyHealthMyCare

MyHealthMyCare

 

Community impact of the videos has been positive, as evidenced by participant responses to nine screening events held as part of the project’s distribution strategy. For example, 98% of survey participants agreed the videos were easy to understand and 96% agreed the videos and materials showed options for what to do when they don’t understand a healthcare service or bill. 97% agreed that the videos provided suggestions to improve communications with healthcare providers. A majority of participants indicated they learned new terms. In encouraging viewers to connect with good resources for finding additional information, the series promotes use of local libraries as well as the NLM Medline Plus website. Approximately 60% of surveyed participants were not aware of the Medline Plus website before watching the videos.

MyHealthMyCare2

Knowledge Management (KM) In Action: Silverman Symposium Posters Online

[Guest post by Margo Coletti]

First, some background: The Silverman Symposium is an annual celebration of quality improvement at Beth Israel Deaconess Medical Center and the BID community hospitals, now in its 8th year. The Symposium is sponsored by the Silverman Institute for Health Care Quality & Safety (the QI department at BIDMC). The Symposium consists of a morning lecture, followed by two afternoon poster sessions to showcase our own safety and quality improvement initiatives. Each year, over 100 posters are mounted and displayed, either on paper or electronically.  The number of posters has grown every year. For the 2015 symposium we had 183 posters. The poster session is our opportunity to show what we’ve accomplished and share our work with each other. During the session, we make connections, discuss our work, garner ideas, and learn from each other. This is knowledge sharing at its finest.

Last spring we asked ourselves: What happens after the Symposium? How can we help the ideas, the connecting, the learning, the sharing continue? Up until this year, the posters had been archived in PDF format on the Silverman Symposium website, but they were not searchable. They were not even discoverable unless the searcher knew the title and year of the poster. In the spring of 2014, after that year’s symposium, we approached a Silverman Institute director. We explained that we in Knowledge Services wanted to harness the knowledge represented by the posters and make it accessible after the symposium. This was an ideal opportunity to utilize and showcase our knowledge management (KM) skills.

With the approval and cooperation of the Silverman Institute, we applied for a Knowledge Management Pilot Project funding from the NN/LM NER. The goal of our project was to produce a searchable, openly-accessible repository of projects, represented by posters, in order to foster knowledge sharing both within the BID organizations and within the global healthcare community.  The objectives were to:

  1. Organize the Silverman Posters PDFs into one searchable repository that is openly accessible and discoverable via Google or any other web search engine.
  2. Design a database that can be used by Knowledge Services as a blueprint for similar projects.
  3. Raise the level of awareness of the quality and safety projects which are undertaken each year in BIDMC.
  4. Raise the visibility and value of Knowledge Services.

The grant allowed us to hire a consultant, Brandy King, MLS, to provide technical expertise in the software selection and database design. It also paid for the first year’s software license. Knowledge Services Director, Margo Coletti, AMLS, AHIP and Senior Information Specialist, Nathan Norris, MLS, AHIP, worked with Brandy King and with Silverman Institute Director of Regulatory Affairs, Kathy Murray. Brandy came on board in August, 2015, and the database software, Omeka, was selected in September.

The work that went into designing the database was shared by everyone on the team. We considered the needs of all of the stakeholders: the database owners (Knowledge Services), the content owners (Silverman Institute), the authors (BID staff members), and the end users (healthcare professionals both within and outside of the BID organization). The Omeka software proved problematic in some areas and we had to work around the quirks and limitations. The most challenging piece was the taxonomy. We considered several options for building a searchable vocabulary and in the end we agreed that the Institute of Medicine’s quality indicators would be of greatest value to the organization. Diane Young, MLS, Information Specialist, joined the team in January, 2015, for the most labor-intensive phase of the project, the data input. By April 9th, the day of the 2015 Symposium, we had loaded, edited and tagged 644 posters, dating from 2012 through 2015.

Silverman Symposium Posters Online can now be viewed at http://bidmc.omeka.net . It is a work in progress as we are still adding the back file from 2006 through 2011. And starting with 2016, we will be reassessing our tags, perhaps adding other indicators of quality such as patient safety goals.

Our project has had an immediate impact on our organization in its recognition of the function and abilities of Knowledge Services. On April 23rd, we presented the database at the BIDMC Leadership Meeting. After the meeting, we were approached by two different people, representing Nursing and Ethics respectively, to work with each of them on different KM projects.

The database itself has contributed to the mission of the medical center, “extraordinary care, where the patient comes first, supported by world-class education and research.” Each of the QI projects represented by the posters is an exercise in knowledge sharing that benefits patient care, teaching and research. It allows our staff to learn from each other and it allows people outside the institution to learn from us as well.

Finally, as the project uses database technology to harness our internal knowledge assets to benefit our community of users, it serves as an example of KM in action (the 3-legged stool of KM: people, technology and knowledge assets). As such, our project was featured in a CE class at MLA 2015, “Knowledge Sharing for Improvement: Hospital Librarians as Knowledge Managers.”

We are grateful to the New England Region for their support.

Submitted by Margo Coletti, Director, Knowledge Services, Beth Israel Deaconess Medical Center, Boston, MA

This project has been funded in whole or in part with federal funds from the National Library of Medicine, National Institutes of Health, under Contract No. HHSN276201100010C with the University of Massachusetts, Worcester.

Lessons Learned: Outputs are Cool!

[Guest post by Karen Vargas, OERC]

Cindy Olney and I just returned from the American Evaluation Association Summer Institute in Atlanta, GA. My mind exploded from how much I learned! The blog posts for the next couple of months will be filled with lessons learned from the Institute. I am going to start with Outputs, because they were the greatest surprise to me.

In his “Introduction to Program Evaluation,” Thomas Chapel, Chief Evaluation Officer for the Centers for Disease Control and Prevention, said that he thought outputs were just as important as outcomes. This was quite shocking to me, since it always seemed like outputs were just the way of counting what had been done, and not nearly as interesting as finding out if the desired outcome had happened.

Outputs are the tangible products of the activities that take place in a project. For example, let’s say the project’s goal is to reduce the number of children with Elevated Blood Lead Levels (EBLL) by screening children to identify the ones with EBLL and then referring them to health professionals for medical management. In this brief project description, the activities would be to:

1) Screen children to identify the ones with EBLL
2) Refer them to health professionals for medical management

If outputs are the tangible products of the activities, they are sometimes thought to be something countable, like “the number of children screened for EBLL” and “the number of referrals.” This is how the project manager can ensure that the activities took place that were planned.

However, if you think about the way an activity can take place, you can see that some methods of completing the activities might lead to a successful outcomes, and some might not. A better way of thinking of the outputs might be “what would an output look like that would lead to the outcome that we are looking for?” To use “referrals” as an example, let’s say that during the program 100% of the children identified with EBLL were referred to health professionals, but only 30% of them actually followed up and went to a health professional. If the only information you gathered was the number of referrals, you cannot tell why the success rate was so low. Some of the things that could go wrong in a referral is that people are referred to physicians who are not taking more patients, or to physicians who don’t speak the same language as the parents of the child. So you might want to define the referral output as including those factors. The new output measure could be “the number of referrals to ‘qualified’ physicians,” in which ‘qualified’ is defined by the attributes you need to see in the physicians, such as physicians who are taking new patients, or physicians who speak the same language as the family.

The lesson for me is that outputs are as important as outcomes because by thinking carefully about outputs at the beginning of the planning process, you can ensure that the project has the greatest chance of successful outcomes, and by using outputs during process evaluation, you can make any needed corrections in the process as it is happening to ensure the greatest success of the project.

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