Gary Viner

What Do Primary Care Practitioners Want to Know? A Content Analysis of Questions Asked at the Point of Care

Introduction: Assessing physician needs to develop continuing medical education (CME) activities is an integral part of CME curriculum development. The purpose of the present study was to demonstrate the feasibility of identifying areas of perceived greatest needs for continuing medical education (CME) by using questions collected electronically at the point of care. Methods: This study is a secondary analysis of the “Just‐in‐Time” (JIT) information librarian consultation service database of questions using quantitative content analysis methods. The original JIT project demonstrated the feasibility of a real‐time librarian service for answering questions asked by primary care clinicians at the point of care using a Web‐based platform or handheld device. Data were collected from 88 primary care practitioners in Ontario, Canada, from October 2005 to April 2006. Questions were answered in less than 15 minutes, enabling clinicians to use the answer during patient encounters. Results: Description of type and frequency of questions asked, including the organ system on which the questions focused, was produced using 2 classification systems, the “taxonomy of generic clinical questions” (TGCQ), and the International Classification for Primary Care version 2 (ICPC‐2). Of the original 1889 questions, 1871 (99.0%) were suitable for analysis. A total of 970 (52%) of questions related to therapy; of these, 671 (69.2%) addressed questions about drug therapy, representing 36% of all questions. Questions related to diagnosis (24.8%) and epidemiology (13.5%) were also common. Organ systems questions concerning musculoskeletal, endocrine, skin, cardiac, and digestive systems were asked more than other categories. Discussion: Questions collected at the point of care provide a valuable and unique source of information on the true learning needs of practicing clinicians. The TGCQ classification allowed us to show that a majority of questions had to do with treatment, particularly drug treatment, whereas the use of the ICPC‐2 classification illustrated the great variety of questions asked about the diverse conditions encountered in primary care. It is feasible to use electronically collected questions asked by primary care clinicians in clinical practice to categorize self‐identified knowledge and practice needs. This could be used to inform the development of future learning activities.

A development framework for mobile healthcare monitoring apps

Developing healthcare monitoring apps is non-trivial as it requires a balance between simple, easy-to-use interfaces, and powerful business intelligence reporting capabilities, both of which must be integrated into the day-to-day tasks and procedures of clinical practice. This paper presents a development framework for building and deploying mobile healthcare monitoring apps. The framework combines an application development methodology (that ensures adoption and effectiveness of apps when deployed) with an application architecture and component library (to simplify and reduce the development effort needed to implement, deploy and maintain such apps). The development framework is evaluated using a case study of a mobile healthcare monitoring app developed and deployed in collaboration with a team of healthcare researchers and doctors to support the training of residents in family medicine.

Do Continuing Medical Education (CME) Events Cover the Content Physicians Want to Know? A Content Analysis of CME Offerings

Introduction: The purpose of this study is to assess whether annual refresher session offerings match the needs of physicians by coding and comparing session syllabi to physician questions collected electronically at the point of care. Methods: Thirteen syllabi from annual refresher continuing medical education (CME) events offered to family physicians in Canada were collected and their session titles and descriptions entered into a database. Titles and descriptions were coded using the International Classification for Primary Care version 2 (ICPC‐2). Titles and descriptions were further coded depending on whether the sessions involved a drug treatment/medication component. Syllabi content was compared to previously determined questions asked by physicians at the point of care. Results: Of the original 701 session titles, 625 (89.2%) were suitable for analysis. CME sessions focused on musculoskeletal, digestive, skin, urologic, and general categories were underrepresented in comparison to point‐of‐care questions. The reverse was true for the psychological/mental health category. Discussion: Differences between questions asked by physicians at the point of care and the content of contemporaneous CME refresher courses can be analyzed to identify gaps in CME offerings. This knowledge could be used to develop CME curricula and highlight areas of need for inclusion in refresher courses.

Development of a Resident Practice Profile in a Business Intelligence Application Framework

Abstract In recent years, practice profile applications have started to appear that allow medical practitioners to log their experiences electronically to provide feedback in the form of reports. This paper presents a case study in which a Resident Practice Profile application was developed using a Business Intelligence application framework that flexibly integrates user interfaces and reporting while minimizing the labour required for application coding. The methodology used in the case was iterative action based research in which three different frameworks were used and compared in terms of their effectiveness for developing a practice profile application. As well, the Resident Practice Profile application was compared to two similar practice profile applications from the literature.