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applicability to health professional education, credentialing & - - PowerPoint PPT Presentation

Dec 19, 2022 210 likes •470 views

An exploration of Blockchain and its applicability to health professional education, credentialing & research Disclosures: Ian Graham MBBS, M Health Planning, Cert. Essential Skills in Medical Education, FRACMA Director of

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SLIDE 1

An exploration of Blockchain and its applicability to health professional education, credentialing & research

Disclosures:

Ian Graham MBBS, M Health Planning, Cert. Essential Skills in Medical Education, FRACMA

  • Director of Professional Affairs - ANZCA
  • Executive Director of Medical Services - East / West Wimmera Health Service
  • Consultant - SED Clinical Education Practice and Learning
  • Member, Board of Directors - MedBiquitous
  • Co-founder and inaugural President - HISA

No other affiliation (financial or otherwise) with any pharmaceutical, medical device, information technology or communications organisation

Goal: Achieving ‘mutually assured disruption!”

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SLIDE 2

What I like about Blockchain ….

Blockchain

  • Distributed ledger - avoiding central

management & storage

  • Interoperability - connectivity
  • Self-sovereignty - user control
  • Transparency & provenance -

capacity of parties to transact

  • Immutability - permanent, append only
  • Trust - confidence in the infrastructure,

privacy & governance

Grech A and Camilleri AF (2017) Blockchain in Education. Inamorato dos Santos, A. (ed.) EUR 28778 EN; European Commission JRC Science for Policy Report; doi:10.2760/60649 Orcutt M (2018) Blockchain, MIT Technology Review, May/June 2018, pp. 18-23

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SLIDE 3

Blockchain

  • Recording of every transaction in a

time period

  • Recognition of value including non-

financial (e.g. education, information)

  • Grouped together in a block
  • Blocks ‘chained’ together in

chronological order

  • Reminiscent of the base pairs in a

DNA double helix

Funk E, Riddell J, Ankel F, Cabrera D (2018) Blockchain Technology: A Data Framework to Improve Validity, Trust, and Accountability of Information Exchange in Health Professions Education. Academic Medicine: June 12, 2018 - Volume Publish Ahead of Print doi: 10.1097/ACM.0000000000002326

What I like about Blockchain ….

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SLIDE 4
  • Competency Based Medical Education

(CBME)

xAPI

Undergraduate (Universities)

→ Prevocational training (Hospitals) → Vocational training (Colleges)

Blockchain in health professional education

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

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SLIDE 5
  • Competency Based Medical Education

(CBME)

  • Competencies & Learning Outcomes

Australian and New Zealand College of Anaesthetists (2017) Anaesthesia Training Program Curriculum, Updated September, 2017

xAPI

AR_PF 2.2

Describe how the history and culture of various indigenous populations impacts upon their current health status, education and communication

Role: Professional Assessment: CPRQ, FEx IT_AM 2.3

Demonstrate assessment of the Adequacy of ventilation and identify airway obstruction

Role: Medical Expert Assessment: M-DOPS

Blockchain in health professional education

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

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SLIDE 6
  • Competency Based Medical Education

(CBME)

  • Competencies & Learning Outcomes
  • Workplace Based Assessment

xAPI

Blockchain in health professional education

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

Above average Average Below average

Funk E, Riddell J, Ankel F, Cabrera D (2018) Blockchain Technology: A Data Framework to Improve Validity, Trust, and Accountability of Information Exchange in Health Professions Education. Academic Medicine: June 12, 2018 - Volume Publish Ahead of Print doi: 10.1097/ACM.0000000000002326

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SLIDE 7
  • Competency Based Medical Education

(CBME)

  • Competencies & Learning Outcomes
  • Workplace Based Assessment
  • Entrustable Professional Activities

EPA No / Code: EPA1 – Anaesthesia 1 Title: Provide safe, efficient and effective anaesthesia and sedation for ASA I-II patient having low risk surgery with Level 4 supervision Description: This activity involves providing general anaesthesia, regional anaesthesia and sedation to low risk patients (ASA I-II) - including emergency patients - for minor or intermediate complexity surgery. This is a core anaesthetic skill. It involves integration of knowledge (pharmacology, physiology, anatomy), technical skills (airway management, intravascular access), and non- technical skills (patient and team communication, collaboration, professionalism).

Knowledge Skills Behaviours Workplace Based Assessments

Blockchain in health professional education

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

ten Cate O, Chen HC, Hoff RG, Peters H,Bok H, van der Schaaf MF (2015) Curriculum development for the workplace using Entrustable Professional Activities (EPAs); AMEE Guide No. 99. Medical Teacher; 37: 983–1002

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SLIDE 8
  • Competency Based Medical Education

(CBME)

  • Competencies & Learning Outcomes
  • Workplace Based Assessment
  • Entrustable Professional Activities
  • EHR / monitors / simulators

Big data

Blockchain in health professional education

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

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SLIDE 9

Blockchain

  • Competency Based Medical Education

(CBME)

  • Competencies & Learning Outcomes
  • Workplace Based Assessment
  • Entrustable Professional Activities
  • EHR / monitors / simulators
  • Experience data (xAPI /Tin Can API)

Actor

↓

Verb

↓

Noun

↓

Context Marion administered

Propofol for colonoscopy

xAPI

Blockchain in health professional education

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

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SLIDE 10
  • Competency Based Medical Education

(CBME)

  • Competencies & Learning Outcomes
  • Workplace Based Assessment
  • Entrustable Professional Activities
  • EHR / monitors / simulators
  • Experience data (xAPI /Tin Can API)
  • Lifelong portable portfolio

Blockchain in health professional education

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

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SLIDE 11

Blockchain in credentialing / scope of practice

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Verification of identification,

qualifications & certifications

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SLIDE 12

Blockchain in credentialing / scope of practice

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Verification of identification,

qualifications & certifications

  • Documenting clinical / teaching

experience & currency of practice

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SLIDE 13

Blockchain in credentialing / scope of practice

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Verification of identification,

qualifications & certifications

  • Documenting clinical / teaching

experience & currency of practice

  • Entrustable Professional Activities

Intercollegiate Collaboration on CBME in Anaesthesia (2018) Draft Entrustable Professional Activities (EPAs), University of Utrecht, The Netherlands

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SLIDE 14

Blockchain in credentialing / scope of practice

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Verification of identification,

qualifications & certifications

  • Documenting clinical / teaching

experience & currency of practice

  • Entrustable Professional Activities
  • Managing appointments /

reappointments & scope of practice

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SLIDE 15

Blockchain in credentialing / scope of practice

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Verification of identification,

qualifications & certifications

  • Documenting clinical / teaching

experience & currency of practice

  • Entrustable Professional Activities
  • Managing appointments /

reappointments & scope of practice

  • Measuring performance, documenting
  • utcomes, peer review and patient

feedback

Quality, Safety and Patient Experience Branch, Victorian Government, Department of Health, Melbourne, Victoria (2011) Credentialling and defining the scope of clinical practice for medical practitioners in Victorian health services – a policy handbook

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SLIDE 16

Blockchain in credentialing / scope of practice

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Verification of identification,

qualifications & certifications

  • Documenting clinical / teaching

experience & currency of practice

  • Entrustable Professional Activities
  • Managing appointments /

reappointments & scope of practice

  • Measuring performance, documenting
  • utcomes, peer review and patient

feedback

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SLIDE 17

Blockchain in health / clinical research

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Local, regional, national and international

multicentre trials / Human Research Ethics

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SLIDE 18

Blockchain in health / clinical research

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Local, regional, national and international

multicentre trials / Human Research Ethics

  • Tracking conditions, medical devices,

prostheses, implants

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SLIDE 19

Blockchain in health / clinical research

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Local, regional, national and international

multicentre trials / Human Research Ethics

  • Tracking conditions, medical devices,

prostheses, implants

  • Personalised control of 3rd party access to

EHR through smart contracts / consent

Informed Consent

Benchoufi M, Porcher R, Ravaud P (2017) Blockchain protocols in clinical trials: Transparency and traceability of consent (2017); Version 5. F1000Research 6: 66; Published online 2018 Feb 1. doi: 10.12688/f1000research.10531.5

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SLIDE 20

Blockchain in health / clinical research

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Local, regional, national and international

multicentre trials / Human Research Ethics

  • Tracking conditions, medical devices,

prostheses, implants

  • Personalised control of 3rd party access to

EHR through smart contracts / consent

  • Conduct of assessments, investigations,

therapies in accordance with protocols

Chan A-W, Tetzlaff JM, Altman DG, Laupacis A, Gøtzsche PC, Krleža-Jerić K, Hróbjartsson A, Mann H, Dickersin K, Berlin J, Doré C, Parulekar W, Summerskill W, Groves T, Schulz K, Sox H, Rockhold FW, Rennie D, Moher D. (2013) SPIRIT 2013 Statement: Defining standard protocol items for clinical trials. Ann Intern Med 2013;158:200-207. http://www.spirit-statement.org (Accessed July, 2018)

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SLIDE 21

Blockchain in health / clinical research

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Local, regional, national and international

multicentre trials / Human Research Ethics

  • Tracking conditions, medical devices,

prostheses, implants

  • Personalised control of 3rd party access to

EHR through smart contracts / consent

  • Conduct of assessments, investigations,

therapies in accordance with protocols

  • Data aggregation and management
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SLIDE 22

Blockchain in health / clinical research

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Local, regional, national and international

multicentre trials / Human Research Ethics

  • Tracking conditions, medical devices,

prostheses, implants

  • Personalised control of 3rd party access to

EHR through smart contracts / consent

  • Conduct of assessments, investigations,

therapies in accordance with protocols

  • Data aggregation and management
  • Monetisation of research activity

Mamoshina P, Ojomoko L, Yanovich Y, Ostrovski A, Botezatu A, Prikhodko P, Izumchenko E, Aliper A, Romantsov K, Zhebrak A, Obioma Ogu I, Zhavoronkov A (2017) Converging blockchain and next-generation artificial intelligence technologies to decentralize and accelerate biomedical research and healthcare. Oncotarget. 2018 Jan 19; 9(5): 5665–5690. doi: 10.18632/oncotarget.22345

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SLIDE 23

Blockchain in health / clinical research

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

  • Local, regional, national and international

multicentre trials / Human Research Ethics

  • Tracking conditions, medical devices,

prostheses, implants

  • Personalised control of 3rd party access to

EHR through smart contracts / consent

  • Conduct of assessments, investigations,

therapies in accordance with protocols

  • Data aggregation and management
  • Monetisation of research activity
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SLIDE 24

Blockchain challenges

Blockchain

  • Trust (MyHR)
  • Explaining the principles of Blockchain
  • Gaining consensus across jurisdictions,

Colleges, universities, regulators

  • Going beyond Bitcoin
  • Challenging centralised authority
  • Challenging traditional vendors
  • Driving the standards agenda
  • Herding cats and facilitating flamingos!

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust

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SLIDE 25

Blockchain challenges

Blockchain

Health professional education Credentialing / scope of practice Health / clinical research

Thank you

Dr Ian Graham igraham@anzca.edu.au

Distributed ledger ◆ Interoperability ◆ Self-sovereignty ◆ Transparency ◆ Immutability ◆ Trust