Virtual Educational Outreach Intervention in Primary Care Based on the Principles of Academic Detailing

Baldwin, Laura Mae; Fischer, Michael; Powell, Jennifer; Holden, Erika; Tuzzio, Leah; Fagnan, Lyle J.; Hummel, Jeff; Parchman, Michael L.

doi:10.1097/ceh.0000000000000224

Cited by 14 publications

(15 citation statements)

References 25 publications

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“…Academic detailing is a multifaceted service that involves collaborative outreach through unbiased, targeted educational interventions designed to improve clinical decision-making. 13 , 14 , 15 , 16 , 17 It is based on relationship building and provides specific practice-change recommendations to providers. Academic detailing has repeatedly proven to be an effective strategy for influencing provider behavior on a variety of topics, including prescription of benzodiazepines, 18 , 19 , 20 antibiotics, 21 , 22 , 23 nonsteroidal anti-inflammatory drugs, 24 , 25 and provision of naloxone.…”

Section: What Is Academic Detailing?mentioning

confidence: 99%

“…The core principles of academic detailing can be adapted to a virtual platform, thereby extending its influence, especially when physical isolation orders are in place to protect the public. 14 , 47 Although it is understandable that patients or providers may prefer to be seen in person, 48 , 49 evidence suggests that the effectiveness of academic detailing on the virtual platform is comparable. 14 , 49 The ability of an academic detailing program to elicit meaningful practice change hinges on the interpersonal relationships developed between the detailing team and clinic staff.…”

Section: Current Statementioning

confidence: 99%

“… 14 , 47 Although it is understandable that patients or providers may prefer to be seen in person, 48 , 49 evidence suggests that the effectiveness of academic detailing on the virtual platform is comparable. 14 , 49 The ability of an academic detailing program to elicit meaningful practice change hinges on the interpersonal relationships developed between the detailing team and clinic staff. As academic detailing professionals become more skilled at assessing the needs and barriers endemic to the practice environment, interventions are more likely to be clinically meaningful.…”

Section: Current Statementioning

confidence: 99%

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Virtual academic detailing (e-Detailing): A vital tool during the COVID-19 pandemic

Hoffman¹,

Shayegani²,

Spoutz³

et al. 2020

Journal of the American Pharmacists Association

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As the coronavirus disease (COVID-19) pandemic continues its course in 2020, telehealth technology provides opportunities to connect patients and providers. Health policies have been amended to allow easy access to virtual health care, highlighting the field’s dynamic ability to adapt to a public health crisis. Academic detailing, a peer-to-peer collaborative outreach designed to improve clinical decision-making, has traditionally relied on in-person encounters for effectiveness. A growth in the adoption of telehealth technology translates to increases in academic detailing reach for providers unable to meet with academic detailers in person. The U.S. Department of Veterans Affairs (VA) has used academic detailing to promote and reinforce evidence-based practices and has encouraged more virtual academic detailing (e-Detailing). Moreover, VA academic detailers are primarily clinical pharmacy specialists who provide clinical services and education and have made meaningful contributions to improving health care at VA. Amid the COVID-19 pandemic and physical isolation orders, VA academic detailers have continued to meet with providers to disseminate critical health care information in a timely fashion by using video-based telehealth. When working through the adoption of virtual technology for the delivery of medical care, providers may need time and nontraditional delivery of “evidence” before eliciting signals for change. Academic detailers are well suited for this role and can develop plans to help address provider discomfort surrounding the use of telehealth technology. By using e-Detailing as a method for both familiarizing and normalizing health professionals with video-based telehealth technology, pharmacists are uniquely poised to deliver consultation and direct-care services. Moreover, academic detailing pharmacists are ambassadors of change, serving an important role navigating the evolution of health care in response to emergent public health crises and helping define the norms of care delivery to follow.

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Section: What Is Academic Detailing?mentioning

confidence: 99%

Section: Current Statementioning

confidence: 99%

Section: Current Statementioning

confidence: 99%

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Virtual academic detailing (e-Detailing): A vital tool during the COVID-19 pandemic

Hoffman¹,

Shayegani²,

Spoutz³

et al. 2020

Journal of the American Pharmacists Association

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“…34 The design of the educational outreach visit was based on the principles of academic detailing and is described in more detail elsewhere. 35 Briefly, with input from a small advisory group of primary care clinicians, the study team developed the educational outreach visit protocol to address priority topics and issues related to implementing CVD risk calculation within daily clinic work. The advisory group of clinicians emphasized the need to keep the length of the educational outreach visit to less than an hour because of the high levels of competing demands faced by primary care clinicians.…”

Section: Educational Outreach Visitsmentioning

confidence: 99%

A Randomized Trial of External Practice Support to Improve Cardiovascular Risk Factors in Primary Care

et al. 2019

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PURPOSE We conducted a randomized controlled trial to compare the effectiveness of adding various forms of enhanced external support to practice facilitation on primary care practices' clinical quality measure (CQM) performance. METHODS Primary care practices across Washington, Oregon, and Idaho were eligible if they had fewer than 10 full-time clinicians. Practices were randomized to practice facilitation only, practice facilitation and shared learning, practice facilitation and educational outreach visits, or practice facilitation and both shared learning and educational outreach visits. All practices received up to 15 months of support. The primary outcome was the CQM for blood pressure control. Secondary outcomes were CQMs for appropriate aspirin therapy and smoking screening and cessation. Analyses followed an intention-to-treat approach. RESULTS Of 259 practices recruited, 209 agreed to be randomized. Only 42% of those offered educational outreach visits and 27% offered shared learning participated in these enhanced supports. CQM performance improved within each study arm for all 3 cardiovascular disease CQMs. After adjusting for differences between study arms, CQM improvements in the 3 enhanced practice support arms of the study did not differ significantly from those seen in practices that received practice facilitation alone (omnibus P = .40 for blood pressure CQM). Practices randomized to receive both educational outreach visits and shared learning, however, were more likely to achieve a blood pressure performance goal in 70% of patients compared with those randomized to practice facilitation alone (relative risk = 2.09; 95% CI, 1.16-3.76). CONCLUSIONS Although we found no significant differences in CQM performance across study arms, the ability of a practice to reach a target level of performance may be enhanced by adding both educational outreach visits and shared learning to practice facilitation.

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“…Nevertheless, evidence suggesting such variation has not been conclusive. 18 – 21 Measuring PROM and the business value of IT in healthcare will provide guidance on the efficiency and efficacy of these virtual care methods. 7 , 21 – 24…”

Section: Introductionmentioning

confidence: 99%

Transformation from a traditional model to a virtual model of care in orthopaedic surgery

King

Evans

et al. 2020

Bone & Joint Open

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Virtual encounters have experienced an exponential rise amid the current COVID-19 crisis. This abrupt change, seen in response to unprecedented medical and environmental challenges, has been forced upon the orthopaedic community. However, such changes to adopting virtual care and technology were already in the evolution forecast, albeit in an unpredictable timetable impeded by regulatory and financial barriers. This adoption is not meant to replace, but rather augment established, traditional models of care while ensuring patient/provider safety, especially during the pandemic. While our department, like those of other institutions, has performed virtual care for several years, it represented a small fraction of daily care. The pandemic required an accelerated and comprehensive approach to the new reality. Contemporary literature has already shown equivalent safety and patient satisfaction, as well as superior efficiency and reduced expenses with musculoskeletal virtual care (MSKVC) versus traditional models. Nevertheless, current literature detailing operational models of MSKVC is scarce. The current review describes our pre-pandemic MSKVC model and the shift to a MSKVC pandemic workflow that enumerates the conceptual workflow organization (patient triage, from timely care provision based on symptom acuity/severity to a continuum that includes future follow-up). Furthermore, specific setup requirements (both resource/personnel requirements such as hardware, software, and network connectivity requirements, and patient/provider characteristics respectively), and professional expectations are outlined. MSKVC has already become a pivotal element of musculoskeletal care, due to COVID-19, and these changes are confidently here to stay. Readiness to adapt and evolve will be required of individual musculoskeletal clinical teams as well as organizations, as established paradigms evolve. Cite this article: Bone Joint Open 2020;1-6:272–280.

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Virtual Educational Outreach Intervention in Primary Care Based on the Principles of Academic Detailing

Cited by 14 publications

References 25 publications

Virtual academic detailing (e-Detailing): A vital tool during the COVID-19 pandemic

Virtual academic detailing (e-Detailing): A vital tool during the COVID-19 pandemic

A Randomized Trial of External Practice Support to Improve Cardiovascular Risk Factors in Primary Care

Transformation from a traditional model to a virtual model of care in orthopaedic surgery

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