Nov 2002 Dr Marcelo Sosa ELearning Paradigm for Health Professionals

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Contribution to the Internet Congress Informedica
2002 Paving the way to the global
e-health www.informedica.org/2002
The e-Learning Paradigm for Health Professionals
Dr Marcelo Sosa Iudicissa European Parliament
STOAScientific and Technological Options
Assessment
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Presentation, Justification 1
why have I been given the priviledge of making
this presentation to you?

• Due to the kind invitation of Dr Nora Oliveri-
  who deserves all our recognition and thanks- and
  should be congratulated for her initiatives and
  projects such as Informedica 2002
• I want to express my satisfaction- for being
  able to contribute to such a fascinating on-line
  event- its format is anticipating a future that
  is already here

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Presentation, Justification 2
I have the priviledge of presenting my ideas,
maybe because...

• ..of my professional education (what I have
  learned / apprehended)in medicine, public
  health, informatics, telecommunication
• ..of my work experiences (what I have done)
  family medicine, teaching, Univ of Buenos Aires,
  National School of Public Health, Madrid
  researcher, information systems and new
  technologies scientific officer, AIM-Health
  Telematics program, European Commission
  director, National Library of Health Sciences of
  Spain advisor on telemedicine, National Health
  Institute Carlos III, Madrid director,
  electronic commerce association, consultant and
  entrepreneur of Internet projects responsible,
  science office (STOA) of the European Parliament
  in Brussels

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Presentation, Justification 3
As a result of all the above.. Who am I?
a teacher, a researcher, an advisor, an author,
an expert, a scientist?
The responsibility attached to a label is very
high a toll!
I prefer to say no to all those labels!, but in
fact, I think I am a random mixture of a little
bit of all the above things
This has some advantages a multidisciplinary
vision, eclecticism, few sect fidelities,
indiference of dogma, humbleness, curiosity,
pleasure for learning, teaching, and sharing...
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Presentation, Justification 4

• aesthetic context chossenThis presentations
  background is a papyrus, deserved hommage to the
  ancestor of paper, the medium that has made
  possible the collection and transmission of
  knowledge, now that we enter the electronic era,
  masterfuly summarised by professor Ron LaPorte
  from Pittsburgh University, in the powerfull
  idea P-P-P, From Papyrus-To Paper-To
  PowerPoint.

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Educating health professionals

• lets avoid definitions- what matters we all
  row in the same direction, together- a literary
  licence medicine embraces many disciplines
• it is sciencie and art- this has consequences
  and requisites
• implies personal and social power - which
  brings along exigencies and responsabilities

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Paradigms

• Thomas Kuhn- The structure of scientific
  revolutions, 1970
• Pedro Laín Greek teckhne- History of Medicine
  main phases spontaneous empiric - magic
  technicalwe are at the culmen of an era of
  technical medicine that started in the Golden
  Century in ancient Greece
• Know what and know how to in medicine-
  Knowledge has allways developed in the context of
  great schools (Isle of Kos, Salerno, Montpellier,
  and many others)

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Traditional Paradigm

• Concentration of knowledge- Isle of Kos,
  Ispahan, school of Salerno, etc
• Personalization of knowledge- Masters
  Hippocrates - Avicena Maimonides - Sydenham
• The aprenticeship of the art- Commitment,
  sacrifices, effort, priviledge
• Knowledge as an scarce good- Transmission is
  necessarily personalized

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Educating a professional

• Transmmiting knowledge- To know - Intellectual
  Component
• Acquire skills and habilities- To know how -
  Operative Component
• Acquire and develope attitudes - Hows and
  Whys- Emotional and Moral Component

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Knowledge Cycle
Libraries ---gt Internet Traditional printed
medium books and journals Electronic medium
discs and on-line resources
Universities Hospitals Health Centers Special
schools Etc
Historic collection
Education
Generation
Transmission
Publications Congresses Committees Shadow
colleges Etc
Labs Industry Universities Hospitals Etc
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Information Hierachy
Discrete values must be correct and precise
required in massive amounts of scarce value when
isolated.
Data
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Information Hierachy
Sets of data put in relation between each other,
they acquire new meanings and operative value on
reality

• Information
• Data

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Information Hierachy

• Knowledge
• Information
• Data

Experience building up from analysis and
synthesis of information
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Information Hierachy

• Wisdom or Intelligence
• Knowledge
• Information
• Data

Zenit
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In his book on the Internet, Telematics and
Health, Marcelo Sosa writes ofinformation as the
cornerstone of medical sciences and pays tribute
tothat information giant Dr. Hector Sosa
Padilla, who was a pioneer in assisting PAHO in
development of information systems. Dr. Sosa
Padilla is quoted thus
Information Knowledge
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Information Sources in Health Sciences
These concepts, managed by information and
documentation sciences in the last decades, are
strongly affected by the new realities opened up
by the Internet however, it is advisable to bear
them in mind as a scheme on sources hierarchy.

• Primary sources example article in BMJ-
  Books- Articles- Reports- Contributions to
  meetings- etc.

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Is there an information problem in medicine?

• Information explosion-15 million facts must a
  medical student learn-1990-91 50,000 articles
  in gastroenterology-250,000 art. Every 2 years,
  342 / day, 4.2 /min.
• Facts that are not factsp.e. apendicitis and
  pain localization
• The imprecission of medical language F. T.
  de Dombal, 1993

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Iniciatives on telematics health
Principal Ideas Information Society
Employment, Growth, Competitiveness Main
milestones 1993-"Delors white book
1994-"Bangemann Report 1994-98 -Priority to
ICT and Telematics RD Principal Iniciatives and
Projects Action Plan Priority in Framework
Programs IV-V-VI Trans-European Telecom
Networks ISPO E-Europe e-Health Europe
European Union
www.cordis.lu
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RD on health telematics
- AIM (Advanced Informatics in Medicine) II
Framework Program (FP) / 1989-1990, 42
projects, 22 MEcus - Healthcare Telematics
III FP / 1991-1993, 50 projects, 105 MEcus -
Telematics Applications - Health IV FP /
1994-1998, 120 projects RDValidation,140
MEcus - IST-Information Society Technologies -
Systems and services for the citizen - Health V
FP / 1999-2003 250 MEuros- Continuation in VI
FP / 2002-2005


European Union
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The long march of EU RD()
Barcelona Conference
AIM Euroforum Seville
Lisbon Conference
Services for Citizens
TELEMATICSAPPLICATIONS
V FP
TELEMATICSAPPLICATIONS
IVPM
AIM
Bangeman Report
III PM
II FP
INFORMATION SOCIETY
BICEPS
1984 1986 1988 1990 1992 1994 1996 1998 2000
() RD, research and development
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Examples of Projects

• CHIC (Health information regional models)
• HECTOR (emergencies-Telemedicine)
• PROREC (Electronic Health Records)
• CoCo ( Regional Networks)
• IT-EDUCTRA (Health Professionals Education and
  Training)
• WIDENET Creation of the European Health Records
  Institute EUROREC
• MOBIDEV Mobile Comunications in healthcare

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Education and Training for Health Informatics in
EuropeState of the Art - Guidelines -
ApplicationsEdited by A. Hasman , A. Albert ,
P. Wainwright , R. Klar and M. Sosa 1995, 286
pp., hardcover ISBN 90 5199 234 3
Eductra
Concerted action,started in 1992 with 12
countries of the then European Community
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Eductra
...general guidelines for European curricula in
health informatics as they were developed and
elaborated by the members of the EDUCTRA
Concerned Action (1992-1994). The third part of
this volume entails the detailed descriptions and
applications of curricula in health informatics
in European states
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Information Society

• Informatics Revolution transistor, printed
  circuits, microprocessor, PCs, Moors law,
  CD-ROM, DVD, operating systems and software
• Telecom Revolution transmission via satellites,
  digitalization of basic telephony, local
  networks, ISDN, broadband technologies, fiber
  optics, mobile telephony, GSM (European success
  story), cable TV, videoconference, residential
  DSL
• Internet Revolution open standard, data packets
  commutation, collaborative efforts, servers,
  electronic mail and WWW, platform for
  convergence, e-commerce

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Information Society Trends

• Liberalization of telecommunications, universal
  access and tariff reductions
• From data processing to knowledge access through
  multimedia information
• Development of workgroup, distant learning,
  teleworking and telemedicine
• Massive creation of new products, services and
  electronic businesses of Internet-based companies
• Emergence of a new model of a digital economy

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New Paradigms
Health
Internet
Electronic Health eHealth
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Citizens Trends

• Higher economic possibilities and prospects of
  individual and family achievements
• Welfare state culture
• Better levels of information and more critical
  attitudes
• Desire of more personal, family and social
  autonomy
• Higher level of exigence of public services
  (infraestructures, transport, media, health
  care...)

Empowerment
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Health Trends

• Influence of the media and the Internet
• Sociological changes in the health professions
• Changes in the physician-patient relation,
  braking away from authoritarian and paternalistis
  schemes
• Changes in the relation between users and health
  care services, as a consequence of social changes
• Appearance of a tax-payer concience and an
  informed consumer attitude

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New Paradigms
Education
Internet
Electronic Learning e-Learning
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Learners Trends

• Posibilities of better vocational achievements
• Broad educational supply with great ramifications
  of thematic areas
• Better possibilities of geographic mobility for
  all. In Europe 1 million university students
  have beneffited from the Erasmus program (one
  year in a foreing university)

Learning Empowerment
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Education Trends

• Influencie of the media and the Internet
• Sociologic changes in the education professions
• Changes in the learner-teacher relations, braking
  away from authoritarian and paternalistic models
• Changes in the relation between users and
  educational establishments, as a consequence of
  social changes
• Emergence of a conscience of tax-payer and
  informed consumer

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Pioneers
Dr Francis Timothy de Dombal England, 1937-1995
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Internet, Telematics and HealthMarcelo
Sosa-Iudicissa, Nora Oliveri, Carlos Gamboa, Jean
Roberts 1997, 556 pp., hardcover plus CD-ROM
ISBN 90 5199 289 0
Pioneers
Contributions from Tim de Dombal, Ron LaPorte and
other distinguished professionals totaling up to
80 authors from 22 countries.
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Pioneers
F.T. De Dombal, J.R. Hartley, D.H. SleemanA
Computer-assisted system for Learning Clinical
Diagnosis. The Lancet. Medical Education 18
January 1969
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Pioneers
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New developments

• Massive utilization of basic information
  repositories. Example Pittsburgh University
  Supercourse
• Use of simulation environments, virtual reality
  and immersion environments
• Videoconference from any where to any where, from
  one-to-one, from one-to-many, or from
  many-to-many
• Development of tools based on artificiall
  intelligence engines and knowledge databases

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Emerging Paradigm

• Education and training along the whole life
• Without barriers of time or place
• Access to best knowledge whereever it is located
• Possibility for all to be readers and writers,
  students and teachers
• Utilization of all technologies available, at
  present or in the future, for accessing contents
  and learning experiences

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The Knowledge Society

• We build it up together
• For the benefit of all

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Many thanks for your interest to all participants
of Informedica 2002 and the Supercourse who have
read this presentation. Your opinions or
comments are welcomed. Dr Marcelo
Sosa-IudicissaMSosa_at_EuroParl.EU.int