Virtual AHEC Discussion with NCAHEC Leaders

Facilitator: Dave Kirby, Dave@KIrbyIMC.com, 919-272-1157

Format for the session

The slides are meant to help structure an exchange in which I can explain what I’ve found and seek input from you all in a way that will allow me to refine a final report to NCAHEC on the Virtual AHEC.

The review encompasses the technical, business and organizational elements relevant to Virtual AHEC.

The discussion is structured around NCAHEC’s most recent strategic planning exercise (July 2005)

Virtual AHEC – a working definition

Single client web portal designed to: Integrate access to online courses, digital

library, and client registration. Improve services to existing clients and attract

new clients. Improve branding, support marketing Provide a basis for new client-centered

services. Discussion: Does this correspond

with your view of the Virtual AHEC?

NCAHEC key SWOT items: They affect Virtual AHEC approach

NCAHEC makes a terrific contribution to building and educating NC’s health workforce.

NCAHEC is far and away the best (the “gold standard model”) AHEC in the country.

Succeeding in the next era challenges NCAHEC to: Reduce risks of a cost-revenue gap Address increasing competitors (e.g. free CME) Reform the regional-statewide program and organizational

boundaries (especially realigning cost/revenue/resource sharing to foster better results)

Address resources shortages (e.g. staff, faculty)

Opportunities include: Better measurement of program outcomes both to assure optimal

effectiveness and to demonstrate that effectiveness to funding agents, partners, clients.

Enhanced use of technology in ways that lower costs and improve effectiveness of programs.

Development of untapped markets. Focusing on customer experience/satisfaction

Strategic Imperatives- Summary

Over the next few slides let’s talk about how the Virtual AHEC could aid in each of these imperatives: Creating new value and better branding Growing market

in a way that values regional elements Improving IT’s contribution

Support for admin, clinical, and educational needs. Respond more quickly to new opps

Strengthening educational programming Improve primary care resident

recruitment/retention Improve attractiveness for faculty to teach and

precept in AHEC programs.

Strategic Imperatives: Create new value and better branding

Demonstrate value and measurable outcomes to funders and partners

Utilize a well-focused and targeted branding strategy to enhance stakeholder awareness

Demonstrate the value of programs to the legislature through a cohesive communication plan

Identify and implement additional efficiencies in core services for state and regional AHECs

Discussion: How do you see the Virtual AHEC aiding in addressing this imperative?

My comments about creating new value and branding.

If Virtual AHEC is positioned as a single portal through which all online AHEC services flow.

1) Virtual AHEC would be an important source of marketing and outcome information by providing a central registry of clients and connecting it with episodic data (e.g. classes, online courses, ADL usage, etc) per client. Combining this data provides a more comprehensive customer view that can be leveraged for marketing, value demonstrations, and other planning.

2) Each new service could be more effective and efficient by leveraging the existing services and data. (e.g. User profile and online and classroom course data could aid in creating a transcript service for individual and institutional clients which, in turn, would aid in knowing where to focus future programming.)

3) The data could be leveraged to better understand and make explicit the relationship networks among AHEC clients that aid in creating learning communities (a key aid to each region).

Draft Recommendation: Define Virtual AHEC in a way that the online AHEC services go only through this portal. (e.g. Make this the only way to get to ADL, AHEConnect). Collect episodic data from the services into one customer database. Use the resultant data for marketing, outcomes analysis, value demonstrations, and assisting learning community development.

Strategic Imperatives: Growing market

Collaborate in new ways for market growth and improved efficiency while respecting established regional relationships

Establish a pro-active market position to expand new and existing revenue sources.

How do you see the Virtual AHEC aiding in addressing this imperative?

My comments on growing market

The data in a Virtual AHEC can be used to aid in market analysis, as a support to new services, and as an attraction on its own.

Will require team work among the regions. Draft recommendation: Once a rich customer

database is in place under Virtual AHEC, 1) Use it to attract current customers to more services

and to attract new customers. 2) Seek to provide fee-based online services to out-of-

state clients. Perhaps beginning with some of the states that NC is more strongly allied with (e.g. SC).

3) Seek courseware development through grants (that pay in-state faculty to develop) and out-of-state faculty or professional organizations (e.g. ANA, ASRT). (Note: professional organizations may be competitors in this area.)

Strategic Imperatives: Improving IT’s contribution

Build a more efficient, effective, integrated information technology infrastructure to serve our administrative, clinical, information and educational needs.

Create the capacity for a rapid flexible response to new opportunities

How do you see the Virtual AHEC aiding in addressing this imperative?

My comments: Improving IT’s contribution

Virtual AHEC is an IT integration project. Draft recommendation: Use the Virtual AHEC project

process as a model for IT development and management within the AHEC. (e.g. process for requirements gathering, accountability).

Most new opportunities don’t appear quickly, they develop over time. The development can be tracked and AHEC positioned to make the appropriate response in each time frame- and also avoid too hasty moves into unproductive areas.

Draft recommendation: Institutionalize innovation. (e.g. Create a staff role charged with exploring new (potential) opportunities and bringing them to the NCAHEC leadership. Require a regular (6 month report). Set aside small funding to prototype. Seek grants that give resources to pilot new facilities).

Strategic Imperatives: Strengthening educational programming

Work with our partners to aggressively strengthen primary care resident recruitment, funding and retention

Create organizational strategies to make it more attractive for faculty to teach and precept in AHEC programs

How do you see the Virtual AHEC aiding in addressing this imperative?

My comments on strengthening educational programming

The Virtual AHEC can be setup with services that aid the primary care resident group. (e.g. Supporting the people who will become residents (starting with their roles Health Careers activities).)

See prior comment about supporting online course development.

Use Virtual AHEC to better support cross-regional classroom sessions – with higher head counts.

Use Virtual AHEC as basis for periodic survey of faculty about what would improve attractiveness of teaching for them.

Addressing balance between regional and statewide program elements.

Once an IT-based activity (e.g. online courses) is created, it is generally easier (lower cost per unit) to extend on a statewide basis than is a face-to-face activity (e.g. classroom sessions).

Face-to-face activities – especially with trusted near peers – are generally more compelling (i.e. practice altering) experiences for learners than experiences with only enduring materials (online or otherwise).

Taking full advantage of these factors implies the need to: focus regional resources more on face-to-face activities, support those activities with a (statewide) online resource, and provide statewide online support for services that don’t benefit

from face-to-face contact. leveraging existing regional groups’ interest and capability in

developing online resources for statewide use.

The Virtual AHEC project is one place where this shift between regional and statewide program elements based on these factors can be played out productively. If this shift is not addressed well, the Virtual AHEC is unlikely to succeed.

Addressing balance between regional and statewide program elements.

Draft recommendation: Leadership should develop a set of goals for the Virtual AHEC project that take advantage of these factors and then monitor the Virtual AHEC development to assure that the goals are met. (e.g. Develop a central calendaring system for all of NCAHEC that regional staff will be required by regional leadership to use.)

Defining “Customer” for the Virtual AHEC.

Most of the focus for Virtual AHEC has been on supporting individual learners,

Could Virtual AHEC support the institutional AHEC client better (e.g. hospital, clinic, community groups)?

Draft Recommendation: Virtual AHEC’s planning should specifically include consideration of how to serve institutional clients (e.g. Providing CE transcript data for use in institutional accreditation.)

About online courses

• Strategically, how do online courses fit into the AHEC mission?

• Should there be more than one online course program identified as an NCAHEC offering through Virtual AHEC?

• Draft Recommendation: Support only one technical infrastructure for provision of online courses under Virtual AHEC. Support multiple sources of content (from the various regions and beyond). Provide funds and initiative to create synergies between the online courses and the other services (e.g. ADL, online transcript. Provide the online course service with a steering committee.

About AHEC Digital Library

How does ADL fit into the AHEC Mission? Can/should the ADL be made available to

more clients (at an agreeable cost?- mostly license fees)

Can ADL and online courses be integrated better into learning community activities?

Draft recommendation: Provide funds and initiative to assure that elements that integrate ADL with the other Virtual AHEC services are created and maintained.

About CASCE

How does CASCE fit into the AHEC mission? What elements are missing from CASCE that are needed to

fully implement the Virtual AHEC concept? Think of CASCE as two closely linked functions: user

authentication and user profiling. Draft recommendations: CASCE should be the root from which the customer-

centric database for a well-marketed AHEC emerges. CASCE should be altered to require authentication for

access to services and support pass-through authentication to the component services (e.g. ADL).

CASCE’s user profile should include elements needed to support marketing of AHEC services and any new services.

Regional staff and user’s themselves should use this method of registering users exclusively.

Assure that the authentication function can adapt to new authentication schemes over the next few years (e.g. smart tokens, biometrics)

New Services- Draft recommendations

Central calendaring for AHEC events should be created as a new service under the Virtual AHEC. Regional staff should use this facility exclusively.

Create a comprehensive transcript service of all client educational activities. Automatically record AHEC-provided experiences and allow users (or institutions) to record non-AHEC items.

Together, these services will solve some often noted problems for both users and institutions while adding the elements needed for marketing, outcome measurement, and accountability?

Add the Horizon electronic card catalog as a linked-to resource through the Virtual AHEC; get value from the new usage data for this service that the upgraded CASCE will provide. Plan to better integrate the Horizon elements in a second step.

Technical issues

Hosting location(s) The servers for the Virtual AHEC and the highly used components

need to be in a well-supported physical environment. There is little need to co-locate these servers with production teams.

Bandwidth The chief need is for bandwidth provision form the servers to the

end users. It is most likely that bandwidth needs will increase over the next

few years as both the number of users increase, the number of usages increases, and the bandwidth for future service types grows (e.g. HDTV-level video)

Technology selections Choices for technologies need to thoughtfully balance:

The “best of breed” advantages with the “best fit with our other tools” advantages

The cost of training technologists on a new technology with the relative advantage of using that new technology.

IT Organizational issues

Establish and manage accountability; align IT objectives with business goals

Leverage the interest and capability in the regions. (e.g. the Centers of Excellence concept).

Institutionalize innovation- by assigning initiative and funding the exploration. For a given potential innovation, start with reporting on it, move to prototyping it, then to pilot projects, then to full production. The goal of reporting, prototyping, and piloting is to guide and time decisions about when and how integrate the innovation into AHEC services. Today, podcasting, blogs, and wikis have some potential for providing learning community supports. So, today’s work is to report on some potential usages cases and look for an opportunity to prototype one or more of them.

Other

What haven’t we talked about that would aid in getting to the next step with the Virtual AHEC concept?

(e.g. year level goals/resourcing plan)

Cost and revenue issues? Inside/outside vendor for services?