Eric Robertson and Tim Noteboom presented on using technology to improve physical therapy practice. Their presentation highlighted [1] barriers to evidence-based practice like a lack of time, [2] web tools that can help with collaboration, learning and productivity like blogs, wikis and Google tools, and [3] case studies of innovative implementations including a student resource wiki and a clinic using social media for communication. The goal was to explore how physical therapists can integrate new technologies into practice to overcome challenges and work more efficiently.

1. Eric Robertson, PT, DPT Tim Noteboom, PT, PhD
2009 APTA Annual Conference
Baltimore, MD
PT Hacker: Using Technology to
Make You a Better PT
A Program of Collaboration and Innovation

2. HACKER: DEFINED
(′hak·ər) (computer science) A person who uses a
computer system without a specific, constructive
purpose or without proper authorization.
1. A person who enjoys exploring the details of
programmable systems and how to stretch their
capabilities
6. An expert or enthusiast of any kind. One might be an
astronomy hacker, for example.
7. One who enjoys the intellectual challenge of creatively
overcoming or circumventing limitations.
http://www.answers.com/hacker

3. About Me: Eric
•Physical Therapist
•Orthopaedics & Manual Therapy
•Assistant Professor,
•Medical College of Georgia
•Interest in Web Technology & EBP
•Blogger

4. About Me: Tim
•Director, Department of Post-
Professional Programs@ Regis
University
•Board Certified in Sports PT
•Interest in EBP & Web Technology

5. Our Mission
1. Identify organizational challenges in the area of efficiency
and productivity.
2. Explore Web 2.0 and Medicine 2.0 principles and concepts.
3. Review the latest web tools related to work
efficiency, evidence based practice, and collaborative
innovation.
4. Case Examples: Provide case examples of various solutions
to improve work efficiency, evidence-based
practice, collaborative enterprise, and practice management.

7. Our Navigation Plan
1. Overview of Web 2.0 Concepts
and Introduction
2. Barriers and Blockades:
Personal and Professional
Productivity Killers
3. Web 2.0 Tools and Solutions
with Select Product Demos
4. Case Examples of Innovation
and Collaboration

8. “Evidence-based medicine practice is
the conscientious, explicit, and
judicious use of current best evidence
in making decisions about the care of
individual patients.”
Sackett, D.L. et al. (1996) Evidence based medicine:
what it is and what it isn't. BMJ 312 (7023), 13
January, 71-72).

9. EBP Time Barriers
•Busy Clinic
•More and more evidence
•Only enough time to
read a few articles
•Productivity
•Billable Time
•Family Life
Without enough TIME, the concept of EBP Fails!

10.  Sharing of Ideas
 Collaboration
 Communication
 Interaction!
“Web 2.0 is not a fad, but is changing the way
patients and physicians interact.”
Web 2.0 A New, Interactive Web Experience
Guistini D. How Web 2.0 is Changing Medicine.
BMJ 333(7582): 1283-84. (December 2006).

11. INTERACTION!

12. Disruptive Innovations
Development of new technologies can cause a reduction in innovation. We
would like to minimize this!

13. DISRUPTIVE INNOVATIONS…
“...it is often entirely rational for incumbent
companies to ignore disruptive innovations, since
they compare so badly with existing technologies or
products, and the deceptively small market available
for a disruptive innovation is often very small
compared to the market for the established
technology.”
http://en.wikipedia.org/wiki/Disruptive_technology

14. Vic Gundotra, Google VP of Engineering at Google I/O, 2009

15. Web 2.0 in a Nutshell
• Make Sites Sticky
• Notification of updated content (feeds)
Web 1.0
• Pull Information
• One -way
• Stand alone / Firewalls
• E-mail Alerts & Listservs
Web 2.0
• Open Source
• Collaboration
• Syndicate / Push Information
• Liberation of Information

16. The Past… Now…

17. Characteristics:
Web 2.0 …
• Applications without software…it lives on the web
• Users add value
• Social networking aspect
• User-friendly interface

19. HEALTH 2.0 MEDICINE 2.0
Copyright 2007 by Scott Shreeve, MD. Made available under the Creative Commons Non-Commercial Attribution 2.5 License

20. Health 2.0
• Light-weight definition:
• quot;The use of social software…to promote
collaboration between patients…medical
professionals, and other stakeholders in healthquot;
Sources:
1. Adapted from Jane Sarasohn-Kahn's quot;Wisdom of Patientsquot; report, by Matthew Holt, Last updated June 6, 2008
2. Eysenbach, Gunther. Medicine 2.0 Congress Website launched (and: Definition of Medicine 2.0 / Health 2.0). Posted at:
Gunther Eysenbach's random research rants (Blog). URL: http://gunther-eysenbach.blogspot.com/2008/03/medicine-20-
congress-website-launched.html.

21. Use of Web 2.0 Tools in Healthcare
Use Role Example Users
Staying Informed Stay up to date on RSS, Podcasts, Search Health
latest developments in Tools Professionals,
a field Public
Education Delivery of E-Learning, Web Health
professional and Seminars, Distance- Professionals
continuing education based, podcasts
Collaboration and Decision making in Wikis, literature Health
Practice daily practice, searches, shared Professionals
collaborative research documents
Managing a Information related to Multiple Public
Condition condition and
treatment options
Adapted from Wikipedia.com:
http://en.wikipedia.org/wiki/Health_2.0

22. Personal and Professional Productivity Killers
BARRIERS AND BLOCKADES

23. The Clinician
Keep up with evidence?
Access Continuing Ed?
Tap into the profession’s
collective knowledge from
often remote locations?
Peer-to-Peer interactions?

24. The Private Practice
Facilitate Training?
Synchronize Policies?
Efficiency in Process?
Branding and Marketing?
Does individualism have a place in Web 2.0?

25. The Student
Students have changed
radically
They are no longer the
people our educational
system was designed to
teach
Have grown up in a digital
age
Digital immigrant teachers
speak a different language

26. The Educator
Regis Faculty comment:
“I just visit the
Internet, my students
live there”
Barriers:
•Prioritization – Update
content or add technology?
•Lack of knowledge
•Lack of support
•Effectiveness of
technology?

27. Digital • Learning a new language
Immigrants • Accent still evident
Digital • Early innovators
Settlers • Early adopters
Digital • The only world they ever
Natives knew…

28. Immigrants and Natives
• Immigrant Teachers • Native Students
• Slow controlled release of • Receive information
information from limited quickly from multiple
sources sources
• Step by step • Parallel processing
• One thing at a time • Multi-tasking
• Independent individual focus • Simultaneous
• Serious network/collaborate
• Linear/sequential access • Fun/games
• Text primary • Random access
• Deferred gratification/reward • Visuals/sound primary
• Teach “just in case” • Instant gratification/reward
• Curriculum guide/tests • Learn “just in time”
• Relevant and useful

30. Personal and Professional Productivity Boosters
WEB TOOLS AND APPS

31. Intentional and Reflective Learning
• Blogs & Wikis vs. Traditional CMS
• Collaborative nature promotes higher levels of learning
• Much more than a copy machine
• Learning as a goal
• Web 2.0 tools can foster this
• Contribute to content
• Collaboration
• Open for peer-review

32. Important Collaborative Tools
• Blogs
• Allow Self-Directed Learning, provoke discussion, chronology of content
• Wikis
• Moderated, Various Quality of Information, useful for organization of
information, from the Hawaiian word for “quick” referencing easy edits.
• Podcasts / Videos
• PT Journal Podcast Series, PT Student Videos of CPR’s
• File Sharing / Tagging / Pictures / etc.
• NEJM: Pictures in Medicine, social bookmarking
• Searching and Push Technologies
• Power Searches, RSS Feeds
• Social Networks / Crowdsourcing
• Facebook, TWITTER!, e-patients

33. THE AVERAGE GOOGLE USER NEVER USES
MORE THAN 3% OF THE CAPACITY OF
GOOGLE’S TOOLS.

34. Other Ways to Use Google

35. • See
Appointments
• Streamline
Organizational
Calendaring Scheduling
• Increase the
collective
knowledge!

36. Become a Power Google User
POWER SEARCHING
Search operators, file type filters, quality info!

37. Google Reader!

38. RSS

39. RSS
►Originated in late 90’s from Netscape Corp.
►Widespread use Nov 2002, New York Times
►a.k.a. XML, RSS 2.0, Atom, or just “Feed”

40. RSS
►Coding format used to publish web pages with
frequently updated content.

41. RSS
►Permits continuous instant alerting to the latest
ideas

42. RSS
►Requires an AGGREGATOR to display the Feeds
…like an inbox for the web.

43. RSS Made Simple
http://www.commoncraft.com/
And now for a demo…

45. NYT has tons of feeds!

46. Why not use e-mail alerts?

47. Examples of Collaboration and Innovation
CASE STUDIES

48. Resources as assets
Extend use of learning resources
beyond the time of the course

49. Regis TDPT Courses

50. Student Resource Site

51. Student Resource Site
Students have ongoing access

52. How should a work team develop
new program?
Solution:
Use wiki to develop collaborative site

54. PB Works wiki software
www.pbworks.com

55. Links to easily created pages

56. Content generation by team

57. Who edited and when?

58. How can students apply knowledge
to create new content?
Solution:
Use wiki/YouTube for
student assignments

59. Power of Amazon.com
is not in online
products but in the
collective sharing of
experience

60. How small clinics can leverage technology
CLINICAL IMPLEMENTATION

61. One Organization’s Example
Needs Solutions
• Communication • Blog, Twitter
• Schedules • Synchronized calendars
across platforms
• Wiki/content management
• Distribute training & system for document
information archival and distribution
• Google Docs
• Standardized reports • Key products: Adobe
• Collect, share research Reader, Evernote/Zotero

63. Examples
• Orientation of new students in TDPT program
– Advisor presents Powerpoint & answers questions
• Meeting with distance TDPT faculty
• Problem-solving computer issues
• Recording Fellow presentations
• Recording screen-shot tutorials

64. It’s like an Easy Button!
REFERENCING WITH
ZOTERO

68. Let’s give a try…..
Clinician @ APTA: “I’m thinking about attending a session by Tim Flynn. I
wonder what research he has published?”
Solution: Use Zotero to access reference information for all or most recent
publication, and view during or after his presentation.
Clinician @ AAOMPT: “Huh?”

69. It’s is an Easy Button!
ZOTERO DEMO

70. Physio-pedia.com
•Taking it to the next level
•World-wide Evidence-
based Encyclopedia written
by, and for Physical
Therapists
•Can serve as a turn key wiki
for PT educators.

71. • Where have all the textbooks gone?
A resource for clinicians, instructors and students!
Currently being utilized by instructors and students from:
• Medical College of Georgia, School of Allied Health Science
•Evidence In Motion, Orthopaedic Residency
•Royal College of Surgeons in Ireland, School of Physiotherapy
•University of Hertfordshire, School of Health and Emergency Professions
• Student-generated content • Instructor-generated Content

72. Twitter.com/EricRobertson
Twitter.com/tnoteboom
Just WHAT, will we
use Twitter for?
•Microblogging
•On-the-go communication
•Crowdsourcing
•Patient interactions?

73. Considerations of a Personal and Professional Brand
MANAGING YOUR IDENTITY

74. Dangers of Social Media and Web Apps?
Some fears reflect personal comfort, some reflect
misinformation, others…just need to be accepted.

75. Managing Your Online Identity
1. Have a Message
2. Spread the Message
3. Be Consistent
!!!Who do you really want to see this
pic?
http://lifehacker.com/357460/manage-your-online-reputation

76. 5 Fool-Proof Ways to Stay Out of
Trouble for Your Posts
1. Get Permission
2. Be Nice
3. Manage the Permissions of Your Medium
4. “Will I Offend Anyone?”
5. Create Alerts for Your Stuff

78. My Strategy:
Get • RSS (Google Reader)
Information • Set up Searches and Filters
• Google Docs
Collaborate • Wikis
• Web Meetings
• Blog
Share • Social Sites

79. Your Strategy?
• Determine your bottlenecks and issues
• Find the application to solve it
• Learn to use each tool in depth…
– (though don’t spend too much time learning!)
– Example: Learn how to search Gmail efficiently, or
learn how to Jott to Google Calendar
• Colleagues: Ask and Share!

80. Elegant Solutions
Simple Solutions….
A coordinated web strategy for professional
development.

81. THE INTERNET IS
EVERYWHERE…

82. IT’S PART OF OUR LIVES…

84. DEPART FROM ANCIENT
SYSTEMS OF LEARNING AND
STORAGE…

86. MODERN STORAGE
SOLUTIONS

88. INVESTIGATE
ENCOURAGE
EXPLORE

89. A MUCH RICHER LEARNING
EXPERIENCE…

90. The World’s
Information
at your…
FINGERTIPS!

91. Eric Robertson, PT, DPT Tim Noteboom, PT, PhD
2009 APTA Annual Conference
Baltimore, MD
Go Explore!
THANK YOU!

92. REFERENCES AND ATTRIBUTIONS
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