September 13, 2018

QuizTime app created to aid opioid education efforts for providers

Vanderbilt University Medical Center will partner with the Tennessee Department of Health to offer workplace-based education to health professionals across the state via QuizTime, a smartphone application developed at VUMC. This continuing education activity will focus on proper utilization of opioid and non-opioid therapies in managing pain.

The QuizTime app team includes (front row, from left) David Hall, MMHC, Bonnie Miller, MD, MMHC, Matt McEvoy, MD, Leslie Fowler, MEd, (back row, from left) David Edwards, MD, PhD, April Kapu, DNP, Robert Caughey, MD, MS, Don Moore, PhD, and Tyler Barrett, MD, MSCI. (photo by Nathan Morgan)

by Kathy Whitney

Vanderbilt University Medical Center will partner with the Tennessee Department of Health to offer workplace-based education to health professionals across the state via QuizTime, a smartphone application developed at VUMC. This continuing education activity will focus on proper utilization of opioid and non-opioid therapies in managing pain.

Funding for the initiative comes from the Centers for Disease Control and Preven-tion/NCIPC opioid crisis cooperative agreement, Overdose Prevention in States — Surge Support (OPIS S2).

The aim of OPIS S2 is to advance understanding of the opioid overdose epidemic and scale up prevention activities across all 50 States and Washington, D.C. The CDC reviewed and considered all submissions, and prioritized funding based on geographic need, disease burden and populations disproportionately impacted by the opioid epidemic.

“The CDC is partnering with states to fund programs aimed at curbing the opioid epidemic, and Vanderbilt will be a key collaborator for the state of Tennessee. We plan to engage with multiple organizations across the state to disseminate opioid-related education via QuizTime to any professional willing to participate,” said Matt McEvoy, MD, professor of Anesthesiology and principal investigator of the project.

In 2017, 1,776 Tennesseans died from drug overdoses, the highest annual number of such deaths since reporting began, according to TDH. Data show almost three-fourths of drug overdose deaths in Tennessee were associated with opioids. There were 1,268 overdose deaths associated with all opioids; of those, 644 were associated with prescription opioids for pain, which include drugs such as hydrocodone, oxycodone, morphine and codeine. Prescription opioids for pain were associated with more overdose deaths in 2017 than any other group of drugs.

Heroin was associated with the deaths of 311 Tennesseans in 2017, a 20 percent increase over the previous year. Fentanyl was associated with 500 deaths, a 70 percent increase since 2016.

Prescription opioids have contributed to the epidemic. Over 80 percent of heroin users report that their first exposure came from opioids prescribed to them or to a friend or family member.

QuizTime provides a practical learning paradigm for educators and learners. The QuizTime app sends a question once a day to clinicians by text or email. Once they submit their answers, they receive immediate feedback about the topic. Through this approach, learners gain access to relevant material at a time most convenient for them each day. Furthermore, the educational content can be distributed at a scale difficult to achieve through traditional face-to-face, classroom-based education. As an example, a recent QuizTime educational intervention at VUMC simultaneously reached almost 1,000 users.

“Creating long-term connections in learning is essential for persistence of the new knowledge beyond the initial learning phase, and a quiz-based approach assists by activating the power of retrieval in the learning process. Accessing knowledge or prior learning and retrieving it for use or testing strengthens the pathways to long-term memory,” said Geoffrey Fleming, MD, vice president for Continuous Professional Development, VUMC.

QuizTime supports just-in-time learning to thousands of users simultaneously via text messages or emails. Clinicians have access to relevant content via a smart adaptive learning platform, said Toufeeq Ahmed, PhD, executive director of Education Informatics and assistant professor of Biomedical Informatics and leader of the QuizTime development team.

“QuizTime is designed to scale to massive online courses that can have tens of thousands of learners in each course. Learning analytics and dashboards in QuizTime make it easy to measure learner engagement and learning outcomes,” he said.

To achieve this expansion, a large team is being assembled that will include VUMC faculty from the departments of anesthesiology, emergency medicine, obstetrics and gynecology, surgery, psychiatry, medicine, pediatrics and biomedical informatics.

“Emergency Department clinicians across Tennessee are faced with the terrible consequences of this opioid epidemic on nearly every shift. We are excited to partner with such an outstanding team of leaders from across VUMC, the Tennessee Department of Health, and our peer institutions on this life-saving initiative,” said Tyler Barrett, MD, medical director and associate professor of Emergency Medicine and co-investigator on the project.

“It is exciting to join with multiple specialists around Vanderbilt and Tennessee to bring up-to-date education on pain management to everyone who wants it, in a rapid, regional specific way. Taking advantage of technology to do this makes education accessible to busy medical providers,” added David Edwards, MD, chief of the Division of Pain Medicine and co-investigator on the project.

The OPIS S2 is a one-year project that began Sept. 1.

“We are grateful to Dr. David Reagan’s team from the Tennessee Department of Health for this exciting opportunity to demonstrate the power of effective educational approaches in refining the practice habits of busy clinicians,” said Bonnie Miller, MD, MMHC, Senior Associate Dean for Health Sciences Education, and Executive Vice President of Educational Affairs, VUMC, and senior adviser for the project. “We hope this ultimately leads to healthier lives for the people that we serve.”