The DETAILS BLOG
Capturing Stories from the Field: Reflections, Challenges, & Best Practices in Clinical Outreach Education
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Director’s Letter: Mike Fischer, MD, MS  The opioid crisis has been recognized as a major national public health problem, but it actually reflects a collection of many thousands of local crises playing out in individual cities and counties. Each region faces a distinctive set of challenges, driven by economic and social factors, local medical practice patterns, political environment and pressures, and many other considerations. Identifying and implementing effective solutions to address the opioid crisis requires developing an understanding of how these individual challenges interact, and what strategies are most effective in specific situations--one of which is academic detailing.  The NaRCAD team is partnering with the CDC (Centers for Disease Control and Prevention) and NACCHO (the National Association of City and County Health Officials) on an exciting pilot program working with local health officials to develop customized interventions to reduce opioid overdose and death. Four sites experiencing significant public health problems related to opioids were selected: Boone County, Kentucky; Bell County, West Virginia; Manchester, New Hampshire; and Dayton, Ohio.  Public health officials at each site identified a wide range of local stakeholders to participate in developing a community action plan and recruited trainees to complete NaRCAD’s academic detailing training course, which we customized to address the unique challenges that each community faces. We also developed a specialized online toolkit for these sites, including discussion boards, local resources, and printable resources.  A trainee from Bell County, Kentucky, delivers a key message. We traveled to each site in March and April of this year, facilitating hands-on trainings in the techniques of academic detailing in alignment with the CDC prescribing guidelines. Trainees came from diverse backgrounds, including pharmacists, nurses, public health officials, and students in the health professions, including pharmacy students, dental students, and medical school students. Plans for implementing AD varied by site depending on the local health care environment; some sites focused more heavily on appropriate prescribing of opioids by clinicians, while others prioritized increasing referral rates for patients with opioid use disorder (OUD), including access to medication-assisted treatment (MAT).  Practicing a concise introduction in Manchester, New Hampshire. As the AD trainees at each pilot site continue their work in the field, we’ll learn more about how these diverse strategies succeed, and how we can support adaptations to make academic detailing more impactful. This important collaboration has allowed us to form invaluable partnerships with CDC and NACCHO, leveraging national resources to improve local responses to this epidemic through plans that respond more precisely to local needs and priorities. We’re excited for this pilot program to serve as a model for future opioid safety AD interventions, and we’ll be providing updates here on the blog. In the meantime, tell us: what's happening in your local community around the opioid crisis? Sound off in the comments section below, and let us know if you think clinician-facing education could be a strategy that would improve outcomes for your community. And join us for our next training and our terrific annual conference to learn more about this and other exciting AD projects. -Mike  Biography.
Michael Fischer, MD, MS | Director of NaRCAD Dr. Fischer is a general internist, pharmacoepidemiologist, and health services researcher. He is an Associate Professor of Medicine at Harvard and a clinically active primary care physician and educator at Brigham & Women’s Hospital. With extensive experience in designing and evaluating interventions to improve medication use, he has published numerous studies demonstrating potential gains from improved prescribing. Read more.
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 Mike Fischer, MD, MS, NaRCAD Director Fall is the season for conferences, and the most exciting one for us is #NaRCAD2017: Combatting Threats to Optimal Care! This year’s conference is a great chance for everyone interested in AD to learn more, whether you’re part of a long-standing program or just beginning to learn about the versatility and effectiveness of implementing this strategy to improve health outcomes. Our agenda is up, so take a peek, and register if you haven’t yet!  The keynote presentations will provide critical insights for creating and sustaining AD programs in different settings. Dr. Zoe Edelstein will kick off Day 1’s programming, representing the New York Department of Health and Mental Hygiene. This keynote will teach us about their public health detailing intervention to increase use of HIV pre-exposure prophylaxis (PrEP). The New York program was originally founded in 2002, so Dr. Edelstein’s presentation will help anyone from a public health background understand how to both develop and sustain AD, and to adapt it for new and pressing health challenges.  Dr. Carol Havens from Kaiser Permanente will provide a detailed overview of the longest-running AD program in the US, a program that was developed with input from Jerry Avorn soon after the original AD studies were published. We look forward to being inspired by lessons learned from a leading integrated health care system’s ongoing commitment to improving the quality of care around opioid safety with clinical outreach education. The rest of our conference agenda draws almost entirely from proposals submitted by members of our NaRCAD network – we received twice as many proposals this year! We’re looking forward to our “Field Presentations” sessions, featuring empiric results from detailers on the ground; expert panelists from the CDC, state departments of public health, and clinical care sharing important impressions on clinician stigma on the critical issues of HIV prevention and opioid safety; and breakout sessions covering many of the practical issues and challenges that detailers face when bringing best evidence to clinicians. Of course, for many of us, the highlight of each conference is the annual update from Jerry Avorn on the state of AD--see his recent blog piece, “Who Do You Trust?” for a preview of what’s to come!  The NaRCAD team is excited by the knowledge that integral opportunities, connections, and partnerships will be created at our unique 2-day event. But as excited as our team and our extended community may be about the conference, it’s not the only terrific development underway at NaRCAD this fall. We’ve continued to provide training and support for groups from around the country and the globe, with 2 trainings in the techniques of AD this past September, and more planned this fall and winter! Keep your eyes on our Training Series page for the official announcement of our Spring 2018 AD techniques training, and contact us at any time about opportunities and resources to support your AD program. See you soon, -Mike Biography. Michael Fischer, MD, MS, NaRCAD Director
Dr. Fischer is a general internist, pharmacoepidemiologist, and health services researcher. He is an Associate Professor of Medicine at Harvard and a clinically active primary care physician and educator at Brigham & Women’s Hospital. With extensive experience in designing and evaluating interventions to improve medication use, he has published numerous studies demonstrating potential gains from improved prescribing. Read more. Director's Letter: Summer 2017 | Mike Fischer, MD, MS, NaRCAD Director Academic detailing is naturally versatile, growing from the initial studies focused on prescribing decisions to include interventions to improve childhood screening, assessment of cardiovascular risk, smoking cessation treatment, and many other important clinical topics.  Whenever medical care and patient outcomes can be improved by outreach education to frontline clinicians, there’s an opportunity for AD to make a crucial difference. We’ve seen our partner organizations use AD in novel and exciting ways, making adaptations to fit their specific interventions and to combat diverse challenges. Healthcare is in a period of ongoing, rapid change—and continued innovation in clinical outreach education is critical in improving the quality of patient care. But for new ideas to have an impact, they need to be evaluated and communicated to the larger community. Tell us more about what you’re working on—we’ll connect you with others addressing the same clinical topic, or working with a similar geography or population, and we’ll share your experiences and results via our best practices blog, website, newsletter, and social media platform. Along with trainings and networking opportunities, NaRCAD provides targeted consultation and technical assistance to improve your successes in the field. We also participate in collaborations with programs as part of multifactorial interventions and research studies.
If so, drop us an e-mail, give us a call, or write a note in the comments section below--we’ll be in touch to figure out next steps, whether that involves submitting a proposal together, figuring out a customized training, or connecting you with experts that can support your project.  Whether you’re looking to strengthen your team, meet thought leaders in the field, or tell us more about your work in person, we hope you’ll join us at our Fall Training in September, and our annual International Conference on AD this November--registration is open for both, and we look forward to seeing you soon! -Mike Biography. Michael Fischer, MD, MS, NaRCAD Director
Dr. Fischer is a general internist, pharmacoepidemiologist, and health services researcher. He is an Associate Professor of Medicine at Harvard and a clinically active primary care physician and educator at Brigham & Women’s Hospital. With extensive experience in designing and evaluating interventions to improve medication use, he has published numerous studies demonstrating potential gains from improved prescribing. Read more.  Director's Letter | Mike Fischer, MD, MS The entire health care system is grappling with uncertainty. What will happen to the provisions of the Affordable Care Act? Will clinicians and health systems face major changes in how they are expected to provide care and how they are reimbursed? Will state and local public health agencies have support for the many initiatives undertaken in recent years? As we wait for answers to these questions, the role of academic detailing is more important than ever. AD programs will face new challenges, and will need to understand how AD can be adapted to fit changing constraints and still have a beneficial impact on clinician engagement, the quality of care, and patient outcomes. At NaRCAD, we look at this unpredictable environment and see a mandate to collaborate and innovate, working with our partners to develop and evaluate novel ways to implement AD.  At NaRCAD, we look at this unpredictable environment and see a mandate to collaborate and innovate. Planning for NaRCAD2017, our annual conference, is well underway, and the call for proposals is open. Submit results of your current work or your ideas for panels and breakout sessions that will let you share your work and inspire colleagues.  To keep AD growing and thriving requires an active pipeline of newly trained detailers, which we have just added to with our recent AD Techniques Training on March 30 & 31, 2017. This spring’s training class came to Boston to learn the techniques of academic detailing in order to support important interventions, including better use of smoking cessation treatment for patients with serious mental illness, increasing HPV vaccination rates, enhanced safety of opioid prescribing, and improving the care of chronic diseases such as COPD, HIV/AIDS, diabetes, heart failure, and kidney disease. Our trainees hailed from Canada, Brazil, and around the U.S., including South Carolina, Rhode Island, Idaho, Massachusetts, Oregon, Texas, Kentucky, Connecticut, and Colorado, bringing their unique experiences and backgrounds to 2 days filled with hands-on learning opportunities. Stay tuned for upcoming details about our Fall 2017 training, to be held this September--dates announced soon! What continues to motivate us during times of uncertainty is working with the NaRCAD community, and we want 2017 to continue to be a year of even deeper engagement. Submit to the 2017 conference, share your ideas, suggestions, and comments on our blog, or reach out to us directly. We’re excited to continue to support your work and to build new collaborations--tell us what you need as part of our community of clinical outreach educators. -Mike Biography. Michael Fischer, MD, MS, NaRCAD Director
Dr. Fischer is a general internist, pharmacoepidemiologist, and health services researcher. He is an Associate Professor of Medicine at Harvard and a clinically active primary care physician and educator at Brigham & Women’s Hospital. With extensive experience in designing and evaluating interventions to improve medication use, he has published numerous studies demonstrating potential gains from improved prescribing. Read more. Mike Fischer, MD, MS, Director of NaRCAD | January 2017 Director's Letter Growth. Support. Engagement. These words characterized 2016 for NaRCAD, and have us planning for an exciting 2017. In 2016, we had our most successful and impactful year to date. Our community has grown to over 1000 national and international supporters of clinical outreach education.  At #NaRCAD2016, our 4th annual conference on academic detailing, the agenda reflected what’s happening in the field, composed largely of ideas and presentations submitted by you, the members of our network. Keep your eyes open for our Call for Presentations on our NaRCAD Conference Series page— #NaRCAD2017 will be held here in Boston on November 6th & 7th, 2017 and applications for presentations will be accepted starting March 1st. After this past year’s success, we’re even more committed to providing customized support to individuals, groups, and large organizations working on clinical outreach education.  In addition to our core training sessions in Boston (our next session is March 30th & 31st), we’re continuing to offer on-site topic-specific trainings, customized workshops, and special educational sessions on the principles and practice of AD. In addition to providing direct support, we’ve been excited to successfully connect people and programs with each other, allowing for the exchange of ideas and best practices among both national and international experts. We’re proud of our ability to meet our partners where they are, whether they’re starting, expanding, or adapting AD interventions, and this year, we’re looking forward to supporting and improving your work.  We started this process by sending you our first annual community survey in December, and we thank our many members who responded. (You can still weigh in if you have thoughts, although our raffle is over!) We’ve listened to your insightful suggestions, and we’re already taking action to support your needs. This year, we’ll be launching the new COrE (Clinical Outreach Education) Series, exploring AD program development, specific clinical content, and other topics you’ve suggested. Featuring AD experts, the NaRCAD team, and using both interview and live webinar formats, the COrE Series is a great opportunity for advanced learning, support, and collaboration. Stay tuned for more information! We’ll also be increasing engagement opportunities via our Partner Network; we’ll be reaching out individually to learn more about your current work, and we’ll offer an interactive site where you can make your own partner connections with experts working on similar topics. As we grow even more in the coming year, your ideas and reflections remain invaluable. You don’t have to wait for us to contact you! We invite you to be in touch with our team and tell us more about your program—what challenges you’ve faced, what successes you’ve experienced, best practices you’d like to share, programs you’d like to know more about, and the resources you need to help you succeed. -Mike  Biography. Michael Fischer, MD, MS, NaRCAD Director
Dr. Fischer is a general internist, pharmacoepidemiologist, and health services researcher. He is an Associate Professor of Medicine at Harvard and a clinically active primary care physician and educator at Brigham & Women’s Hospital. With extensive experience in designing and evaluating interventions to improve medication use, he has published numerous studies demonstrating potential gains from improved prescribing. Read more. Director’s Letter: Fall 2016 | Mike Fischer, MD, MS, Director of NaRCAD When the leaves start to turn here in Boston, we know it’s almost time for NaRCAD’s International Conference on Academic Detailing. This year’s 4th annual conference features several new and exciting sessions we’re excited to share with our community. #NaRCAD2016 highlights the work of innovators in academic detailing from many locations and organizations, ranging from large national health systems to small independent programs.  Diverse clinical topics will be featured at our interactive sessions, including pediatric developmental screening, smoking cessation in patients with serious mental illness, opioid misuse and overuse, screening for ADHD, and many others. Breakout sessions offer attendees a chance to work closely with leaders in the field, featuring in-depth and hands-on exploration of specific elements of academic detailing. Whether your focus is on training detailers, preparing clinical topic materials, or program evaluation, our dynamic breakout sessions offer a chance to network and acquire new skills.  Our conference is our largest event of the year, but our team has been busy this fall with other activities. At our Boston-based training in September we welcomed trainees from organizations across the country, all of whom concentrated on learning the techniques of academic detailing. We also spent two days this fall in San Francisco, working with the city’s Department of Public Health on an intervention to increase the use of pre-exposure prophylaxis (PrEP) for patients at risk of contracting HIV. We’re excited to continue supporting our partners at the SFDPH as they move forward on this important initiative.  Come join us at #NaRCAD2016! There’s only a month left to register, and space is limited. Check out our conference hub archival page to see what previous events were like, including on-demand video and program highlights. We’re excited that clinical outreach education has been such an effective strategy to address the pressing problems facing patients, clinicians, and health systems. This year, we know that the opportunity to learn, share ideas, and connect with experts will continue to ignite inspiration for our community’s important work in improving quality of care and patient outcomes in 2017 and beyond.  Biography.
Michael Fischer, MD, MS | Director, NaRCAD Dr. Fischer is a general internist, pharmacoepidemiologist, and health services researcher. He is an Associate Professor of Medicine at Harvard and a clinically active primary care physician and educator at Brigham & Women’s Hospital. With extensive experience in designing and evaluating interventions to improve medication use, he has published numerous studies demonstrating potential gains from improved prescribing. Read more. Director's Letter, Summer 2016 Mike Fischer, MD, MS, NaRCAD Director Summer is in full swing, but we’re already looking ahead to #NaRCAD2016, our 4th International Conference on Academic Detailing, which we’ll host this fall on November 14th & 15th in Boston. We received a wonderful response to our first-ever call for proposals, with submissions from across the country and around the world, making the 2016 conference our most exciting and community-informed meeting yet. Our team was inspired by the innovative and diverse proposals we received. Following in the footsteps of previous conference series programming, this year’s applications demonstrated a dedication to improving the quality of care and patient outcomes. #NaRCAD2016 applicants showcased success across a broad spectrum of AD interventions: in outpatient and inpatient settings, in public and private systems, and for a wide range of clinical topics. We’re thankful to all who applied for #NaRCAD2016, and we encourage those who are just beginning to roll out an intervention to consider applying for next year’s conference. Along with presentations from our selected applicants, this year’s program will include carefully designed content from leaders in the field, interactive learning sessions, and networking opportunities, including an evening reception. This year will be your chance to learn about cutting edge interventions being implemented across the globe, to share your unique perspective and experiences, and to collaborate with a thriving community of clinical outreach education colleagues. In that spirit of collaboration, we’re always eager to hear from you, the members of our learning network. We can support your AD programming with expert techniques training, materials development, evaluation, or by highlighting your work. We’re also dedicated to personally connecting our network members to one another, working to amplify our community’s knowledge, tools, and impact. Take a minute to tell us what resources you need, to explore our Learning Center, or to join the conversation—either virtually, or in Boston in November.
We’ll see you at #NaRCAD2016—registration is now open, and space is limited! If you have questions, let our team know. -Mike  Director's Letter | Mike Fischer, MD, MS NaRCAD has jumped right into action in 2016! We’ve been getting out of Boston, working with colleagues across the country in a range of settings. As we’ve partnered with state and local public health agencies, long-term care providers, primary-care networks, and other organizations, we’ve seen how the principles of AD can be adapted to fit the needs of different clinicians and patients. The work of our colleagues teaches us how we can best support clinical outreach education, raise its visibility, and improve health outcomes together.
We want to hear how all of you are tackling these challenges, and we hope you’ll share your successes with us. We’re featuring best practices on our blog and connecting partner organizations, and we know that in-person connection at our annual conference is a highlight for many in our field. As we begin preparing for the 4th International Conference on Academic Detailing, we’re inviting you to submit your work for presentation at NaRCAD 2016. We hope you’ll take advantage of this opportunity to share your successes and challenges—the deadline is approaching fast, so get those submissions in, and feel free to contact the NaRCAD team with any questions about the process. And Save the Date for November 14th & 15th here in Boston—we’d love you to join us at the conference to exchange ideas and strategies with colleagues from across the country and around the world. At NaRCAD, we’re always expanding the range of services we provide, including our core training series on the techniques of AD, specialized workshops and seminars, and consultation on materials development for AD interventions. Let us know what we can do to strengthen your program and highlight your program successes this year.
Director's Letter We’ve just celebrated the 5th anniversary of NaRCAD, the only national resource center and network advancing clinical outreach education. We’re also celebrating a terrifically successful 2015. Highlights included running two sold-out academic detailing techniques trainings here in Boston; traveling to San Francisco and Oklahoma City for two customized off-site trainings; and bringing everyone together for #NaRCAD2015: Motivating Change, Transforming Care, our most successful annual conference so far.
We’re proud of it all, and more, including the brand-new NaRCAD Website—enjoy and explore a new gateway to academic detailing, including more interactive resources and expanded opportunities for connection, learning, and sharing. With so much to celebrate from 2015, we’re setting the bar high with big goals for the year ahead. Here’s what we’ll be up to in 2016, with you as our partners: Transformative Trainings: Registration for our May training in Boston is open and already filling up fast! We’re also happy to be in high demand for at least 5 “on-the-road” educational sessions and related projects across the US this year. If you want to learn more about the ways we can share our resources and expertise to help your clinical outreach education program grow and succeed, let us know—we’d love to learn about what you’re doing and see how we can help. #NaRCAD2016: Collaborating to Create Change. Our annual conference is the capstone of the year, so mark your calendars for November 14-15, 2016. What’s new this year? #NaRCAD2016 will feature opportunities to submit a proposal to showcase your clinical outreach education experience, data, and insights with the rest of the NaRCAD community. Keep your eyes on your e-mail and our conference page for more details about submission, coming soon. More Collaboration for Improved Health Outcomes: With 5 years of partnerships under our belt, we’re continuing to connect every day with new colleagues working in the field of AD and clinical outreach education. We’re excited to keep expanding our community and creating opportunities for deeper collaboration across programs. We invite you to stay connected as we continue to publish new blogs and interviews, feature partners on our network directory, expand our Learning Center offerings, and recommend evidence-based health news and events on our social media feeds. Most of all, our team wants to hear from you! Drop us a note to tell us what you’re doing, and tell us how we can help strengthen your program and highlight your successes. See you this year! Dr. Mike Fischer  Mike Fischer, MD, MS, NaRCAD Director
NaRCAD is thriving, thanks to the engagement and enthusiasm of our network of healthcare professionals working to improve patient outcomes. The best way to become more involved in that network is to join us for our 3rd International Conference on Academic Detailing. This year’s conference will be our most exciting and interactive event to date, with a stimulating 2-day program bringing together thought leaders for expert panels, best practices, breakout tracks, networking, and invigorating group discussions on innovations in the field. Our keynote presentations will provide critical insights for everyone working to improve healthcare quality and patient outcomes. On Monday, Nov. 9th, Dr. Carolyn Clancy, Chief Medical Officer of the Veterans Health Administration, will highlight the VA’s use of academic detailing to address the epidemic of opioid overdose and misuse to save veteran’s lives. On Tuesday, Nov. 10th, Dr. Don Goldmann, Chief Medical and Scientific Officer at the Institute for Healthcare Improvement, will provide his insights on how to engage front-line clinicians in committing to change – drawing on IHI’s years of experience in promoting patient safety. Many questions about academic detailing still need to be explored, new ideas generated, and connections made. We need to foster solution-based discussion from a wide range of voices, representing clinical education, public health, practice transformation, government, the non-profit sector, hospital networks, academic institutions, and others. But the most important ingredient for the success of this event is you. Join us as we work together to discover solutions, connect you with others that can amplify your impact and elevate your work, and share your experiences and insights on the best ways to navigate a rapidly-changing healthcare landscape. We hope you’ll join us this November 9th and 10th, and that you’ll help us spread the news about this unique, transformative event. See you in November! |
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