ORIENTATION BOOKLET | 2 ECHO MHSU at IHA

ECHO Mental Health & Substance Use

Orientation Booklet

LE OF

CON

TENTS

ORIENTATION BOOKLET | 3 ECHO MHSU at IHA

Table of Contents Sponsorship ........................................................................................................................ 4

What is Project ECHO? ....................................................................................................... 4

Project ECHO in Canada ..................................................................................................... 4

Goals of the MHSU ECHO Program ................................................................................... 5

Benefits for Interior Health Providers ................................................................................ 5

Core Principle of Project ECHO ......................................................................................... 5

How Our Typical ECHO Session is Structured .................................................................. 6

Mental Health & Substance Use ECHO Curriculum Outline ............................................ 6

Evaluation Process ............................................................................................................. 6

What cases should I present? ............................................................................................ 7

What information should be included in a case presentation? ....................................... 7

How to present a case ......................................................................................................... 7

How do I sign up for the program? .................................................................................... 8

How do I get Zoom? ............................................................................................................ 8

Basics of the ECHO Session .............................................................................................. 8

Connecting to the ECHO Session:..................................................................................... 9

Participating in the Sessions: ............................................................................................ 9

Your Zoom View: ............................................................................................................... 10

Example of Typical Case Presentation Facilitation ........................................................ 11

Expectations of Spoke Participants ................................................................................ 11

How can I receive technical support?.............................................................................. 12

Videoconferencing Etiquette ............................................................................................ 13

ORIENTATION BOOKLET | 4 ECHO MHSU at IHA

OVERVIEW OF THE HPV VACCINATION ECHO CURRICULUM OVERVIEW OF THE MHSU ECHO CURRICULUM

Sponsorship

‣ The Mental Health & Substance Use ECHO program is presented and funded by a partnership between the Canadian Red Cross and Interior Health Authority

‣ Participation is free. All primary care providers interested in learning how to better manage patients with mental health & substance use disorders in their practices are invited to participate.

What is Project ECHO?

‣ Project ECHO® (Extension for Community Healthcare Outcomes) helps democratize medical knowledge and develops specialty care capacity in underserved communities.

‣ Using a model of tele-mentoring, collaborative medical education and care management, Project ECHO® empowers front-line primary care professionals to provide the right care, in the right place, at the right time.

‣ Launched in 2003, Project ECHO® grew out of one doctor’s vision. Sanjeev Arora, M.D., a social innovator and liver disease specialist at the University of New Mexico Health Sciences Center in Albuquerque, was frustrated that he could serve only fraction of the HCV patients in his state who needed treatment. He wanted to serve as many patients with HCV as possible, so he created a free, virtual clinic and mentored community providers across New Mexico in how to treat the condition.

‣ Today, dozens of teleECHO clinics addressing much more than HCV take place every week—and their reach extends far beyond New Mexico. Project ECHO® currently

has over 308 hub sites globally, operating in 35 countries for over 40 distinct common complex conditions.

For more information, please visit: https://echo.unm.edu/

Project ECHO in Canada

‣ ECHO Ontario Mental Health was established in 2013 by the Center for Addiction and Mental Health (CAMH) and the University of Toronto. ECHO in Ontario offers 26 ECHO programs across 9 organizations. 8 of the 26 programs focus on Mental Health & Addictions and over 140 sessions are offered annually. To date, about 1,856 healthcare providers have been reached.

‣ For more information, please: https://www.echoontario.ca/

ORIENTATION BOOKLET | 5 ECHO MHSU at IHA

Goals of the MHSU ECHO Program

Participants will be able to:

‣ Increase access to evidence-based practices to manage patients with mental health & substance use disorders in their practices.

‣ Join a learning community (network) to enhance capacity in managing mental health & substance use disorders and to decrease professional isolation.

Benefits for Interior Health Providers

‣ No cost Continuing Professional Development (CPD)

‣ 6.0 MOC Section 1 Group Learning credits / 6.0 Mainpro+ Group Learning credits. Each physician should claim only those credits accrued through participation in the activity.

‣ Professional interactions with colleagues with similar interest (“learning community”)

‣ Mix of work and learning

‣ Access to specialists

‣ Increased confidence about the subject

‣ Able to treat their patients at a higher level

Core Principle of Project ECHO

The ECHO model develops knowledge and capacity among healthcare providers through on going tele-mentoring and education. Core principles are:

‣ Use technology to leverage scarce resources (i.e., content experts);

‣ Share “best practices” to reduce disparities;

‣ Use case-based learning to master complexity; and

‣ Evaluate participation and learning outcomes

ORIENTATION BOOKLET | 6 ECHO MHSU at IHA

How Our Typical ECHO Session is Structured

‣ ECHO sessions take place via videoconference, using a PC, Mac, or smart device and simple cloud-based software called Zoom. Zoom is available at no cost to participants.

‣ The “Hub” includes experts in mental health & substance use, and may include partners from other organizations

‣ Each session will begin with introductions of all participants. Each session will include a short (10-20 minute) didactic presentation followed by cases presentation to be

discussed by the entire group. All participants are encouraged to contribute actively to case discussions.

‣ Sessions will last one-hour and a half and will begin promptly at 3:30 pm PST.

Mental Health & Substance Use ECHO Curriculum Outline

‣ Please refer to the Interior Health Project ECHO website for the curriculum

Evaluation Process

‣ It is critically important for us to evaluate the effectiveness of our curriculum. Therefore, we ask ECHO participants to complete brief CME / Satisfaction Survey after each session.

‣ Participants will also be asked to complete Pre and Post Questionnaires, and possibly a brief interview or focus group at the end of the program.

ORIENTATION BOOKLET | 7 ECHO MHSU at IHA

CASE PRESENTATIONS CASE PRESENTATIONS

What cases should I present?

‣ Participants will be asked to select a date at registration time for case presentation. However, this does not guarantee your case will be presented as the hub can only discuss one or two cases at each session.

What information should be included in a case presentation?

‣ Case presentation form: Available on the website under “Participant Resources”

‣ It is critical to preserve patient confidentiality during the case presentations as much as possible. Freedom of Information and Protection of Privacy Act (FIPPA) must be adhered to at all times. Refrain from using:

• name, address or telephone number;

• Personal Health Number (PHN), identification number, symbol or other particular assigned to them;

‣ Due to the nature of the sessions, other FIPPA identifiers may be discussed in order to understand the patient case. These may include age, sex, sexual orientation, marital status, race, national or ethnic origin, color, or religious beliefs or associations; information about educational, financial, criminal or employment history; etc. We ask that if an individual is identifiable, that the participants do not discuss the case outside of the session.

‣ Special attention should be paid when providing details in patient’s social history. This is especially important if the patient is from a small community. When possible, use as little information as possible and do not discuss the case outside of the ECHO sessions.

‣ Complete the case presentation form with as much information as you can to help the subject matter expert/speaker address your concern/question(s).

How to present a case

‣ Email the case presentation form to echo@interiorhealth.ca the Monday before the session.

‣ During the ECHO session, the session facilitator will call on you to present your case. Please verbally summarize the case in two minutes or less.

‣ The facilitator will promote discussion among all participants, starting with clarifying questions regarding the case.

ORIENTATION BOOKLET | 8 ECHO MHSU at IHA

LOGISTICS LOGISTICS

How do I sign up for the program?

‣ If you haven’t already done so, please complete the ECHO Registration Form available the website: https://www.interiorhealth.ca/sites/Partners/ProjectECHO

‣ The registration form includes a Statement of Collaboration (an agreement for): • Patient Relationship Disclaimer • Commitment to Collaboration • De-identified Information Notice and Confidentiality • Participation Notice • Recording, Photographs and Guests

How do I get Zoom?

Individual Sign-In:

‣ You may download the free version of the Zoom client for PC or Mac by visiting https://zoom.us/download and click the blue “sign up, it’s free” button for instructions. If your computer doesn’t have a built-in video camera and microphone, a simple USB webcam is all you need. Zoom apps are also available for iOS and Android.

‣ There will be a ‘Zoom test’ available to all participants prior to program start.

Group Sign-In:

‣ If you are joining from a practice with a large team, you can join a Zoom meeting using any hardware-based videoconferencing equipment. Please contact us if you have any concerns with connecting from videoconferencing setups.

To avoid delays and other technical issues on the day of the session, we will be reaching out to your lead contact prior to the first ECHO session to confirm that they were able to upload the Zoom software. A “Zoom test” will be scheduled with your lead.

Basics of the ECHO Session

‣ Sessions will take place from 3:30 – 5:00 PM PST every other Wednesday

‣ Once you register, you will receive a calendar placeholder for all the sessions.

‣ On the day of or one day prior to the session, you will receive an email with session materials. The email will contain:

• A unique sign-in information for each session

• Agenda

ORIENTATION BOOKLET | 9 ECHO MHSU at IHA

• Didactic presentation materials

‣ To sign in to the Zoom session, use the unique link for each session in the weekly invitation, this link is also available on ECHO Extranet Site (you will receive access to the password-protected ECHO after the first session)

‣ If you plan to present a patient case, please email the case presentation form by Monday on the week of the presentation at the latest

‣ Please join in using Zoom. If you do not have access to the internet, connection by telephone is possible. Please connect prior to 3:30 pm PST.

Connecting to the ECHO Session:

‣ Once you connect to the session please mute yourself when not speaking. The mute button is a small icon on the left hand side of the Zoom screen that looks like a microphone. When you are called on to participate please click the mute button again to unmute yourself. This will reduce background noise and improve the sound quality of the sessions.

‣ Once you sign on to the Zoom session please type the full name of each participant joining the session from your site in the chat box. This will ensure that attendance is accurately reflected, which is a requirement for collecting CME credits, and will also support our reporting requirements for the Canadian Red Cross.

• If any new participants will be joining from your site, notify us at echo@interiorhealth.ca so that they can be added to the participant list for CME credits and for our tracking purposes.

‣ After the session has completed please complete the weekly evaluation. Again, this is another requirement in order to receive CME credits for the sessions that you have attended. All weekly evaluations are found on the Community of Practice website.

Participating in the Sessions:

ECHO sessions are built to be interactive and we encourage your participation. To Contribute Verbally:

• “Raise your hand” Raise your actual hand so that the facilitator/hub can see you Or at the bottom of the Zoom screen you will see a “Participants” box, when you click

this box a pop up screen will appear. At the bottom of the pop-up box there is a “raise hand” button for you to click.

• Once you have raised your hand (electronic or actual) the facilitator will call on you to contribute to the conversation.

• When the facilitator calls on you please introduce yourself with your full name, organization and role, e.g. “John Smith, family physician from Williams Lake” so that all participants can begin to recognize one another.

To Contribute via Chat:

ORIENTATION BOOKLET | 10 ECHO MHSU at IHA

• Ensure that your Zoom username is your name or the name of the organization. • Write your question or comment in the chat. • To change Zoom username: click the “Participants” tab at the bottom of the Zoom screen,

on the participants pop-up in the bottom left hand corner click “Rename” and rename yourself to either your name if you are participating alone, or the organization name if you are being joined by multiple participants at your site.

*If you experience any issues during the session, technological or otherwise, please privately message the Session Moderator, in the chat box or text 250-808-0364 or send an email to petra.bader@interiorhealth.ca.

Your Zoom View:

‣ In our sessions, you will mostly use the following functions: mute, video, participant and chat.

To mute and unmute yourself

Please keep your video on

during sessions

Click here to rename yourself or raise an “electronic

hand”

To send a private or group message. If the icon is

flashing, it means there is a message for you.

ORIENTATION BOOKLET | 11 ECHO MHSU at IHA

Example of Typical Case Presentation Facilitation

1. Hub facilitators introduces the presenter i. “Dr. Smith, you have a case today, please present your case”

2. Presenter summarizes the case i. Patient cases are usually presented based on case presentation form; all fields should

only include information relevant to the discussion, and should be anonymous. ii. Primary care provider (PCP) provides summary of anonymous case to the group iii. PCP describes the current state of the patient iv. PCP describes the areas that you would like assistance in managing and treating

3. Hub facilitator summarizes the presentation and confirms with the presenter that the presentation summary is accurate

4. Hub facilitator asks the spoke community of practice for questions

i. Questions will start with video participants ii. Next we will ask for questions from telephone participants iii. Finally, the Hub team will be asked for questions

5. Hub facilitators asks audience for recommendations and impressions in this order:

i. Video participants ii. Telephone participants iii. Hub team

The Hub facilitator summarizes recommendations and consensus on treatment plan

Expectations of Spoke Participants

Interior Health’s ECHO MHSU strives to support a collegial, supportive, and respectful environment. The following are pillars to ensure a supportive environment that should be followed by all Hub and Spoke participants. Etiquette Spoke participants are expected to practice good videoconferencing etiquette, a full description of videoconferencing etiquette is found below. Nurturing Participants are expected to support and encourage fellow primary care providers, fostering a learning environment. Nudging Participants are expected to use gentle nudges to help participants discover and learn more about the assessment and management of mental health disorders and addictions. Presenting Cases All spokes are expected to offer one case presentation per series. Our team might conduct follow-up discussions after case presentations to get feedback about presenter’s experience. Evaluate All spoke participants are expected to complete an online survey which will help us evaluate each weekly session after the completion of the case presentation.

ORIENTATION BOOKLET | 12 ECHO MHSU at IHA

CONTACT INFORMATION

How can I receive technical support?

‣ For question about Zoom, including testing your site connection, please contact echo@interiorhealth.ca

‣ For questions about your equipment and hardware, please contact IH Service Desk at 1-855-242-1300

CONTACT INFORMATION

‣ Please direct any questions/concerns to:

Petra Bader, Project ECHO Lead at petra.bader@interiorhealth.ca

‣ For urgent issues, call or text 250-808-0364

ORIENTATION BOOKLET | 13 ECHO MHSU at IHA

Videoconferencing Etiquette

Always… Always test the equipment well before the videoconference.

Always mute your audio when joining a Zoom session.

Always announce ground rules to new participants at your site.

Always open the video links a few minutes before you start.

Always eliminate environmental distractions.

Always limit body movement and broad gestures. They can be very distracting.

Always remind all new participants about confidentiality.

Always sign in by writing the full name of all the participants at your site in the Zoom chatbox.

Always have every attendee introduce themselves (name and role in the organization).

Always identify participants over chat if they sign in late.

Always make eye contact with the camera when you are speaking.

Always speak clearly and in a conversational tone.

Always be encouraging.

Sometimes… Sometimes use gentle redirection when someone dominates time or is critical or

confrontational to a colleague.

Sometimes remind people about the risk of inadvertent disclosure of protected health

information.

Never… Never disclose protected health information.

Never criticize a person’s ideas, even when they are wrong.

Never use sarcasm or ironic humor. It doesn’t translate well.

Never diminish a person or criticize a past decision.

Never engage in side conversations.

Never make extraneous noise.

Never talk over other people. If someone is speaking, let them finish, or signal your wish to

talk.