Annals of Global Health 71

Expanding competency-based credentialing in Program/Project Purpose: Hillside Healthcare International

healthcare: A case for digital badges for global (HHCI) is a faith-based non-government organization (NGO) founded
health delivery in 2000. Primary care professionals provide basic healthcare to remote
residents of southern Belize. In 2012, a need for specialized derma-
A.C. Beals1, A. Kazberouk2, J. Rosenberg1, K. Wachter1, S. Choi2,
tology assistance was identified with a high volume of dermatologic
Z. Yan2, R. Weintraub1; 1Global Health Delivery Project at Harvard
cases and a paucity of dermatology specialists in-country. Given the
University, Boston, MA/US, 2Harvard Medical School, Boston, MA/US
shortage of dermatologists in low resource settings with large numbers
Program/Project Purpose: The World Health Organization esti- of cutaneous diseases, there has been an increased interest to address
mates there are 59 million health care workers worldwide. Many of these challenges through telemedicine. A long-term partnership with
them have non-clinical responsibilities as managers and policy-makers, the Medical College of Wisconsin (MCW) created a unique clinical
but lack opportunities to develop and showcase the necessary skills. and educational opportunity for dermatology faculty, trainees and the
Formal programs such as an MBA or MPH are often expensive and primary care physicians in Belize. This Abstract describes how our
inaccessible, while informal recognition is difficult to validate to po- collaboration launched a low-cost teledermatology program.
tential employers and donors. Taking inspiration from competency- Structure/Method/Design: Several factors are required for a low
based credentialing in education, architecture, and other industries, at cost, mutually beneficial academic/NGO teledermatology collaboration
the Global Health Delivery Project at Harvard University (GHD) we to be successful and useful. Shared objectives are essential in program
are developing badges for healthcare delivery. Through our digital development and co-ownership. The entire process must accommodate
badges, we hope to formally acknowledge the skills of health care the legal requirements, technological capabilities, administrative sup-
workers that are not always gained through traditional means and to port, and time requirements of each partner. A substantial clinical need
provide a professional development roadmap for healthcare workers. must first be recognized, with an interest from subspecialty consultation
Structure/Method/Design: GHD built and operates an open-access on the part of the academic institution. Management of the consulta-
platform, GHDonline, with more 14,000 professionals from 182 tions can be integrated into the dermatology residency curriculum,
countries learning, discussion and collaborating on key challenges in allowing continuity and information sharing over time.
global health delivery. We have worked to research, develop, and test Outcomes & Evaluation: Extramural funding was obtained to pur-
digital badges since early 2014. After an expert panel in 2013, our users chase essential start-up teledermatology equipment. Key tele-
discussioned key issues as managers in global health delivery. In dermatology program stakeholders at MCW included in-kind support
response we are developing badges in management, public health, and from dermatology faculty and residents, faculty leadership positions on
public policy. Participants will be able to receive a “basic” badge after an the HHCI board of directors, and legal counsel. Key teledermatology
online assessment and progress to “advanced” badges with additional stakeholders from HHCI were predominately leadership (medical and
assessments, coursework, and structured interviews. Badges will be NGO directors), and additional input was sought from HHCI staff.
made available for a range of healthcare providers including nurses, MCW created dermatology training modules for HHCI primary care
pharmacists and physicians. Initial testers and participants will be providers, including instructions on how to capture quality clinical
selected from members of GHDonline. With their feedback we will images on cameras provided by nominal extramural funding. A formal
iterate on the design and content. We are partnering with employers medical chart review helped to characterize and quantify dermatologic
and donors to ensure badges are valuable to recipients. We have disease presentation and develop an appropriate medication formulary
assessed existing online courses and resources and have been con- tailored to differential diagnoses of common endemic diseases. The
ducting focus groups and interviews with healthcare providers to test total cost was less than five thousand dollars.
badge components. We are currently prototyping a management and Going Forward: Lack of reliable internet connection and func-
public policy badge to launch in spring/summer of 2015. tioning computers is one of the largest barriers preventing store-and-
Outcomes & Evaluation: Healthcare providers have had positive forward teledermatology use. The inability to see three-dimensional
reactions to the concept of digital badging for health care delivery. imaging, ask additional follow-up questions, and perform skin bi-
There are many online resources related to the field of healthcare opsies creates challenges for the program. An additional challenge is
delivery available already that will be easier to navigate and be more the limited treatment options and diagnostic modalities available in
valuable with the introduction of a badging or recognition system. Belize. Each partner continues to offer their perspectives, edits, ad-
Going Forward: We need to broaden awareness of badges among ditions in each step of development, and implementation. Ensuring
employers and donors in order to make them an accepted credentialing the process has the time to develop organically, adapt with partner
mechanism for healthcare workers. Further work also requires evaluating suggestions, and strengthen as the process further develops, leads to a
the scalability of the badges, while taking into consideration the specifics well thought-out teledermatology program.
of each country. Ultimately, we aim to pave the way for broader adoption Funding: American Academy of Dermatology and Dr. Elaine
of competency-based credentialing and education in global health. Kohler Summer Academy of Global Health Research.
Funding: We have received support from the Venture Residency Abstract #: 01ITIS004
Program at the Harvard Innovation Lab and are seeking additional
funding, as well as opportunities for public-private partnerships.
Abstract #: 01ITIS003 Improving pneumococcal vaccination rates of medical
inpatients in Urban Nepal: A trial of quality improvement
processes
Developing a low cost, mutually beneficial
A. Bock1, K. Chintamaneni2, L.E. Rein1, T. Frazer1, G. Kayastha3,
teledermatology collaboration
T. MacKinney4; 1Medical College of Wisconsin, Wauwatosa, WI/US,
M. Bobbs1, T. Frazer2, S. Humphrey1, M. Bayer1, B. Wilson1, E. Olasz1, 2
Medical College of Wisconsin, Milwaukee, WI/US, 3Patan Hospital,
K. Holland1, K. Johnson1, J. Kuzminski1; 1Medical College of Wisconsin, Kathmandu, NP, 4Medical College of Wisconsin and Patan Academy of
Milwaukee, WI/US, 2Medical College of Wisconsin, Wauwatosa, WI/US Health Sciences/Patan Hospital (Nepal), Wauwatosa, WI/US