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AMIA 10x10 Partner Programs

AMIA 10x10 at OHSU in Partnership with the Society of Technology in Anesthesia

About the Society of Technology in Anesthesia

The Society for Technology in Anesthesia (STA) is an international organization of physicians, engineers, students and others with an interest in anesthesia-related technologies. Membership is open to all who are interested. The journal, Anesthesia & Analgesia is STA's official publication. A quarterly newsletter, Interface, is published and available online. The Society's mission is to improve the quality of patient care by improving technology and its application. The Society promotes education and research, collaborates with local, national, and international organizations, sponsors meetings and exhibitions, awards grants, and recognizes achievement.

Special Offering for the Society of Technology in Anesthesia

This offering is tailored to STA members. Although open to anyone, it culminates in an in-person session at Society for Technology in Anesthesiology Meeting to be held in San Diego, CA, January 19, 2008, 1-7 pm.

Course Description

Objectives

The 10x10 program was started when former American Medical Informatics Association (AMIA) President Dr. Charles Safran asserted that the United States needs one physician and one nurse trained in medical informatics in every hospital in the country. Dr. William Hersh of Oregon Health & Science University (OHSU) operationalized this definition by working with AMIA to launch the 10x10 program that aims to train 10,000 health care and related professionals in medical informatics by the year 2010. The 10x10 program aims to provide introductory training to build the workforce that will enable information technology to improve the quality, safety, and cost-effectiveness of health care. Since the program was launched in 2005, over 300 people have enrolled the course, with most completing it and many going to advanced study in the field.

The goal of the AMIA-OHSU 10x10 course is to provide a detailed overview of informatics to those who will work at the interface of health care and information technology. It also aims to provide an entry point for those wishing further study (and career development) in the field.

Course Logistics

The course is offered in two parts: an 11-unit Web-based component followed by an intensive one-day in-person session held in conjunction with the Society for Technology in Anesthesiology Meeting (San Diego, CA; January 19, 2008, 1-7 pm). The Web-based portion is provided through readings, lectures, interactive discussion, and self-assessment tests. The in-person session will bring attendees together to integrate the material, allow presentation of course projects, and meet leaders in the field as well as other students.

The registration deadline for the course is October 17, 2007. We will accept enrollees after that date on a space-available basis.

The course is an adaptation of the on-line Introduction to Biomedical Informatics class currently taught in the OHSU biomedical informatics education program. This survey course provides a broad overview of the field, highlighting the key issues and challenges for the field. The course is taught in a completely asynchronous manner, i.e., there are no "scheduled" classes. However, students must keep up with the course materials so they can benefit from the interactive discussion with faculty and other students. The course uses the following teaching modalities:

  • Voice-over-Powerpoint lectures - The key material is delivered using the Flash plug-in, which is freely available and already installed in almost all Web browsers. The content is easily accessed by connections to the Internet using a telephone modem.
  • Interactive threaded discussion - Students engage in discussion on important issues using the on-line bulletin board. An on-line faculty moderator helps keep the discussion on track.
  • Reading assignments - The course uses the best-known general textbook in the field, Biomedical Informatics - Computer Applications in Health Care and Biomedicine, by Shortliffe and Cimino (eds.), with supplemental readings as necessary. In addition, students are pointed to key other documents, reports, and papers from the field.
  • Homework/quizzes - Each of the 11 units is accompanied by a 10-question multiple-choice self-assessment that aims to have the student apply the knowledge from the unit.

The on-line part of the course is accessed via the Blackboard course delivery tool. At the onset of the course, each student is provided a login and password by the OHSU distance learning staff, who also provide technical support for the course. Students are required to purchase the textbook; all other assigned readings are either freely available on-line or provided by OHSU. Students are expected to keep up with the materials each week and participate in ongoing discussion. They should anticipate spending 4-8 hours per week on the course.

The in-person component aims to bring students, faculty experts, and the materials together for an intensive in-person session. For the in-person session, students must complete a short course project consisting of an environment scan of an organization (which could be their own practice or a department in their hospital) to assess readiness for an organization-wide IT implementation, such as electronic health record. At the in-person session, they will present their assessment to their fellow students and faculty, gaining new insights into the required elements for such an undertaking.

The on-line portion of the course will run from early October to early January. The in-person session will take place at the Society for Technology in Anesthesiology meeting in San Diego, CA on January 19, 2008.

Curriculum

Instructor
The instructor for the course is William Hersh, MD. The best way to reach him is via email (hersh@ohsu.edu).

Readings
Reading assignments consist of chapters from the required textbook as well as additional articles and other readings. Students are responsible for learning all content in the readings, whether discussed in the lectures or not.

The textbook for the class is: Edward H. Shortliffe, James J. Cimino (Eds.), Biomedical Informatics: Computer Applications in Health Care and Biomedicine (3rd edition), Springer-Verlag, 2006. Please note that the third edition of this textbook is required and that the book is not included in the price of tuition.

Overview of the topics covered in the program:

The following table outlines the curriculum with unit number, topic, reading assignment, and date posted. The course materials are lumped into five groups (Units 1-2, 3-4, 5-6, 7-8, 9-11). Materials for each unit must be completed by the specified due date.

Unit Topic Reading Date Posted Date Due
1 Welcome and Overview of Field 1, 2, 23, and Hersh papers 10/3 10/17
2 Biomedical Computing 5, 6, and Malan paper 10/10 10/17
3 Electronic Health Records and Health Information Exchange 12, 13 10/24 11/14
4 Decision Support and Health Care Quality 20 10/31 11/14
5 Standards, Privacy and Security, Costs and Implementation 7 11/7 11/14
6 Evidence-Based Medicine and Medical Decision Making 3 11/21 12/5
7 Information Retrieval and Digital Libraries 19 11/28 12/5
8 Bioinformatics 22 12/12 1/2
9 Imaging Informatics and Telemedicine 9, 14, 18, Hersh paper 12/19 1/2
10 Other Informatics: Consumer Health, Public Health, and Nursing 14, 15, 16 1/2 1/16
11 Organizational and Management Issues in Informatics 6 1/9 1/16

Detailed Course Outline

Unit Segments
1. Welcome and Overview of Field 1.1 A discipline whose time has come
1.2 The discipline of biomedical informatics
1.3 Problems in health and biomedicine motivating biomedical informatics
1.4 Seminal documents and reports
1.5 Resources of field
2. Biomedical Computing 2.1 Types of Computers
2.2 Data Storage in Computers
2.3 Computer Hardware and Software
2.4 Computer Networks
2.5 Software Engineering
2.6 Challenges for Biomedical Computing
3. Electronic Health Records and Health Information Exchange 3.1 Clinical Data
3.2 History and Perspective of the Health (Medical) Record
3.3 Potential Benefits of the Electronic Health Record
3.4 Definitions and Key Attributes of the EHR
3.5 EHR Examples
3.6 Current Status of the EHR
3.7 Health Information Exchange
4. Decision Support and Health Care Quality 4.1 Historical Perspectives and Approaches
4.2 Health Care Quality
4.3 Medical Errors and Patient Safety
4.4 Approaches to Improving Quality and Safety
4.5 Reminders and Alerts
4.6 Computerized Provider Order Entry (CPOE)
5. Standards, Privacy and Security, Costs and Implementation 5.1 Standards: Basic Concepts
5.2 Identifier and Transaction Standards
5.3 Message Exchange Standards
5.4 Terminology Standards
5.5 Privacy, Confidentiality, and Security: Basic Concepts
5.6 HIPAA Privacy and Security Regulations
5.7 Cost-Benefit of the EHR
5.8 Implementing the EHR
6. Evidence-Based Medicine and Medical Decision-Making 6.1 Definitions and Application of EBM
6.2 Interventions
6.3 Diagnosis
6.4 Harm and Prognosis
6.5 Summarizing Evidence
6.6 Putting Evidence into Practice
6.7 Limitations of EBM
7. Information Retrieval & Digital Libraries 7.1 Information Retrieval
7.2 Knowledge-based Information
7.3 Content
7.4 Indexing
7.5 Retrieval
7.6 Evaluation
7.7 Digital Libraries
8. Bioinformatics 8.1 Overview of Basic Molecular Biology
8.2 Important Biotechnologies Driving Bioinformatics
8.3 Genetics-Related Diseases
8.4 Bioinformatics Information Resources
8.5 Informatics Challenges and Opportunities for Molecular Biology
9. Imaging Informatics and Telemedicine 9.1 Imaging in Health Care
9.2 Modalities of Imaging
9.3 Image Management
9.4 Telemedicine: Definitions and Barriers
9.5 Efficacy of Telemedicine
10. Other Informatics: Consumer Health, Public Health, and Nursing 10.1 Consumer Health Informatics Overview
10.2 Consumer Information Access and Decision-Making
10.3 Consumer-Provider Communication
10.4 Personal Health Records
10.5 New Models of Health Care
10.6 Public Health Informatics
10.7 Nursing Informatics
11. Organizational and Management Issues in Informatics 11.1 Organizational Behavior
11.2 Organizational Issues in Failure and Success of Informatics Projects
11.3 Change Management


Competencies

The OHSU offering of 10x10 aims to impart the following competencies to students:

  • The value proposition of health information technology and how medical informatics and other fields contribute to it.
  • The role of various individuals in the health information technology workforce.
  • The basic tenets of biomedical computing to enable optimal selection of hardware, software, and network connections for a given setting.
  • The essential functions of the electronic health record (EHR) and the barriers to its use.
  • The principles of implementing EHRs in ambulatory, hospital, and other settings.
  • The role of clinical decision support in health care settings and within the EHR.
  • Computerized provider order entry and how it enhances clinical decision support.
  • The role of IT in nursing.
  • The importance of standards and interoperability of clinical data and the major initiatives underway.
  • Maintaining privacy, confidentiality, and security, including the role of HIPAA.
  • The convergence of motivations for the secondary use of clinical data.
  • The basic principles of health care quality assessment, including pay for performance programs, and how the EHR enables them.
  • The role of health information exchange and Regional Health Information Organizations (RHIOs).
  • The personal health record (PHR), its interface with the EHR, and its value in promoting personal health.
  • The function of public health information systems and their interaction with clinical systems.
  • The core principles of evidence-based medicine and their application in clinical practice.
  • Accessing medical knowledge resources and linking them to clinical practice.
  • People and organizational issues in the use of health information technology.
  • The unique aspects of nursing information and practice in relation to clinical information systems.
  • The growing impact of genomics on medicine and its implications for health information systems.
  • The management of images in clinical settings, including the use of PACS systems.
  • The role of telemedicine and barriers to its use.
  • The key issues in organizational, project, and business management in informatics projects and the notion that informatics projects require more than an understanding of technology.

Students who successfully complete this offering will be provided with a complimentary 2008 AMIA Membership, the in-person session at the STA Annual Meeting, a 10x10 Completion Certificate and will be eligible for CME Credit.

Beyond 10x10

The goal of the AMIA 10x10 Program is to train clinicians and other health care professionals in informatics so they can be knowledgeable participants in IT implementations in their local settings. The 10x10 program alone will not make one a full-time professional in informatics (any more than a semester of medicine or nursing will make one a doctor or nurse!). The program is being structured, however, to allow those who complete the course to carry the credits forward into other graduate programs in informatics. The details need to be arranged with each individual program.

Since the course is an adaptation of the introductory course in the OHSU biomedical informatics, those who complete the 10x10 course will be able to obtain credit for the course in the OHSU program. Upon enrolling in the OHSU Graduate Certificate or Master's Degree program, students will need to complete the final examination for the OHSU course and will then be awarded three credits in the OHSU graduate program. (OHSU is on an academic quarter system, with each quarter consisting of 11 weeks of instruction. A three-credit course is comparable to a course with three contact hours per week plus additional work for reading assignments, homework, and projects.) Most of OHSU's informatics courses are taught on-campus and on-line, and each course is considered equivalent whether it is taught live or via distance.

More details about the individual degree programs are available on the OHSU informatics education Web site, but the following table provides an overview of the programs.

Program Name Description Admission Requirements Graduation Requirements
Graduate Certificate in Biomedical Informatics Core courses in informatics Bachelor's degree in any field 24 credits (generally 8 3-credit courses)
Master of Biomedical Informatics "Professional" master's degree with capstone project Bachelor's degree in any field plus introductory courses in Computer Science and Anatomy & Physiology 52 credits (48 hours of instruction plus 4 hours of capstone project)
Master of Science in Biomedical Informatics "Research" master's degree with master's thesis Bachelor's degree in any field plus introductory courses in Computer Science and Anatomy & Physiology 60 credits (48 hours of instruction plus 12 hours of master's thesis)
Doctor of Philosophy (PhD) in Biomedical Informatics PhD program for advanced leaders and research in the field Bachelor's degree in any field plus introductory courses in Computer Science and Anatomy & Physiology 135 credits, including dissertation