10x10 with The Academy of Nutrition and Dietetics

The Academy/AMIA 10x10 Informatics Education Program

The goal of the AMIA-OHSU 10x10 program is to provide a detailed overview of biomedical and health informatics to those who will work at the interface of healthcare and information technology.

10x10 with the Academy of Nutrition and Dietetics: Course Description

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
  • 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.
  • 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 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 function of public health information systems and their interaction with clinical systems.
  • 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.
  • Evolving nutrition informatics related information, areas of practice and appropriate resources for continued work.

Complete Curriculum

The table below lists the segments covered within each unit.

1. Overview of Field and Problems Motivating It

1.1 What is Biomedical and Health Informatics?
1.2 A Discipline Whose Time Has Come
1.3 Problems in Healthcare Motivating Biomedical and Health Informatics
1.4 Who Does Biomedical and Health Informatics?
1.5 Seminal Documents and Reports
1.6 Resources for Field-Organizations, Information, Education
1.7 Introduction to Nutrition Informatics

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 Nutritional Computing-Software and Resources for Practitioners

3. Electronic and Personal Health Records (EHR, PHR)

3.1 Clinical Data
3.2 History and Perspective of the Health (Medical) Record
3.3 Definitions and Key Attributes of the EHR
3.4 Benefits and Challenges of the EHR
3.5 EHR Examples
3.6 Personal Health Records
3.7 Nutrition Informaticians-On the Front Line of Electronic Healthcare

4. Standards and Interoperability

4.1 Standards and Interoperability: Basic Concepts
4.2 Identifier and Transaction Standards
4.3 Message Exchange Standards
4.4 Terminology Standards
4.5 Natural Language Processing of Clinical Text

5. Meaningful Use of the EHR

5.1 Patient Safety and Medical Errors
5.2 Healthcare Quality
5.3 Clinical Decision Support (CDS)
5.4 Computerized Provider Order Entry (CPOE)
5.5 Health Information Exchange (HIE)
5.6 HITECH and Achieving Meaningful Use
5.7 Nutrition and Meaningful Use

6. EHR Implementation and Evaluation

6.1 Clinical Workflow Analysis and Redesign
6.2 System Selection and Implementation
6.3 Evaluation of Usage, Outcomes and Cost
6.4 Nursing Informatics
6.5 Public Health Informatics
*6.6 Patient Engagement
6.7 Implementation, Interoperability, and Re-use of Nutrition Information

7. Protection and Analytical Use of Data

7.1 Privacy, Confidentiality, and Security
7.2 HIPAA Privacy and Security Regulations
7.3 Evidence-based Medicine
7.4 Clinical Practice Guidelines
7.5 Healthcare Data Analytics

8. Information Retrieval (Search)

8.1 Information Retrieval
8.2 Knowledge-based Information
8.3 Content
8.4 Indexing
8.5 Retrieval
8.6 Research: Evaluation and Future Directions
8.7 Nutrition Information Retrieval and Use

9. Imaging Informatics and Telemedicine 9.1 Imaging in Health Care
9.2 Modalities of Imaging
9.3 Digital Imaging
9.4 Telemedicine: Definitions, Uses, and Barriers
9.5 Efficacy of Telemedicine
(9.6 Patient-Clinican Communications-being replaced with 6.6)
9.7 Telemedicine & Imaging in Nutrition
10. Research Informatics 10.1 Clinical Research Informatics
10.2 Translational Bioinformatics
10.3 Overview of Basic Molecular Biology
10.4 Personalized/Precision Medicine
10.5 Nutrigenomics
11. Consumer Health Informatics
 

11.1 Consumer Health Informatics & Other Related Terms
11.2 Consumer Facing Technologies in Use
11.3 Patient Generated Data
11.4 The Role of Standards in Consumer Health
11.5 Opportunities in Nutrition Related Consumer Health

12. Competencies in Nutrition Informatics 12.1 Work of the Academy
12.2 Proposed Competencies
12.3 Present and Future Opportunities
 

Course Logistics

The course is offered in two parts:

1.  A 12-unit Web-based component starting May 7, 2014.  The Web-based portion is provided through readings, lectures, interactive discussion, and self-assessment tests.

2. An intensive one-day in-person session which will take place on Saturday, October 18th and is held in conjunction with the Academy's FNCE Meeting on October 18-21, 2014 in Atlanta, GA  The in-person session on October 18, 2014 at FNCE will bring participants together to integrate the material, allow presentation of course projects, and meet the instructor as well as other students in person.

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 any type of connection to the Internet.
  • 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 supplemental readings as necessary. In addition, students are pointed to key documents, reports, and papers from the field.  There is no textbook for this course.
  • Homework/quizzes - Each of the 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 Sakai 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.  All 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 unit on the course.  All on-line activities are asynchronous, so there is no specified time that a student must be on-line.  There is no textbook required for this course. 

The goal of the course project is for students to identify an informatics problem in their local setting (e.g., where they practice or work) and propose a solution based on what is known from informatics research and best practice.  It is due before the in-person session at the end of the course.  If a student does not have access to a health care setting, they can do the project in another setting, such as a company or organization. Here are the details of the assignment:

  • You should assess some local setting (work environment, practice, hospital, etc.) to identify an informatics-related problem or a problem that could be improved by an informatics solution.
  • Based on your knowledge of research and best practices in informatics, you should propose a solution to the problem.
  • The problem and solution should be written into a 2-3 page document that should include references that justify the framing of the problem and the proposed solutions. This should be submitted in a Word document by email by the specified due date at the end of the course.
  • The room at the in-person session will have round tables, and you will break into small groups around the tables. Each group will select one individual to present an overview of the group's discussion. The remaining people in the group will serve as discussants in a short (10-15 minute) panel presentation at the session.

Readings

The course has no required textbook. Students are provided readings from 1-3 key articles or reports for each unit. Students are also provided comprehensive lists of references for topics covered in the lectures. In addition, there are two optional textbooks that students may want to consider, for which a table below lists chapters appropriate for each unit in the course:

  • Shortliffe, EH and Cimino, JJ, Eds. (2014). Biomedical Informatics: Computer Applications in Healthcare and Biomedicine (Fourth Edition). New York, NY, Springer.
  • Hoyt, RE, Yoshihashi, A, et al., Eds. (2014). Health Informatics: Practical Guide for Healthcare and Information Technology Professionals, Sixth Edition. Pensacola, FL, Lulu.com. 

The reading assignments from these books are optional, and no material will appear on the homework, quizzes, or final exam that is not also covered in the class. But some students prefer to also read a textbook when learning. The appropriate chapter readings for each unit in the course are as follows:

Unit Topic Shortliffe Hoyt
1 Overview of Field & Problems Motivating It 1 1
2 Biomedical Computing 5, 6 7, 11
3 Electronic & Personal Health Records (EHR, PHR) 2, 12, 17 2, 4
4 Standards and Interoperability 7, 8 6
5 Meaningful Use of the EHR 13, 22 5, 15, 16, 17
6 EHR Implementation and Evaluation 11, 15, 16 10, 21
7 Protection and Analytical Use of Data 3, 10 3, 8, 14
8 Information Retrieval (Search) 21 12, 13
9 Imaging Informatics and Telemedicine 9, 18, 20 18, 19
10 Research Informatics 24, 25, 26 20, 22

 

Instructor

The instructor for the course is William Hersh, MD. The best way to reach him is via email (hersh@ohsu.edu). He also maintains the Informatics Professor Blog.  Dr. Hersh does not keep regular office hours but phone calls or meetings can be arranged with him.
Nutrition-related content will be provided by Marty Yadrick, Peggy Turner, and Lindsey Hoggle, who will also serve as faculty on behalf of the Academy. 

Curriculum and Dates

This special 10x10 course offering, in partnership with the Oregon Health & Science University (OHSU) for the Academy of Nutrition and Dietetics, will start on May 7, 2014 with the in-person session taking place at the Academy's FNCE 2014 on October 18th.  The registration deadline is May 7, 2014. After that date, you must contact the course instructor for late registration if space allows.

In-Person Session, October 18, 2014

The following table outlines the curriculum with unit number, topic, reading assignment, and date posted.  The due date for each unit is when the next cycle of material is posted.  We are lenient about giving extensions but participants are strongly encouraged not to fall behind, since it can be difficult to catch up.  The course materials are lumped into five groups (Units 1-2, 3-4, 5-6, 7-8, 9-11). Nutrition related content will be provided by Marty Yadrick, Peggy Turner, and Lindsey Hoggle on behalf of the Academy.

Unit Topic Date Posted
1 Overview of Field and Problems Motivating It

5/7/14

2 Biomedical Computing 5/14/14
3 Electronic and Personal Health Records (EHR, PHR) 5/28/14
4 Standards and Interoperability: Privacy, Confidentiality & Security 6/4/14
5 Meaningful Use of the EHR 6/18/14
6

EHR Implementation and Evaluation

6/25/14
7 Evidence-Based Medicine 7/9/14
8 Information Retrieval and Digital Libraries 7/16/14
9 Imaging Informatics and Telemedicine 7/30/14
10 Translational Bioinformatics and Personalized Medicine 8/06/14
11 Consumer Health Informatics

8/20/14

12 Nutrition Informatics Competencies      8/27/14

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 in 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 and health informatics educational program, 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.

The website also has information about OHSU's National Library of Medicine-funded fellowship program, Graduate Certificate Track in Health Information Management (HIM), and master's degree programs in bioinformatics.

More details about the individual degree programs are available on the OHSU informatics education website, 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 (46 hours of instruction plus 6 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

Students who successfully complete this offering will be provided with a complimentary 2014 AMIA Affiliate calendar year Membership (Jan. 1st to Dec. 31st), the in-person session at the Academy of Nutrition and Dietetic FNCE 2014, a 10x10 Completion Certificate and will be eligible for CDR Category CPE Credits.