10x10 with NSU: 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 each of the 6,000 hospitals in the United States.

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, nearly 1,300 people have completed the various 10x10 courses, some going on to advanced study in the field.

The NSU 10x10 course is designed to teach fundamental concepts in biomedical informatics. The concepts are illustrated through their integration into landmark projects of historical significance up to the development of contemporary systems. After completion of the course, the student should be able to define basic terminology and concepts in biomedical informatics; summarize seminal systems in the history of biomedical informatics; analyze problems using biomedical informatics evaluation methods; assess the qualities of biomedical information systems in the research and clinical arenas; and to apply those concepts via decision-making to the healthcare environment.

This on-line, interactive course is an introductory survey of the discipline of biomedical informatics.  This course will introduce the student to the use of computers for processing, organizing, retrieving and utilizing biomedical information at the molecular, biological system, clinical and healthcare organization levels through substantial, but not overwhelming, reading assignments.  The course is targeted at individuals with varied backgrounds including medical, nursing, pharmacy, administration, information technology, and computer science. The course will describe essential concepts in biomedical informatics which are derived from medicine, computer science and the social sciences.

There is no assumption the student is well versed in information technology, computer science, or biomedical information systems. However, students will be required to quickly obtain proficiency in the NSU Blackboard system to read instructor postings on the Blackboard homepage for this course, to submit Essay Assignments (upload Word files) and post Discussion Board assignments on-time, accurately, and at the graduate level of work. Students will be required to use the Live Classroom & Live Chat Room facilities on the dates/times as scheduled in the Assignments Section.

Course Logistics

The course is offered in two parts:

1. A 12-week Web-based component starting May 13, 2013. The Web-based portion is provided through voice-over power point presentations, readings, interactive discussion, group projects, and virtue live classroom sessions.  The course uses synchronous and interactive asynchronous online learning approaches.

2. An intensive, half-day in-person session held during the AMIA Annual Symposium in November in Washington, DC.  The Symposium takes place from November 16-20, 2013 at the Hilton Washington. The exact date of the in-person session is still to be determined. 

This course is designed to teach fundamental concepts in biomedical informatics.  The concepts are illustrated through their integration into landmark projects of historical significance up to the development of contemporary systems.  After completion of the course, the student should be able to define basic terminology and concepts in biomedical informatics; summarize seminal systems in the history of biomedical informatics; analyze problems using biomedical informatics evaluation methods; assess the qualities of biomedical information systems in the research and clinical arenas; and to apply those concepts via decision-making to the healthcare environment.

The course is taught in a combination of synchronous and asynchronous manners; i.e., there will be three synchronous virtue class sessions and asynchronous discussion throughout the course.

The course uses the following teaching modalities:

• Voice-over-Powerpoint lectures - The key material is delivered via the internet using the Flash plug-in, which is freely available and already installed in almost all Web browsers.
• Interactive threaded discussion - Students will engage in discussion on issues related to each week's course using the Blackboard's Live Classroom and interactive bulletin board. An on-line faculty moderator helps keep the discussion on track.
• Reading assignments - Reading assignments consist of chapters from the required textbooks 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.

Course Structure and Requirements

The course is taught online via the Blackboard facility.  Students are to become familiar with Blackboard (to include navigating the course homepage and all of its elements, reading assignment instructions and assignment submissions).  Again, students will also be required to read "all" Additional Reading URL assignments posted on the homepage. Weekly Discussion Board use (including posting assignments), email use, and reading additional required assignments are located on the course home page and on the Course Menu on the left side of the Homepage Screen.  There will also be one (1) Essay requirement at Mid-Term and one (1) Knowledge Paper (Term Paper) required.

Live-Chat Sessions.  BlackBoard Live Chat Sessions will be scheduled.  See the Assignments section within BlackBoard each week.  The purpose will be to present and clarify course material, enhance overall learning, provide a forum for real-time discussions and questions/answers, as well as professor and student presentations.  The sessions are scheduled in the Assignments Section of the homepage.  They are typically scheduled Thursdays from 7-9 pm (eastern).  Additional sessions may be scheduled (TBA).  A computer with audio in (microphone) and out (speakers or headphones) and a high-speed Internet connection will be required to participate in the discussion. 

Live-Classroom Sessions (via Elluminate). In addition to Live Chat Sessions, there may be BlackBoard Live Classroom Sessions scheduled.  The dates and times will be posted in the Assignments Section of BlackBoard.  A computer with audio in (microphone) and out (speakers or headphones) and a high-speed internet connection will be required to participate in the discussion.

Attendance Policy
Students are to complete all online assignments on time and are to attend all Chat and Live Sessions as scheduled (always scheduled in advance and typically on Thursday evenings between 7 and 9 pm Eastern), unless otherwise directed.  All Discussion Board work is to be completed on time.  There are also weekly topics posted to the Discussion Board designed to generate student interaction and participation is required.  All coursework completion and attendance are strictly required by HPD policy.

Required Textbooks

Textbook 1 (required):  Edward H. Shortliffe, James J. Cimino, (Eds.), Biomedical Informatics: Computer Applications in Health Care and Biomedicine (3rd edition), Springer-Verlag, 2006. ISBN978-0-387-28986-1.  The reading foundation upon which the course is built.

Textbook 2 (required):  Louise L. Liang (Editor), Connected for Health: Using Electronic Health Records to Transform Care Delivery  (paperback edition 1), Josey-Bass; A Wiley Imprint, 2010.  A real-world Case Study of Biomedical Informatics.

Textbook 3 (required):  Fred Trotter & David Uhlman, Hacking Healthcare: A Guide to Standards, Workflow, and Meaningful Use (paper edition 1; also e-copies can be downloaded to tablets), O'Reilly Media, Inc., 2013. Brief readings that provide, in straight-forward lay person's terms, issues in the field of Biomedical Informatics.

Additional Resources:

Readings, videos, and other material are posted in the Additional Readings (URL) section of the course homepage.  While not required readings, they are designed to provide current real-world examples of the concepts learned.  Students should check the Assignment comments by the instructor carefully each week to ensure completion of all assignment readings.  Students should also check email and Announcements frequently for course updates.  There are required weekly Discussion Board assignments based on the required readings.

Course Learning Objectives

Upon completion of this course, the student will be able to:

• Demonstrate in writing and verbally a basic understanding of the learned concepts of biomedical informatics and their direct application to healthcare.
• Demonstrate the ability to compare, select, apply and integrate multiple technologies in and across a healthcare organization.
• Discuss key legal and and ethical issues that must be considered when implementing biomedical technology and supporting information systems.
• Differentiate multiple methods to evaluate the costs versus benefits of implementing biomedical information systems.
• Produce evidence of a forward thinking ability to stay current in biomedical informatics.

Additional Exit Learning Objectives

• The evolution of information technology and its application in health care
• The nature of medical data, its acquisition, storage and use
• The role of information technology in health care management
• Standards in medical informatics
• Computer architectures including hardware, software, networks and communications, and security
• Nature and design of computer systems
• The information retrieval process
• The nature of the electronic medical record
• Principles of medical decision-making and their relation to information technology applications
• Information technology use in integrated delivery networks
• Features of a clinical decision-support system
• Imaging systems, image management, and telemedicine
• Bioinformatics
• Informatics applied to public health, consumer uses of informatics, and patient care systems
• Methods of evaluation and information technology assessment

Evaluation Format (required):
There is 1 Essay Assignment (at Mid-Term) with a simultaneous Discussion Board Posting of the Essay. 1 Discussion Board Essay Critique/Discussion, for the Essay, of a fellow student's essay assignment posting.  Weekly Discussion Board topics/questions are posted to the Discussion Board and participation is required. There is also a 10-page Knowledge Paper (Term Paper) required (excluding title page, introduction pages and citations/references).  A Knowledge Paper turned in with less than 10 full pages will be reduced in grade for not meeting the requirement. Late Knowledge Papers will be reduced 1 letter grade for each day late after a qualitative grade is assigned.  Late Essays are down graded the same.

There will be 1 Essay Assignment (20% of the course grade) - no make-up sessions.

The essay will be graded 20% of the course grade.  The essay is to be submitted via the BlackBoard Assignments Submission Facility and simultaneously posted to the BlackBoard Discussion Board for fellow students to critique.  The easiest way to meet the requirement is to put the assignment in an MS Word file and upload it.  The file name should reflect your last name and assignment (e.g. NSU.Linda.Smith.Summer.2012.Essay)  The essay heading itself should include your name and essay assignment (single spaced).  The essay is to be 2 pages in length (excluding any title page or citations) and is to be supported with 2 citations (APA format).  Citing the textbook may be done but will not be counted as fulfilling the 2-citation requirement.  The essay is to draw upon the course textbook, additional assigned readings, and student research.  Ultimately, it is to reflect "your" conclusions based on your work.  The essay is to be submitted simultaneously via the BlackBoard Assignments facility and to the Discussion Board.  Submit it in MS Word (.doc files).  You should read the weekly Assignment instructions as well as the syllabus.

There will be 1 Essay Discussion Board Assignment (Critique)--an extension of the mid-term Essay Assignment (also 20% of the total course grade).

A one-page minimum (excluding title and citations) student critique is required:  Students will critique at least 1 of their fellow student's posted Essay.  Again, each Essay critique will be one-page in length (excluding title and citations) supported by one appropriate citation (external to the textbook).  The critique must be professional discussion.  Comments such as "great job" or "I liked your essay" are ok, but not acceptable as your overall critique.  Discuss how you interpret your fellow student's essay in a manner similar to how you would do so in a classroom setting and also provide a citation to support your comments.  The Discussion Board topic will include, but not necessarily be limited to, the following concepts and contemporary biomedical informatics issues:

1. With the advent of full-text searching, should the National Library of Medicine abandon human indexing of citations in MEDLINE? Why or why not?
2. Describe three situations in which lack of integration of information systems with clinician's workflow can lead to inadequate patient care, reduced physician productivity, or poor patient satisfaction with an HCO's services.  Identify and discuss the challenges and limitations of two methods for improving process integration.
3. President Obama recently pledged billions of dollars of investment in Healthcare to include Healthcare Information Technology.  Make cases both against and for investing billions of taxpayer dollars in an NHII.
4. Can quality standards for system developers and maintainers simultaneously safeguard against error and abuse and stimulate scientific progress? Explain your answers. Why is there an ethical obligation to adhere to a standard of care?
5. What are two ways in which radiology reports of examination interpretations can be generated, and what are the advantages and disadvantages of each approach, in terms of ease and efficiency of report creation, timeliness of availability of reports to clinicians and usefulness for retrieval of cases for both research and education?

**Since students will be dependent on each other to complete the DB critique assignments on time, late Discussion Board assignment submissions and postings will receive a grade of zero. The Essay & Discussion Board work is to be considered a complete assignment.  Partial completion of assignments (e.g only the Essay or only the Discussion Board work) will result in a grade of "I" (Incomplete) for that assignment.

Weekly Discussion Board (DB) Topics (10% of the course grade for participation). 

Topics, based on the Liang Textbook & Additional Readings (URLs on the homepage), are posted weekly to the Discussion Board.  Students are required to post discussion to the Discussion Board.  No citations are required for these assignments.  They are designed to generate discussion about the reading material and provide a platform for the weekly exchange of ideas.  Participation could make the difference between a lower and higher course grade.  Weekly DB work is Pass/Fail, but 10% of your course grade is factored into your overall grade.  Participation is mandatory and is expected to be graduate level work.

The Knowledge (Term) Paper (50% of the course grade).

A 10 page Knowledge (Term) Paper is required to be submitted the final week of class.  It is called a Knowledge Paper because it is to reflect the knowledge you gained during the course, not simply a reiteration of other scholar's works.  This is not a graduate research course.  Think of your work as a quality item that would have to be produced for an employer, presented to peers, and discussed by a peer group (live or via a discussion board).  The paper should draw from the textbook, BlackBoard postings (Additional Readings) by the course instructor, and pertinent published literature in the area independently researched by the student.  Late Knowledge Papers will be marked down 1 letter grade (after initial qualitative grading) for each day late. Graduate level work is required. A few possible topics:

• Clinical Decision Support, Outcomes, and Patient Safety
• Clinical Workflow and Human Factors
• Consumer Informatics and PHRs
• Data Integration and Exchange
• Data Mining, NLP, Information Extraction
• Education
• EHR and CPOE Systems
• Informatics, Discovery, Innovation and Industry
• Policy and Ethical Issues
• Public Health Informatics and Biosurveillance
• Terminology and Standards
• Transitional Bioinformatics
• EMR/EHR
• Security & Privacy
• It is also acceptable to apply one of the above topics or another approved topic to a real-world application in your workplace.  Contact Professor Hatton for guidance and approval.
  

Knowledge Paper & Two Essays Qualitative Grading Guideline:

Your course instructor has gone to considerable effort to compile and post possible Knowledge Paper Topics and what is known as Bloom's Taxonomy under the Additional Resources section of the course homepage.  Both provide guidelines to topics and, more importantly, guidelines that will be used in grading your written work. Your instructor in grading your work will reference Bloom's Taxonomy.
 

Grading Policy -  Grading will be based on student ability to reflect the learning goals and objectives in coursework.  Grading will be based on numeric scores (numbers, percentages), which are converted to letter grades.  The course Instructor will provide course grade status to each student at Mid-Term after completion of the Essay and upon Course Completion.

This course adheres to the COM student handbook.  Student grades will be based upon the level of performance in meeting course requirements.  These requirements include product content, product organization, scholarship (in text citations and references list), writing style, and timely submission. Course products found deficient in these areas are subject to grade point reduction. Don't waste precious essay, discussion board, or knowledge paper space with fillers-they will not count towards fulfilling the requirement. All works are to be thoughtful discussion, not bullet lists of pros and cons about a topic. Your writing should clearly delineate what you are doing, findings, analysis, use of contrast and comparison, and "your" conclusions founded upon your work. An additional note: "Unknown Author" or "Unknown origin" citations will not be accepted.  Google definitions and online dictionaries are not to be cited as references in support of assignment deliverables.  Use professional sources. Again, this is graduate level work. Citations must therefore be easily auditable.

Overall Course Grading Structure

Grade Conversion

Course and Instructor Evaluation Policy:  Evaluation of the course and instructor shall be carried out at the end of the course. The results will be analyzed and presented to the Curriculum Committee and reviewed by the Instructor. .

Plagiarism Reminder: According to the Nova Southeastern University Student Handbook (http://www.nova.edu/cwis/studentaffairs/forms/ustudenthandbook.pdf), plagiarism is defined as "the adoption or reproduction of ideas, words, or statements of another person as one's own without proper acknowledgment." It is plagiarism to represent another person's work, words, or ideas as one's own without use of a center-recognized method of citation.  Knowingly giving or allowing one's work to be copied, giving out exam or essay questions or answers, or releasing or selling term papers is also prohibited.  Violations of conduct standards, including plagiarism or allowing one's work to be copied, may be grounds for dismissal from the program and/or course with a failing grade.  In brief, do not represent the work of others as being your own.

The on-line part of the course is accessed via the interactive web-based Blackboard^TM learning environment and Live Classroom. At the onset of the course, each student is provided a login and password by the Nova Southeastern University College of Osteopathic Medicine distance learning staff to access the course online. Students will be expected to spend 4-8 hours per week on the course (2-3 hours of lecture plus 2-5 hours of independent work/interaction with colleagues in preparation for and following the lecture).

Course Schedule

The following represents the Course Schedule "roadmap." However, you are responsible to check the weekly Assignment postings in BlackBoard of this course for changes and updates.  The BlackBoard "Discussions" facility (Discussion Board) will also be used frequently for updates to the course schedule. There are also additional URL Reading Assignments that are designed to provide real-world examples of the concepts learned. It is critical you check the BlackBoard Assignments for weekly Live Chat/Live Classroom Sessions (Thursdays).  Note the text readings are heavier up front and a bit lighter as you near the Knowledge Paper due date.  However the readings are no less important :

Always check the discussion board frequently for updates, live chat or classroom scheduling, and other important information. You will be expected to check the discussion board postings frequently without additional reminders.  Always contact the instructor by BlackBoard email with questions and to set-up a telephone call.

The on-line portion of the course will run from May 13 to August 2, 2013.

Readings

Reading assignments consist of chapters from the required textbooks, additional reading material provided throughout the course, as well as freely available articles, reports, documents, web-based resources, and other readings. Students are responsible for learning all content in the readings, whether discussed in the lectures or not.

Instructors

The Director and Lead instructor for the Nova Southeastern 10x10 course is Jennie Q. Lou MD, MSc.
Professor and Program Director of MSBI
Professor of Public Health and Internal Medicine
Office phone - (954) 262-1619
Email:  jlou@nova.edu

Additional Faculty for the Nova Southeastern 10x10 course include:

Daniel K. Hatton, PhD (dr dan)
Adjunct Associate Professor, Biomedical Informatics Program
Program Phone:  (954) 262-1613
Office phone/cell (San Diego, CA):  (858) 395-0800
Email:  dh199@nova.edu, However you are to use BlackBoard e-mail.

**Note: Dr. Hatton is located in San Diego, CA.  He is also a fulltime executive consultant and travels.  He has no office on campus. Therefore, email, telephone conversations, discussion board sessions, and live sessions will be the primary methods of discussing or clarifying course material. You should begin with an email to Dr. Hatton within BlackBoard to set up and coordinate a telephone conversation. The only challenge in telephone conversations will be in coordinating times for the call that match the student instructor availability. Dr. Hatton does have global Internet connectivity and a global cell phone and always returns phone calls.

The best way to reach the director and instructor is via email at jlou@nova.edu and dh199@nova.edu

Beyond 10x10

The goal of the AMIA 10x10 program is to train future leaders in the development, dissemination, and evaluation of information technology as it relates to the healthcare environment. 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.

More details about further training opportunities are available on Nova Southeastern University College of Osteopathic Medicine's website at http://medicine.nova.edu/ .

*For further questions or immediate assistance please contact Susanne Vellucci at: susanne@amia.org