• 10x10 with OHSU in conjunction with ACEP

    Biomedical and Health Informatics for Emergency Physicians

Introduction to Biomedical and Health Informatics for Emergency Physicians

10x10 with OHSU in conjunction with ACEP: Course Description

Overview of the topics

  • • Overview of Field and Problems Motivating It

  • • Biomedical Computing

  • • Electronic and Personal Health Records (EHR, PHR)

  • • Standards and Interoperability

  • • Advancing Care with the EHR

  • • Data Science and Analytics

  • • EHR Implementation, Security, and Evaluation

  • • Information Retrieval (Search)

  • • Other Areas of Informatics

  • • Research Informatics

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 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 importance of standards and interoperability of clinical data and the major initiatives underway.

  • • Maintaining privacy, confidentiality, and security, including the role of HIPAA.

  • • 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.

Curriculum and Dates

The following table outlines the curriculum with unit number, topic, date posted and date due. The course in general runs with two weeks in a row of posted materials and then a third week to finish the work. 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 once one is too far behind. Materials for each unit must be completed by the specified due date.

UnitTopicDate PostedDate Due
1Overview of Field and Problems Motivating It


7/3/19

7/24/19
2Biomedical Computing
7/10/19
7/24/19
3Electronic & Personal Health Records (EHR, PHR)7/24/198/14/19
4Standards and Interoperability7/31/198/14/19
5Advancing Care with the EHR8/14/199/4/19
6

Data Science and Analytics

8/21/199/4/19
7EHR Implementation, Security, and Evaluation
9/4/19
9/25/19
8Information Retrieval (Search)9/11/199/25/19
9Research Informatics9/25/1910/16/19
10Other Areas of Informatics10/2/1910/16/19

Detailed Course Outline

The table below lists the segments covered within each unit.

1. Overview of Field and Problems Motivating It1.0 Overview of Field and Problems Motivating It
1.1 What is Biomedical and Health Informatics?
1.2 A Short History of Biomedical & Health Informatics
1.3 Problems in Healthcare Motivating Biomedical and Health Informatics
1.4 Who Does Biomedical and Health Informatics?
1.5 Resources for Field - Organizations, Information, Education 
2. Biomedical Computing2.0 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
3. Electronic and Personal Health Records (EHR, PHR)

3.0 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

4. Standards and Interoperability

4.0 Standards and Interoperability
4.1 Standards & Interoperability: Basic Concepts
4.2 Identifier and Transaction Standards
4.3 Message Exchange Standards
4.4 Terminology Standards
4.5 SMART on FHIR

5. Advancing Care with the EHR5.0 Advancing Care with the EHR
5.1 Patient Safety and Medical Errors
5.2 Clinical Decision Support (CDS)
5.3 Healthcare Quality Measurement and Improvement
5.4 Health Information Exchange (HIE)
5.5 From Meaningful Use to Promoting Interoperability
6. Data Science and Analytics

6.0 Data Science and Analytics
6.1 Data Science and Data Analytics
6.2 Machine Learning and Artificial Intelligence
6.3 Natural Language Processing
6.4 Evidence-Based Medicine
6.5 Clinical Practice Guidelines

7. EHR Implementation, Security, and Evaluation

7.0 EHR Implementation, Security, and Evaluation
7.1 Clinical workflow analysis and redesign
7.2 EHR System Selection and Implementation
7.3 Telemedicine and Telehealth
7.4 Privacy and Security
7.5 Evaluation of the EHR

8. Information Retrieval (Search)

8.0 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

9. Research Informatics

9.0 Research Informatics
9.1 Overview of Biomedical Research
9.2 Clinical Research Informatics
9.3 Overview of Basic Molecular Biology
9.4 Translational Bioinformatics
9.5 From Clinical Genetics and Genomics to Precision Medicine
9.6 Genomics Data in the EHR and Other Information Systems

10. Other Areas of Informatics10.0 Other Areas of Informatics
10.1 Imaging Informatics
10.2 Nursing Informatics
10.3 Consumer Health Informatics
10.4 Public Health Informatics
10.5 Population Health

Logistics

The course is offered in two parts:

  1. 1. A 10-unit Web-based component starting July 3, 2019.  The Web-based portion is provided through readings, lectures, interactive discussion, and self-assessment tests.

  2. 2. An intensive, optional, one day in-person session held in conjunction with the ACEP Scientific Assembly 2019 which runs from October 27 - 30, 2019 in Denver, CO.  The in-person session 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 session runs from 9 am until 3 pm and will take place on Saturday, October 26, 2019.
    (NOTE: Participants who are unable to attend the in-person session for hardship reasons are allowed to opt out of attendance.)

The registration deadline for this offering of the course is Wednesday, July 3, 2019.  We will accept enrollees after that date on a space-available basis.  Please contact the course instructor or Susanne Arnold (susanne@amia.org) for late registration if space allows.

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 a variety of readings made available to students. There is no textbook for this course. Students are provided assigned readings from 2-4 key articles or reports for each unit. Students are also provided comprehensive lists of references for topics covered in the lectures.

  • • 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 OHSU's Sakai learning management system. 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 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 online activities are asynchronous, so there is no specified time that a student must be on-line.

The on-line portion of the course will run from early-July through late-October.  The in-person session will take place in conjunction with the ACEP Scientific Assembly 2019 in Denver, CO from October 27-30, 2019. The date of the in-person session is Saturday, October 26, 2019.

Even though the 10x10 course is on-line, it provides a great deal of interaction among the faculty, teaching assistants, and students. A discussion forum is set up for each unit of the course, where students can pose questions, comments, and opinions related to the course materials. The instructor poses 1-2 questions to kick off the discussion but students are encouraged to post their own questions and engage in discussion with their classmates.

Course Project

Students must complete a course project to obtain the AMIA 10x10 Certificate of Completion. The goal of the project is to identify an informatics problem in your local setting (e.g., where you practice or work, or otherwise have access) and propose a solution based on what is known from informatics research and best practice. The project write-up is due by October 23, 2019. If you do not have access to a health care setting, you can do the project in another setting, such as a company or organization. The instructor can help if you have a challenge with this. The problem and solution should be written into a succinct 2-3 page (please no longer!) document that should include references and justify the framing of the problem and the proposed solutions. This is submitted in a Word document uploaded to Sakai. 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 the specified due date at the end of the course.

  • • The room at the in-person session has round tables, and you will break into small groups around the tables. Each group selects 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.

The in-person component aims to bring students, faculty experts, and the materials together where they will present their assessment to their fellow students and faculty, gaining new insights into the required elements for such an undertaking.

Optional Final Exam

The 10x10 course has no final exam, and those who complete all of the online coursework will receive the AMIA 10x10 Certificate of Completion.  At the end of the course, an optional final exam is given for those who are eligible and desire graduate-level academic credit for the course from OHSU. The exam is an open-book, take-home final exam that is completed over a one-week period.  Credit is typically sought by those desiring further study in biomedical and health informatics or for those requiring an academic transcript for tuition reimbursement. More information about the final exam and how to enroll at OHSU to receive academic credit is provided once the course has started.

Learning Objectives

After participating in this activity, the learner should be better able to:

  • • Discuss the value proposition of health information technology and how medical informatics and other fields contribute to it.

  • • Understand the role of various individuals in the health information technology workforce.

  • • Understand the basic tenets of biomedical computing to enable optimal selection of hardware, software, and network connections for a given setting.

  • • Know the essential functions of the electronic health record (EHR) and the barriers to its use.

  • • Know the principles of implementing EHRs in ambulatory, hospital, and other settings.

  • • Discuss the role of clinical decision support in health care settings and within the EHR.

  • • Recognize computerized provider order entry and how it enhances clinical decision support.

  • • Discuss the role of IT in Nursing.

  • • Know the importance of standards and interoperability of clinical data and the major initiatives underway.

  • • Talk about the convergence of motivations for the secondary use of clinical data.

  • • Understand the basic principles of health care quality assessment, including pay for performance programs, and how the EHR enables them.

  • • Know the role of health information exchange and Regional Health Information Organizations (RHIOs).

  • • Discuss the personal health record (PHR), its interface with the EHR, and its value in promoting personal health.

  • • Know the importance of standards and interoperability of clinical data and the major initiatives underway.

  • • Maintain privacy, confidentiality, and security, including the role of HIPAA.

  • • Discuss the core principles of evidence-based medicine and their application in clinical practice.

  • • Access medical knowledge resources and link them to clinical practice.

  • • Understand people and organizational issues in the use of health information technology.

  • • Discuss the unique aspects of nursing information and practice in relation to clinical information systems.

  • • See the growing impact of genomics on medicine and its implications for health information systems.

  • • Utilize the management of images in clinical settings, including the use of PACS systems.

  • • Know the role of telemedicine and barriers to its use.

  • • Understand the function of public health information systems and their interaction with clinical systems.

  • • Discuss 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.

Readings

There is no textbook for this course. All assigned readings are freely available online or supplied by OHSU.

Optional In-Person Session

An intensive, optional, one day in-person session held in conjunction with the ACEP Scientific Assembly 2019 which runs from October 27 - 30, 2019 in Denver, CO. The in-person session 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 session runs from 9 am until 3 pm and will take place on Saturday, October 26, 2019.

NOTE: Participants who are unable to attend the in-person session for hardship reasons are allowed to opt out of attendance.

Accreditation Statement

The American Medical Informatics Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement

The American Medical Informatics Association designates this enduring material for a maximum of 46.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Students who successfully complete this offering will be provided with the in-person session at the ACEP Scientific Assembly 2019, a 10x10 Completion Certificate and will be eligible for up to 46.5 AMA PRA Category 1 credit(s)™, as well as this activity is Approved by the American College of Emergency Physicians for a maximum of 46.50 hour(s) of ACEP Category I credit.

Estimated Time Expected to Complete Activity

Estimated time to complete this activity: 46.5 hours

Criteria for Successful Completion

Completion of this enduring material is demonstrated by participation in all online sessions, completion of a Capstone project, completion of participant survey, attendance at an in-person session for class participants with the faculty is optional.

Commercial Support

No commercial support was received for this activity.

Disclosures for this Activity

William Hersh, MD, FACMI, FACP, discloses that neither he nor his spouse have relevant financial relationships with commercial interests.

Jeff Nielson, MD, MS, FACEP discloses that neither he nor his spouse have relevant financial relationships with commercial interests.

Jim McClay, MD, FACEP discloses that neither he nor his spouse have relevant financial relationships with commercial interests.

The following AMIA staff report that neither they nor their spouses have relevant financial relationships with commercial interests: Pesha Rubinstein, Susanne Arnold, Jeff Williamson.

Contact Information

Questions about AMIA 10x10? Find answers on theĀ FAQs page.

For additional questions about the 10x10 program, please contact Susanne Arnold, Education Program Manager at susanne@amia.org or (301) 657-1291.