10x10 with Oregon Health & Science University: Course Description

Curriculum

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 is difficult to catch up once one is too far behind.

Detailed Course Outline

1. Overview of Field and Problems Motivating It
1.1 What is Biomedical and Health Informatics?
1.2 A Short History of Biomedical and 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. Computing Concepts for Biomedical & Health Informatics
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)
3.1 Clinical Data
3.2 History and Perspective of the Health (Medical) Record
3.3 Examples of the EHR
3.4 EHR Data Entry
3.5 Clinical Decision Support
3.6 Personal Health Records

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 SMART on FHIR

5. Data Science and Artificial Intelligence
5.1 Data Science and Data Analytics
5.2 Machine Learning and Artificial Intelligence
5.3 Natural Language Processing
5.4 Imaging Informatics

6. Advanced Use of the EHR
6.1 Patient Safety and Medical Errors
6.2 Healthcare Quality Measurement and Improvement
6.3 Health Information Exchange (HIE)
6.4 Population Health
6.5 From Meaningful Use to Promoting Interoperability

7. 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)
8.1 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
9.1 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 Informatics
10.1 Nursing Informatics
10.2 Consumer Health Informatics
10.3 Public Health Informatics
10.4 Evidence-based Medicine
10.5 Clinical Practice Guidelines

Logistics

The course is offered in two parts:

• A 10-unit Web-based component starting July 20, 2022. The Web-based portion is provided through on-line lectures, readings, interactive discussion, and self-assessment tests. (Quizzes are required to be completed but grades do not count towards a final grade.)
• An intensive one-day in-person session held in conjunction with an AMIA meeting (see below). 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 registration deadline for the course is July 20, 2022. We will accept enrollees after that date on a space-available basis.

The course is an adaptation of the on-line Introduction to Biomedical and Health Informatics class currently taught in the OHSU biomedical and health 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 - Lectures are provided in MP4 format via the OHSU learning management system. The content is easily accessed by any type of modern device connected to the Internet.
• Interactive threaded discussion - Students engage in discussion on important issues using the on-line threaded discussion forums. An on-line faculty moderator helps keep the discussion on track.
• Optional reading assignments - The syllabus suggests optional readings from a textbook for students.
• 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 (LMS). 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. The course has no required textbook; with all assigned readings either freely available on-line or provided by OHSU. Students are expected to keep up with the materials and 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.

Students must complete all of the self-assessment tests, the course project, and participate in class discussions to receive the AMIA 10x10 Certificate of Completion. Physicians are eligible for up to 46.5 hours of AMA PRA Category I CME Credit(s).™ Because the course is continuing education, it does not use academic letter grades (e.g., A, B, etc.). However, those wanting academic credit by taking the optional final exam (see below) will be assigned a letter grade based on their score on the exam.

It is critical to contact the appropriate person when problems arise:

• For basic Sakai problems (cannot log in, something not apparently working) and course issues (e.g., unit or discussion forum not posted when it should be), contact the Sakai Help Desk at 877-972-5249 or sakai@ohsu.edu. The Sakai Help Desk hours are 8 a.m. - 10 p.m. Pacific, Mon-Fri and 12-5 p.m. Pacific on weekends. The Sakai Help Desk is closed on all OHSU-observed holidays.
• For questions about course content (e.g., do not understand a topic or disagree with homework quiz answer), contact the Teaching Assistant (TA), who will be announced at the beginning of the course.

When appropriate, all issues will be elevated to Dr. Hersh. While Dr. Hersh does not maintain scheduled office hours, he is readily accessible via email and will respond within 24-48 hours. Appointments to discuss course matters by phone or in person can be arranged via email.

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 19, 2022. (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 that justify the framing of the problem and the proposed solutions. This is submitted in a Word document uploaded to Sakai.

Students will present their project to their colleagues at the in-person session that they attend. The room at the in-person session has round tables, and students 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 serve as discussants in a short (10-15 minute) panel presentation at the session.

Learning Objectives

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

• Describe biomedical informatics and its role in health, health care, public health, and biomedical research.
• Compare and contrast the roles of various individuals in the health information technology workforce.
• Identify the basic tenets of biomedical computing to enable optimal selection of hardware, software, and network connections for a given setting.
• Identity the essential functions of the electronic health record (EHR) and the personal health record (PHR), along with barriers to their use.
• Explain the importance of standards and interoperability of clinical data and the major initiatives underway to enable them.
• Describe the principles of patient safety and how health information technology facilitates and exacerbates it. 
• Explain the basic principles of health care quality assessment, including pay for performance programs, and how the EHR enables them.
• Distinguish the different types of clinical decision support and their limitations in clinical practice.
• Explain the process of computerized provider order entry and challenges to its use.
• Discuss health information exchange and its facilitators and barriers.
• Describe the US meaningful use program of EHR incentives.
• Discuss the implementation of the EHR, including workflow analysis and re-design.
• Describe the results of evaluation studies assessing implementation and outcomes from the EHR.
• Discuss informatics applied to nursing, public health, and other specific aspects of the healthcare system.
• Differentiate the difference among privacy, confidentiality, and security and their role in the HIPAA regulations.
• Demonstrate the ability to apply evidence-based medicine and critical appraisal to clinical questions.
• Discuss the basic application of healthcare data analytics.
• • Understand the basic medical knowledge resources and be able to search them effectively.
• Describe the management of images in clinical settings, including the use of PACS systems.
• Classify the different types of telemedicine and telehealth, and their efficacy as shown in clinical studies.
• Discuss the role of biomedical and health informatics in clinical and translational research.
• Describe the key issues and findings of translational bioinformatics. 

Optional Final Exam & Earning OHSU Credit

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, online final exam that is completed during a one-week window at the end of the course. 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.

Those seeking tuition reimbursement from employers or others should check regarding conditions and timelines for reimbursement. Some employers require an official transcript from OHSU showing the final grade before reimbursing class fees. The transcript and course credit are not available until the end of the academic term that follows completion of the 10x10 course.

Beyond 10x10

The goal of the AMIA 10x10 program is to train clinicians and others 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 physician 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 Health & Clinical Informatics Graduate Program, those who complete the 10x10 course will be able to obtain credit for the course in the OHSU program. This credit is taken by passing the optional final examination at the end of the 10x10 course. Upon enrolling in the OHSU Graduate Certificate or Master of Science program, students passing the final examination will 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 Department of Medical Informatics & Clinical Epidemiology Web site, but the following table provides an overview of the programs.

The Web site also has information about OHSU's various fellowship programs, funded by the US National Library of Medicine and others.