BMI 510 - Fall, 2008 On-Campus

BMI 510/610 - Introduction to Biomedical Informatics

William Hersh, M.D., Course Director
3 credit hours
Fall Quarter, 2008
On-campus
Last updated: September 12, 2008

PREREQUISITES

Must have graduate-level standing.

COURSE DESCRIPTION

This course provides a broad survey introduction to biomedical informatics, the field concerned with the acquisition, use, and storage of information in health care, biomedical research, and public health. Students focus on the underlying themes of biomedical informatics, including the proper use of information technology in health and biomedical settings. The course also covers the main applications of information technology in health and biomedicine, including electronic health records, information retrieval, genomics, and telemedicine. The viewpoints of information technology from medicine, computer science, nursing, public health, patients/consumers are considered.

COURSE OBJECTIVES

The objectives for all students are:

Explain 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.
Identify the essential functions of the electronic health record (EHR) and the barriers to its use.
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 it use.
Explain the importance of standards and interoperability of clinical data and the major initiatives underway to enable them.
Differentiate the difference among privacy, confidentiality, and security and their role in the HIPAA regulations.
Explain the basic principles of health care quality assessment, including pay for performance programs, and how the EHR enables them.
Identify components of health information exchange and its implementation via Regional Health Information Organizations (RHIOs)
Identify the components of the personal health record (PHR) and describe its value.
Demonstrate the ability to apply evidence-based medicine and critical appraisal to clinical questions.
Understand the basic medical knowledge resources and be able to perform searching of them.
Describe the management of images in clinical settings, including the use of PACS systems.
Classify the different types of telemedicine and their efficacy as shown in clinical studies.
Explain how people and organizational issues impact the use of health information technology.

INSTRUCTOR

William Hersh, M.D., Professor and Chair, Department of Medical Informatics & Clinical Epidemiology, OHSU, Voice: 503-494-4563, Fax: 503-494-4551, Email: hersh@ohsu.edu, Web: www.billhersh.info. Office hours by appointment.

REQUIRED TEXTBOOK(S)

Edward H. Shortliffe, James J. Cimino, (eds.), Bioedical Informatics: Computer Applications in Health Care and Biomedicine (3rd edition), Springer-Verlag, 2006.

RELEVANT LITERATURE AND RESOURCES

Provided on-line.

COURSE COORDINATION

The course is taught through a combination of distance learning and on-campus activities. Teaching modalities include:

Access to the entire course via the OHSU Sakai system
Voice-over-Powerpoint lectures using the Flash browser plug-in
Handouts of Powerpoint slides and cited references
Reading assignments in the form of PDFs
On-line multiple-choice homework assignments

Classroom sessions will be devote to discussion and question-answering from the lectures, readings, and homework assignments. The class will meet from 12:30-1:50 pm on Wednesdays in BICC 124 (BICC Theater).

COURSE OUTLINE

Here is outline for the course, with the unit name, reading assignment, and date the material is posted. All work in all units is due one week after it is posted (i.e., when the next unit's material is posted).

Unit	Topic	Reading	Date Posted
1	Overview of Field and Problems Motivating It	1, 2, 23, and Hersh papers	10/1
2	Biomedical Computing	5, 6, and Malan paper	10/8
3	Electronic Health Records	12, 13	10/15
4	Clinical Decision Support; EHR Implementation	16, 20	10/22
5	Standards and Interoperability; Privacy, Confidentiality, and Security	7	10/29
6	Secondary Use of Clinical Data: Personal Health Records, Health Information Exchange, Public Health, Health Care Quality, and Clinical Research	14, 15, 16	11/5
7	Evidence-Based Medicine and Medical Decision Making	3	11/12
8	Information Retrieval and Digital Libraries	19	11/19
9	Imaging Informatics and Telemedicine	9, 14, 18, Hersh paper	11/26
10	Translational Bioinformatics	22	12/3
-	Final Examination Due		12/10

The term paper is due by 5 pm Pacific time on 12/3. The take-home final exam will be distributed on 12/3 and be due by 5 pm Pacific time on 12/10.

EVALUATION

Student grading is based on the following:

On-line multiple-choice homework assignments - 30%
Term paper - 30%
Final examination - 30%
Class participation - 10%

DETAILED COURSE OUTLINE

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 care motivating biomedical informatics
1.4 Seminal documents and reports
1.5 Resources of field - organizations, information, education

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
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 Nursing Informatics

4. Clinical Decision Support; EHR Implementation
4.1 Historical Perspectives and Approaches
4.2 Medical Errors and Patient Safety
4.3 Reminders and Alerts
4.4 Computerized Provider Order Entry (CPOE)
4.5 Implementing the EHR
4.6 Use and Outcomes of the EHR
4.7 Cost-Benefit of the EHR

5. Standards and Interoperability; Privacy, Confidentiality, and Security
5.1 Standards: Basic Concepts
5.2 Identifier and Transaction Standards
5.3 Message Exchange Standards: HL7, DICOM, IEEE 1073 / ISO 11073, NCPDP/SCRIPT, ELINCS, CCR/CCD
5.4 Terminology Standards: ICD-9/10, DRG, ICPC, NCDC, LOINC, CPT, SNOMED, UMLS
5.5 Privacy, Confidentiality, and Security: Basic Concepts
5.6 HIPAA Privacy and Security Regulations

6. Secondary Use of Clinical Data: Personal Health Records, Health Information Exchange, Public Health, Health Care Quality, Clinical Research
6.1 Personal Health Records
6.2 Health Information Exchange
6.3 Public Health Informatics
6.4 Health Care Quality
6.5 Clinical Research Informatics

7. Evidence-Based Medicine and Medical Decision Making
7.1 Definitions and Application of EBM
7.2 Interventions
7.3 Diagnosis
7.4 Harm and Prognosis
7.5 Summarizing Evidence
7.6 Putting Evidence into Practice
7.7 Limitations of EBM

8. Information Retrieval and Digital Libraries
8.1 Information Retrieval
8.2 Knowledge-based Information
8.3 Content
8.4 Indexing
8.5 Retrieval
8.6 Evaluation
8.7 Digital Libraries

9. Imaging Informatics and Telemedicine
9.1 Imaging in Health Care
9.2 Modalities of Imaging
9.3 Digital Imaging
9.4 Telemedicine: Definitions and Barriers
9.5 Efficacy of Telemedicine

10. Translational Bioinformatics
10.1 Translational Bioinformatics - The Big Picture
10.2 Overview of Basic Molecular Biology
10.3 Important Biotechnologies Driving Bioinformatics
10.4 Genetics-Related Diseases
10.5 Bioinformatics Information Resources
10.6 Translational Bioinformatics Challenges and Opportunities

ACADEMIC HONESTY

Course participants are expected to maintain academic honesty in their course work. Participants should refrain from seeking pat published solutions to any assignments. Literature and resources (including Internet resources) employed in fulfilling assignments must be cited. See http://www.ohsu.edu/dmice/enrolled/plag.shtml for details.