Electronic Health Records
Foundation of Clinical Informatics (INLS 890 - 154)
Dr. Javed Mostafa
Tuesday & Thursday, 11:00-12:15PM
304 Manning Hall
School of Information and Library Science
University of North Carolina at Chapel Hill
Course Description
Electronic Health Record (EHR) systems are the backbone of modern clinical data management systems. In this class we will focus on EHR data standards with a strong emphasis on associated data management requirements, applications, and services.
Along with a close examination of the standards criteria being developed by the Office of the National Coordinator (ONC), the course will also focus on a set of widely adopted standards such as the Health Level 7, SNOMED, ICD9/10, CPT, and MeSH. The course is aimed at data management specialists, data management administrators, and students interested in health data analytics.
Objectives include learning about the following areas and engaging in related activities:
o Standards that ensure EHR systems are both secure and interoperable with other systems
o Data management, architecture and information exchange platforms
o Informatics principles that support quality of care and evidence-based practice
o Data governance and regulations associated with securing health data
o EHR future and evolution: Next generation technologies being shaped by the Federal Government through financial incentives/penalties (meaningful use)
o Practical experience with EHR tools and applications
Course Requirements
* Project (Group Effort)
- 5% Topic Selection and Overview Presentation
- 5% Abstract and Outline
- 10% Draft Submission and Formative Evaluation Feedback
- 25% Final Project Report
* 15% Field Report
* 25% Take-home final exam
* 15% Class participation: Activities in class, regular attendance, and contributions to class list
Grading
Based on current UNC grading scales, the following grades and corresponding numeric ranges are applicable:
Graduate Students
|
Grad Grade |
Range |
|
H |
95-100 |
|
P |
80-94 |
|
L |
70-79 |
|
F |
69 or below |
Required Text-book
Electronic Health Records: A Guide for Clinicians and Administrators
Jerome H. Carter (Ed.), American College of Physicians; 2nd edition, 2008.
The previous edition of the book is adequate to fulfill most of the requirements of this course.
Additional Recommended Book
Hacking Healthcare. Trotter, F., & Uhlman, D. O'Reilly, 2011.
Useful Articles
List of readings on EHR and related topics.
Additional readings will be assigned and shared as needed.
Course Outline & Calendar
Class 1 - Jan 10
Introduction to the class and distribution of the syllabus. Important dates, exam, and assignments described.
Class project requirements discussed.
Class 2 - Jan 15
Overview of EHR; platform, standards, applications, and evolution
Readings: Chapter 1
Class 3 - Jan 17
EHR as a gateway and integration hub. Applications contd.
Readings: Chapter 1
Class 4 - Jan 22
EHR in action from the perspectives of patients, clinicians, and public health.
Readings: Staggers et al.,2001 (History of EHR); Teich, 1998 (Issues related to Integrated Health Networks); Payne et al., 2010 (Current Case Study); Fernandopulle & Patel, 2010 (Current Case Study)
Class 5 - Jan 24
Health data architectures, standards, and protocols I.
Readings: Chapters 6
Class 6 - Jan 29
Health data architectures, standards, and protocols II.
Readings: Chapter 6, Chapter 2, Payne, T. (2008). In Practical Guide to Clinical Computing Systems (Thomas Payne, Ed.). Architecture of Clinical Computing Systems (Chapter 2); Chou, D., & Sengupta, S. (2008). In Practical Guide to Clinical Computing Systems (Thomas Payne, Ed.). Infrastructure and security (Chapter 4).
Class 7 - Jan 31
Health vocabularies, taxonomies, and ontologies I.
Readings: Cimino, J. (2000). From Data to Knowledge through Concept-Oriented Terminologies: Experience with Medical Entities Dictionary. J. Am Med Inform Assoc (7): 288-297.
Health IT Day Sponsored by CHIP. Consult Heather Lewis and keep an eye on chip.unc.edu.
Class 8 - Feb 5
No class. North Carolina Healthcare Information and Communications Alliance (www.nchica.org) Health Informatics Education Meeting.
Class 9 - Feb 7
Health vocabularies, taxonomies, and ontologies II.
Readings: Chapter 4
Class 10 - Feb 12
Data management, architecture and information exchange platforms.
Class 11 - Feb 14
Data modelling in basic and data warehousing contexts.
Readings: Chapter 4; Weber, G. et al (2009). Additional readings to be assigned.
Due: Project System Selection and Overview Presentations
For assistance with project scope and system selection please see the page here.
Class 12 - Feb 19
Data analytics, visualization, and challenges.
Readings: To be assigned.
Class 13 - Feb 21
Clinical workflows and clinical processes.
Readings: Chapter 8
Class 14 - Feb 26
Usability Testing Methodology
Class 15 - Feb 28
Evidence-based care and quality improvement I.
Reading: Chaudhry, B., Wang, J., Wu, S., et al. (2006). Additional readings to be assigned.
Class 16 - March 5
Evidence-based care and quality improvement II
Readings: Chapter 10; Zhou L. et al. (2009).
Class 17 - March 7
Evidence-based care and quality improvement III
Class 18 - March 19
Evidence-based care and quality improvement IV
Class 19 - March 21
Clinical decision support
Reading: Chapter 9; Bates, D.W. & Gawande, A.A. (2003).
Class 20 - March 26
Clinical decision support II. Usability of CDS systems.
Reading: Chapter 9, Chapter 7, Kuperman, G.J. 7 Gibson, R.F. (2003); Osheroff, J.A., Teich, J.M., Middleton, B., Steen, E.B., Wright, A. & Detmer, D.E. (2007).
Class 21 - March 28
Implementing EHR and evaluating systems. Data Governance.
Reading: Chapters 16 and 17; Caleen, J.L., Braithwaite, J. & Westbrook, J.A. (2008). Hamalka, J.D. (2010).
Class 22 - April 2
Implementing EHR and evaluating systems. Data Governance. Meaningful use. (Continued)
Class 23 - April 4
Guest lecture: Data visualization for clinical care.
Class 24 - April 9
Field Trip: Dr. Carlton Moore, Ambulatory Care Center (102 Mason Farm Rd).
Field Trip Report Form - Take it with you
The report is due on April 11.
Class 25 - April 11
Guest Lecture: Clinical data warehouse and applications.
Take Home Exam Review. Exam questions distributed on April 12th; completed exam due by April 18th.
Class 26 - April 16
EHR regulations, privacy, and security
Reading: Chapters 12 and 13
Class 28 - April 18
Guest lecture
Class 29 - April 23
Advanced topics: Consumer-centric EHR and PHR applications.
Class 30 - April 25
Class presentations. Wrap-up.
Contact Information
Instructor Office hours: Wednesday 10A-11A. The instructor will be in Room 300A, Manning Hall.
TA Office hours: Thursday 1P-2P. The TA will be in Room 300, Manning Hall.
Please do not hesitate to contact the instructor or the TA to schedule other meeting times.
Ph: (919) 610-6230
Fax: (919) 962-8071
Email: jm@unc.edu (instructor) and xyfan@email.unc.edu) (TA)