Electronic Health Records
Foundation of Clinical Informatics (INLS 725)
Dr. Javed Mostafa
Tuesday & Thursday, 11:00-12:15PM
014 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 of project report submission (emphasizing usability data) -- April 21st
- 25% Final Project Report -- April 23rd is Project Presentation and May 1st is Final Project Report Due
* 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 |
Undergraduate Students
UG Grade |
Range |
A |
94-100 |
A- |
90-93 |
B+ |
87-89 |
B |
84-86 |
B- |
80-83 |
C+, C, C- |
70-79 |
D |
60-69 |
F |
59 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.
Reinventing American Health Care. Emanuel, E. PublicAffairs, 2014.
Health Care Information Systems. Wager, K. & Lee, Frances. Jossey-Bass, 2013.
Additional readings will be assigned and shared as needed.
Course Outline & Calendar
Class 1 - Jan 8
Introduction to the class and distribution of the syllabus. Important dates, exam, and assignments described.
Class project requirements discussed.
Class 2 - Jan 13
Overview of EHR; platform, standards, applications, and evolution
Readings: Chapter 1
Class 3 - Jan 15
EHR as a gateway and integration hub. Applications contd.
Readings: Chapter 1
Class 4 - Jan 20
EHR in action from the perspectives of patients & clinicians
Class 5 - Jan 22
Health data architectures, standards, and protocols I.
Readings: Chapters 6
Readings: Payne et al., 2010 (Current Case Study); Fernandopulle & Patel, 2010 (Current Case Study)
Class 6 - Jan 27
Health data architectures, standards, and protocols II.
Readings: Chapter 2, Payne, T. (2008). In Practical Guide to Clinical Computing Systems (Thomas Payne, Ed.). Architecture of Clinical Computing Systems (Chapter 2);
Class 7 - Jan 29
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.
Class 8 - Feb 3
Health vocabularies, taxonomies, and ontologies II.
Class 9 - Feb 5
Data management I.
Readings: Chapter 4
Class 10 - Feb 10
Data management II. Architecture and information exchange platforms.
Readings: Chapter 4
Project Part1: Project System Selection and Overview Presentations. Due: February 17th, 2015
For assistance with project scope and system selection please consult the guide distributed in the class.
Class 11 - Feb 12
Data modelling in basic and data warehousing contexts. Usabilty.
Readings: Chapter 4.
Class 12 - Feb 17
Implementing EHR: coding, vocabularies, interfaces, XML, and APIs.
Readings: Chapter 6.
Class 13 - Feb 19
Coding and interfacing (contd.). Clinical workflows and clinical processes.
Readings: Chapter 8
Class 14 - Feb 24
Usability Testing Methodology
Readings: Health Information Tech Usability
Class 15 - Feb 26
Make-up class: Coding and Usability testing.
Class 16 - Mar 3
Evidence-based care and quality improvement I
Readings: Chapter 10.
Class 17 - March 5
Guest Speaker.
Class 18 - March 17
Evidence-based care and quality improvement II.
Reading: Buntin, et. al. (2011).
Clinical decision support
Reading: Chapter 9
Class 19 - March 19
Clinical decision support II. Usability of CDS systems.
Reading: Chapter 9.
Class 20 - March 24
Data analytics, visualization, and challenges.
Readings: To be assigned.
Class 21 - March 26
Guest Lecture: Clinical data warehouse and integration of data.
Class 22 - March 31
Implementing EHR and evaluating systems. Data Governance. Meaningful use I.
Reading: Chapters 16 and 17
Class 23 - April 2
Data Governance & Meaningful use II.
Field Trip: 5PM with Dr. Carlton Moore. Meet *** Dr. Moore at the Health Science Library lobby *** (new location!)
Field Trip Report Guidelines - Take it with you.
The report is due on April 11.
Class 24 - April 7
Meaningful Use II contd.
Reading: Caleen, J.L., Braithwaite, J. & Westbrook, J.A. (2008). Hamalka, J.D. (2010).
Take Home Exam Review. Exam questions distributed on April 9th; completed exam due by April 14th.
Class 25 - April 9
EHR regulations, privacy, and security
Reading: Chapters 12 and 13
Class 26 - April 14
Advanced Topics: Information Security & Consumer-centric Health Information I
Due date for draft project report (with emphasis on usability data) is on April 21st. The project presentation is on April 23rd and the final written report is due by May 1st. The presentation and the report will be graded together, and counted toward the 25% the total grade.
Class 27 - April 16
Advanced topics: Consumer Health Information II.
Class 28 - April 21
Guest Lecture: UNC Hospital IT Environment and Governance
Class 29 - April 23
Class presentations. Wrap-up.
Contact Information
Instructor Office hours: Thursday 2P-3PM. The instructor will be in Room 300A, Manning Hall.
TA Office hours: Thursday 1P-2PM. 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 vcarrasc@live.unc.edu) (TA)