Electronic Health Records
Foundation of Clinical Informatics (INLS 725)
Dr. Javed Mostafa
Tuesday & Thursday, 11:00-12:15PM
117 Manning Hall
School of Information and Library Science
University of North Carolina at Chapel Hill
Course Description
Due to recent government regulations in the USA, the prevalence of Electronic Health Record (EHR) systems in care settings has increased dramatically. They are the primary source of data that care providers rely on to diagnose, treat, and track patients. They are also used by health care administrators and managers of clinical environments to monitor and assess quality of care and ensure that care delivery meets stringent standards set by accreditation bodies and government organizations.
Accumulated EHR data, collected for a specific population (e.g., immune records of children), over a long period of time, often called health registries are mandatory in certain cases and often are the primary resources used for public health systems and services. EHR systems are also used for ongoing public health surveillance and for assessing outbreaks of community-wide diseases and other threats to public health. Finally, EHR systems have increasingly become critical in supporting medical research, particularly for recruitments and supporting both prospective and retroactive trials.
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), DUE ON APRIL 12th.
- 25% Final Project Report
* 15% Field Report DUE ON APRIL 14th.
* 25% Take-home final exam DUE ON APRIL 19th.
* 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 |
Honor Code
All students are expected to follow general classroom decorum and respect the rights of everyone to have a safe and collegial environment for learning. Violations of general academic practices and norms will not be tolerated. Please refer to the Carolina Honor system to learn more about basic academic expectations at UNC at Chapel Hill: https://studentconduct.unc.edu/honor-system.
Do not hesitate to contact the instructor at any time if you have any questions about the honor system and related matters.
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 Books
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.
Consumer Health Informatics. Wetter, T. (Ed.). Springer, 2016.
Implementing an Electronic Health Record System. Walker, J.M., Bieber, E.J., & Richards, F. (Eds.). Springer, 2014.
Additional readings will be assigned and shared as needed.
Course Outline & Calendar
Class 1 - Jan 12
Introduction to the class and distribution of the syllabus. Important dates, exam, and assignments described.
Class project requirements discussed.
Class 2 - Jan 14
Overview of EHR; platform, standards, applications, and evolution
Readings: Chapter 1
Class 3 - Jan 19
EHR as a gateway and integration hub. Applications contd.
Readings: Chapter 1
Class 4 - Jan 21
EHR in action from the perspectives of patients & clinicians
Reading: Trotter, F., & Uhlman (additional suggested text-book)
Class 5 - Jan 26
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 28
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 - Feb 2
Data management I.
Readings: Chapter 4
Class 8 - Feb 4
Data management II. Architecture and information exchange platforms.
Class 9 - Feb 9
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 10 - Feb 11
Health vocabularies, taxonomies, and ontologies II.
Readings: Chapter 4
Class 11 - Feb 16
Data modelling in basic and data warehousing contexts. Usabilty.
Readings: Chapter 4.
Class 12 - Feb 18
Usability & Testing Methodology I
Readings: Health Information Tech Usability
Class 13 - Feb 23
Usability & Testing Methodology II
Class 14 - Feb 25
Implementing EHR: coding, vocabularies, interfaces, XML, and APIs.
Readings: Chapter 6.
Class 15 - March 1
Coding and interfacing (contd.). Clinical workflows and clinical processes.
Readings: Chapter 8
Class 16 - March 3
Guest Speaker.
Class 17 - March 8
Evidence-based care and quality improvement I
Readings: Chapter 10.
Class 18 - March 10
Evidence-based care and quality improvement II.
Reading: Buntin, et. al. (2011).
Clinical decision support
Reading: Chapter 9
Class 19 - March 22
Implementing EHR and evaluating systems. Data Governance. Meaningful use I.
Reading: Chapters 16 and 17
Class 20 - March 24
Meaningful Use II contd.
Reading: Caleen, J.L., Braithwaite, J. & Westbrook, J.A. (2008). Hamalka, J.D. (2010).
Class 21 - March 29
Guest Lecture: Clinical data warehouse and integration of data.
Class 22 - March 31
EHR regulations, privacy, and security I
Reading: Chapters 12 and 13
Class 23 - April 5
EHR regulations, privacy, and security contd.
Consumer-centric Health Information I
Reading: Chapters 12 and 13
Class 24 - April 7
Field Trip: 11A with Dr. Carlton Moore.
Class 25 - April 12
Consumer-centric Health Information II
Draft Project Report Due.
Class 26 - April 14
Advanced Topics: Consumer-centric Health Information III
Field Report Due.
Class 27 - April 19
Advanced topics: Mobilie Health & EHR
Take-home Final Due.
Class 28 - April 21
Guest Lecture: UNC Hospital IT Environment and Governance
Class 29 - April 26
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
Email: jm@unc.edu (instructor) and vcarrasc@live.unc.edu) (TA)