Electronic Health Records
Foundation of Clinical Informatics (INLS 725)
Dr. Javed Mostafa
Tuesday & Thursday, 11:00-12:15PM
214 Manning Hall
Carolina Health Informatics Program (CHIP)
iSchool @ Carolina
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, LOINC, 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)
- 30% Final Project Report
* 35% 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 |
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: Understanding and Using Computerized Medical Records
Gartee, R. Pearson. 2017.
A version is available for rent from Amazon.com. This is the version we are recommending for this class.
Additional Recommended Books
Electronic Health Record: Standards, Coding Systems, Frameworks, and Infrastructures. Sinha, P. K., Sunder, G., Bendale, P., Mantri, M., Dande, A. Wiley-IEEE Press, 2013.
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 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
Reading: Trotter, F., & Uhlman (additional suggested text-book)
Class 5 - Jan 24
Health data architectures, standards, and protocols I.
Readings: Payne et al., 2010 (Current Case Study); Fernandopulle & Patel, 2010 (Current Case Study)
Class 6 - Jan 29
Health data architectures, standards, and protocols II.
Readings: Payne, T. (2008). In Practical Guide to Clinical Computing Systems (Thomas Payne, Ed.). Architecture of Clinical Computing Systems (Chapter 2)
Class 7 - Jan 31
Data management I.
Class 8 - Feb 5
Health vocabularies, taxonomies, and ontologies I.
Class 9 - Feb 7
Data Standards and Usability
Class 10 - Feb 12
Class Presentations: Project Part 1
Class 11 - Feb 14
Knowledge Representation. Ontologies II. Expert Systems.
Readings: Chapter 2; 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 12 - Feb 19
Data modelling in basic and data warehousing contexts. Usabilty.
Readings: Health Information Tech Usability
Class 13 - Feb 21
Data modelling in basic and data warehousing contexts II.
Class 14 - Feb 26
Data analytics and interchange formats based on XML and APIs.
Readings: Chapter 12.
Class 15 - Feb 28
Data analytics contd.
Class 16 - March 5
Evidence-based care and quality improvement I
Readings: Chapter 7 and 8. Additional readings will be assigned.
Class 17 - March 7
Guest Speaker.
Class 18 - March 19
Work-flow, interaction, and critical data at the point-of-care (SOAP)
Class 19 - March 21
Guest Lecture: Clinical data warehouse and integration of data.
*Class 20 - March 26*
Medical Guidelines: Evidence-based Care I
*Class 21 - March 28*
Evidence-based care and quality improvement II.
Implementing EHR and evaluating systems. Data Governance. Meaningful use.
Readings: Chapter 9; Buntin, et. al. (2011).
Reading: Caleen, J.L., Braithwaite, J. & Westbrook, J.A. (2008). Hamalka, J.D. (2010).
Class 22 - April 2
Clinical decision support
EHR regulations, privacy, and security I
Reading: Chapters 9, 10 and 11
Class 23 - April 4
EHR regulations, privacy, and security contd.
Reading: Chapter 11
Class 24 - April 9
Meaningful Use & its implications
Consumer-centric Health Information I
Class 25 - April 11
Consumer-centric Health Information II
Draft Project Report Due.
Class 26 - April 16
Advanced Topics: Consumer-centric Health Information III
Class 27 - April 18
Advanced Topics: Patient enagagement, mobilie health, and patient-generated health data
Take-home Final Due.
Class 28 - April 23
Guest Presentation
Class 29 - April 25
Guest Presentation
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)