OHSU Online · School of Medicine
Clinical Information Systems
- Spring 2019
- 3 Credits
- 04/01/2019 to 06/21/2019
- Modified 03/29/2019
An in-depth study of the acquisition, storage, and use of information in the electronic medical record. Students will learn about the types of information used in clinical care: text, structured data, images, and sounds. Other topics covered include: clinical vocabularies (existing schemes and their limitations); how clinical information is generated and utilized; methods of information storage and retrieval; departmental systems (laboratory, radiology, and hospital information systems); organizational systems (including financial systems and the electronic medical record); telemedicine; and the legal, regulatory, and social problems of clinical systems, including security and confidentiality.
Prerequisite: BMI 510/610.
Offering: Online: Fall, Winter, Spring
You will learn through the Sakai learning management software at http://sakai.ohsu.edu. The online component includes reading material, lectures (including streaming presentations and handouts), project material, learning assignments, and online discussions. If you have any technical questions or if you need help logging in, please contact the Sakai Help Desk, which is open Mon – Fri, 8 am – 9 pm and weekends 12 pm – 5 pm, Pacific Time.
(Email) [email protected]
Vishnu Mohan MD MBI FACP FAMIA
About me: I am an internist, clinical educator, and clinical informatician, and an Associate Professor in Medical Informatics, Medicine, and Management here at OHSU. I am board certified in internal medicine and in the subspecialty of clinical informatics. I serve as Program Director for the ACGME-accredited Clinical Informatics subspecialty fellowship at OHSU.
Teaching: I teach four core clinical informatics courses at DMICE - BMI 560/660 (Design and Evaluation in Health Informatics), BMI 512/612 (Clinical Information Systems), BMI 513 (Electronic Health Record Lab), and BMI 519 (Business of Healthcare Informatics). I also teach ISQA 551 (Healthcare Information Technology for Managers) for the PHSU/PSU MBA in Healthcare Management program. As an internist and clinician-educator, I also teach residents, medical students, and clinical informatics fellows.
Research interests: My primary research interest is in ensuring patient safety in the delivery of healthcare, and in promoting clinical diagnostic reasoning in today’s technology-rich clinical environment. I study how clinicians interact with technology, and how technology affects their decision-making. I am also interested in using high-fidelity simulations to examine how clinicians interact with technology. I have been involved with developing protocols that promote EHR safe use.
Other interests: I am also interested in clinical and biomedical informatics education, as well as curriculum development that helps to train the clinical and health IT workforce.
Homepage: My OHSU web page is at: https://bit.ly/2Ub9Q39
Address: BICC 409
Department of Medical Informatics and Clinical Epidemiology
Oregon Health & Science University
3181 Sam Jackson Park Rd
Portland, OR 97239
Email: [email protected]
Telephone: 503 494 4469
How to reach me: Email is always the best way to communicate with me.
My office hours are by appointment – email me for a time when we can meet virtually or face-to-face.
There is no prescribed textbook for the course. Core readings will be made available to students as the course progresses.
This course will enable you to:
- Learn about clinical information systems (CIS), with emphasis on electronic health records (EHRs)
- Appreciate CIS-related concepts of clinical workflows and user interface design
- Address important applications of CIS, including computerized physician order entry, clinical decision support, and clinical reporting
- Understand how organizations approach implementation, maintenance and optimization of EHRs in both outpatient and inpatient settings
- Gain knowledge of topics associated with CIS privacy and security, EHR certification, interoperability, and Meaningful Use guidelines
- Utilize practical approaches to real-world challenges associated with clinical information systems
Course Competencies, Outcomes, and Objectives
By design, this course has a diverse evaluative framework that includes evaluation of both individual and group activities in order to provide a comprehensive and accurate reflection of the student’s course activities. The grading is divided into 4 components:
Online participation = 30%
Clinfowiki post = 10%
Group project = 30%
Final paper = 30%
Grades are assigned on a curve, but are generally based on the following cutoffs:
How will I be graded for participation online?
Each week, students will be required to participate in discussions, held in the Forums section on Sakai. Discussions will typically center on a topic that I will put up at the beginning of each week. We will also discuss group projects, individual student final projects, and other CIS-related topics that you may want to talk about during the term.
Forums participation is graded using the following rubric:
0 = no participation
1 = minimal participation
2 = adequate participation in discussion (students posts satisfy the requirements)
3 = student post demonstrates that they have met learning objectives
4 and 5 = superior participation in a meaningful manner that promotes the learning of others
You will see that there is a significant weightage towards participation that allows others to learn from your perspectives.
What are the assignments I will have to complete during this course?
During week 5 of this course, you will be assigned to a group of about 3-4 students (the group size varies depending on class size and the number of scenarios offered for this activity), and tasked with completing a group project that is designed around case scenarios. You will have 3 weeks to complete your project. Clinical informatics is a collaborative field, and these projects are intended to offer insight into the types of collaboration that you may be engaging in as a clinical informatician. Students are expected to collaborate on all deliverables, and each group will be assigned a single grade that will apply to all students within that group.
Individual student term project
The student project represents a significant individual effort that should be similar to one you might be assigned as the Director of Clinical Information Systems. You will be required to deliver a 5-10 page (not including references or executive summary) report, complete with a 1-page executive summary. Please take the time to proofread your submission for grammar and language before submission. To allow all students to operate under the same requirements, the paper should be typed, double spaced, with the font selected to 12 pt Times New Roman.
Please submit original work for your student project. Do not reuse material from other courses.
Examples of prior student final project topics:
- Request for Proposal for a CIS
- Analysis of a CPOE implementation plan
- Clinical Decision Support proposal
- Post-implementation CIS evaluation plan
- CIS business case including return on investment estimates
- Case study describing a current or past CIS, EMR, etc. implementation, along with current status
- Overview of local health information system infrastructure from an interoperability perspective
- Proposal to implement a speech recognition system for adult primary care providers
- Benefits and challenges associated with implementing an open source EHR
- Review of EHR downtime contingency planning
- Efficiency of anesthesia information management systems in the perioperative setting
- Text messaging in healthcare
- Utilizing EHRs to improve TQM/CQI
- Optimizing patient portals with respect to patient adoption and use
- Utilizing the EHR for chronic disease management
- Moving the EHR to the Cloud
- Enforcing HIPAA compliance in small rural hospitals
You will be expected to contribute an article to OHSU Clinfowiki, a clinical informatics wiki project that is a resource for clinicians, clinical informaticians, and information system professionals working in healthcare. I serve as the Editor for Clinfowiki, which can be found at: http://www.clinfowiki.org
What are students expected to do in order to successfully complete this course?
To succeed in this course, you are expected to:
- Review reading assignments; including lectures, chapters from the required textbook, articles or handouts, and independent reading for projects and questions. You are responsible for learning all content in the assigned readings, whether discussed in the lectures or not.
- Participate in class discussions; this class actively encourages engagement and participation by all students. Your participation grade is based on your level of contribution to the learning of others.
- Complete assignments and projects in a timely fashion. It is anticipated that you will substantiate your assertions with appropriate attribution, and demonstrate that you possess the ability to critically retrieve and analyze information that is available in the informatics literature. Many assignments and projects involve teamwork for preparation, presentation, and grading. As is common in real life, there are penalties for late submissions and bonuses for those who turn their work in early.
- Complete quizzes and other evaluative tools during the course in a timely fashion.
Course & Instructor Evaluations
The course is structured in a modular fashion as a series of weekly components. Each weekly module includes a lecture, additional reading material, and assignments. Tests may also be held online, at the discretion of the instructor. Lectures may be delivered by guest lecturers with experience in the operational informatics universe.
Example of the course schedule and topics covered (note that the actual schedule for this course may vary from the example):
Introduction - What Is A Clinical information System?
User Interface Design and EHR Usability
Computerized Provider Order Entry
Clinical Decision Support
Clinical quality informatics
Implementation and Go-Live
Configuring clinical information systems
Privacy and Security
Course Policies and Resources
What is your philosophy on learning and the role of the instructor?
At this level of education, I anticipate that students will be adult learners and already have significant insight into the way they learn best.
My classes emphasize a culture where participation and sharing information results in the dissemination of knowledge and wisdom. Expect to spend a significant proportion of your time engaged in online conversation with other students and with me.
When I teach a course at the graduate level, I often find that I learn as much from you as you do from your instructors. I see my role as primarily that of a facilitator, helping you reach your learning goals for the course.
What is the best way to participate in Forums?
Participation scores are graded weekly, so read and post on the Forum regularly! The weekly score is based on your level of contribution to the learning of others. I’m looking for quality, not quantity! It’s not how much you post, but what you say and how you say it.
Remember that a Forum format is just that – a place for meaningful discussion. Responses to posts often are as useful to enhance learning as the original post itself. The Forum is a great format to help us learn from each other.
Please read all prior responses before replying to a specific post. This will help grow the conversation and avoid repletion.
Please respect the opinions of others when posting on the Forum.
Please do take the time to frame your posts clearly and concisely, with attention to grammar and punctuation.
School Policies and Resources
Grading Criteria, Academic Standards, & Release of Final Grades:
Graduate Studies in the OHSU School of Medicine is committed to providing grades to students in a timely manner. Course instructors will provide students with information in writing at the beginning of each course that describes the grading policies and procedures including but not limited to evaluation criteria, expected time needed to grade individual student examinations and type of feedback they will provide.
All coursework applied towards degree requirements must meet the minimum cumulative grade point average of at least 3.0.
Refer to the School of Medicine Graduate Studies Forms & Policies for withdraw, incomplete, and in-progress grading standards. Final course grades will be posted with the OHSU Registrar the Monday following the last day of the term. On those occasions when a grade has not been submitted by the deadline, the following procedure shall be followed:
- The Department*/Program** Coordinator will immediately contact the Instructor requesting the missing grade, with a copy to the Program Director and Registrar.
- If the grade is still overdue by the end of next week, the Department*/Program** Coordinator will email the Department Chair directly, with a copy to the Instructor and Program Director requesting resolution of the missing grade.
- If, after an additional week the grade is still outstanding, the student or Department*/Program** Coordinator may petition the Office of Graduate Studies for final resolution.
*For courses that are run by a specific department.
**For the conjoined courses (course number is preceded by CON) that are run by Graduate Studies.
Graduate Studies Guidelines:
Students are responsible for following all OHSU School of Medicine, Graduate Studies, and program/department guidelines & policies. For more information, please visit here. For program/department guidelines & policies, please inquiry with the program/department director and/or coordinator.
School of Medicine Conduct Policy (housed under the graduate studies guidelines section)
Students are responsible for their own academic work. Students are expected to have read and practice principles of academic honesty, as presented in the Graduate Studies Student Handbook.
The School of Medicine reserves the privilege of retaining only those students who, in the judgement of the faculty, satisfy the requirements of scholarship and clinical performance necessary to maintain the highest standards. The Student Handbook has information about academic standards and probation and dismissal policies.
Graduate Studies Copyright Information
Every reasonable effort has been made to protect the copyright requirements of materials used in this course. Class participants are warned not to copy, audio, or videotape in violation of copyright laws. Journal articles will be kept on reserve at the library or online for student access. Copyright law does allow for making one personal copy of each article from the original article. This limit also applies to electronic sources.
Graduate Studies Inclement Weather Procedures
Inclement weather procedures can be found here. In the case of inclement weather, the faculty member will email or place a voice-mail greeting on her/his office telephone number by 6:00am on the day of the clinical or class to give instructions to students about the class schedule.
OHSU Graduation Core Competencies
1. Professional Knowledge and Skills
Demonstrate competence in the core knowledge, skills, and practices as defined by degree programs and relevant professional licensing and credentialing boards.
2. Reasoning and Judgement
Demonstrate the ability to identify and define problems, critically compare options, make timely decisions or recommendations, identify uncertainties, and use findings to improve outcomes in light of evolving evidence.
3. Evidence-Based Practice and Research
Demonstrate the ability to access, evaluate, and apply relevant science knowledge to support evidence-based health care, disease prevention, health promotion and discovery.
4. Lifelong Learning
Demonstrate the ability to recognize gaps in knowledge and experience through informed self-assessment and reflective practices, and take actions to address those gaps.
Demonstrate active listening and oral and written communication skills with diverse individuals, communities, and colleagues to ensure effective, culturally appropriate exchange of information.
6. Professionalism and Ethics
Demonstrate integrity, honesty, knowledge of ethical principles and the standards of professional conduct, and the ability to apply ethical principles in clinical care, research, education or community service.
Demonstrate the abilities required to foster and work effectively within collaborative, team-based environments.
8. Safety and Quality Improvement
Demonstrate the ability to identify situations that compromise safety and participate in risk reduction and continuous quality improvement.
Demonstrate an appropriate understanding of evolving health care systems, health and science policy, and resource allocation in order to optimize human health and scientific discovery.
10. Patient/Client-Centered Care
Additionally, clinical degree program graduates will be able to...
Demonstrate the ability to collaborate with diverse individuals, families, and communities to provide quality care that is respectful of and responsive to their preferences, needs, attitudes, beliefs and values.
Institutional Policies and Resources
Statement Regarding Students with Disabilities:
OHSU is committed to inclusive and accessible learning environments in compliance with federal and state law. If you have a disability or think you may have a disability (mental health, attention-related, learning, vision, hearing, physical or health impacts) contact the Office for Student Access at (503) 494-0082 or OHSU Student Access to have a confidential conversation about academic accommodations. Information is also available at Student Access Website. Because accommodations may take time to implement and cannot be applied retroactively, it is important to have this discussion as soon as possible.
Student Evaluation of Courses:
Course evaluation results are extremely important and used to help improve courses and the learning experience of future students. Responses will always remain anonymous and will only be available to instructors after grades have been posted. The results of scaled questions and comments go to both the instructor and their unit head/supervisor. Refer to Student Evaluation of Courses and Instructional Effectiveness, *Policy No. 02-50-035.
*To access the OHSU Student Evaluation of Courses and Instructional Effectiveness Policy, you must log into the OHSU O2 website.
Copyright laws and fair use policies protect the rights of those who have produced the material. The copy in this course has been provided for private study, scholarship, or research. Other uses may require permission from the copyright holder. The user of this work is responsible for adhering to copyright law of the U.S. (Title 17, U.S. Code). To help you familiarize yourself with copyright and fair use policies, the University encourages you to visit its Copyright Web Page
Sakai course web sites contain material protected by copyrights held by the instructor, other individuals or institutions. Such material is used for educational purposes in accord with copyright law and/or with permission given by the owners of the original material. You may download one copy of the materials on any single computer for non-commercial, personal, or educational purposes only, provided that you (1) do not modify it, (2) use it only for the duration of this course, and (3) include both this notice and any copyright notice originally included with the material. Beyond this use, no material from the course web site may be copied, reproduced, re-published, uploaded, posted, transmitted, or distributed in any way without the permission of the original copyright holder. The instructor assumes no responsibility for individuals who improperly use copyrighted material placed on the web site.
Syllabi Changes and Retention:
Syllabi are considered to be a learning agreement between students and the faculty of record. Information contained in syllabi, other than the minimum requirements, may be subject to change as deemed appropriate by the faculty of record in concurrence with the academic program and the Office of the Provost. Refer to the *Course Syllabi Policy, 02-50-050.
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OHSU is committed to creating and fostering a learning and working environment based on open communication and mutual respect. If you encounter sexual harassment, sexual misconduct, sexual assault, or discrimination based on race, color, religion, age, national origin, veteran’s status, ancestry, sex, marital status, pregnancy or parenting status, sexual orientation, gender identity, disability or any other protected status please contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or [email protected]. Inquiries about Title IX compliance or sex/gender discrimination and harassment may be directed to the OHSU Title IX Coordinator at 503-494-0258 or [email protected]
Modified Operations, Policy 01-40-010:
Students should review the Student Portal, O2, or call OHSU’s weather alert line at 503-494-9021 for the most up-to-date information on OHSU-wide modified operations which include but are not limited to delays or closures for inclement weather. For specific campus information, outside of Portland, check the following sites:
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