Diploma of Medical Informatics

Course Introduction:
The practice of modern medicine and biomedical research requires sophisticated information technologies with which medical professionals can manage patient information, plan diagnostic procedures, interpret laboratory results, and carry out investigations Medical Informatics is the active link between information technology and medicine, both fields are rapidly growing in technology and application, and as many other life aspects; it has become impossible to practice modern medicine without advanced information technologies
Healthcare professionals recognized that a large percentage of their work activities relate directly to information management, in the same time there is a powerful trend in the whole world towards automating healthcare information management. This essential conversion is heading towards our communities in a very speedy manner, which – within few coming years - will leave computer illiterate medical professionals far behind, being unarmed with century technology and consequently unable to compete in an open market environment
Hospitals nowadays include IT knowledge as an essential condition to accept new staff whether physicians, pharmacists, dentists, nurses or medical technologists. Most of the hospitals all over the world, at Gulf area and recently at Egypt started to acquire and implement sophisticated Hospital Information Systems, and staff personnel are now requested to use these systems in all work activities. So it is no longer luxury to have the knowledge and experience of using computers at work.

Course Objectives:

To increase healthcare professionals’ awareness of the current and future computer applications in medicine, and provide them with a mechanism to understand available resources.
To prepare healthcare professionals for better use and benefit of computers, HIS, and IT applications creating a new generation of healthcare professionals who are knowledgeable at computers, and consequently are able to compete with international professionals at any point of practice.
prepare Healthcare professionals who are interested to start their professional career in Medical Informatics.
Finally, to encourage our healthcare professionals to participate actively in the process of developing and implementing HMIS and Medical IT at our national healthcare facilities pushing our profession and society in a step forward among advanced world nations.

Course Material:
This course material is based on an accurately selected group of well recognized up-to-date text books in the field of Medical Informatics, Health Informatics, Healthcare Management Information systems, and Electronic Medical Records. In addition, the content of a large number of recently published articles, researches, and scientific reviews have been summarized and added to enrich the text and enhance the application examples. Illustrative images have been used to make a more clear understanding of the sessions’ subjects. Sample medical software, screen shots of hospital information systems, and some manuals of healthcare management information systems – of both local and international vendors - are provided to add a higher practical value to the course content.

Medical Informatics Program Curriculum

Session 1: Medical Informatics and Essentials of Medical Computing:

Introduction to Medical Informatics
Medical Informatics Definitions
Why do we need Medical Informatics?
Information management in biomedicine
The study of computer applications in medicine
Program objectives
Essential concepts of medical computing
Computer architecture
Hardware
Definitions
CPU
Memory
Storage
Input devices
Output devices
Local data communication
Internet communication
Software
Operating systems
Programming languages
Data management
Data base management systems
Network software
Data acquisition and processing
Data and system security

Session 2: Computer and IT Effects on Medicine:

History of computers
Integrated information management
Electronic health records: anticipating the future
Essential issues that must be addressed
Integrating patient record with other information resources
Computers and biomedicine
Terminology
Historical Perspective
Relationship to biomedical science and medical practice
Relationship to computer science
Relationship to biomedical engineering
The nature of medical information
Integrating medical computing and medical practice

Session 3: Medical Data: Acquisition, Storage, and use:

Medical data
Types of medical data
Medical data collection
Uses of medical data
Create the basis for historical record
Support communication among providers
Anticipates future health problems
Record standard preventive measures
Identify deviations from expected trends
Provide a legal record
Support clinical research
Weaknesses of traditional paper based medical records
Logistic issues
Redundancy and inefficiency
Influence on clinical research
Passive nature of paper records
The structure of medical data
Coding systems
The date-to-knowledge spectrum
Strategies of medical data selection and use
Role of computer in medical data collection

Session 4: Medical Decision Making:

Clinical decision nature
Uncertainty
Probability
Diagnostic process
Probability assessment
Subjective probability assessment
Objective probability estimates
Measurement of diagnostic tests
Abnormal test results
Test performance
Sensitivity and specificity
Studying test performance
Test bias and meta analysis
Post test probability (Bayes’ theorem and predictive value)
Expected value decision making
Comparison of uncertain prospects
Representation of choices with decision trees
Performance of a decision analysis
Representation of patients’ preferences
Performance of sensitivity analysis
Representation of long term outcomes with markov models
The decision whether to treat, test, or do nothing
Alternative graphical representation for decision models
The role of probability and decision analysis in medicine

Session 5: System Design and Engineering:

How can a computer system help in healthcare
What is a system?
Functions of a computer system
Data acquisition and presentation
Record keeping and access
Communication and integration of Information
Surveillance
Information storage and retrieval
Data analysis
Decision support
Education
Identifying and analyzing the need for a computer system
Understanding medical information systems
Illustrative cases
Involving future users during development
Developing and implementing systems in healthcare
Systems acquisition alternatives
Commercial off-the-shelf software
Technology transfer
Specifying information processes
Building a new software system
Alternative methodologies
Business objects
Incorporating remote services
Designing for effectiveness
Planning for change

Session 6: Standards in Medical Informatics:

The idea of standards
The need for medical informatics standards
Standards undertakings and organizations

The standards development process
information standards organizations

Coded terminologies, vocabularies, and nomenclatures

Specific Terminologies
ICD-9-CM, ICD-10, DRGs, ICPC, CPT, SNOMED, LOINC, HCPCS

Data interchange standards

General concepts and requirements
Specific data interchange standards
ACR/NEMA, ASTM-E31, Health Level 7, IEEE-MEDIX, NCPDP, ANSI-X12, ADA-MD-156, UCC, HIBCC, WEDI…etc.

Today’s reality and tomorrow’s directions

Session 7: Ethics in Medical Informatics:

Ethical issues in medical informatics
Medical informatics applications; appropriate use, users, and context

The standard view of appropriate use
Appropriate users and educational standards
Obligations and standards for system developers and maintainers

Privacy, confidentiality, and data sharing

Foundations of health privacy and confidentiality
Electronic clinical and research data

Social challenges and ethical obligations

Informatics and managed care
Effects of informatics on traditional relationships

Legal and regulatory matters

Difference between law and ethics
Legal issues in healthcare informatics
Regulation and monitoring of computer applications in healthcare

Session 8: Evaluation and Technology Assessment:

Introduction and definitions of terms

Evaluation and technology assessment
Reasons for performing studies

The challenges of study design and conduct

The complexity of medicine and healthcare delivery
The complexity of computer based information resources
The complexity of study methods

The full range of what can be studied
Approaches to study design

The anatomy of all studies
Philosophical bases of approaches to evaluation
Multiple approaches to evaluation
Stages of technology assessment

Conduct of objectivist studies

Structure and terminology of comparative studies
Issues of measurement
Control strategies in comparative studies
Threats to validity
Cost effectiveness and cost benefit studies

Conduct of subjectivist studies

The rationale for subjectivist studies
A rigorous but different methodology
Natural history of subjectivist study
Data collection and data analysis methods

Conclusion: The mindset of evaluation and technology assessment

Session 9: Electronic Medical Records:

Definition of EMR, CPR
Ways in which a computer based patient record differs from a paper based record
History of Medical Records
Historical development of EMR
Functional components of EMR

Integrated view of patient data
Clinical decision support
Clinician order entry
Access to knowledge resources
Integrated communication support

Fundamental issues for EMR

Data entry
Data display
Query and surveillance systems

Challenges ahead

Users’ information needs
User interfaces
Standards
Legal and social issues
Costs and benefits
Leadership

Recent applications of EMR

Web portal of EMR
Web-based EMR
Portable EMR
Laser and magnetic cards
Wireless devices
Pocket and Tablet PCs
Implantable microchip

Session 10: Information Management in Integrated Delivery Networks:

Information management in healthcare organizations

Evolution from hospital to healthcare information systems
Information requirements
Integration requirements
Security and confidentiality requirements
Benefits of healthcare information systems
Managing information systems in a changing healthcare environment

Functions and components of healthcare information systems

Patient management
Departmental management
Care delivery and clinical documentation
Clinical decision support
Financial and resource management
Managed care support

Alternative architectures for healthcare information systems

Central systems
Modular systems
Distributed systems

Architecture for a changing environment
Healthcare information systems comparison
Forces that will shape the future of healthcare information systems

Session 11: Patient Care and Patient Monitoring Systems:

Information management in patient care

Basic concepts
Supportive information

Evolution of patient care systems
Current research

Models formulation
Innovative systems development
Systems implementation
Study of the effect of systems

Patient monitoring

Historical perspective

Development of ICU
Computer based monitoring

Data acquisition and signal processing
Information management in the ICU
Active issues in patient monitoring

Data quality and validation
Continuous versus intermittent monitoring
Data recording
Invasive versus noninvasive monitoring
Integration of patient monitoring devices
Closed loop therapy
Treatment protocols

Session 12: Medical Imaging Systems:

Imaging and imaging informatics

Roles of imaging in healthcare
The radiologic process and its interaction

Image generation

Basic concepts
Historical development of imaging modalities

Image management

Basic concepts; acquisition, storage, transmission, format standardization, display, and cost
RIS, PACs and teleradiology

Image manipulation and analysis
Integration of images with other healthcare information
Future directions for radiology imaging systems

Session 13: Information Retrieval Systems:

Evolution of medical information retrieval
Information retrieval process

Content
Indexing
Information needs
Query formulation
Retrieval
Evaluation

Trends in medical information retrieval

Distributed hypermedia
The need for a common medical vocabulary – unified medical language system
Aggregation of content

Future challenges in medical information retrieval

Session 14: Clinical Decision Support Systems:

Nature of clinical decision making

Types of decisions
The role of computers in decision support

Historical perspective

Leeds abdominal pain system
MYCIN
HELP

A structure for characterizing clinical decision support systems

System function
The mode of giving advice
Style of communication
Underlying decision making process
Human computer interaction

Construction of decision support tools
Examples of clinical decision support systems

Diagnosis: The internist-1/QMR project
Patient management: The EON system

Future of decision support systems

Session 15: Computers in Medical Education:

The role of computers in medical education
Modes of computer based learning

Drill and practice
Didactic: the lecture
Discrimination learning
Exploration versus structured interaction
Constrained versus unconstrained response
Construction
Simulation
Feed back and guidance
Intelligent tutoring systems

Current applications

Preclinical applications
Clinical teaching applications
Continuing medical education
Consumer health education
Distance learning

Design, development, and technology
Evaluation

Session 16: Bioinformatics:

The problem of handling biological information

Sources of information explosion
Implications for clinical informatics

The importance of bioinformatics

Importance of sequences in biology
Importance of structures in biology

Roots of modern bioinformatics

Early work in sequence and structure analysis
The parallel rise of bioinformatics and computes

Current applications successes from bioinformatics

Sequence databases
Structure databases
Molecular-disease databases
Key bioinformatics algorithms
Web based storage, search, and retrieval
Molecular visualization

Future challenges as bioinformatics and clinical informatics converge

Completion of multiple human-genome sequences
Linkage of molecular information with symptoms, signs, and patients
Computational representation of the biomedical literature
A complete computational model of physiology

Session 17: Internet & future application of computer in healthcare:

Progress in healthcare computing
Integration of computer based technologies
Future role of computers in healthcare
Forces affecting the future of medical computing

Changes in computers and biomedical technology
Changes in the background of health professionals
Legal considerations
Healthcare financing

Medical data mining

The foundations and evolution of data mining
Data mining definition and techniques
Data mining and knowledge discovery (KDD)
Medical data mining applications

Looking back: what have we learned?

Session 18: Course Revision:

Reviewing basic concepts of each session
Reviewing main skills acquired, main objectives and fundamental elements
Summarizing conclusions and highlighting recommendations
Answering questions and giving examination instructions

Final Evaluation:

Students’ evaluation (Grading system):
Class attendance 20 %
Class participation 20 %
Home works / Final project 30 %
60 MCQs exam 30 %
Program evaluation
Through a feed back form to evaluate course content, course importance, clear students’ comments, criticism, and suggestions
Instructor evaluation
Through a feed back form to evaluate instructor skills, defects, and applicable suggestions

Notes:
This program is composed of 18 sessions, each of which is given in a 4 hours duration – from 6 pm to 10 pm - once a week. Sessions are presented in a power point slide show of 50 slides on average for each. Print-out of slides as well as additional reading materials will be given to students prior to the beginning of each session. Students’ feed back forms will be used to evaluate program, instructor, as well as to clear comments, criticism, and suggestions. Students’ evaluation will depend on their class attendance, discussion participation, home works, and a final 90 minutes MCQs exam.

Each session will begin with a brief review of the previous session and answering its home work questions and any inquiry about its content. Then the session of day is used, after that we will review current session main points and answer questions.

Duration: 72 hrs

Cost: 3999 L.E.