OHSU MINF 705B / MINF 709A

Clinical Informatics Medical Student Elective

William Hersh, M.D.
Professor
Department of Medical Informatics & Clinical Epidemiology
Oregon Health & Science University
Course Director
Last updated: September 30, 2024

This document contains the Course Syllabus for the Oregon Health & Science University (OHSU) medical student elective course, Clinical Informatics. The course is offered in two formats, a two-week block (705B) or over a full academic quarter (709A). Both versions of the course provide the same content and anticipate about 72 hours of work. This course is derived from the graduate-level introductory course at OHSU, BMI 510. It is fully virtual and mostly asynchronous, with students working on their own but required to have a 30-60 minute meeting with the instructor near the end of the course. There are no prerequisites.

Objectives

The goal of this course is to provide a detailed overview of biomedical and health informatics. It provides up-to-date details on current events in the field, including electronic health records, data standards and interoperability, clinical decision support, artificial intelligence (AI), population health, patient engagement, and telehealth. It also describes and sets the context for new technologies, such as SMART on FHIR, large language models (LLMs), generative AI, and wearables.

SOM MD Program Competencies

ICS5 - Effectively access, review, and contribute to the electronic health record for patient care and other clinical activities.
PBLI3 - Use clinical decision support tools to improve the care of patients and populations.
PBLI6 - Analyze practice data using quality measurement tools and adjust clinical performance with the goal of improving patient outcomes and reducing errors.
PPPD5 - Adhere to professional standards when using information technology tools and electronic/social media.

Course Logistics

The course provides a broad overview of the field, highlighting the key issues and challenges for the field. The course is taught in a completely asynchronous manner, i.e., there are no "scheduled" classes. The course uses the following teaching modalities:

Voice-over-Powerpoint lectures - These are delivered via Echo360, which makes them available on any device connected to the Internet.
Reading assignments - The course uses supplemental readings as necessary. In addition, students are pointed to key documents, reports, and papers from the field.
Assessments - Each of the units is accompanied by a 10-question multiple-choice self-assessment that aims to have the student apply the knowledge from the unit.
Self-reflection - Students must write a 2-3 page paper describing a clinical or related situation where some aspect of clinical informatics covered in the course could have been used to improve a clinical or other outcome benefiting a patient or care delivery.
A 30-60 minute synchronous discussion session near the end of the course to answer questions about the course or the field.

MINF 705B is typically completed during a two-week block, starting the Monday of the first week and concluding at the end of the day on the Friday of the second week. MINF 709A is completed on the timetable for the BMI 510 course for graduate students, with the last unit due by the 11th week of the quarter. MINF 709A students are not required to post in the discussion forum, complete a graduate student term paper, or take the final exam as BMI 510 students are required to do. The curriculum of the course is also used for the American Medical Informatics Association (AMIA) 10x10 ("ten by ten") program, but MINF 705B and 709A are not required to travel to an AMIA meeting. MINF 705B and 709A students are expected to average 70% across all of the multiple-choice self-assessments.

Instructor

The instructor for the course is William Hersh, MD. The best way to reach him is via email (hersh@ohsu.edu). You may also find interesting reading in his blog.

Grading

The final grade for the course is Pass/No Pass. Student received a passing grade by scoring 70% or higher on the multiple-choice assessments for the 10 units of the course and attending the synchronous session at the end of the course.

Syllabus

The table below outlines the curriculum with unit number and topic. The course has no required textbook. Students are also provided comprehensive lists of references for topics covered in the lectures. There is an optional textbook (co-edited by the course instructor) that students may want to consider: Hersh WR, Ed. (2022). Health Informatics: Practical Guide, Eighth Edition, which has a Web site and is available from Lulu.com in paper and eBook format. The reading assignments from the book are optional, and no material will appear on the homework quizzes or final exam that is not also covered in the class. But some students prefer to also read a textbook when learning. The appropriate chapter readings for each unit in the course are as follows:

Unit	Topic	Textbook Chapter(s)
1	Overview of Field and Problems Motivating It	1, 2
2	Computing Concepts for Biomedical and Health Informatics	3, 23
3	Electronic and Personal Health Records (EHR, PHR)	4, 7
4	Standards and Interoperability	5
5	Artificial Intelligence	6
6	Advanced Use of the EHR	8, 9, 10
7	EHR Implementation, Security and Evaluation	11, 12, 13, 22
8	Information Retrieval (Search)	14
9	Research Informatics	15, 16
10	Other Areas of Informatics	17, 18, 19, 20

When Problems Arise

It is critical to contact the appropriate person when problems arise:

For basic Sakai problems (cannot log in, something not apparently working) and course issues (e.g., unit or discussion forum not posted when it should be), contact the Sakai Help Desk at 877-972-5249 or sakai@ohsu.edu. The Sakai Help Desk hours are 8 am-10 pm. Pacific Mon-Fri and 12-5 pm Pacific on weekends. The Sakai Help Desk is closed on all OHSU-observed holidays.

For questions about course content (e.g., do not understand a topic or disagree with homework quiz answer), contact Dr. Hersh by email. While Dr. Hersh does not maintain scheduled office hours, he is readily accessible via email and will respond within 24-48 hours. Appointments to discuss course matters by phone or in person can be arranged via email.

Detailed Course Outline

1. Overview of Field and Problems Motivating It
1.1 What is Biomedical and Health Informatics?
1.2 A Short History of Biomedical and Health Informatics
1.3 Problems in Healthcare Motivating Biomedical and Health Informatics
1.4 Who Does Biomedical and Health Informatics?
1.5 Resources for Field - Organizations, Information, Education

2. Computing Concepts for Biomedical and Health Informatics
2.1 Types of Computers
2.2 Data Storage in Computers
2.3 Computer Hardware and Software
2.4 Computer Networks
2.5 Software Engineering

3. Electronic and Personal Health Records (EHR, PHR)
3.1 Clinical Data
3.2 History and Perspective of the Health (Medical) Record
3.3 Examples of the EHR
3.4 EHR Data Entry
3.5 Clinical Decision Support
3.6 Personal Health Records

4. Standards and Interoperability
4.1 Standards and Interoperability: Basic Concepts
4.2 Identifier and Transaction Standards
4.3 Message Exchange Standards
4.4 Terminology Standards
4.5 SMART on FHIR

5. Artificial Intelligence
5.1 Definitions and Resources
5.2 Data Science and Machine Learning
5.3 Predictive AI
5.4 Generative AI
5.5 Trustworthy AI

6. Advanced Use of the EHR
6.1 Patient Safety and Medical Errors
6.2 Healthcare Quality Measurement and Improvement
6.3 Health Information Exchange (HIE)
6.4 Population Health
6.5 Natural Language Processing
6.6 From Meaningful Use to Promoting Interoperability

7. EHR Implementation, Security, and Evaluation
7.1 Clinical Workflow Analysis and Redesign
7.2 EHR System Selection and Implementation
7.3 Telemedicine and Telehealth
7.4 Privacy and Security
7.5 Evaluation of the EHR

8. Information Retrieval (Search)
8.1 Information Retrieval
8.2 Knowledge-based Information
8.3 Content
8.4 Indexing
8.5 Retrieval
8.6 Research: Evaluation and Future Directions

9. Research Informatics
9.1 Clinical Research Informatics
9.2 Overview of Basic Molecular Biology
9.3 Translational Bioinformatics
9.4 From Clinical Genetics and Genomics to Precision Medicine
9.5 Omics Data in the EHR and Other Information Systems

10. Other Areas of Informatics
10.1 Nursing Informatics
10.2 Consumer Health Informatics
10.3 Public Health Informatics
10.4 Imaging Informatics
10.5 Evidence-Based Medicine