Day 1 - Monday, May 27, 2002

Session 1: 8:30 - 9:00 AM

Faculty

Educational Objectives

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Session 1A: 9:00 - 10:00 AM

Faculty

Educational Objectives

At the completion of the session, participants will: 

• Understand the "interagency model" and the government-industry-university approach to the HPCC work.
• Understand the initial opportunities in biomedical applications of the NII.
• Have a beginning set of funding contacts.

Session Outline

1. High Performance Computing and Communications federal program
• Background and Legislation
• Objectives and Organization
• Phase 1
• Accomplishments - Grand Challenges
• Progress on Grand Challenge Problems
• Phase 2
• National Information Infrastructure
• National Challenge Applications
• Non-medical
• Medical
2. NLM Role in the NII
• Intramural Research
• UMLS
• Visible Human
• Extramural Research
• NII medical testbed
• Telemedicine
• Computer-based patient record
• Public Policy Issues
• Medical Data Privacy
• National Security
• Intellectual Property Rights
• Traditional Copyright Demands
• Today's Revolution in Electronic Publishing
• Federal Research Funding Sources for Medical Informatics
• NLM Programs
• Other HHS Programs
• Other federal agency support

Session 2: 10:30 AM - 12:00 N

Faculty

Educational Objectives

At the completion of the session, the participant will: 

• Understand telemedicine as an information process
• Become familiar with HIPAA and the misconceptions associated with its implementation
• Be familiar with the NLM Telemedicine Program as a demonstration of how information can influence health outcomes.

Session Outline

1. History
2. Definition
• Information to support medical decision making
• Signal processing and imaging
• Arrangements to practice medicine at a distance
3. Security and privacy of medical records
4. HIPAA
5. NLM's National Telemedicine Initiative

Session 3: 1:30 PM - 3:00 PM

Faculty

Educational Objectives

At the completion of the session, the participant will: 
 

• Understand the national need for a high-speed/high-reliability network and its relevance to healthcare
• Be familiar with the federal Next Generation Internet Program and the academic Internet2 Program, and how the two are inter-related.
• Be familiar with the NLM/NGI Program as a demonstration of the relevance of NGI technology in healthcare.

Session Outline

1. The National Challenges
2. Current Internet vs. NGI
• Passive vs active
• "Quality of Service" (QoS)
• Priority services
3. Federal Next Generation Internet Program
• Agencies
• Goals and metrics
• Applications areas
4. Academic Internet2 Project
• Project goals
• Corporate partners
• Applications and application areas
• Middleware
• Abilene Network
5. NGI and Internet2
• Joint engineering objectives
6. NLM/NGI Program
• "Networking Health:  Prescriptions for the Internet"
• Needed NGI services
• Phase I:  Planning  (FY-99)
• Phase II:  Implementation  (FY-00/02)
• Phase III:  Scaling (FY-03/05)

Session 4: 3:30 PM - 5:00 PM

Faculty

Educational Objectives

At the completion of the session, participants will: 

• Have created a personal web page with one or more images, and hyperlinks using free HTML editor (Netscape Composer)
• Have a basic understanding of digital image editing software (Photoshop).
• Have created a class resource that enables participants to know one another better

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Evening Session

Faculty

Educational Objectives

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Day 2 - Tuesday, May 28, 2002

Session 1: 8:30 AM - 10:00 AM

Faculty

Educational Objectives

At the completion of the session, participants will: 

• Know the issues facing the US regarding copyright and database protection world-wide
• Know if they support or do not support federal privacy legislation, and its features
• Understand the basis for current data encryption methods.
• Will have tested at least two Security Token Authentication devices.
• Know if they prefer to operate Challenge Response or Time Synchronous security devices.

Session Outline

1. Intellectual Property Rights
• WIPO Treaty proposals
• Pub Med Plans
2. Encryption
• Basic concepts
• DES Public-Private Key
• Implementation and Devices
a) Data Encryption Technology 
• Private Key Encryption
• Digital Encryption Standard
• Kerberos
• Public-Private Key Encryption
b) System Considerations 
• Length of Cipher Keys
• Security Token Authentication
c) Devices 
• Challenge - Response
• Time Synchronous
3. Medical Data Privacy
• Requirements
• Legislation
• Overview
• Status of Federal Privacy Legislation
• Contentious Issues
• Initial Practical Experience with Medical Data Privacy Assurance

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Session 2: 10:30 AM - 12:00 N

Faculty

Educational Objectives

• Have received an introduction to the history of the Unified Medical Language System
• Be introduced to the content of the UMLS Knowledge Sources: the  Metathesaurus, the Semantic Network and the SPECIALIST lexicon
• Have viewed a demonstration of the UMLS Knowledge Source Server
• Have viewed a demonstration of the UMLS Metathesaurus browser application in the Internet Grateful Med program, including the introduction of related concepts and co-terms
• Have received an introduction to technologies that are shaping the further development of the Internet and the ways we use it.

• Unified Medical Language System
• History
• The UMLS Metathesaurus
• The UMLS Semantic Network
• The SPECIALIST lexicon
• The UMLS Knowledge Source Server
• The Internet Grateful Med Metathesaurus browser as an example of a UMLS application, with emphasis on related concepts and co-terms
• Internet Futures
• Context
• Internet Protocol (IP)
• IPv6
• Quality of Service (QOS)
• Optical switching
• Virtual Private Networks (VPNs)
• Digital Spread Spectrum
• Bluetooth
• Wireless Access Protocol (WAP)
• Ubiquity (wearable computing)
• Dynamic content
• Standards/open source

Session 3: 1:30 - 3:00 PM

Faculty

Educational Objectives

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Session 4: 3:30 - 5:00 PM

Faculty

Educational Objectives

Session Outline

1. PubMed Overview
2. Automatic Term Mapping
• Search Formulation and Retrieval
• Search Refinement
• Feature's Bar (Limits, Preview/Index, History and Clipboard)
3. Related Articles
4. LinkOut
5. Cubby
6. NLM's Gateway Overview
7. Searching Multiple Databases
8. Using MeSH
9. Define Your Own Display Format
10. Hands on lab time

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Evening Session

Faculty

Educational Objectives

• Understand the historical evolution of computerized data handling methods
• Know the relative strengths and weaknesses of hierarchical, relational, information network, and object-oriented database systems
• Understand the process of development of a set-theory-based relational data model, including entity-relationship definitions, principles of fully normalized relational models, state transitions and data flow diagrams.
• Understand the design principles involved in the transformation of a flat file record structure to a normalized relational structure (lab exercise).

Session Outline

• Database definitions and paradigms
• What is a Database?
• Historical Evolution of data management techniques
• General benefits of Database Management Systems (DBMSs)
• DBMS types
• Heirarchical
• Information Network (linked lists and pointers)
• Relational
• Object-oriented
• XML
• Principles of Relational database design
• Representation of real world objects and their attributes
• Relationships between objects
• Table notation formalisms
• Relationships: one-to-one, one-to-many, many-to-many
• System design and building methods
• Entity-relationship diagrams
• State Transition Models
• Data Flow Diagram
• Transforming flat files to tables
• A sample problem in database design

Day 3 - Wednesday, May 29, 2002

Sessions 1 and 2:  8:30 AM - 12:00 N

Faculty

Session Outline

Within medical informatics, there is increasing interest in evaluation and empirical studies.  From an administrative perspective, as institutions invest in new technology, it is critical for them to know how these systems can contribute to health care, education, and research so they can set develop plans and set priorities.  From a more academic perspective, research projects in informatics, including doctoral dissertations and masters theses, now often include an evaluation or empirical study component.  Much of the funded research in informatics is required to have such a component. 

This day-long session on evaluation will provide participants with an understanding of the range of evaluation methods that are used in informatics and will address how studies are designed as well as how data for these studies are collected, analyzed, and reported.  We will address during the day many of the challenges that make evaluation difficult, emphasizing those challenges that are particular to medical informatics, and we will discuss methods that have been developed for addressing many of these challenges. 

Educational Objectives:

At the completion of the session, participants will be able to: 

1. Describe the purposes of evaluation in medical informatics.
2. List several factors that can make it difficult to do evaluation in medical informatics effectively, as well as strategies that can be employed to address these difficulties.
3. Distinguish objectivist (quantitative) and subjectivist (qualitative) approaches, describe the assumptions that underlie them, and explain why both methods are used.
4. Identify the major steps in the process of conducting objectivist and subjectivist studies.
5. Identify the individuals or groups comprising the “audience” for an evaluation study.
6. Describe how the methods and purposes of a study can be matched the level of maturity of an information resource.
7. Frame many of the recurring difficulties of evaluation in medical informatics as problems of measurement.
8. Distinguish between measurement errors that are issues of reliability from those that are issues of validity.  Distinguish between different types of validity.
9. Explain how “measurement studies” can be conducted to identify the sources of error in any measurement process, and to estimate the magnitude of these errors.
10. Explain what is meant by a “gold standard” in the framework of a measurement study.

Identify measurement methods and features of measurement instruments that can be employed to reduce measurement errors. 
11. Identify some specific evaluation questions or issues that lend themselves particularly well to subjectivist approaches.
12. Explain how the questions and key issues of a study arise through the process of immersion.
13. Describe the major data collection strategies in subjectivist research, how these are used in a complementary way within a study, and how the data generated by each are analyzed.
14. Explain the steps a researcher can take to ensure the veracity of the findings of a subjectivist study.
15. Describe some of  the barriers to combining objectivist and subjectivist methods within a single study.

Session 3 - 1:30 - 3:00 PM

Faculty

Goals:
 
1. Understand the major sources of Biomedical Informatics Data
2. Be able to list 3 approaches to data acquisition
3. Be able to describe two types of ASR systems
4. Understand the role of NLP in structuring information

Outline:

1. Sources of Data
2. Signal Acquisition
3. Image Acquisition
4. Collecting Data from People
5. Speech Recognition
6. What is NLP?
7. Medical Sublanguage
8. NLP Challenges
 

Human Computer Interaction

Faculty

Educational Objectives

Goals:
1. Be able to describe importance of formal HCI design.
2. Be able to identify major trends and themes in the field
3. Be able to list and apply heuristic interface principles
4. Understand importance and fundamentals of accessible design. 

Outline:
1. What is HCI?
2. Psychology of User Interfaces
3. Psychology of Perception
4. Basic HCI Principles
5. Information Design
6. Web Usability
7. Accessibility
8. Evaluating User Interfaces
 

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MBL Clambake (no evening workshop) 

Day 4- Thursday, May 30, 2002

Sessions 1 and 2: 8:30 AM - 12:00 N

Faculty

Educational Objectives

This session examines medical data, where they come from, how they are represented , and how they are used.  In order for a computer to manipulate data symbolically, the data must be represented in a way that the computer can "understand"; this is generally accomplished through the use of controlled terminlogies.  The objectives for these sessions are: 

• Define medical terminologies and their attributes
• Review the state of the art
• Examine advanced uses of medical data through the use of advanced terminologies

• Examination of typical medical data
• Uses of medical data
• Terminology characteristics
• Terminology desiderata
• Survey of what's available
• ICD9-CM and ICD-10
• DRGs
• NDC Codes
• SNOMED
• Read
• Nursing terminologies
• MEDCIN
• LOINC
• MeSH
• UMLS
• The Medical Entities Dictionary
• Case studies of advanced uses of data
• Summary reporting
• HCFA requirements
• Clinical research
• Expert systems
• Automated decision support
• Linking to on-line information sources
• Learning more

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Sessions 3 and 4: 1:30 - 5:00 PM

Decision-Analytic Methods for Evidence-based Practice

Suzanne Bakken, RN, DNSc

Educational Objectives

At the conclusion of the workshop, the learner will be able to do the following: 
1. Define evidence-based practice.
2. Describe the informatics foundation for evidence-based practice.
3. Identify the components of expected value decision making.
4. Construct and solve a decision tree using a decision analysis software package.

1. Definitions of Evidence-based Practice
2. Information Foundation for Evidence-based Practice
3. Introduction to Probabalistic Reasoning
4. Expected Value Decision Making
1. Building and solving a decision tree using DATA 
2. Web-based utility assessment

Evening Workshop: 7:00 - 9:00 PM

Faculty

Educational Objectives

Session Outline

1. Present an overview of a generic database web serving system. This overview will consist of identifying and defining the function of the the different elements that compose a database server.
2. A brief introduction to a few of the different database solutions to show how different vendors address the model described in 1.
3. Create an interactive web database using Filemaker Pro 4.0 with a sample database which will address the following:  Querying the database using FORM and embedded URLS
4. Editing a Record via the web
5. Adding/Deleting Records
6. Processing results with format files.
7. Understanding how HTML and database meta tags can interact by:

a. Listing multiple records

b. Formatting a single record

c. Using conditionals to selectively format records

d. Using color and graphics with numeric content

Creating embedded links to Entrez, PubMed, others

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Day 5 - Friday, May 31, 2002

Session 1: 8:30 - 10:00 AM

Faculty

Educational Objectives

• Understand the basic principles that underlie the design, implementation, and maintenance of a successful digital library.
• Have an understanding of digital library research issues.
• Have pointers to useful resources in digital library research.

Session Outline

1. Informatics Research Agenda for Digital Libraries
2. Basic Principles in the Design and Implementation of a Digital Library
• System Design Principles and Practices
• Standards
• Modularity
• Extensibility
• New technologies
• Content and Collection-based Principles and Practices
• Data acquisition and selection
• Metadata
• Intellectual property
• Permanence and persistence of digital objects
• Human Factors Principles and Practices
• Accessibility, usability
• Automation of manual tasks
3. Case Study
• Profiles in Science
• ClinicalTrials.gov
4. Hands-on Exercise
• Assigning metadata tags

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Session 2: 10:30 AM - 12:00 N

Faculty

Educational Objectives

1. Learn how to interpret a the results of a functional genomics study written in publication
2. Learn how to view the impact of genomics on individualized medicine

Session Outline

1. Why bioinformatics is central to the genomics revolution 
• Brief refesher on basic genomic biology 
2. What is functional genomics and what are the principal bioinformatics techniques used in elucidating the function of genes?
3. Shared themes in clinical informatics and bioinformatics; why these are two sides of a single discipline.

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Sessions 3 and 4: 1:30 -5:00 PM

Faculty

Educational Objectives

Session Outline

Day 6 - Saturday, June 1, 2002

Session 1: 8:30 - 10:00 AM

Faculty

Christopher Cimino, M.D.

Educational Objectives

1. have an understanding of the basic building blocks of the educational interaction: communication, assessment, role-modeling, skills development, and dialogue. 
2. be exposed to an example of Medical Informatics objectives with a focus on distinguishing skills, knowledge and attitudes. 
3. understand how Informatics skills, knowledge, and attitudes relate to different educational interactions; particularly role-modeling and skill development. 
4. understand how specific Medical Informatics objectives relate to specfic types of educational technology 
5. be exposed to several types of educational technology and understand how each complements or complicates each type of interaction 
6. understand how Informatics teaching can be integrated with other medical education.

Outline

• How Does Education Occur? 
• How do we teach? 
• How do we choose what to teach? 
• What is the educational environment? 
• How does teaching occur? 
• Where does teaching occur? 
• What passes between teacher and student 
• Benefits of Integrated Education 
• Obstacles to Integrated Education 
• Where does technology fit in? 
• How do we decide what to teach? 
• Mission
• Needs 
• Goals 
• Objectives 
• Solutions 
• How do we decide what to teach? 
• Knowledge Objectives 
• Skill Objectives 
• Attitude Objectives 
• IMIA Medical Informatics Objectives 
• Organizing principles 
• Domain topics 
• IT User vs. IT Specialist 
• Degree of career progression 
• Examples of teaching and assessing Informatics objectives
• Skills
• Knowledge
• Attitude
• Technology as a teaching tool 
• Infrastructure needed to teach skills 
• Role models needed for teaching attitude 
• Integration into work-flow needed to develop role models 
• How do we decide what to teach? 
• Student Evaluation 
• Program Evaluation 
• Evaluation of educational technology 
• Education success as measured by science 
• Cost 
• Satisfaction 
• Social Change 
• Changing the environment 
• What kind of institution are you at? 
• Your setting determines stakeholders 
• Stakeholders 
• Who determines educational approach? 
• Who determines educational content? 
• Who supports technology? 
• Instigating Change 
• Innovation 
• Long term growth 
• "Willing" but cautious participants 
• Implementing Change 
•  Make use of power of iteration 
•  Conserve support effort 
•  Shape user expectations to be reasonable 
•  Making use of early failure 

Session 2: 10:30 AM - 12:00 N

Education Informatics - Faculty Development 

Faculty

Christopher Cimino, M.D.

Educational Objectives 

This session will look at the adaption of clinical faculty to teaching medical informatics. Using specific examples on the internet, participants will face and overcome some of the common obstacles. At the completion of this session 
participants will have 

1. gained practical skills in finding informatics information geared to education. 
2. understand the obstacles to motivating faculty to integrate informatics teaching into other disciplines 
3. know the types of behaviors that promote positive attitudes amoung collegues and students 

Each exercise will be followed by a group discussion of the results of the exercise and concrete lessons learned. 

    Exercise 1: 
        Internet resources to enhance the teaching of a skill objective 
        Examining learning curve obstacles. 

    Exercise 2: 
        Internet resources to enhance the teaching of a knowledge objective 
        Examining quality obstacles 

    Exercise 3: 
        Internet resources to enhance the teaching of a attitude objective 
        Examining reliability obstacles 

    Other obstacles: 
        Social obstacles 
        Work flow obstacles 
        Resource obstacles 

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Session 3: 1:30 - 3:00 PM

Faculty

Educational Objectives

Session Outline

3:00 PM

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