• To provide open discussion among the participants on the definitions and scope of medical informatics
• To identify the component disciplines witin the field of biomedical informatics
• To introduce a clinical case summary that will be used throughout the the course to show how theoretical and practical aspects of informatics relate to health care

At the conclusion of the session, participants should:

• Have a basic understanding of the components of medical informatics
• Be able to characterize these components as technologies, concepts and skills

Outline

I. What is Medical Informatics - An open discussion
II. Component Disciplines
III. Concepts, Technologies and Skills
IV. External Forces
V. Case Presentation
VI. Course Overview

This lecture will discuss some research opportunities in Medical Informatics.

At the completion of the session, participants will:

• be able to accept or challenge this list of research opportunities
• be able to operate and understand ClinicalTrials.gov
• be able to access and evaluate examples of new Interactive Publications

Outline

1. Research Areas and Challenges in 2005
2. Electronic Health Record
3. Prospective Population Studies
4. Information for the Public: e.g., ClinicalTrials.gov
5. Interactive Publications

Outline

Bioinformatics and Clinical Bioinformatics:

1. What is Bioinformatics?
   
2. Problems considered in Bioinformatics
   
3. Genomics, proteomics, transcriptomics, etc
   
4. Health Informatics compared to Bioinformatics
   
5. Genomics data and patient care
   
6. Impact of Bioinformatics on Health Information Systems

• Define "database"
• Review the history of database architectures
• Teach the princples of database normalization
• Identify the basics for object-oriented database design
• Reinforce principles with a design exercise

• Understand the evolution of modern database architecture
• Understand some of the principles behind choices to be made when designing a database
• Have a basic understanding of database normalization

1. Definition
2. History of Database Architectures
3. Database Normalization
4. Object-Oriented Table Design
5. Exercise: Database for Medline Records
6. Exercise: Clinical Database

Outline

Outline

At the conclusion of the workshop, the learner will be able to do the following:

• Identify the components of expected value decision making.
• Construct and solve a decision tree using a decision analysis software package

Outline

• Introduction to Probabalistic Reasoning
• Expected Value Decision Making
• Building and solving a decision tree using DATA

At the conclusion of the workshop, the learner will be able to do the following:

• Discuss issues and challenges associated with application of evidence into nursing practice.
• Differentiate among stand alone, context-specific, and integrated EBP tools.
• Describe at least two approaches for integrating EBP tools into practice.

Outline

• Data for evidence-based practice
• Stand alone tools
• Context-specific approaches
• Integrated approaches
• Challenges and issues with application of evidence into nursing practice

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

• Discuss the relationship between team goals, individual goals, and team roles in contributing to the function of a team.
• Identify 4 task processes that help teams achieve short term goals.
• Identify 4 relationship processes that help teams achieve long term goals.
• Identify qualities that lead to dysfunctional teams.
• Be able to critique the function of a team of which they are a member.

Outline

• Definitions
• Team Goals
• Relation of individual and personal goals to team goals
• Understanding the roles of the team members
• Short term goal tasks: initiation, fact-finding, orienting, summarizing
• Long term goal tasks: gate-keeping, harmonizing, encouragement, analyzing
• Dysfunctional teams: lack of trust, fear of conflict, lack of commitment, avoidance of responsibility, inattention to results Analyzing a team (exercise)

Outline

Session Outline

• NCBI Entrez Searching
• Parsing PubMed Queries
• Automatic Term Mapping
• What's New with PubMed
• Clinical Queries
• Journal Names
• Linking from Web Search Engines
• Spelling Suggestions
• Single Citation Matcher
• Full & First Author Searching
• My NCBI
• Automatic E-mail Updates
• LinkOut
• Mobile PubMed
• Gateway Overview
• NLM Catalog
• Hands On Lab Time

Outline

This lecture will approach the subject of telemedicine from the perspective of an information process. The lecture will start with NLM's historical involvement in telemedicine. Technical, regulatory and societal impediments to the utilization of telemedicine will be discussed. Modern telemedicine is dependent on digital networking. After a brief Internet history the lecture will summarize current and next generation networking concepts. The federal interagency Next Generation Internet (NGI) program and the academic Internet2 Project will be discussed. The application of NGI technology to healthcare will be demonstrated through examples funded by the NLM.

At the completion of the session, the participant will:

• Understand telemedicine as an information process
• Understand the technical, regulatory and societal impediments to the utilization of telemedicine
• Understand the national need for next generation 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 next generation networking concepts
• Be familiar with the NLM programs as a demonstration of the relevance of advanced networking technology in telemedicine and healthcare
• Gain an appreciation of the current and future networking challenges and opportunities

Outline

• NLM's involvement in telemedicine
• Definition of telemedicine
• Impediments to telemedicine
• History of the Internet
• Networking concepts
• Connection methods
• NLM's National Telemedicine Initiative
• Telemedicine lessons learned
• Next generation networking - federal and academic
• Quality of Service - QoS - concepts
• Next generation network health examples
• Scalable Information Infrastructure

This lecture is designed to provide a complete overview of Care Provider Order Entry. The learner will be taken through the past, present and future of this valuable clinical technology.

Overview

• To provide an overview of the motivation behind care provider order entry (CPOE) in both inpatient and ambulatory settings
  
• To introduce the functionality provided in typical CPOE systems
  
• To address some challenges to idealized CPOE and how these challenges are being addressed with current research and potentially mitigated with future developments
  

Outline

• Patient safety overview
  
• What is CPOE
  
• History of CPOE in the US.
  
• CPOE as a threat to safety
  
• State-of-the-art CPOE overview
  
• New roles for CPOE
  
• Evidence supporting CPOE Adoption
  
• Barriers to CPOE adoption

This session will consider issues in consumer health informatics with a special focus on health literacy. The role of information technology in addressing the needs of consumers will be discussed. Students will develop a working list of potential informatics interventions in their own institutional settings. At the conclusion of the session, participants should:

• Have an understanding of issues in consumer health informatics
• Have gained insight into the problems of health literacy
• Have an understanding of the role of information technology in consumer health

Outline

1. What is consumer health informatics
2. Online health information
3. Health literacy
4. Role of information technology
5. Exercise and discussion

• Describe terminology concepts and characteristics
• Provide examples of coding clinical data
• Examine the state of the art with respect to current standards
• Examine case studies of use and reuse of coded data

At the conclusion of the session, participants should:

• Understand the motivation for coding clinical data
• Understand the "desiderata" for high-quality controlled terminologies
• Be familiar with currently available terminologies

Outline

This pair of lectures is organized into six "threads" that will be woven together concurrently:

I. Clinical case
II. Use and reuse of data
III. Coding clinical data
IV. Available terminologies
V. Terminology concepts and desiderata
VI. Practical considerations

This session will look at the application of technology to teaching health care and the integration of medical informatics teaching in the educational environment. At the completion of this session participants will

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

Outline

• Overview of curriculum development and management
  • From mission to objectives; educational jargon explained
  • Content delivery and it's relation to objective types
  • Informatics content; example objectives
• Intgegrated teaching
  • Advantages
  • Disadvantages
• Teaching with Technology
  • Cost and Management
  • Evaluation of success
• Changing the environment
  • What kind of institution are you at?
  • Who determines educational approach?
  • Who determines educational content?
  • Who supports technology?
• Instigating Change
  • Innovation vs. Long term growth
  • "Willing" but cautious participants
  • Make use of power of iteration
  • Conserve support effort
  • Shape user expectations to be reasonable
  • Making use of early failure

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

• Work as a member of a team to create a functioning database backed web site
• Discuss the relationship between team goals, individual goals, and team roles in contributing to the function of this web site
• Analyzing a team

Outline

• Participants will work in groups to address the project goal states at the beginning of the week.
  PDAs and the Portable Potpourri
  Kevin B. Johnson, MD, MS
  Objectives

  This class will focus on the emerging uses of portable computing in health care. Although some specific example applications will be demonstrated, the goal of this discussion is to provide an overview of the “art of the possible” with portable technology

  At the completion of the session, the participant will:

  • Understand the capabilities of current PDA technology
  • Recognize domains of medical care, education, and research that have benefited from PDA-based systems
  • Gain an appreciation of the current and future technical challenges and opportunities

  Outline

  • Definitions
  • History of PDAs
  • PDA Technical Details
  • Connection methods
  • Emerging Patterns of Use
  • Challenges of Mobile Computing
  • Next generation network health examples
  Evaluation Methods in Medical Informatics
  Kevin B. Johnson, MD, MS; Joan Ash, PhD, MLS, MBA
  Objectives

  Outline

  What separates medical informatics from methodological disciplines like computer science is its focus on applying methods and its emphasis on evaluation. In this session, we will introduce the basic concepts of evaluation in medical informatics. By the end of the session, the participants will be able to:

  • appreciate the need for evaluation and the role of stakeholders
    
  • recognize what is difficult about evaluation in medical informatics
    
  • apply a framework for selecting what to evaluate
    
  • describe the relation between quantitative and qualitative evaluation
    
  • define basic concepts in quantitative evaluation, such as metrics, reference standards, measurement versus demonstration, and reliability versus validity
    
  • enumerate the main steps in qualitative evaluation based on ethnographic methods
  Managing Technological Change
  J. Ash
  Objectives

  This session presents an overview of the issues that must be addressed to effectively manage technological change. It will include a case study.

  Educational Objectives:

  • To become aware of the non-technical issues connected with technological-informatics changes.
  • To understand several of the reasons for system failure
  • To review a case to determine what non-technological issues could have been addressed initially.
  • To review what change agents need to do to facilitate organizational success

  Outline

  • About change
    
  • -- Models
    
  • -- Theories
    
  • Unintended consequences of technological change
    
  • Informatics projects and change
    
  • -- Success and failure
    
  • -- Principles
  Public Health Informatics
  R. Kukafka
  Objectives

  Outline

  Visible Human Project: An Introduction to Medical Imaging
  Michael J. Ackerman, Ph.D.
  Objectives

  This lecture will provide a prospective on NLM's Visible Human Project as an entry point into understanding the fundamentals of digital imaging, medical imaging, multi-dimensional informatics, image processing, virtual reality, open source software and extreme programming.

  At the completion of the session, the participant will:

  • Be familiar with the history and goals of NLM's Visible Human Project
  • Understand digital imaging fundamentals and their consequences in image processing and medical imaging
  • Be familiar with the concepts associated with open source software and open source data and an appreciation for the controversies associated with their use
  • Be familiar with modern software development methodologies
  • Gain an appreciation for the use and potential of the Insight Tool Kit (ITK)

  Outline

  • History of the Visible Human images
  • Digital image representation
  • Visible Human applications
  • Haptics
  • Beyond the images
  • Open source software
  • Extreme programming
  • Segmentation & Registration
  • ITK applications
  The Internet: Reflections on What's Coming
  Lawrence C. Kingsland, III, Ph.D.
  Educational Objectives

  This lecture discusses several aspects of upcoming technologies that are having and will have an impact on the way we view and use the Internet. At the completion of the session, participants will:

  • Have received an introduction to the elements that underpin the Internet
  • Be introduced to protocols present and emerging
  • Receive a quick tour of the 802.xx wireless stew
  • Be aware of some truly fascinating new technologies on the way
  • Receive links to useful sites tracking developments in these fields

  Session Outline

  • The Internet is ...
  • Protocols, addresses, names, oh my
  • Routing
  • Virtual Private Networks (VPNs)
  • Quality of Service (QoS)
  • Unlimited bandwidth
  • Digital spread spectrum
  • Bluetooth
  • 802.egad
  • New tech
  • Ubiquity
  • Dissemination