Adapting the AMIA-OHSU 10x10 Course For a Public Health Informatics Audience William Hersh, MD Professor and Chair Department of Medical Informatics & Clinical Epidemiology Oregon Health & Science University hersh@ohsu.edu

Acknowledgments Co-faculty and co-authors Partnership Funding Janise Richards, PhD, MPH, MS, Centers for Disease Control and Prevention JA Magnuson, PhD, Oregon Department of Human Services Roland Gamache, PhD, MBA, Indiana Department of Public Health Partnership American Medical Informatics Association (AMIA) Funding Cooperative Agreement from CDC awarded to AMIA: Partnership to Enhance Public Health Informatics – CDC-RFA-HK07-703

“Education is the most powerful weapon [that] you can use to change the world.” Nelson Mandela

Overview of talk Impediments and challenges to health information technology (HIT) Goals and curriculum of 10x10 program Adaptation of the 10x10 program to public health informatics

Impediments and challenges to HIT familiar to us all In clinical (and by extension, public health) settings (Hersh, JAMA, 2004) Cost and financing Synchronization with clinical workflow Interoperability, standards, and terminology Privacy and confidentiality Developing a workforce of professionals and users Latter coming to be recognized of increasing importance Calls for action, e.g., AMIA-AHIMA Summit Report (2006) Myriad of efforts developing competencies Growth of degree and fellowship programs

Educating those intermediate between practitioners and end users AMIA President Charles Safran called for educating one physician and one nurse from each US hospital in informatics Or, put another way, aim to educate 10,000 health care professionals by 2010 Operationalized as 10x10 (“ten by ten”) Program Course consists of adaptation of introductory on-line graduate course with addition of a one-day face-to-face session Initial (Hersh, IJMI, 2007) and subsequent (Feldman, AMIA, 2008) offerings well-received Other partners are also offering 10x10 courses (including CDC-funded students): UAB, UIC

Curriculum of OHSU 10x10 course Overview of Discipline and Its History Biomedical Computing Electronic Health Records Decision Support; EHR Implementation Standards, Privacy and Security, Costs and Implementation Secondary Uses of Clinical Data Evidence-Based Medicine and Medical Decision-Making Information Retrieval and Digital Libraries Bioinformatics Imaging Informatics and Telemedicine Organization and Management Issues in Informatics

Teaching modalities of OHSU 10x10 Each unit includes Voice-over-Powerpoint lectures – 2 to 3 hours Threaded discussions – initial set posed by instructor Readings Self-assessment multiple-choice quizzes Also includes Course project – environmental scan with short write-up In-person session Optional final exam for those wanting/needing transcript and/or further study

Sample screens from course

Adapting the course for public health informatics AMIA awarded grant from CDC All three clinical informatics 10x10 courses provided special offerings for public health informatics Grant pays tuition but not travel to in-person session OHSU approach Recruit three public health informaticians as co-faculty and have them Moderate discussion, adding public health-specific questions Develop new unit on public health informatics

Special public health informatics unit Outline Public Health Informatics Goals, Overview and Partnerships with HIEs (Richards) Funding (Magnuson) Workforce (Richards) Standards (Magnuson) Privacy, Confidentiality, Ethics (Magnuson) Public Health Examples, Surveillance (Gamache) Future Initiatives and Public Health Informatics Partnerships (Gamache) Readings Shortliffe, Chapter 15 Knowledge Management for Public Health Professionals (ASTHO PDF) The Big Picture – Developing an Enterprise View of Public Health Information Systems (BigPicture PDF)

Report of course so far Started April 30, finishing in early September Number of students – 21 enrolled, 15 nearing completion Educational background 10 epidemiology (MPH and DrPH) 2 nursing (one with MPH) 2 MD 1 microbiology and law Current work setting 7 state public health 6 country or regional health organization 2 federal (CDC, HRSA) 1 association (ASTHO)

Total enrollment in all CDC-funded courses so far Institution Winter-Spring, 2008 Summer-Fall, 2008 OHSU 21 18 UAB 13 10 UIC 15 12

Conclusions Most students able to complete challenging curriculum More details about OHSU and other students to emerge from post-course analysis later this year Plan to continue offering via CDC funding For more information http://www.amia.org/10x10/