1. 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

2. 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

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

4. 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

5. 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

6. 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

7. 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

8. 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

9. Sample screens
from course

10. 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

11. 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)

12. 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)

13. 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

14. 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