Towards Smarter Healthcare: New Healthcare IT Curriculum

Transcription

1 Towards Smarter Healthcare: New Healthcare IT Curriculum Praveen R. Rao, University of Missouri-Kansas City Web page: Abstract We propose to develop new Healthcare IT curriculum for students pursuing Computer Science and Information Technology degrees at University of Missouri-Kansas City. Our proposal aims at realizing IBM s vision of Smarter Healthcare. We will to develop three new courses to educate and train students with industry and technical skills needed to succeed in the healthcare IT industry. The courses will enable students to think radically about instrumented, interconnected, and intelligent solutions for healthcare. The first course introduces health informatics. The second course focuses on advanced topics, namely, enterprise health analytics and health information exchange. The third course trains students with business and IT skills required to develop real-world health IT solutions through mini-projects with hospitals in Kansas City. The courses are designed to provide a smooth fusion of theory and practice in health informatics. They are comprised of lectures, assignments and case studies, invited talks by medical professionals, and programming projects using smarter healthcare solutions from IBM. The proposed curriculum is ideal for CS and IT programs that wish to jumpstart their healthcare IT curriculum. 1 Introduction The rising cost of healthcare is one of the major concerns faced by the nation. By 2019, it is projected that the nation would spend $4.48 trillion for healthcare. Through effective use of Information Technology (IT), healthcare costs can be lowered and better quality care can be provided to patients. In a recent report by Stead and Lin [12], data sharing and collaboration and large scale management of health care data have been identified as key IT challenges to advance the nation s healthcare system. Vast amounts of information (e.g., electronic health records, drug data) remain largely untapped due to the lack of suitable IT solutions. Today, personal health information resides in digital silos and healthcare systems do not easily share information with each other. By tearing down these silos, vast amounts of clinical information can be utilized by medical practitioners and researchers to provide efficient, quality, timely, and cost-effective care to patients. There is a growing number of local, state, and national level health information exchange (HIE) initiatives. The goal of HIE is to allow sharing of and access to clinical data to achieve Institute of Medicine s (IOM) vision of a learning healthcare system by providing safe, timely, effective, efficient, equitable and patient-centered care [7]. National Cancer Institute s cabig is another nation-wide initiative whose vision is to speedup research discoveries and improve patient outcomes by connecting the members of the cancer community to share knowledge and data [8, 11]. Food and Drug Administration s Sentinel Initiative is another effort to have an electronic system capable of querying multiple healthcare data sources to actively monitor the safety of medical products [3]. These initiatives affirm the growing need for electronic sharing and exchange of healthcare data. The American Recovery and Reinvestment Act of 2009 (ARRA) is providing Medicare and Medicaid incentives to physicians and hospitals that are meaningful users of qualified electronic health record systems. Meaningful users are those that use a certified Electronic Health Record (EHR) technology, support electronic exchange of health information, and use EHR in reporting on clinical and other quality measures [2]. Those failing to successfully meet the goals are liable for penalties. Furthermore, the HITECH act requires the qualified electronic health records to have the capacity to provide clinical decision support, support patient order entry, capture and query information relevant to healthcare quality, and exchange electronic health information with, and integrate such information from other sources [4]. With ARRA incentives, clinical analytics is 1

2 receiving much attention as it provides a means to identify and measure best practices, outcomes and treatments, improve patient safety, and reduce costs. To meet the goals of recent healthcare reforms, it has become increasingly important to prepare a skilled workforce for the health IT industry. With billions of dollars being invested by the government for adoption of EHR, the need for health informaticians is skyrocketing [1]. The objectives of this proposal are: (1) to develop Health Informatics curriculum for CS and IT degree students at University of Missouri-Kansas City (UMKC), and (2) to provide courseware to faculty of other institutions who intend to jumpstart their Health Informatics program. The proposed curriculum will educate and train students with technical and industry skills required to succeed in the health IT industry. It will train students to think radically about instrumented, interconnected, and intelligent solutions for healthcare. The courses are designed to provide a smooth fusion of theory and practice in health informatics. They are comprised of lectures, assignments and case studies, invited talks by medical professionals, and programming projects using smarter healthcare solutions from IBM. The PI is an expert in semistructured data management and works actively in health IT research in collaboration with medical professionals in Kansas City [9, 10]. The remainder of the proposal is organized as follows. The curriculum structure and contents are described in Section 2. The benefits of the proposed curriculum are listed in Section 3. The timeline and milestones are described in Section 4. The membership of the PI/UMKC in the IBM Academic Initiative program is described in Section 5. 2 Proposed Curriculum Development The proposed curriculum is organized into three courses that can be taken by senior-level undergraduate and first-year graduate students pursuing CS/IT degrees: The first course introduces Health Informatics. The second course focuses on advanced topics in Health Informatics, namely, enterprise health analytics and health information exchange. The third course trains students with necessary business and IT skills required to develop real-world health IT solutions through mini-projects with hospitals in Kansas City. 2.1 Course C1: Introduction to Health Informatics This course covers introductory material in Health Informatics and provides exposure to open source and IBM software solutions for healthcare IT. A. Concepts, Terminologies, and Technologies This component will cover basic definitions, concepts and terminologies in healthcare informatics. It will introduce point-of-care technologies, electronic medical record systems, electronic health records, patient health records, computerized physician order entry systems, and clinical decision support systems. It will also discuss clinical trails and evidence based medicine. B. Information Security This component will discuss the issues of health information security and medical privacy. It will cover legal and ethical issues related to privacy and confidentiality, health information privacy and security practices, policies, and laws (e.g., HIPAA). C. Interoperability Standards for Healthcare Data Interchange This component will discuss the challenges arising in achieving interoperability between software applications exchanging electronic health records. It will discuss electronic data interchange standards and medical controlled vocabularies. HL7 and DICOM standards will be 2

3 covered, and clinical terminologies such as SNOMED CT [5], LOINC, ICD-10, CPT, etc., and UMLS [6] metathesaurus will be discussed. D. Commercial and Open-Source Software Tools This component will provide students hands-on experience in using a range of open-source tools and IBM software products for smarter healthcare. These include open-source electronic health record systems such as OpenVista and OpenEMR, and commercial tools such as IBM Infosphere Clinical Analytics, IBM Health Information Exchange, and IBM Cognos. Cloud versions of IBM software solutions will be sufficient. 2.2 Course C2: Advanced Topics in Health Informatics This course will cover advanced topics in health IT, specifically, enterprise health analytics and health information exchange. Course C1 is a prerequisite. A. Introduction to Data Warehousing This component will cover data warehouse architectures, data modeling (e.g., dimensional data model, star and snowflake schemas), physical database design, OLAP (e.g., MOLAP, ROLAP), and data quality assurance. B. Enterprise Health Analytics This component will discuss the need for collecting, aggregating, and analyzing disparate information sources in healthcare; data warehousing and business intelligence in healthcare; use of scorecards and dashboards; improvement of patient safety, care quality, operational efficiency; and reporting compliance with quality standards. C. Health Information Exchange This component will discuss the need for exchange of electronic health records; data integration systems based on federated database models and service-oriented architectures for health information exchange; case studies of existing data integration systems such as the cabig Initiative, regional health information exchange initiatives (e.g., Nebraska Health Information Initiative), and the FDA s Sentinel Initiative; master patient index and messaging standards (HL7, SOAP); security implications; and auditing/monitoring access to patient records. D. Site Tours of IT Departments of Hospitals in Kansas City Students will visit the IT departments of Truman Medical Center, St. Luke s Hospital, and Children s Mercy Hospital, which are partner hospitals to UMKC. Students will interact with IT experts through presentations and Q & A sessions and learn about practical challenges and opportunities in developing health IT solutions. E. Programming Project Students will engage in a team based project to design and implement dashboards for clinicians to report on metrics such as patient safety, care quality, and treatment costs using IBM Cognos. (A cloud based version of IBM Cognos will be desirable.) Students will use deidentified clinical data available from the i2b2 project ( 2.3 Course C3: Healthcare IT Implementation This course will cover topics pertaining to business and IT skills for real-world health IT implementation. Course C2 is a prerequisite. 3

4 A. Project management This component will cover project management life cycle (project initiation/definition, planning, execution, closure); models in business management, project management, and IT management and their integration; and project management knowledge areas (e.g., cost management, risk management, organization change management). B. Business case development and analysis This component will teach students how to develop business cases for health IT projects and techniques for analysing them. The different pieces of a business case that will be covered include executive summary, value propositions/business opportunity (e.g., desired outcomes, risks, benefits), alternatives (e.g., evaluation criteria), and project recommendation (e.g., objectives, scope, deliverables, impacts, workload, commitments). Common analysis techniques such as break-even analysis, value chain analysis, payback analysis, etc. will be covered. C. Software as a Service (SaaS) IT Services This component will cover the objectives, concepts, and processes of software service life cycle, which includes service strategy, service design, service transition, service operation, and continual service improvement. D. Invited Talks Speakers from Cerner Corporation (Dr. Douglas McNair), Truman Medical Center (Dr. Jeffrey Hackman), and UMKC School of Medicine (Dr. Timothy Hickman) will each deliver a guest lecture to discuss the challenges and opportunities in real world health IT implementation. E. Health IT Project In this project, each student team will visit one local hospital (Children Mercy Hospital, St. Lukes Hospital, Truman Medical Center Hospital Hill) affiliated with UMKC. Each team will visit the IT department and prepare business case for a mini project. Then using best practices in project management, the team will design and implement a suitable solution service for the hospital using IBM Cognos or IBM Infosphere Clinical Analytics. Each team will demonstrate their solution in class. 3 Skills Addressed by the Proposed Curriculum Table 1 lists the different business and IT skills that students will learn from different course components in the proposed curriculum. 4 Timeline and Milestones The courses C1, C2, and C3 will be taught in Spring 2011, Fall 2011, and Spring 2012, respectively. Each course will last for a duration of 16 weeks. The course materials for C1, C2, and C3 will be available for electronic distribution in June 2011, January 2012, and June 2012, respectively. 5 Membership in the IBM Academic Initiative Program The PI is a member of the IBM Academic Initiative program and has active collaboration with IBM Informix Lab in Lenexa (KS). He works closely with Amit Dandekar and Dr. Pradeep Natarajan 4

5 Skill Healthcare IT best practices Leadership, collaboration, and teaming Communications across disciplines Creative and critical thinking, analysis and synthesis Organizational change management Business case development and analysis Business project management Solution service strategy through understanding value creation Solution service design and modeling Solution service management and lifecycles to ensure quality Course Components C1-(A,B,C,D), C2-(A,B,C,D,E) C2-E, C3-E C2-D, C3-(D,E) C2-(B,C,D,E), C3-E C3-A C3-(B,E) C3-(A,E) Table 1: Business and IT skills covered by specific course components on a research and development project related to IBM Informix database software. He has greatly benefited from the resources provided by the IBM Academic Initiative program for teaching (e.g., IBM/Amazon Web Services teaching grant to use Amazon EC2 and IBM software, IBM Academic Skills Cloud). The enrollments in his courses have increased and students have enjoyed first hand experience in developing and deploying software in a cloud. If funded, the proposed activities will foster further collaboration between UMKC and IBM. While it will provide a unique opportunity for students to gain skills in using IBM software products, IBM can identify top students through early interactions and can enhance their recruitment efforts in this region. References [1] Connecting the Dots of Medicine and Data. [2] Definition of Meaningful Users of Certified EHR Technology. DefUseEHRUsers.pdf. [3] FDA s Sentinel Initiative. [4] Qualified Electronic Health Records. [5] SNOMED Clinical Terms. [6] Unified Medical Language System. [7] Crossing the Quality Chasm: A New Health System for the 21st Century. The National Academies Press, Washington D.C., [8] D. Fenstermacher, C. Street, T. McSherry, V. Nayak, C. Overby, and M. Feldman. The Cancer Biomedical Informatics Grid (cabig). In Proceedings of IEEE Engineering in Medicine and Biology Society, pages , Shanghai, China, [9] P. R. Rao, S. A. Edlavitch, J. L. Hackman, T. P. Hickman, D. S. McNair, and D. S. Rao. A Collaborative Platform for Sharing Electronic Health Records of Cancer Patients. In Missouri Regional Life Sciences Summit, Animal to Human Health Collaborations - Regional Partnerships for Innovation, March [10] P. R. Rao, S. A. Edlavitch, J. L. Hackman, T. P. Hickman, D. S. McNair, and D. S. Rao. Towards Large-scale Sharing of Electronic Health Records of Cancer Patients. In Proc. of 1st ACM International Health Informatics Symposium (IHI), Nov [11] J. Saltz, S. Oster, S. Hastings, S. Langella, T. Kurc, W. Sanchez, M. Kher, A. Manisundaram, K. Shanbhag, and P. Covitz. cagrid: Design and Implementation of the Core Architecture of the Cancer Biomedical Informatics Grid. Bioinformatics, 22(15): , [12] W. W. Stead and H. S. Lin. Computational Technology for Effective Health Care: Immediate Steps and Strategic Directions. The National Academies Press, Washington D.C.,