BMI 513 – Electronic Health Record Laboratory Course– Mohan
Online
3 credit hours
Spring Quarter 2012
Instructor: Vishnu Mohan MD MBI FACP
Email: mohanv@ohsu.edu
Office hours: by appointment – email for a time to meet, or leave a message at 503 494 4469.
PREREQUISITES
Successful completion of BMI 512.
COURSE OVERVIEW
BMI 513 introduces the student to an electronic health record, and familiarizes students with the
clinical informatics operating environment. This is a practical, lab oriented course, and will allow
students to understand the complex interactions and features that make up a modern clinical
information system.
This course examines the use of the EHR in both inpatient and outpatient clinical environments,
and focuses on specific elements of the EHR including order set development, customization,
clinical decision support, ancillary services such as the clinical laboratory and radiology, and billing
and coding functionality. The course also explores analytics and system security from the
perspective of EHR customization.
LEARNING OBJECTIVES
This course will allow students to:
Engage in "hands on" learning in an environment that closely simulates a real-world
clinical informatics setting
Interact with an EHR in a manner that improves their understanding of system
functionality
Understand from a practical perspective how EHRs are organized and configured
Understand EHR functionality in the setting clinical workflows and processes
REQUIRED TEXTBOOK
Title: Electronic Health Records
Author: Byron Hamilton
Publisher: McGraw Hill
Edition: 2 edition (August 20, 2010)
Language: English
ISBN-10: 0077477553
ISBN-13: 978-0077477554
Student will also need administrative access to a Windows PC (they will be downloading and
installing versions of two EHRs during this course)
COURSE COORDINATION
This class is available to online students during Spring term 2012.
The course is available through the Sakai learning management software at http://sakai.ohsu.edu.
The online component includes lectures, PowerPoint slides and handouts, reading assignments, lab
tutorial material, and additional exercises.
EXPECTATIONS
To succeed in this course, students are expected to:
1. Review reading assignments; including lectures, chapters from the required textbook,
articles or handouts, and independent reading for projects and questions. Students are
responsible for learning all content in the assigned readings, whether discussed in the
lectures or not.
2. Participate in lab sessions and exercises.
3. Complete lab sessions, exercises, and other assigned work in a timely fashion. Many lab
sessions involve prior preparation.
4. Complete quizzes and other evaluative tools during the course in a timely fashion
DETAILED COURSE DESCRIPTION
Course structure and content
The course is structured in a modular fashion as a series of weekly components. Each module
consists of:
1. a lecture, that defines specific informatics concepts associated with the module's
designated lab activity, and discusses theoretical concepts in the context of clinical
informatics
2. reading material with emphasis on case studies and clinical settings
3. a tailored lab activity with specific step-by-step instructions for learning objectives
and with alternative tree pathways
4. a lab video (demonstration by instructor)
5. a set of exercises
6. and a quiz.
Students will have access to a distribution of VistA, the EHR used by the VA system.
Students are encouraged to download their own copies of the VistA executable file, which
will be provided at the beginning of the course. Students will need access to a computer
with a copy of Windows XP, Vista, or 7 with administrative rights for the duration of the
course. Note that computers running MacOS or Linux are NOT supported for this course.
Example of the course schedule and topics covered (note that the actual schedule for this
course may vary from the example; formal schedule will be published during week 1 of the
course)
1
2
3
4
5
6
7
8
9
10
11
12
Introduction and installation / setup
Inpatient EHR exercises - emphasis on workflow
Outpatient EHR exercises - emphasis on workflow
Customizing the interface
Clinical Decision support -- emphasis on design
considerations
Clinical laboratory and radiology modules - emphasis on
Usability
Vista Terminal lab for templates
Vista Terminal lab for order set development
Customization feature set development - emphasis on
design
Reports and queries - emphasis on database use and
analytics
Building security into EHRs - emphasis on design
considerations
Final module
Detailed Description of Course Content
After an introductory module that addresses installation and setup requirements, and acts
as a general preface to the course. Lab exercise topics in these modules are intended to
familiarize students with specific concepts of the electronic health record including
medication reconciliation, associating orders with diagnoses, signing orders, and building
problem lists.
Inpatient and Outpatient EHR Exercises
Exercises allow students to build patient and provider accounts, and replicate clinical
workflows. Students follow a patient's progress through the healthcare system as an
inpatient and an outpatient, logging onto the EHR as an Administrator, a Nurse, a Physician,
and a Pharmacist.
Order Set Development and Customization Feature Set Modules
Lab exercise topics for these include building order sets and customized screens (by
specialty and by role). Students will also discuss user interface and design considerations
to optimize user experience.
Clinical Decision Support Module
Students study conceptual specifications of knowledge management, provider order entry
and clinical decision support systems. Lab exercise topics include elements of knowledge
management, as well as ontologies and terminologies.
Students learn how to build CPOE into EHRs, build alerts and reminders, and develop a
tiered framework for deploying alerts. They will learn how to recognize and reverse alert
fatigue.
Billing and Coding Module
In this module, students learn about methods to code visits, hospital stays, procedures, and
ABN alerts. They will also learn how to schedule templates, optimize appointment
schedules, link coding and billing in the EHR, and generate a superbill. They will also learn
how to design and build provider billing/coding reminders.
Clinical Laboratory and Radiology Modules
This module familiarizes students with clinical laboratory and radiology functionality of
the EHR. Lab exercise topics include importing labs and images into EHRs, displaying lab
results (visual display of data, models to optimize data use, HCI considerations), and image
indexing and archive access
Analytics and Security Modules
The analytics module emphasizes data analysis and predictive informatics. Topics for this
module include DRG analysis, risk stratification, medication usage, clinical best practice
identification, and cost management strategies including meaningful use criteria.
With respect to system security, in addition to learning about concepts of identification,
authentication, and log-on policies, students will learn and participate in lab exercises on
how to set optimal time-outs, concepts of secured messaging with patients and link to PHR,
and data exchange between EHR modules.
EVALUATION
Note that this course is graded as pass/fail
Weightage for evaluation:
Class participation = 10%
Lab activity = 50%
Lab exercises = 20%
Final exam = 20%
GRADING POLICY
Graduate Studies in the OHSU School of Medicine is committed to providing grades to students in a
timely manner. Course instructors will provide students with information in writing at the beginning of
each course that describes the grading policies and procedures including but not limited to evaluation
criteria, expected time needed to grade individual student examinations and type of feedback they will
provide.
Class grades are due to the Registrar by the Friday following the week of finals. However, on those
occasions when a grade has not been submitted by the deadline, the following procedure shall be
followed:
1) The Department1 /Program Coordinator2 will immediately contact the Instructor requesting the
missing grade, with a copy to the Program Director and Registrar.
2) If the grade is still overdue by the end of next week, the Department1 /Program Coordinator2
will email the Department Chair directly, with a copy to the Instructor and Program Director
requesting resolution of the missing grade.
3) If, after an additional week the grade is still outstanding, the student or Department1 /Program
Coordinator2 may petition the Office of Graduate students for final resolution.
1
2
For courses that are run by a specific department.
For the conjoined courses (course number is preceded by CON_ that are run by Graduate
Studies.
ACADEMIC HONESTY
Course participants are expected to maintain academic honesty in their course work. Participants
should refrain from seeking published solutions to any assignments. Literature and resources
(including Internet resources) employed in fulfilling assignments must be cited. Turnitin software
may be used at the discretion of the course instructor.
See http://ozone.ohsu.edu/som/faculty/docs/graduatecouncil/profconductpolicy.pdf for details.
SPECIAL NEEDS
Our program is committed to all students achieving their potential. If you have a disability or think
you may have a disability (physical, learning, hearing, vision, psychological) which may need a
reasonable accommodation please contact Student Access at (503) 494-0082 or e-mail at
orchards@ohsu.edu to discuss your needs. You can also find more information at
http://www.ohsu.edu/student-access. Because accommodations can take time to implement, it is
important to have this discussion as soon as possible. All information regarding a student’s disability is
kept in accordance with relevant state and federal laws.