Organizational and Sociological Issues in Health IT

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INFO780-902-200625: Organizational and Sociological Issues in Healthcare Informatics

Winter Term 2006-2007 (January 8 - March 24, 2007)

Scot M. Silverstein, MD

Assistant Professor of Healthcare Informatics and IT

College of Information Science & Technology

Drexel University, 3141 Chestnut St., Philadelphia, PA 19104 scot.silverstein@ischool.drexel.edu

(215)895-1085

In view of increasing recognition that information technology is essential to improve healthcare quality and control costs, strengthening the breadth and depth of the health informatics workforce is a critical component in the transformation of the American health care system.

Sessions in this course on sociotechnical issues in healthcare informatics involve appropriate readings from 1) the textbook “ Managing Technological

Change: Organizational Aspects of Health Informatics, Lorenzi & Riley, Springer, 2 nd edition, 2004 (one of the few on this subject), 2) articles selected from a review of the periodical literature indexed by the National Library of Medicine on this topic, 3) other readings that I select from web, media and print sources, 4) some personal essays, and 5) electronic discussions via Blackboard.

Book chapter references are keyed to the textbook, and article references to the list of articles on the spreadsheet readinglist_780.xls

in the same folder as this syllabus and at the following URL: http://www.ischool.drexel.edu/faculty/ssilverstein/info780/readinglist_780.xls

. The next-to-last column of the spreadsheet contains a session number (1-10). Note: some articles are required, others optional – see the required/optional column. Most articles will be posted in appropriate Blackboard folders, and are also available online via http://sfx.library.drexel.edu/sfx_local/a-z/default in full text and PDF formats.

There will be a midterm written exam (posted Wed Feb 7 and due Sun Feb 11 ), and a Final Paper (topic proposal due Fri Feb 16 , paper itself due Wed

Mar 21 ).

Grades will be determined based on: midterm exam (25%), final paper (50%), Blackboard eDiscussion participation (25%). See grading standards at the end of the syllabus. Also see “Standards for Academic Honesty” at the end of the syllabus and on the Blackboard INFO780 site.

NOTE: please be assured that medical experience is not a requirement for the course and you will not be evaluated on the basis of how much medical knowledge or background you have - or do not have. Of course, you will likely know more about certain aspects of medical care after this course than before!

Session #

Week 1

Date becomes available in

Blackboard

“Course

Materials” section

Mon Jan 8

Topic Notes Readings/References

1. Chapters from Lorenzi &

Riley

2. Articles are keyed to readinglist_780.xls spreadsheet available in Blackboard

“Course Information/Basic

Housekeeping” section

3. Additional materials will be available in Blackboard

“Course Materials” section

Introduction to Healthcare Informatics and the healthcare environment

What is Healthcare Informatics, who are its practitioners

Healthcare organiza tions in today’s healthcare environment

 Introduction to healthcare IT’s unique challenges

Please email scot.silverstein@ischool.dre

xel.edu

as soon as possible with your full name, phone number and email address.

See description of

Informatics paper in the first

Course Information folder in Blackboard (Note: topic proposal due Fri Feb 16, paper itself due Wed Mar

21).

Ch. 1, 2, 3

Articles for session 1

“Building the Work Force for

Health Information

Transformation ” http://www.ahima.org/emerging_is sues/Workforce_web.pdf

VA EHR Demo http://www1.va.gov/CPRSdemo/

Week 2 Tue Jan 16

(Monday 1/15 is university holiday)

Healthcare IT strategy and organization

Role of leadership in setting strategy

Health IT Strategic plans

Role of informatics specialists

Week 3

Week 4

Mon Jan 22

Mon Jan 29

Preparatory steps to facilitate change in healthcare organizations

Readiness for change

Teambuilding

Project planning and management

Implementing change

Gaining clinician acceptance

Critical role of leadership

Political minefields, swimming with the sharks

Personal reactions to environmental challenges

.

Ch. 4, 5, 6

Articles for session 2

“CEO Survival Guide to EHR systems ” http://www.ncqhc.org/executiveins titute/EHRbookfinal.pdf

“The Candid Healthcare CIO” http://www.candidcio.com/

Ch. 7, 8, 9, 10, 11

Articles for session 3

Ch. 12, 13, 14, 15, 16

Articles for session 4

Week 5

Week 6

Week 7

Week 8

Mon Feb 5

Mon Feb 12

Mon Feb 19

Mon Feb 26

Health IT difficulty and “failure” examples and analyses

Real-world case examples. What goes wrong and why?

 Avoiding the “F” word

Clearing up misconceptions - focus on the

“people factor”

Clinical vs. Management computing

Tactics and stereotypes

Territorial issues

Unqualified decision making

Understanding the resistance towards

“morbidity and mortality” prevention in health IT

Political, social and regulatory issues in healthcare IT

Affording the change

Information privacy and confidentiality

ROI issues

Managing post-implementation

People issues

Project evaluation

Midterm exam questions posted Wed. Feb. 7, due

Sun Feb 11

Final paper topic proposal due Fri. Feb. 16

Articles for session 5

Website http://www.ischool.drexel.edu/fac ulty/ssilverstein/medinfo.htm

Articles for session 6

Articles for session 7

“Trust and Sources of Health

Information ” http://archinte.amaassn.org/cgi/content/full/165/22/2

618

Ch. 17, 18, 19, 20

Articles for session 8

Week 9

Week 10

Mon Mar 5

Mon Mar 12

Large scale clinical IT initiatives

National Health Information

Infrastructure (NHII)

ONCHIT

National Programme for IT (NPfIT) -

NHS Connecting for Health

Others

Current issues in health IT

Articles for session 9

Final Paper due Wed Mar

21

“Accelerating Transformation through Health Information

Technology ” http://www.healthtransformation.n

et/content/Files/CHT%20Connecti vity%20Conference%20Report%2

0%2D%2011%2028%2005%20%

284%29.pdf

Articles for session 10

At the end of this course, students should be able to understand and discuss:

1.

How and why clinical information technology is increasingly important to healthcare

2.

The basic structure of healthcare organizations

3.

Sociotechnical issues that may delay or impede implementation and use of clinical IT

4.

The unique issues in the healthcare field regarding clinical computerization, as well as similarities to issues in other domains

5.

Clinician attitudes, both pro and con, towards clinical IT and process change

6.

Leadership issues, including the role of healthcare informatics professionals in health IT project leadership and success

7.

The value and role of medical informatics education for IT and information professionals involved in healthcare settings

8.

Large-scale, regional and national initiatives in healthcare IT

9.

why it is advantageous to see clinical IT projects as “ incredibly complex social endeavors in unforgiving clinical environments that happen to involve computers, as opposed to computer projects that happen to involve doctors

.”

Midterm & Final Paper Information is at: http://www.ischool.drexel.edu/faculty/ssilverstein/INFO780_Research_Paper_Winter_2006-7.doc

There will be a midterm written exam (posted Wed Feb 7 and due Sun Feb 11 ), and a Final Paper (topic proposal due Fri

Feb 16 , paper itself due Wed Mar 21 ). Assignments should be submitted via the Digital Dropbox in Blackboard.

1. The midterm will be a written test. I will evaluate your answers based on how they show comprehension of the readings, critical thinking about the issues raised, creativity, and cross-fertilization with ideas from your own backgrounds.

2. Details about the Final Paper are in the MS-Word document above. I will help in topic selection. Please let me know if you have questions.

On the final paper, the goal is to author a paper that can demonstrate and enhance your understanding of a topic of current interest in health informatics.

Excellent sources of paper topic ideas: A site such as http://www.amia.org/informatics/news/ is rich with many current topics that you could review in more detail in a paper. Pick on of interest and email me with your ideas, so they can be refined. A site such as http://www.informatics-review.com

is also worth reviewing as a source of ideas.

Standards for Academic Honesty:

Standards for academic honesty are described in the Student Handbook which is available as a .pdf here , starting on page 50, and at Drexel University's academic honesty policy at http://www.drexel.edu/studentlife/judicial/honesty.html

. All students are responsible for reading and understanding these policies and procedures.

Important excerpt from the Student Handbook:

Plagiarism: the inclusion of someone else’s words, ideas, or data as one’s own work. When a student submits work for credit that includes the words, ideas, or data of others, the source of that information must be acknowledged through complete, accurate, and specific references, and, if verbatim statements are included, through quotation marks as well. By placing his/her name on work submitted for credit, the student certifies the originality of all work not otherwise identified by appropriate acknowledgments. Plagiarism covers unpublished as well as published sources. Examples of plagiarism include, but are not limited to:

 Quoting another person’s actual words, complete sentences or paragraphs, or an entire piece of written

 work without acknowledgment of the source

Using another person’s ideas, opinions, or theory, even if it is completely paraphrased in one’s own words without acknowledgment of the source

 Borrowing facts, statistics, or other illustrative materials that are not clearly common knowledge without acknowledgment of the source

Copying another student’s essay test answers

Copying, or allowing another student to copy, a computer file that contains another student’s assignment, and submitting it, in part or in its entirety, as one’s own

 Working together on an assignment, sharing the computer files and programs involved, and then submitting individual copies of the assignment as one’s own individual work

Students are urged to consult with individual faculty members, academic departments, or recognized handbooks in their field if in doubt regarding issues of plagiarism.

Important!

Under university policy, students found guilty of plagiarism may fail the assignment and the course. You may expect that the minimum penalty will be a one full grade reduction in your final grade. Students committing plagiarism will be reported to the University Judicial Office where a permanent record of the offense will be maintained.

The College of IST takes the issue of Academic Honesty very seriously. Note that regardless of the decision of the

Judicial Affairs Office in such matters, and depending on the severity of the infraction, a Graduate student may not be readmitted to the College of IST after their first offense of the Academic Honesty policy.

Grading scale (derived from a scale used by the Indiana University program, which has been adopted as the uniform grading scale by their faculty, and which is used by Dr. Kate McCain who communicated the scale at IST):

A+ 100 Professional work of the highest caliber.

A 95 Outstanding achievement. Student performance demonstrates full command of the course materials

and demonstrates a high level of originality and/or creativity that far surpasses project and course expectations.

A- 90 Excellent achievement. Student performance demonstrates thorough knowledge of the course materials and exceeds project and course expectations by completing all requirements in a superior manner.

Note: A key difference between a B and an A is the degree to which the work turned in is original, creative, and shows mastery of key concepts. Doing what is expected and no more, or simply following suggestions for improvement, however well done, earns, at best, a B+.

B+ 87 Very good work. Student performance demonstrates above-average comprehension of the

course materials and exceeds project and course expectations on all tasks as defined in the course syllabus.

B 84 Student performance meets designated project and course expectations and demonstrates

understanding of the course materials at an acceptable level.

B- 80 Marginal work. Student performance demonstrates incomplete understanding of course materials.

Note: In graduate school, a C does not mean satisfactory, even though it is considered a “passing” grade. It’s an indication that there is something wrong that needs to be addressed

C+ 77

C 74

Unsatisfactory work. Student performance demonstrates incomplete and inadequate understanding

of course materials.

C- 70

D+ 68

D 64

D- 60

F 0.0

Unacceptable work at varying levels of unacceptability.

Failing—or dropped the course and forgot to inform the appropriate personnel

Students needing accommodations:

Any student with a documented disability who needs accommodations should contact the Office of Equality and

Disability via the contact information below. All communication is strictly confidential.

Contact Information:

3201 Arch Street

Suite 210

Philadelphia, PA 19104

Mailing Address:

3141 Chestnut Street

81-210

Philadelphia, PA 19104

Phone (215) 895-1401

TTY (215) 895-2299

Fax (215) 895-1402

Rhonda Karp, Ed.D.

Sr. Associate Vice President

Equality, Disability and Civil Rights Compliance Officer rk29@drexel.edu

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