Oregon Health & Science University
Department of Medical Informatics and Clinical Epidemiology
BMI 512/612: Clinical Information Systems
Offered In-class (Winter Term) and Online (Fall, Winter, Spring, Summer Terms)
3 credit hours
Summer Quarter 2012 (Online)
Instructor: Vishnu Mohan MD MBI FACP
KEY INFORMATION FOR THIS COURSE
Course Number
Course Title
Number of Credits
Quarter
Instructors (with e-mail
addresses)
BMI 512/612
Required Textbook
Carter, Jerome H. (ed.) Electronic Health Records, 2nd Edition.
2008, American College of Physicians.
Term Dates
Monday, June 25, 2012 - Friday, September 7, 2012
Clinical Information Systems
3
Summer 2012
Vishnu Mohan MD MBI FACP
mohanv@ohsu.edu
503-494-4469
PREREQUISITES
Successful completion of BMI 510.
COURSE OVERVIEW
This course introduces the student to basic concepts surrounding clinical information
systems and the practical application of these concepts. The breadth of material covered is
large, and hence this course is intended to provide knowledge at a high level, with an
emphasis on the operational informatics environment.
BMI 512 is a required course for students in the graduate certificate program.
FACULTY INFORMATION
Vishnu Mohan MD MBI FACP
Contact details:
BICC 409, Department of Medical Informatics and Clinical Epidemiology,
Oregon Health & Science University,
3181 Sam Jackson Park Rd,
Portland, OR 97239
Email: mohanv@ohsu.edu
Telephone: 503 494 4469
How to reach me: Email is always the best way to communicate with me. My office
hours are by appointment – email for a time to meet virtually or face-to-face, or leave
a message at 503 494 4469.
Teaching: I teach three core clinical informatics courses at DMICE - BMI 560/660: Design
and Evaluation in Health Informatics, BMI 512/612: Clinical Information Systems, and BMI
513: Electronic Health Record Lab. I also teach ISQA 551: Information Technology for
Healthcare course for the PHSU/PSU MBA in Healthcare Management program. As an
internist and clinician-educator, I also teach residents and medical students.
Research interests: My primary research interest is in clinical diagnostic reasoning, and
how clinicians interact with technology such as clinical decision support and computerized
physician order entry (CPOE). We study this interaction in a unique way, using a
qualitative, interdisciplinary approach. I'm also interested in using high-fidelity simulation
to look at how clinicians interact with technology, in clinical and biomedical informatics
education, and in developing curriculum for the health IT workforce.
Homepage: My OHSU web page is at: http://goo.gl/OXAVY
LEARNING OBJECTIVES
This course will enable students to:
1. Gain important knowledge about clinical information systems (CIS), with
emphasis on electronic health records
2. Understand how medical records are configured and organized
3. Appreciate basic concepts in user interface design
4. Learn important applications of CIS: computerized physician order entry,
clinical decision support, and clinical reporting
5. Learn how organizations approach large, complex implementation projects
and achieve success – in both the hospital and ambulatory environments
6. Recognize the importance of clinical workflow to CIS implementation; learn
how to analyze and redesign business processes
7. Learn practical approaches to real-world challenges associated with CIS
8. Develop critical appraisal and presentation skills
9. Hone self-study and collaboration skills
10. Develop skills utilized by a director of a clinical informatics department
REQUIRED TEXTBOOK
Carter, Jerome H. (ed.) Electronic Health Records, 2nd Edition. 2008, American College of
Physicians.
COURSE COORDINATION
This class is available through the Sakai learning management software at
http://sakai.ohsu.edu. The online component includes lectures, PowerPoint slides and
handouts, reading assignments, and project material.
OFFERINGS
The course is offered in both online as well as in-class sections. Please see the DMICE
course calendar for the schedule of offerings during the academic year.
Note: if you are enrolled in a term that offers both sections, please confirm that you
have registered to the appropriate (online or in-class) section.
The online section is conducted entirely via Sakai, and learning occur through online
lectures delivered using the Flash format, PowerPoint slides and handouts, reading
assignments, and additional project material. Students participate in discussions using the
Sakai Forums tool.
The in-class section meets once a week at BICC. For these students, the online component is
augmented by their in-class experience, which includes large-group as well as small-group
sessions with an emphasis on case-based learning.
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 class discussions; this class actively encourages engagement and
participation by all students. The student's participation grade is based on their level of
contribution to the learning of others.
3. Complete assignments and projects in a timely fashion. It is anticipated that students will
substantiate their assertions with appropriate attribution, and demonstrate that they
possess the ability to critically retrieve and analyze information that is available in the
informatics literature. Many assignments and projects involve teamwork for
preparation, presentation, and grading. As is common in real life, there are penalties for
late submissions and bonuses for those who turn their work in early.
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
weekly module includes a lecture, additional reading material, and assignments. Tests may
also be held online, at the discretion of the instructor. Lectures may be delivered by guest
lecturers with experience in the operational informatics universe. Guest lecturers may also
participate in in-class sessions.
Example of the course schedule and topics covered (note that the actual schedule for this
course may vary from the example):
Week 1
Course introduction
What is the electronic health record?
Week 2
Terminology
Clinical configuration of electronic health records
Week 3
CPOE
User interface design
Week 4
Clinical decision support systems
Clinical reporting
Week 5
Midterm
Week 6
Implementation considerations – Hospital
Clinical workflow
Week 7
Implementation considerations - Ambulatory
Patient care device integration
Week 8
Certification of electronic health records
Privacy and security
Week 9
Community Connectivity / Health Information Exchange
Meaningful Use of Electronic Health Records
Week 10
Final Projects
Week 11
Final Projects
Informatics talk
Each student will be required to participate in the creation, organization, and presentation
of at least one informatics talk during this course. The student will be responsible for
creating and giving a short presentation describing the problem, for presenting both sides
of the argument, for handing out 1-3 short readings that provide the audience with
background information on the topic, and for answering questions from the other members
of the class. It is anticipated that the talk will not exceed 30 minutes of class time. Students
are expected to participate in discussing informatics talk topics.
Format for the weekly informatics talk:

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



Short presentation to describe the problem (5-10 min)
Pros (2-5 min)
Cons (2-5 min)
Expert (optional) – someone in the class, me, outside (5-10 min)
Discussion in-class
Literature – background readings that help frame the issue
Weekly assignments
Students are expected to complete assignments assigned on Sakai most weeks in a timely
fashion. Some assignments may require collaboration with other students.
Examples of homework assignments:

Review of the CIS informatics literature

Contribution of an article to ClinfoWiki ( a project that was started by
Dean Sittig, a former instructor of this course, and is designed to become a
resource for clinicians, information system professionals working in
healthcare, and clinical informatician.
ClinfoWiki can be found at:
http://www.informatics-review.com/wiki

Designing and implementing a CIS measurement (a particular measure related
to implementation, use, or evaluation of some aspect of a clinical
information system)
Group projects
At the beginning of the term, you will be assigned to a group. These groups are intended to
be larger than those you will form to collaborate on the Informatics Talks, and are designed
to reflect real life clinical informatics situations. There are two Group projects in this
course, and you will have 2-3 weeks to complete each project.
Clinical informatics is a collaborative field, and these projects are intended to offer insight
into the types of collaboration that you may be engaging in as a clinical informaticist.
Individual Student project
The student project represents a significant individual effort that should be similar to one
you might be assigned as the Director of Clinical Information Systems. Each student will be
required to deliver a 5-10 page (not including references or executive summary) report,
complete with a 1-page executive summary.
25% of the student project grade consists of evaluations from fellow students. 75% of the
grade is comprised of the evaluation of the instructor.
Examples of student project topics:









Request for Proposal for a Clinical Information System
Computer-based Physician Order Entry implementation plan
Clinical Decision Support proposal
CIS evaluation plan
Clinical Information System business case including Return on Investment
estimates
Case study describing a current or past CIS, EMR, etc. implementation, along
with current status
Overview of Local Health Information Infrastructure (sites minimum 15)
Proposal to implement a speech recognition system for adult primary care
providers
Open source CIS running – demo, manual
EVALUATION
By design, this course has a diverse evaluative framework that includes evaluation of both
individual and group activities in order to provide a comprehensive and accurate reflection
of the student’s course activities.
INDIVIDUAL ACTIVITIES
Online or in-class participation = 25%
Weekly assignments = 25%
Student Project = 20% (25% of this evaluation is from other students)
GROUP ACTIVITIES
Group Project 1 = 10%
Group Project 2 = 10%
Informatics Talk = 10%
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 past published solutions to any assignments.
Literature and resources (including Internet resources) employed in fulfilling assignments
must be cited. See http://www.ohsu.edu/xd/education/library/researchassistance/plagiarism.cfm?WT_rank=1# for information on code of conduct for OHSU and
http://www.ohsu.edu/xd/education/teaching-and-learning-center/forstudents/index.cfm for more information on citing sources and recognizing plagiarism.
In an effort to uphold the principles and practice of academic honesty, faculty members at
OHSU may use originality checking systems such as Turnitin to compare a student’s submitted
work against multiple sources.
See http://ozone.ohsu.edu/som/faculty/docs/graduatecouncil/profconductpolicy.pdf for
details.
STUDENT ACCESS
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 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.
COPYRIGHT INFORMATION
Every reasonable effort has been made to protect the copyright requirements of materials
used in this course. Class participants are warned not to copy, audio, or videotape in
violation of copyright laws. Journal articles will be kept on reserve at the library or online
for student access. Copyright law does allow for making one personal copy of each article
from the original article. This limit also applies to electronic sources.
To comply with the fair use fair use doctrine of the US copyright law, Sakai course sites
close three weeks after grades are posted with the Registrar. Please be sure to download all
course material you wish to keep before this time as you will have no further access to your
courses.