clinical informatics and ehealth: open...
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Clinical Informatics and eHealth: Open Curriculum
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http://clinicalinformaticseducation.pbworks.com
Clinical Informatics and eHealth: Open Curriculum
The University of Melbourne (Lead institution)
Dr Kathleen Gray
Ms Dawn Choo
University of Tasmania
Dr Kerryn Butler- Henderson
Dr Sue Whetton
University of Western Sydney
Professor Anthony Maeder
The project extension grant 2014- 2015 was awarded by the Office for Learning and Teaching for ‘A competency based shareable online health informatics subject for health professional students in all Australian universities’.
Clinical Informatics and eHealth: Open Curriculum Health and Biomedical Sciences Part A
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Table of Contents
Health and Biomedical Sciences ............................................................................................................................ 3
Information Sciences .................................................................................................................................................14
Information and Communication Technology ........................................................................................... 22
Management Sciences .............................................................................................................................................. 27
Core Principles and Methods ............................................................................................................................... 32
Human and Social Context ..................................................................................................................................... 51
Clinical Informatics and eHealth: Open Curriculum Health and Biomedical Sciences Part A
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Activity 1: Basic health and biomedical concepts
Theme Health and Biomedical Sciences Part A
Topic Basic health and biomedical concepts
Learning Outcomes Describe the main concepts of physiology, anatomy, pathology and the different levels of biological organisation (molecule, cell, tissue, organ, system).
Learning Resources
Foundation Walker, S., Wood, M., & Nicol, J. (2012). Mastering Medical Terminology:
Australia and New Zealand. Elsevier Health Sciences. http://www.elsevierhealth.com.au/media/anz/samplechapters/9780729541114/Mastering_Medical_Terminology_Australia_and_New_Zealand_Walker_9780729541114.pdf
Intermediate Grossman, S. (2013). Porth’s pathophysiology: Concepts of altered health
states. http://www.lww.co.uk/pathophysiology/porths-pathophysiology
Web Links http://www.nlm.nih.gov/medlineplus/ http://www.betterhealth.vic.gov.au/ http://medreviewed.com/mr/
Learning Activity
Undertake the medical science pop quiz on LMS. Review the pathophysiology for systems where you answered incorrectly and then retake the pop quiz. For any questions that you answered incorrectly the second time you took the quiz, write up the question, review it again, and write what you believe to be the correct answer - in the discussion forum.
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Activity Option 2: Data, information and knowledge in health and biomedicine
Theme Health and Biomedical Sciences Part A
Topic Data, information and knowledge in health and biomedicine
Learning Outcomes Illustrate the use of data, information, and knowledge across the different areas of health & biomedicine.
Learning Resources
Ohno-Machado, L. (2013). Data science and informatics: when it comes to biomedical data, is there a real distinction?. Journal of the American Medical Informatics Association, 20(6), 1009-1009. http://jamia.bmj.com/content/20/6/1009.full
Learning Activity
Provide an example of the use of data across three different areas of health and biomedicine. For each area explain how this is important for information and knowledge. Critically analyse each area to determine, based on the knowledge developed in the previous week and your own research, if data is currently being utilised to the full extent in each of these areas of health. If not, discuss what is required to fully utilise the data.
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Activity Option 3: Factors related to Health
Theme Health and Biomedical Sciences Part A
Topic Factors related to Health
Learning Outcomes Identify the basic determinants related to health, from genetics, physiological, psychosocial, to environmental and how they are assessed.
Learning Resources
World Health Organisation (2014). The determinants of health. http://www.who.int/hia/evidence/doh/en/
Learning Activity
Review the WHO webpages on the Determinants of Health. Select three areas from those listed on page two, and undertake further research
examining how health informatics plays a role in the monitoring and evaluation of the determinants of health.
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Activity Option 4: Clinical Decision Making
Theme Health and Biomedical Sciences Part A
Topic Clinical Decision Making
Learning Outcomes Define the processes of clinical decision-making and diagnostic/therapeutic strategies.
Learning Resources
American Speech- Language- Hearing Association (2014). Framing the Clinical Question. http://www.asha.org/members/ebp/framing/
Hoffmann, T. C., Légaré, F., Simmons, M. B., McNamara, K., McCaffery, K., Trevena, L. J., & Del Mar, C. B. (2014). Shared decision making: what do clinicians need to know and why should they bother?. The Medical Journal of Australia, 201(1), 35-39. http://www.mja.com.au/journal/2014/201/1/shared-decision-making-what-do-clinicians-need-know-and-why-should-they-bother
Queensland Health (2012). Guide to Informed Decision-Making in Healthcare. www.health.qld.gov.au/consent/documents/ic-guide.pdf
Learning Activity
Using the PICO framework and the worked case example in the first learning resource, formulate your own clinical question pertaining to a population of patients whom you may see in your area of clinical practice, suggest interventions, comparisons and outcomes (therapy or treatment goals). Explain how you managed to narrow your search in the research literature using PICO and how this facilitated your clinical decision-making process.
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Activity Option 5: Models of care delivery
Theme Health and Biomedical Sciences Part A
Topic Models of care delivery
Learning Outcomes Explain how continuity of care, shared care and other models of care are essential for inter-organisational relationships and the overall healthcare system.
Learning Resources
Stroke Foundation (2010). Clinical Guidelines for Stroke Management. http://strokefoundation.com.au/site/media/Clinical_Guidelines_Acute_Management_Recommendations_2010.pdf
Learning Activity
Select an area of service in stroke management (i.e. inpatient care, discharge planning, community rehabilitation or long-term rehabilitation) and create a clinical pathway or flowchart of service delivery related to this model of care. Describe how a multi-disciplinary or inter-professional approach is applied to the model of care which you have selected.
Clinical Informatics and eHealth: Open Curriculum Health and Biomedical Sciences Part B
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Activity Option 1: Evidence based clinical practice
Theme Health and Biomedical Sciences Part B
Topic Evidence based clinical practice
Learning Outcomes Describe the components of evidence-based clinical practice.
Learning Resources
The Cochrane Collaboration (2014). Evidence-based health care and systematic reviews. http://www.cochrane.org/about-us/evidence-based-health-care
Learning Activity
Define evidence based clinical practice. Name and give examples of two different types of credible health informatics resources that a clinician in your profession can refer to, to obtain evidence-based health information.
Clinical Informatics and eHealth: Open Curriculum Health and Biomedical Sciences Part B
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Activity Option 2: Health administration and health services research
Theme Health and Biomedical Sciences Part B
Topic Health administration and health services research
Learning Outcomes Explain how health systems are managed, funded, serviced, organised and measured.
Learning Resources
Australian Institute of Health and Welfare (2013). Australia’s health system. http://www.aihw.gov.au/australias-health/2014/health-system/
Learning Activity
Consider the Australian health services-funding and responsibility figure (Figure 2.1) shown on the AIHW Australia’s health system overview webpage. Imagine that you have been asked to advise a meeting of the Health Ministers of Commonwealth, State and Territory governments on the following question: Where in our health system can we achieve the greatest impact from investing in ehealth? What will you advise?
Clinical Informatics and eHealth: Open Curriculum Health and Biomedical Sciences Part B
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Activity Option 3: Epidemiology and basic health research skills
Theme Health and Biomedical Sciences Part B
Topic Epidemiology and basic health research skills
Learning Outcomes Describe public health, health promotion and the role of information to support them (biometry, epidemiology) as well as to enable health research.
Learning Resources
WHO (2014). Public health. http://www.who.int/trade/glossary/story076/en/ Weblink:
http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-index.htm
Learning Activity
From the website (http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-index.htm), select an area of population health policy. Describe one example of a health research program and one example of a health informatics resource that are used to support this area of policy.
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Activity Option 4: Clinical language and vocabulary
Theme Health and Biomedical Sciences Part B
Topic Clinical language and vocabulary
Learning Outcomes Define simple clinical abbreviations and terms (including abbreviations and acronyms) and their meaning.
Learning Resources
Australian Government, Department of Health (2013). https://www.health.gov.au/internet/main/publishing.nsf/Content/Glossary
Learning Activity
Test your ability to identify the full terms for a list of 50 clinical abbreviations and acronyms (provided on Page 6). Choose five acronyms / abbreviations that you had never heard of. For each one, summarise the meaning of the term or concept, and give a link to an authoritative source of further information online.
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Activity Option 5: Professional roles and resources in health organisations
Theme Health and Biomedical Sciences Part B
Topic Identify the professionals, skills and resources appropriate to a role in an organisation.
Learning Outcomes Define simple clinical abbreviations and terms (including abbreviations and acronyms) and their meaning.
Learning Resources
World Health Organisation (2014). Framework for action on interprofessional education and collaborative practice. http://www.who.int/hrh/resources/framework_action/en/
Learning Activity
Review the WHO Framework for action on IPE and collaborative practice. Discuss the role of health informatics in supporting interprofessional practice.
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Abbreviations for Activity Option 4: Clinical language and vocabulary Number Abbreviation Definition
1 A&BC Air and Bone Conduction 2 A/E Above Elbow [amputation] 3 B&C Breathed and Cried 4 BO Behaviour Objective 5 CAVHD Continuous Arteriovenous haemodialysis 6 CSU Catheter specimen of urine 7 DOA Date of Admission 8 DSA Digital Subtraction Angiography 9 EER Estimated Energy Requirement
10 ED Erectile dysfunction 11 FES Functional electrical stimulation 12 F/U Follow up 13 GCS Glasgow Coma Scale 14 GETT General by endotracheal tube 15 HA Headache 16 HSDNM Heart sounds dual and no murmur 17 ID Infectious disease or identification 18 IG Intragastric 19 j Jaundice 20 JAL Just-Audible Level 21 KUB Kidney, Ureter, Bladder 22 KVO Keep vein open 23 LOC Level of consciousness 24 LRD Living related donor 25 MS Mitral stenosis 26 MVV Maximum voluntary ventilation 27 NAD No active disease 28 NRM No regular medications 29 OD Right Eye (Oculus Dexter) 30 OOB Out of bed 31 PR Physical Rehabilitation 32 P&V Percussion and vibrations 33 Q. dx Double the quantity 34 QAC Before every meal 35 R/O Rule out 36 RTL Reacts to light 37 s Without 38 Sx Symptoms 39 TB Term birth 40 TIA Tumour-Induced Angiogenesis 41 US Usher Syndrome 42 UTI Upper And Lower Tract Infections 43 V-s Vibration second 44 V-tach Ventricular-Tachycardia 45 WBAT Weight Bearing as tolerated 46 WN Well nourished 47 XA X-ray analysis 48 Yo Years old 49 ZAP Zone Of Apposition 50 ZTT Zinc Tally Test
Clinical Informatics and eHealth: Open Curriculum Information Sciences
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Activity Option 1: Applicable mathematical concepts
Theme Information Sciences
Topic Applicable mathematical concepts
Learning Outcomes Explain the concepts of inferential statistics, probability & logic.
Learning Resources
Australian Bureau of Statistics (2013).Statistical Language Glossary. http://www.abs.gov.au/websitedbs/a3121120.nsf/home/statistical+language+-+statistical+language+glossary
Learning Activity
Find a research article in your clinical field which illustrates the use of both descriptive and inferential statistics. Identify and interpret findings from the study which are based on probability and logic concepts.
Clinical Informatics and eHealth: Open Curriculum Information Sciences
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Activity Option 2: Basic knowledge of IS concepts
Theme Information Sciences
Topic Basic knowledge of IS concepts
Learning Outcomes Indicate how concepts such as data, information, knowledge, hardware, software, computing, networks, and information systems can be used.
Learning Resources
Australian Government Information Management Office (AGIMO). (2006). Australian Government information interoperability framework. http://www.finance.gov.au/policy-guides-procurement/interoperability-frameworks/information-interoperability-framework/
Learning Activity
Define each of the following key terms in your own words: a. data, b. information, c. knowledge, d. hardware, e. software, f. computing, g. networks, h.. information systems. Find and show an example of a publication from the peer-reviewed literature which demonstrates how these terms can be differentiated clearly, and another example that demonstrates how they can sometimes be used interchangeably.
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Activity Option 3: Information theories
Theme Information Sciences
Topic Information theories
Learning Outcomes Apply theories of informatics/computer science (e.g. activity theory, distributed cognition) for the purposes of designing and implementing information systems.
Learning Resources
Pingree, S., Hawkins, R., Baker, T., DuBenske, L., Roberts, L. J., & Gustafson, D. H. (2010). The value of theory for enhancing and understanding e-health interventions. American Journal of Preventive Medicine, 38(1), 103. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2826889/
Learning Activity
Briefly describe a theory and provide an example of how it has shaped the design, development and assessment of a health care information system.
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Activity Option 4: Quality principles across the IS life cycle
Theme Information Sciences
Topic Quality principles across the IS life cycle
Learning Outcomes Apply quality principles and methods across the information system's life cycle (e.g. requirement specification, implementation, risk management and user training).
Learning Resources
Australian Bureau of Statistics (2009). The ABS Data Quality Framework. http://www.abs.gov.au/websitedbs/D3310114.nsf/home/Quality:+The+ABS+Data+Quality+Framework
Learning Activity
First, search and select a journal article that describes a real example of the ISLC for a health care system. Next, identify a risk management method that can be used in the information system life cycle. Lastly, identify how this method could have been applied to the system selected (journal article), including limitations of the model and problems experienced in the ISLC that may have been overcome if this model were used.
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Activity Option 5: Realisation of benefits from IS
Theme Information Sciences
Topic Realisation of benefits from IS
Learning Outcomes Appraise the realisation of benefits from information and systems through ongoing evaluation and assessment of system functionality.
Learning Resources
Victorian Auditor General’s Office (2008). Investing smarter in public sector ICT: turning principles into practice. http://www.audit.vic.gov.au/reports__publications/reports_by_year/2008/20080730_ict_bpg.aspx
Learning Activity
Provide an example of the use of IS in your clinical stream and appraise the intended benefits of the system using the six stages outlined in the learning resource. What subjective benefits are there outside of these six stages?
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Activity Option 6: Attributes and limitations of data and information
Theme Information Sciences
Topic Attributes and limitations of data and information
Learning Outcomes Apply the key attributes (e.g., quality, integrity, accuracy, timeliness, appropriateness) of data and information and their limitations to an intended use (e.g., clinical and analytical uses).
Learning Resources
Bowman, S. (2013). Impact of electronic health record systems on information integrity: quality and safety implications. Perspectives in Health Information Management, 10(Fall). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797550
Learning Activity
Read the EHR Integrity article. Identify and discuss one method being used in Australia to ensure data integrity for electronic health information.
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Activity Option 7: Data analysis and visualisation
Theme Information Sciences
Topic Data analysis and visualisation
Learning Outcomes Apply basic analytical and visualisation methods for knowledge discovery and representation of information.
Learning Resources
Kandel, S., Paepcke, A., Hellerstein, J. M., & Heer, J. (2012). Enterprise data analysis and visualization: An interview study. Visualization and Computer Graphics, IEEE Transactions on, 18(12), 2917-2926.
http://vis.stanford.edu/files/2012-EnterpriseAnalysisInterviews-VAST.pdf
Learning Activity
Apply the data analytical and visualisation methods mentioned in the learning resource to a sourced case and provide specific suggestion on overcoming barriers to adopting data visualisation tools.
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Activity Option 8: Identification of gaps in data sources
Theme Information Sciences
Topic Identification of gaps in data sources
Learning Outcomes Analyse gaps in data sources in collaboration with stakeholders in order to meet their needs for analysis and interpretation of data.
Learning Resources
Gruber, D., Cummings, G. G., Leblanc, L., & Smith, D. L. (2009). Factors influencing outcomes of clinical information systems implementation: a systematic review. Computers Informatics Nursing, 27(3), 151-163.
https://www.ghdonline.org/uploads/Gruber2009-FactorsInfluencingOutcomeEMRImplementationsSystematicReview.pdf My eHealth Record
http://www.myehealthrecord.com.au/Pages/default.aspx
Learning Activity
Review the literature assessing the current health information being captured by the Australian eHealth Record. Discuss with three different key stakeholders (one of which must be a consumer) as to the gaps in the data and make recommendations.
Clinical Informatics and eHealth: Open Curriculum Information and Communications Technology
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Activity Option 1: Basic knowledge of ICT concepts Theme Information and Communications Technology
Topic Basic knowledge of ICT
Learning Outcomes Indicate how knowledge of data structures, algorithms, and programming influence system design.
Learning Resources
Grimson, J. (2001). Delivering the electronic healthcare record for the 21st century. International Journal of Medical Informatics, 64(2), 111-127. http://www.sciencedirect.com/science/article/pii/S1386505601002052
van Ginneken, A. M. (2002). The computerized patient record: balancing effort and benefit. International journal of medical informatics, 65(2), 97-119. http://www.sciencedirect.com/science/article/pii/S1386505602000072
Learning Activity
Imagine you are building an EHR system like the one described in the two papers by Grimson and van Ginneken. Make a list of the data elements that would be stored for each patient or episode of care. Discuss what human factors affecting usage of the system need to be considered when it is designed.
Clinical Informatics and eHealth: Open Curriculum Information and Communications Technology
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Activity Option 2: Problem solving through ICT
Theme Information and Communications Technology
Topic Problem solving through ICT (algorithms, search, reasoning, visualization)
Learning Outcomes Apply problem-solving methods and technical approaches to health & biomedical contexts (e.g. information documentation, storage, and retrieval).
Learning Resources
Sittig, D. F., Wright, A., Osheroff, J. A., Middleton, B., Teich, J. M., Ash, J. S., ... & Bates, D. W. (2008). Grand challenges in clinical decision support. Journal of biomedical informatics, 41(2), 387-392. http://www.sciencedirect.com/science/article/pii/S1532046407001049
Musen, M. A., Middleton, B., & Greenes, R. A. (2014). Clinical decision-support systems. In Biomedical informatics (pp. 643-674). Springer London. http://www.researchgate.net/publication/226706299_Clinical_Decision-Support_Systems/file/9fcfd5082f6e1def38.pdf
Learning Activity
Read the papers by Sittig and by Musen. Then, choose a common disease that you would encounter in your clinical health profession, to use as an example of the decision representation methodology shown in the second reading. Find an authoritative source which describes the symptoms of the disease for diagnosis purposes. Construct a representation (diagram or words) for representing the diagnosis process based on this source.
Clinical Informatics and eHealth: Open Curriculum Information and Communications Technology
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Activity Option 3: Analysis of stakeholder needs along the System Life Cycle
Theme Information and Communications Technology
Topic Analysis of stakeholder needs along the System Life Cycle (user/participatory design processes; cost/benefit considerations; ICT architecture flexibility/interoperability)
Learning Outcomes Interpret and demonstrate the needs of relevant stakeholders to meet all necessary information, business, and technical requirements throughout the System Life Cycle.
Learning Resources
Berg, Marc (2001), Implementing information systems in health care organizations: myths and challenges, International Journal of Medical Informatics , Volume 64 , Issue 2 , 143 – 156. http://amirsadeghi.persiangig.com/hamvoroodi/papers/implementing%20information%20in%20health%20care.pdf
Bose, R. (2003). Knowledge management-enabled health care management systems: capabilities, infrastructure, and decision-support. Expert Systems with Applications, 24(1), 59-71. http://www.researchgate.net/publication/222829455_Knowledge_management-enabled_health_care_management_systems_capabilities_infrastructure_and_decision-support/file/504635231ee58759be.pdf
Learning Activity
The requirements specification process requires the participation of a wide cross section of stakeholders from the community of interest. Consider the issues raised in the pair of papers by Berg and Bose. Describe how two different stakeholders (e.g. clinician and administrator) might explain their expectations of a new management information system for a healthcare service organisation where someone in your profession would work.
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Activity Option 4: Selection and use of ICT
Theme Information and Communications Technology
Topic Selection and use of ICT (selection criteria for systems; utilization assessment; ICT product evaluation)
Learning Outcomes Choose good practices for selection and use of appropriate information and communication technologies to meet business requirements.
Learning Resources
Kushniruk, A. (2002). Evaluation in the design of health information systems: application of approaches emerging from usability engineering. Computers in biology and medicine, 32(3), 141-149. http://www.sciencedirect.com/science/article/pii/S0010482502000112
Ammenwerth, E., Gräber, S., Herrmann, G., Bürkle, T., & König, J. (2003). Evaluation of health information systems—problems and challenges. International journal of medical informatics, 71(2), 125-135. https://svn.win.tue.nl/repos/prom/Papers/SimulationDigitalDentistry/literature/evaluation_of_health_information_systems_problems_and_challenges_ammenwerth_2003.pdf
Learning Activity
An electronic health record (EHR) system is to be implemented in the healthcare organisation where you work. It will offer greater security than the existing system but at the expense of greater complexity of usage. Discuss how these (and other) factors would be reconciled in an evaluation of the software once it is implemented.
Clinical Informatics and eHealth: Open Curriculum Information and Communications Technology
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Activity Option 5: Good practice in System Life Cycle
Theme Information and Communications Technology
Topic Good practice in System Life Cycle (access control; usage audits/monitoring; network/mobile/device security issues; system adoption/migration/legacy)
Learning Outcomes Apply good practices throughout the IT System Life Cycle (including data security networks and devices).
Learning Resources
Cimino, J. J., Socratous, S. A., & Clayton, P. D. (1995). Internet as clinical information system: application development using the World Wide Web. Journal of the American Medical Informatics Association, 2(5), 273-284. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC116267/pdf/0020273.pdf
Kamel Boulos, M. N., & Wheeler, S. (2007). The emerging Web 2.0 social software: an enabling suite of sociable technologies in health and health care education. Health Information & Libraries Journal, 24(1), 2-23. http://onlinelibrary.wiley.com/doi/10.1111/j.1471-1842.2007.00701.x/full
Learning Activity
Read the two papers by Cimino and Kamel Boulos and apply what you have read: Imagine a scenario where a website is used to provide some aspect of clinical services in your health profession. What kinds of services might those be? What could “go wrong” with such a solution? Write a report for the monthly newsletter published for your profession.
Clinical Informatics and eHealth: Open Curriculum Management Sciences
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Activity Option 1: Project and change management
Theme Management Sciences
Topic Project and change management (project lifecycle, project timelines, IT project team roles, technology adoption issues, Gartner curve, change management principles & roles)
Learning Outcomes Explain methods for project and change management (i.e. teams, resources, project planning, collaboration, motivation, conflict resolution and business cases
Learning Resources
The current state of IT Infrastructure and Operations maturity immature! (Gartner, 2009)
The Current state of IT Infrastructure and Operations maturity immature! article
Learning Activity
Use the Gartner maturity curve to explain an instance of adoption of an IT solution in one specific part of the Australian health sector (eg patient record systems by GPs, radiology systems in hospitals) and identify factors which made it successful or unsuccessful.
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Activity Option 2: Alignment of IS with organisational strategies
Theme Management Sciences
Topic Alignment of IS with organisational strategies (HW & SW selection criteria & procedure, strategic planning for IT, SWOT analysis, organisational stakeholder involvement)
Learning Outcomes Apply good practice to ensure that information and information systems are aligned with business/clinical goals and strategies.
Learning Resources
SWOT Analysis Guide (Queensland Health). https://www.business.qld.gov.au/business/starting/market-customer-research/swot-analysis
Learning Activity
Conduct a SWOT analysis to inform the process of a new clinical decision support solution being adopted by a health service delivery agency.
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Activity Option 3: Information cultures and learning within organisations
Theme Management Sciences
Topic Information cultures and learning within organisations (Information for management and strategic purposes, type X Y Z organisations, “learning organisation” versus classis management principles)
Learning Outcomes Apply good practice to individual and team learning in order to promote an information culture across the organisation and to enable the realisation of a learning health system.
Learning Resources
Learning Organisation. http://infed.org/mobi/the-learning-organization/
Learning Activity
Organisational culture is the foundation of a successful Learning Organisation. Identify several elements of organisational culture which contribute to, or detract from, in your current or past workplace, and comment on how they might be improved.
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Activity Option 4: Good practice in process engineering
Theme Management Sciences
Topic Good practice in process engineering (business process engineering principles, workflow analysis, Six Sigma and swim lane methods, petri nets)
Learning Outcomes Apply good practice in process re-engineering, measuring and analysing the outcomes of processes to facilitate business and organisational transformation.
Learning Resources
Business process model notation. www.omg.org/bpmn/Documents/BPMN_V1-0_May_3_2004.pdf
Learning Activity
Describe a hypothetical Business Process Model flow of activities in a typical emergency department setting, and represent the flows and critical points diagrammatically.
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Activity Option 5: Risk management
Theme Management Sciences
Topic Risk management (classic risk management formulation frequency/severity/mitigation, bathtub curve analysis, software lifecycle stages, specific health IT system risks)
Learning Outcomes Analyse issues and opportunities to mitigate risks associated with projects and their environment (including aspects related to infrastructure, conformance and compliance).
Learning Resources
Turning risk into advantage a case study (KPMG, 2011). www.kpmg.com/PT/pt/IssuesAndInsights/Documents/erm23432NSS.pdf
Root cause analysis (RCA) and Risk reduction action plans (RRAP) (Vic
Govt). http://www.health.vic.gov.au/clinrisk/investigation/root-cause-analysis.htm
Learning Activity
Use Root Cause Analysis to conduct a Risk Assessment of replacing a desktop based patient record system (e.g. in allied health setting) with a cloud based system, and suggest how the identified risks can be mitigated.
Clinical Informatics and eHealth: Open Curriculum Core Principles and Methods (Part A)
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Activity Option 1: History of health and biomedical informatics (HBI) and analysis of related literature
Theme Core Principles and Methods Part A
Topic History of health and biomedical informatics (HBI) and analysis of related literature
Learning Outcomes Analyse the history and values of the discipline and its relationship to other fields while demonstrating an ability to read, interpret, and critique the core literature.
Learning Resources
Cesnik, B., & Kidd, M. R. (2010). History of health informatics: a global perspective. Stud Health Technol Inform, 151, 3-8. http://ebooks.iospress.nl/volumearticle/12900.
Learning Activity
“The history of Health Informatics is populated with visionary promises that have failed to materialise despite the best intentions” according to Cesnik & Kidd. Restate this in your own words and give an example that supports or refutes it, based on your own research into reports of ehealth and health information technology in Australian in the past decade.
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Activity Option 2: Theories of HBI
Theme Core Principles and Methods Part A
Topic Theories of HBI
Learning Outcomes Explain the relevance of syntactic, semantic, cognitive, social, and pragmatic theories as they are used in health & biomedical informatics.
Learning Resources
Rippen, H. E., Pan, E. C., Russell, C., Byrne, C. M., & Swift, E. K. (2013). Organizational framework for health information technology. International journal of medical informatics, 82(4), e1-e13. http://www.sciencedirect.com/science/article/pii/S1386505612000317
Learning Activity
Many people have opinions about what are the most fundamental reasons that explain when, why and how information and communication technology works (or doesn’t work) in healthcare. See for example commentaries from well-known bloggers at http://www.hitsphere.com/. Choose one of these bloggers, read a selection of their recent blog posts, and determine which theory or theories – as set out in Rippen et al. – are reflected in their opinions. In your report on this question, give specific examples from their blog posts that map onto the theory/ies that you think are the best fit with their opinions.
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Activity Option 3: Conceptual frameworks in HBI
Theme Core Principles and Methods Part A
Topic Conceptual frameworks in HBI
Learning Outcomes Relate the common conceptual frameworks that are used in health & biomedical informatics to specific problems (for example: modelling for predicting clinical outcomes).
Learning Resources
Borycki, E. M., Kushniruk, A. W., Bellwood, P., & Brender, J. (2012). Technology-induced errors: The current use of frameworks and models from the biomedical and life sciences literatures. Methods of information in medicine, 51(2), 95-103. http://www.ncbi.nlm.nih.gov/pubmed/22101488
Learning Activity
Technology-induced error can occur from the use of health information systems. Borycki et al. set out three broad conceptual frameworks (i.e. tools for thinking) that investigators typically use to explain what went wrong. Visit the webpage “Bad Health Informatics can Kill” http://iig.umit.at/efmi/badinformatics.htm Choose one report, explore it in detail and discuss it in terms of one Borycki’s three frameworks that you find particularly helpful to understand what happened.
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Activity Option 4: Knowledge representations in HBI
Theme Core Principles and Methods Part A
Topic Knowledge representations in HBI
Learning Outcomes Interpret the nature of health and biomedical data and information, encompassing the ability to represent medical knowledge.
Learning Resources
Shortliffe, E. H., & Barnett, G. O. (2014). Biomedical data: Their acquisition, storage, and use. In Biomedical informatics (pp. 39-66). Springer London. http://eknygos.lsmuni.lt/springer/56/046-079.pdf
Learning Activity
Respond to question 3 at the end of the Shortliffe article, but give your answer an Australian context. This includes finding out and reporting on what provisions are in place to standardise medical terminology in Australian health care.
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Activity Option 5: Governance of information systems in healthcare
Theme Core Principles and Methods Part A
Topic Governance of information systems in healthcare
Learning Outcomes Apply good practice to the governance of information systems (e.g. the characteristics, functionalities and management, including procurement).
Learning Resources
Stroetmann, K. A. (2012). Achieving the integrated and smart health and wellbeing paradigm: A call for policy research and action on governance and business models. International Journal of Medical Informatics., 82(4), e29-e37. http://www.sciencedirect.com/science/article/pii/S1386505612000949
Learning Activity
Read Stroetmann's 2012 article to gain an overview of what governance of health information systems involves. Demonstrate your understanding of this concept by producing an organisational chart that shows the major entities, key responsibilities and essential relationships that apply to governance of health information in the public sector, in the State where you live.
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Activity Option 1: Information systems to support patients
Theme Core Principles and Methods Part B
Topic Information systems to support patients
Learning Outcomes Apply good practice to the use of information systems to support patients and the public (e.g. patient-oriented information system architectures and applications, personal health informatics and games).
Learning Resources
Zayas-Caban, T., Dixon, B., (2011). Considerations for the design of safe and effective consumer health IT applications in the home. http://healthit.ahrq.gov/sites/default/files/docs/page/ZayasCabanDixonQSHC052011_comp%5B1%5D.pdf
Mason, M K (2015), What Can We Learn from the Rest of the World? A
look at International Electronic Health Record Best Practices. http://www.moyak.com/papers/best-practices-ehr.html
Nehta: eHealth Interoperability Framework. https://www.nehta.gov.au/implementation-resources/ehealth-foundations/ehealth-interoperability-framework
Enterprise architecture Queensland Health.
www.health.qld.gov.au/directives/docs/hsd/qh-hsd-015.pdf
Learning Activity
Compile a list of good practice principles for consumer/patient oriented systems, websites and applications. Use these principles to evaluate an application. What are possible consequences for failing to apply these principles?
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Activity Option 2: Electronic health records
Theme Core Principles and Methods Part B
Topic Electronic health records
Learning Outcomes Apply good practice to the structure and design of the health record including notions of data quality, longevity, minimum data sets, dealing with multiple patient identifiers, architecture and general applications of the electronic patient record/electronic health record.
Learning Resources
Zayas-Caban, T., Dixon, B., (2011). Considerations for the design of safe and effective consumer health IT applications in the home. http://healthit.ahrq.gov/sites/default/files/docs/page/ZayasCabanDixonQSHC052011_comp%5B1%5D.pdf
Mason, M K (2015). What Can We Learn from the Rest of the World? A
look at International Electronic Health Record Best Practices. http://www.moyak.com/papers/best-practices-ehr.html
Nehta: eHealth Interoperability Framework. https://www.nehta.gov.au/implementation-resources/ehealth-foundations/ehealth-interoperability-framework
Enterprise architecture Queensland Health.
www.health.qld.gov.au/directives/docs/hsd/qh-hsd-015.pdf
Learning Activity
Compile a list of good practice principles for electronic health records. Use these principles to evaluate an application. What are possible consequences for failing to apply these principles?
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Activity Option 3: Informatics in support of education and research
Theme Core Principles and Methods Part B
Topic Informatics in support of education and research
Learning Outcomes Define the need for quality education and the use of informatics to support research and improve information literacy (e.g. flexible and distance learning, library classification, literature retrieval methods, research methods and paradigms).
Learning Resources
Bloomrosen, M., and Detmer, D., (2010). Informatics, evidence-based care, and research; implications for national policy: a report of an American Medical Informatics Association health policy. Journal of the American Medical Informatics Association, pp 115-123. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000781/
Learning Activity
How might informatics contribute to high quality research and information literacy in your professional area?
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Activity Option 4: Interfacing and patient identification
Theme Core Principles and Methods Part B
Topic Interfacing and patient identification
Learning Outcomes Apply good practice to the development or adaptation of interfacing information system components and standards in healthcare.
Learning Resources
What is interoperability? http://www.himss.org/files/FileDownloads/HIMSS%20Interoperability%20Definition%20FINAL.pdf
Learning Activity
What is interoperability and why is it important? Use examples, preferably in the Australian context, to illustrate your discussion.
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Activity Option 5: Decision support systems
Theme Core Principles and Methods Part B
Topic Decision support systems
Learning Outcomes Apply good practice to the use of decision support for patient management, including construction and use of clinical pathways and guidelines.
Learning Resources
Zayas-Caban, T., Dixon, B., (2011). Considerations for the design of safe and effective consumer health IT applications in the home. http://healthit.ahrq.gov/sites/default/files/docs/page/ZayasCabanDixonQSHC052011_comp%5B1%5D.pdf
Mason, M K (2015), What Can We Learn from the Rest of the World? A
look at International Electronic Health Record Best Practices. http://www.moyak.com/papers/best-practices-ehr.html
Nehta: eHealth Interoperability Framework. https://www.nehta.gov.au/implementation-resources/ehealth-foundations/ehealth-interoperability-framework
Enterprise architecture Queensland Health.
www.health.qld.gov.au/directives/docs/hsd/qh-hsd-015.pdf
Learning Activity
Compile a list of good practice principles for decision support systems. Use these principles to evaluate an application. What are possible consequences for failing to apply these principles?
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Activity Option 1: Architectures of health information systems
Theme Core Principles and Methods Part C
Topics Architectures of health information systems
Learning Outcomes Analyse clinical models, mapping data relationships and dependencies that constitutes the architecture of health information systems (e.g., decision support systems, electronic health records, order entry, registries, etc).
Learning Resources
OpenClinical, (2015) Interoperability. http://www.openclinical.org/interoperability.html
Reid PP, Compton WD, Grossman JH, et al.,(editors) (2005), Building a
Better Delivery System: A New Engineering/Health Care Partnership, Chapter 4. www.nationalacademies.org/onpi/030909643X.pdf
Information and Communications Systems, The Backbone of the Health Care Delivery System, Printable Version. http://www.ncbi.nlm.nih.gov/books/NBK22862/
Learning Activity
Use either a health environment you are familiar with, or the Hopetoun/Midtown Scenario as a context for the following activities: Think about an electronic information system (e.g. Discharge summary,
health record) that will share information across two organisations (e.g. The Village Centre and Hopetoun Hospital). Draw a diagram showing the collection, storage and flow of information around this system.
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Activity Option 2: Interoperability and HI standards; integration of clinical data and associated risk Theme Core Principles and Methods Part C
Topics Interoperability and HI standards
Integration of clinical data and associated risks
Learning Outcomes Apply good practice to the use of health informatics standards to enable interoperability. Apply good practice to recording and communicating clinical data and how these are incorporated into systems, taking into account the risks associated with heterogeneous data formats and structures.
Learning Resources
OpenClinical, (2015) Interoperability.
http://www.openclinical.org/interoperability.html Reid PP, Compton WD, Grossman JH, et al.,(editors) (2005), Building a Better Delivery System: A New Engineering/Health Care Partnership, Chapter 4. www.nationalacademies.org/onpi/030909643X.pdf Information and Communications Systems, The Backbone of the Health Care Delivery System, Printable Version. http://www.ncbi.nlm.nih.gov/books/NBK22862/
Learning Activity
Use either a health environment you are familiar with, or the Hopetoun/Midtown Scenario as a context for the following activity: Identify points where there may be risks to patients arising from inadequacies within the system.
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Activity Option 3: Clinical safety and information systems
Theme Core Principles and Methods Part C
Topic Clinical safety and information systems
Learning Outcomes Apply good practice to the assessment of clinical safety risks associated with information and ensure the design, implementation, and adoption of health information technologies and systems appropriately mitigating the risk of inadvertent harm to patients.
Learning Resources
HL7 Australia. http://www.hl7.org.au/
Nehta: Clinical Governance and eHealth. https://www.nehta.gov.au/for-providers/about-ehealth-guidance/ehealth-set-up/clinical-governance-and-ehealth
NSW Health - Health Care Records - Documentation and Management. http://www0.health.nsw.gov.au/policies/pd/2012/pdf/PD2012_069.pdf
Supporting Communication in an Integrated Patient Record System. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1480157/
Learning Activity
Use either a health environment you are familiar with, or the Hopetoun/Midtown Scenario as a context for the following activity: Explain how adherence to interoperability standards (e.g. vocabularies,
messaging, security etc.) can mitigate these risks.
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Activity Option 4: Value of information systems and adoption
Theme Core Principles and Methods Part C
Topic Value of information systems and adoption
Learning Outcomes Apply good practice to the realisation of clinical value of information systems, fostering the adoption of emerging technologies in the health sector.
Learning Resources
Health-e-Nation Leadership Summit, Sydney 2014: Realising the Benefits from Implementation of Electronic Medications Management: http://www.chik.com.au/content/filelibrary/CHIK%20WHitepaper%20eMM%20LOWRES.pdf
Learning Activity
Use either a health environment you are familiar with, or the Hopetoun/Midtown Scenario as a context for the following activity: Create a table listing the clinical advantages and challenges of the system
for effective and efficient clinical care.
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Activity Option 1: Informatics for participatory health Theme Core Principles and Methods Part D
Topic Informatics for participatory health
Learning Outcomes Explain the value of social media, mobile technologies and emerging data sources to improve health as well as to promote consumer and patient engagement (e.g. sensors, ambient technologies, apps, and self-monitoring devices in healthcare).
Learning Resources
Healthcare Improvement Scotland. 2014.e-Participation Toolkit: using online technology to involve patients, carers and communities. http://www.scottishhealthcouncil.org/patient__public_participation/e-participation/idoc.ashx?docid=1c6a9577-ae09-4e13-8beb-720f4479d00a&version=-1
Learning Activity
Are Patients Ready to Become Tech-empowered Healthcare Consumers?* Prepare an Australianised version of the benefits and challenges to e-participation that are presented by the Scottish Health Council. Find recent statistics or other reputable data to include in your report, to illustrate how these benefits and challenges are manifested in Australia. (*The subtitle of an article by Meredith Salisbury, “How Many Heartbeats Today?” published 21 November 2014, in the online magazine Techonomy. http://techonomy.com/2014/11/many-heartbeats-today-patients-ready-become-tech-empowered-healthcare-consumers/ )
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Activity Option 2: New data sources and emerging technologies
Theme Core Principles and Methods Part D
Topic New data sources and emerging technologies
Learning Outcomes List new data sources in a context of progressive healthcare empowered by technology (e.g. microbiome, exposome, phenome, and epigenome).
Learning Resources
Sanchez, F. M., Gray, K., Bellazzi, R., & Lopez-Campos, G. (2014). Exposome informatics: considerations for the design of future biomedical research information systems. Journal of the American Medical Informatics Association, 21(3), 386-390. http://jamia.oxfordjournals.org/content/jaminfo/21/3/386.full.pdf
Learning Activity
Based on reading the Exposome Informatics article from JAMIA, choose one type of exposome data. Do additional online research in order to describe an example of an electronic technology that enables you as an individual to collect and manage this type of data for the purpose of relating it to other data about your personal health.
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Activity Option 3: E-health applications and solutions
Theme Core Principles and Methods Part D
Topic E-health applications and solutions
Learning Outcomes Apply good practice to the use of technology to implement e-health solutions (e.g. telehealth, ePrescription, regional networks, shared care, and inter-organisational information exchange).
Learning Resources
National eHealth Transition Authority (NEHTA). 2012. eHealth Architecture Principles. Version 1.0. https://www.nehta.gov.au/implementation-resources/ehealth-foundations/EP-1022-2012 (To download this document you must create a free account)
Learning Activity
NEHTA’s ehealth architecture sets out 22 principles of good practice. Choose one ehealth application or solution relevant to your clinical field that is currently in use or on the market in Australia. Investigate and report on the way it addresses the 22 principles, or as many of as you can find information about; comment also on the completeness of the information that is publicly available. (Pulse+IT www.pulseitmagazine.com.au is a useful source of information about ehealth applications and solutions)
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Activity Option 4: Knowledge translation in health
Theme Core Principles and Methods Part D
Topic Knowledge translation in health
Learning Outcomes Analyse information in the context of meaningful use of health information systems and health economics.
Learning Resources
Delaney, B. C., Peterson, K. A., Speedie, S., Taweel, A., Arvanitis, T. N., & Hobbs, F. R. (2012). Envisioning a learning health care system: the electronic primary care research network, a case study. The Annals of Family Medicine, 10(1), 54-59. https://transform.kcl.ac.uk/Publications_List_files/Delaney-2012-Envisioning%20a%20Learni.pdf
Learning Activity
Find an Australian case study from the peer-reviewed literature that illustrates some or all of the steps for translating electronic health data into knowledge of benefit to the healthcare system, as presented by Delany et al. Describe how it demonstrates these steps and comment on whether there are areas where it appears to be an incomplete approach to knowledge translation.
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Activity Option 5: Areas of specialisation in HBI
Theme Core Principles and Methods Part D
Topic Areas of specialisation in HBI
Learning Outcomes Explain the differences between the areas of specialisation in HBI (translational bioinformatics, clinical, nursing, public health informatics etc).
Learning Resources
American Medical Informatics Association. Working Groups. http://www.amia.org/working-groups
Health Informatics Society of Australia HISA. Special Interest Groups. http://www.hisa.org.au/?page=sigs
International Medical Informatics Association IMIA. Working Groups. http://www.imia-medinfo.org/new2/WG
Learning Activity
The Wikipedia entry for “Health Informatics” (http://en.wikipedia.org/wiki/Health_informatics#Sub_Specialities) needs updating to describe areas of specialisation more fully. Your task: Using the Australian, American and international societies’ lists of working groups and special interest groups, choose one specialisation that interests you. Define this specialisation, and give examples of current areas of activity within this specialisation, based on a selection of references to current authoritative sources. Write this up as though you were going to edit the Wikipedia page. If you choose this assignment, the instructor will assist you to code your work so that you can actually upload it to Wikipedia, if you wish.
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Activity Option 1: Technology and social aspects Theme Human and Social Context
Topic Technology and social aspects
Learning Outcomes Discuss the areas of design, evaluation and social sciences taking into account technological limitations.
Learning Resources
Van Gemert-Pijnen, J. E., Nijland, N., van Limburg, M., Ossebaard, H. C., Kelders, S. M., Eysenbach, G., & Seydel, E. R. (2011). A holistic framework to improve the uptake and impact of eHealth technologies. Journal of medical Internet research, 13(4). http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278097/
Learning Activity
Read the van Gemert-Pijnen paper. Find one other journal or conference paper describing how someone else has used the CeHRes Roadmap. Write a short report explaining why the Roadmap was developed, and summarising how it was applied in the example you found.
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Activity Option 2: The relevance of ethical and legal issues for health informatics
Theme Human and Social Context
Topic The relevance of ethical and legal issues for health informatics
Learning Outcomes Apply good practice to ethical, legislative political and regulatory obligations related to health information management (e.g. protecting the privacy of consumers).
Learning Resources
Australian Government. Office of the Australian Information Commissioner. Privacy Fact Sheets: Health and eHealth. http://www.oaic.gov.au/privacy/privacy-resources/privacy-fact-sheets/health-and-ehealth/
Learning Activity
Review the Privacy Fact Sheets. Choose one as the basis for a general knowledge test. Compose 5 True or False questions, then ask 10 people to answer them. Write a short report showing your questions and discussing your findings.
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Activity Option 3: Policies, principles and guidelines for health informatics management
Theme Human and Social Context
Topic Policies, principles and guidelines for health informatics management
Learning Outcomes Apply good practice to the collection, use, disclosure, access, protection and destruction of health information.
Learning Resources
PHRN Population Health Research Network. http://www.phrn.org.au/
Learning Activity
Review the PHRN website. Prepare an infographic that explains the role and illustrates responsibilities of a health data custodian. Here's one place you can get advice on how to make an infographic: http://www.theguardian.com/global-development-professionals-network/2014/aug/28/interactive-infographics-development-data
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Activity Option 4: Usability and human factors
Theme Human and Social Context
Topic Usability and human factors
Learning Outcomes Apply good practice to human centred design, usability, human factors and ergonomic sciences.
Learning Resources
Yen, P. Y., & Bakken, S. (2011). Review of health information technology usability study methodologies. Journal of the American Medical Informatics Association, amiajnl-2010. http://jamia.bmj.com/content/19/3/413.full
Learning Activity
Read the Yen paper. Select a health information or communication technology that you have used. Write a short report analysing its usability strengths and weaknesses in terms of user, task, system and environment factors.
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The views in this project do not necessarily reflect the views of the Australian Government Office for
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