pathology informatics: residency curriculum for now and the future

© 2014 APC/API/CAP . All rights reserved.

Pathology Informatics: Residency Curriculum for Now and the Future

West and Midwest Chairs and Administrators Regional ConferenceOctober 21 - 24, 2014

© 2014 APC/API/CAP. All rights reserved. 2

Informatics Training in Pathology

“The landscape of medical

practice is changing…

Appropriate exposure to and

training in informatics will be

essential…Developing a strong

informatics component for

residency training programs will

help advance the

transformational future of the

practice of medicine.”Sinard JH, Powell SZ, Karcher DS. Pathology training in informatics: Evolving to meet a growing need. Arch Pathol Lab Med 2014 (April);138:505-511.


What is PIER?

• Pathology Informatics Essentials for Residents

• Collaborative joint project of APC, API and CAP

• Instructional resource guide and toolkit

• Support for PRODSto address unmet needs for pathology informatics training

• Mapped to ACGME milestones in informatics for pathology residents


PIER Developed by Pathology Informatics Experts and PRODS

Core Team

Drs. Walter Henricks and Liron Pantanowitz (co-leaders)

Dr. Donald Karcher Priscilla Markwood Ann Neumann Sue Plath

Working GroupDr. Raymond D. Aller Dr. Suzanne Zein-Eldin Powell

Dr. Philip J. Boyer Dr. Michael Warren Riben

Dr. Victor Borisovich Brodsky Dr. Rodney A. Schmidt

Dr. Alexis B. Carter Dr. John H. Sinard

Dr. Rajesh C. Dash Dr. Enrique Terrazas

Dr. Michael D. Feldman Dr. J. Allan Tucker

Dr. John R. Gilbertson Dr. J. Mark Tuthill

Dr. James H. Harrison, Jr Dr. Myra L. Wilkerson

Dr. Anil V. Parwani


Residents

• Receive uniform, high quality training in a flexible and timely manner

• Gain essential pathology informatics knowledge and skills

• Be well-prepared to apply pathology informatics to collect, manage and share key medical information with colleagues and patients

Program Directors

Receive:• Up-to-date content suitable

for AP &/or CP• Scalable design based on

program characteristics and needs

• User-friendly toolkit for flexible implementation

• Content updates/releases

• Relevant performance outcomes mapped to ACGME milestones

Benefits


PIER Release Plan

• Release 0– Introduced at July 2014 APC Annual Meeting– Illustrated design, content and support

features

• Release 1– Available now on APC PIER web page– Will be alpha tested starting in November– Available for use by all residency programs

during alpha testing

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PIER Scope and Sequence


The PIER Essentials Align to ACGME Informatics Milestones

SBP7: Informatics: Explains, discusses, classifies, and applies clinical informatics (APCP)

Has not Achieved

Level 1Level 1 Level 2 Level 3 Level 4 Level 5

Demonstrates familiarity with basic technical concepts of hardware, operating systems, and software for general purpose applications.

Understands lab specific software, key technical concepts and subsystems on interfaces, workflow, barcode applications, automation systems (enterprise systems architecture).

Applies informatics skills as needed in project management (data management, computational statistics).

Participates in operational and strategy meetings, apprentices troubleshooting with IT staff, applies informatics skills in laboratory management and integrative bioinformatics (able to aggregate multiple data sources and often multiple data analysis services).

Is proficient in medical informatics systems.

Able to assess and purchase a laboratory information system for anatomic and/or clinical pathology laboratories.

Able to utilize medical informatics in the direction and operation of the laboratory.

Comments:


PIER Scope and Sequence

PIER Essentials 1

PIER Essentials 3 PIER Essentials 4

PIER Essentials 2

• Informatics in Pathology Practice• Information Systems Fundamentals• Importance of Databases• Introduction to Data Standards• Data Availability & Security

• LIS Components & Functions• Specialized LISs & Middleware• Data & Communication Standards • Digital Imaging• Basics of the Health Care Information

Ecosystem

• Pathologist Role in LIS & EHR Projects• LIS Installation & Configuration• Information Systems & Laboratory

Performance• Data Security, Regulatory & Accreditation

Requirements

• LIS Management & Oversight• Order and Results Management• Laboratory Data for Quality

Improvement & Research• Laboratory Data & Enterprise Health

Care Analytics

Entry-Level ProficiencyACGME Milestone Level 1

Instructional Hours: 4-6

Basic ProficiencyACGME Milestone Level 2


Intermediate ProficiencyACGME Milestone Level 3Instructional Hours: 10-12

Advanced ProficiencyACGME Milestone Level 4Instructional Hours: 10-14


PIER Essentials 1

PIER Essentials 1

• Informatics in Pathology Practice• Information Systems Fundamentals• Importance of Databases• Introduction to Data Standards• Data Availability & Security

Entry Level ProficiencyACGME Milestone Level 1



PIER Essentials 2

PIER Essentials 2

• LIS Components & Functions• Specialized LISs & Middleware• Data & Communication Standards • Digital Imaging• Basics of the Health Care

Information Ecosystem

Basic ProficiencyACGME Milestone Level 2Instructional Hours: 8-10


PIER Essentials 3

PIER Essentials 3

• Pathologist Role in LIS & EHR Projects

• LIS Installation & Configuration• Information Systems & Laboratory

Performance• Data Security, Regulatory &

Accreditation Requirements

Intermediate ProficiencyACGME Milestone Level 3Instructional Hours: 10-12


PIER Essentials 4

PIER Essentials 4

• LIS Management & Oversight• Order and Results Management• Laboratory Data for Quality

Improvement & Research• Laboratory Data & Enterprise Health

Care Analytics

Advanced ProficiencyACGME Milestone Level 4Instructional Hours: 10-14


Scope of Content

Out of Scope• Statistics• Bioinformatics • Programming

In Scope

• PIER topics cover what all pathologists need to know for practice

• Content will be maintained to accommodate changing technologies

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PIER Resource Toolkit


Overview

• PIER Scope and Sequence– Identifies the “what” to teach

• PIER Resource Toolkit– Identifies the “how” to teach

• Programs have unique needs and approaches– Toolkit helps PRODS scale topics– Provides implementation options to meet

program needs– Helps PRODS make good training decisions


Organization

• There are 3 key tools for each of the PIER Essentials:– Essentials Map– Resource Options– Outcomes Achievement Checklist


Essentials Map

• Top area– Main topics– Rationale– Outcomes for

achievement– Topic content

• Lower area• Implementation

strategies• Scheduling/progress

tracker


Essentials 1 Map: Top AreaTopic Title Informatics in Pathology

Practice Information Systems Fundamentals

Importance of DatabasesIntroduction to Data Standards

Data Availability & Security

Rationale The practice of pathology relies on the creation, management, and accurate and timely communication of clinical laboratory information.

Computers are essential tools that pathologists use in the management of information for laboratory practice and patient care.

Databases provide core structure and tools that enable pathologists to manage and analyze large amounts of information.

Standards enable sharing of data among different health care information systems (ie, interoperability), which is necessary for patient care.

Pathologists are ultimately responsible for the access to and safety of pathology information.

Outcomes for Achievement

Understand the relevance of informatics in pathology practice.

Describe the difference between information technology (IT) and informatics and recognize how pathologists contribute to informatics initiatives.

Explain the salient differences and similarities among pathology informatics, bioinformatics, public health informatics, health care information technology and health knowledge informatics.

Use correct terminology to describe the major types and components of computer hardware, software, and computer networks.

Conversant in the fundamentals of databases, including data types, fields, records, database structure, and mechanisms for querying data; understands how data storage affects data retrieval options.

Define the types and roles of standards used in pathology, at a basic level.

Understand the elements of data availability as a key part of security.

Content 1. Definition of informatics

2. Relevance of informatics in pathology

3. Different types of informatics

4. The practice of informatics in pathology

1. Hardware

2. Software

3. Networks

4. Communications

5. Internet / Web

1. Database terminology

2. Structured vs. Unstructured data

3. Types of databases

4. Use of databases

1. Messaging protocols

2. Data models

3. Interoperability

4. Introduction to coding systems

1. Data protection and confidentiality

2. Data availability & integrity

3. Data backup & recovery


Resource Options

• Lists content sources to support self-study or to inform the development of didactic materials

• Identifies recommended PIER resources, practical exercises and other optional resources

• Provides a detailed scheduling and progress tracker


Outcomes Achievement Checklist

• Documents progress and accomplishments

• Completion of Essentials documents completion of corresponding ACGME informatics milestone level

• Final sign-off goes into resident’s file


Alpha Testing and Deployment

• Testing Goals

– Obtain feedback on PIER materials

– Obtain feedback on implementation challenges and success tips

• Deployment Goals

– Gather additional tools and resources that can be shared across programs

– Build a cadre of programs that endorse PIER to foster deployment to additional institutions over time


Alpha Test Residency Programs

• Baystate Medical Center

• Cleveland Clinic• George Washington

University• Medical University of

South Carolina• University of Buffalo• University of Kentucky• University of New

Mexico

• University of Miami• University of Pittsburgh• University of Southern

California• University of Toledo• University of Washington• University of Vermont• Vanderbilt University


Our Hope: Widespread PIER Adoption and Implementation

• PIER seeks to ensure that all pathology residents acquire the informatics knowledge and skills needed for the modern practice of pathology

• We need your leadership for pathology residency programs to achieve this outcome together

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Q&A

Bookmark PIER materials at:http://www.apcprods.org/PIER/

http://www.apcprods.org/PIER/


Presentation Follow Up

• Direct any post meeting questions to Sue Plath, CAP Education Manager at [email protected]

pathology informatics: residency curriculum for now and the future

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