98 R. Haux et al.
manage such information systems of health care 3.2. Audience and involved curricula
institutions (cf. ). Appropriately designed educa-
tional programs in medical informatics/health in- The course is given for students of medical infor-
formatics and an increasing number of well-trained matics about 1 year before graduating to a Master
medical informatics specialists will help to pur- of Science in medical informatics at a university.
sue the goal of transforming health care through Necessary requirements are sufﬁcient knowledge
innovative use of information and communication about health care organizations and systems, about
technology [5,6]. project management, and about tactical informa-
tion management (mainly methodology of informa-
tion systems analysis in health care institutions,
2. Objectives see  for the Heidelberg/Heilbronn Medical In-
formatics Program). Mandatory for all medical in-
Our aim is to report on a course for medical infor- formatics students, but obligatory for students in
matics students on hospital information systems, an informatics-based medical informatics program
especially on its strategic information manage- (see , Section 4.1 on informatics-based medi-
ment. We report: cal informatics programs) is profound knowledge
in software engineering and in theory of database
• about its aim, audience, and the educational pro- and information systems.
grams involved, From 1990 until 2000, the course was lectured by
• about its content and structure, as well as the ﬁrst author for students at the Medical Infor-
• about our experiences gained so far. matics Program of the Universities of Heidelberg
and Heilbronn , mainly under the terms hos-
pital information systems and health information
Starting as course at the Medical Informatics systems. In addition, courses with related content
Program of the University of Heidelberg/University had been given at the Universities of Prague (from
of Applied Sciences Heilbronn , it is now orga- 1993 to 1998, ) and Athens (in 1999, ).
nized as international course in the framework of As today national health care systems are in-
the International Partnership for Health Informat- creasingly forced to deal with global problems that
ics Education (I E, http://www.iphie.org, ). call for solutions on an international level, it was
Our considerations and experiences on the inter- decided that our students should be trained to
national aspects as well as an evaluation study further meet the demands of an increasingly inter-
of our international course in 2002 are presented national health care environment. Considering this
in . development, from 2001 onward course was given
in the framework of the International Partnership
for Health Informatics Education I E  jointly for:
3. The course ‘strategic information
management in hospitals: an introduction • medical information science students from the
University of Amsterdam, The Netherlands ;
to hospital information systems’
• medical informatics students ; as well as
• health information management students 
from the University of Heidelberg/University of
Applied Science Heilbronn, Germany.
Our course aims to give answers to the following
In 2002, medical informatics students from the
• Why is systematic information processing in hos- Master of Science program of the newly founded
pitals important? University for Health Informatics and Technology Ty-
• What do hospital information systems look like? rol (UMIT) at Innsbruck, Austria, joined.
• What are good hospital information systems?
• How can we strategically manage hospital infor- 3.3. Content and structure
The course contents, presented in  and online
available for our students, is divided into the chap-
We want to provide our students with the knowl- ters:
edge and skills necessary to professionally begin
with practical work after graduation and to be able 1. Introduction: Signiﬁcance of information pro-
to do research in this ﬁeld. cessing in hospitals, progress in information
Strategic information management for medical informatics students 99
and communication technology, importance of other countries, the combination of presenting
systematic information management. knowledge about hospital information systems and
2. Basic concepts: Data, information and knowl- its strategic management and of elaborating ex-
edge, information systems and their compo- ercises in real clinical settings was found as very
nents, hospital information systems, health important.
information systems, information management Doing exercises in different clinical settings–—
in hospitals. in our case at the University Medical Centers of
3. What do hospital information systems look Amsterdam, Heidelberg, and Innsbruck–—and so be-
like? Hospital functions, modeling hospital in- ing able to identify different solutions concerning
formation systems, a metamodel for modeling architecture and infrastructure of the respective
hospital information systems: 3LGM, informa- information systems to related or even identical
tion processing tools in hospitals, architectures problems, was found very helpful. In particular, it
of hospital information systems, integrity and became clear that students need to have speciﬁc
integration within hospital information systems. practicals in such clinical settings in order to under-
4. What are good hospital information systems? stand the complexity of information management
Quality of structures, quality of processes, out- in hospitals and to identify the need and relevance
come quality, balance as a challenge for infor- of an appropriate theoretical background.
mation management. It also became clear that for such a course it
5. How to strategically manage hospital informa- is very helpful, when its teachers are not only in-
tion systems? Strategic, tactical and operational volved in research in the ﬁeld of the course (see,
information management, organizational struc- e.g. [16—23]), but also in the practice of strategic
tures for information management, strategic information management in hospitals. This helps
planning, monitoring and directing of hospital to discuss real and up-to-date problems and also
information systems. to present own experiences on how to solve such
6. Final remarks. problems as well as to refer to ongoing research.
Like architects, when being academic teachers,
The course is now organized yearly as block
should be able to provide a theoretical background
course with three blocks:
in their courses and should be experienced in
• Block 1: Sections 1—3 are taught separately by building houses, lecturers in the ﬁeld of hospital
teachers of the respective programs either in information systems and its strategic management
Dutch or in German. This block also includes should be able to provide a theoretical background
site visits in the respective university medical in their ﬁeld and should have practical experience
centers (i.e. Amsterdam, Heidelberg, and Inns- information management in hospitals, e.g. in the
bruck) and a presentation of the architectures elaboration and transformation of strategic infor-
and infrastructures of their hospital information mation management plans.
systems. Students are ﬁnally introduced to their Our course is obligatory in all four curricula men-
exercises. They are assigned to groups, ideally tioned. Examinations for this course have to fulﬁl
consisting of students from all three countries. the speciﬁc legal requirements for examinations of
• Block 2: Students start to work on their exercises. the four universities, based on the respective laws
• Block 3: Students and teachers meet for approx- of three nations. In addition, the members of the
imately 3 days at one place (in 2001 they met International Partnership for Health Informatics Ed-
at the University of Heidelberg, in 2002 at the ucation commit themselves to close collaboration
University of Amsterdam, in 2003 they will meet in training health and medical informatics students,
at UMIT in Innsbruck). Sections 4—6 are taught but also to maintain their identity, distinctive fea-
jointly for all students in English. Students do tures and unique proﬁles. We found that this can
group work to jointly ﬁnalize their exercises and best be solved by planing and teaching such a course
prepare their presentations. Finally, they present with teachers from the different universities, and
the results of their exercises. by ‘adjunct faculty’ approaches. E.g. one of the
teachers of this course is a (full time) professor
at one university but also adjunct professor at an-
4. Experiences other, with all the rights of teaching and examining
the students in this university, too. Such interna-
Up to now, our students evaluated our course tional afﬁliated faculty approaches may be helpful
quite positive (see  for details). Besides the in- for universities to establish international courses,
ternational aspects, such as working jointly with to fulﬁl the national legal requirements and the le-
students from medical informatics programs from gal requirements of the respective universities, as
100 R. Haux et al.
well as to preserve the quality levels required for  P. Knaup, R. Haux, A. Häber, A. Lagemann, F. Leiner, Teach-
each university. ing the fundamentals of information systems management
in health care: lecture and practical training for students
The authors are aware of a variety of courses on of medical informatics (Heidelberg/Heilbronn), Int. J. Med.
hospital information systems and on its strategic Inf. 50 (1998) 195—205.
management in various other health informatics  J. Zvarova, On development of medical informatics educa-
and medical informatics programs (e.g. ). Many tion via European cooperation, Int. J. Med. Inf. 50 (1998)
of these programs are documented in the IMIA Year- 219—223.
 M. Diomidus, J. Mantas, Assessing the progress of the
books of Medical Informatics (http://www.imia. M.Sc. course in health informatics under the ERASMUS pro-
org). The authors do not know of a related course gramme, Int. J. Med. Inf. 50 (1998) 159—163.
on this topic, which is jointly organized by several  M.W.M. Jaspers, M. Limburg, J.J. Ravesloot, Medical infor-
universities from different nations. matics in Amsterdam: research and education, in: R. Haux,
C. Kulikowski (Eds.), IMIA Yearbook of Medical Informatics
2001, Schattauer, Stuttgart, 2001, pp. 117—123.
 R. Haux, D. Schmidt, Master of science program in
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