Overview 1. Informatics in Physical Therapy education core documents 2. Informatics competencies in other disciplines 3. A framework and proposed informatics competenciesphoto via Vernio77
Objectives for TodayBy the end of the session, you’ll be able to:1. Describe the current state of health informatics in physical therapist education2. Appreciate informatics competencies prevalent in other healthcare disciplines3. Discuss the informatics competencies necessary for clinicians to be eﬀective in the emerging electronic age
Adoption of health information technology has become atop national priority... Failing to prepare clinicians with theappropriate competencies in information and knowledgemanagement will hamper progress towards our profession’sgoals of fully availing ourselves of technologies that canfacilitate more effective and efficient care.Wilkinson SG, Chevan J, Vreeman DJ. Establishing the centrality of health informatics in physical therapist education: if not now, when? J Phys Ther Educ. 2010;24(3):10-15
Informatics in PT educationcore documentsAlready established concepts that are part of the eld
Core Documents• Evaluative Criteria for Accreditation of EducationPrograms for the Preparation of Physical Therapists[Evaluative Criteria]• Guide to Physical Therapist Practice• A Normative Model of Physical Therapist ProfessionalEducation: Version 2004• Minimum Required Skills of Physical TherapistGraduates at Entry-Level• Vision 2020• RC 6-08 “Support of Electronic Health Records inPhysical Therapy”
Minimum Required Skills of PhysicalTherapist Graduates at Entry-Level
Normative Model Expectation Content Currently IncludedProfessional Duty Recognizes and values multiple methods to acquire knowledge and skills in support of lifelong learning and professional development…Clinical Use simple heuristics in improving decision-making underReasoning uncertainty Use current technology resources to gather information about health personnel supply and demand, models of health care delivery, and eﬃcacy of practiceEvidence-based Consistently use information technology to access sourcesPractice of information to support clinical decisions Manages knowledge and information using online databases, disease registries, electronic medical records, and other information technology systems to facilitate the delivery of health care (informatics)
Normative Model (cont’d) Expectation Content Currently IncludedProfessional Duty Devote time, energy, and resources to advancing the professionAccountability Understands security protections such as access control, data security, and data encryption related to the use of information technology in practice Directly addresses ethical and legal issues related to the use of information technology in practiceCommunication Uses information technology such as word processing, presentation, data analysis software, e- mail, and electronic records to improve clarity and eﬃciency of communications.Education Develop expertise in the use of technology available for patient/client or clinical staﬀ education and consultation
Informatics competenciesin other disciplinesCalls for informatics competencies for health professionals
Core Competency:effective and appropriate use of communicationand information technology.
Core Competencies for All Clinicians:provide patient-centered care, work ininterdisciplinary teams, employ evidence-based practice, apply quality improvement,and utilize informatics.
Recognizes that there arediﬀerent educational needs forclinicians who use technologyin their everyday practice thanfor the specialists who make upthe domain.
Top priority for all health professionals:Efficient information processing andeffective use of information andcommunication technologies.
“ Although most health professionals use IT daily in their work, few know how to adapt their roles and work processes to incorporate IT for the greatest benefit.Stead WW, Searle JR, Fessler HE, Smith JW, Shortliﬀe EH. Biomedical informatics: changing what physicians need to know and how they learn. Acad Med. 2011 Apr;86(4):429-34. PMID: 20711055
Informatics education innursingAlways pushing the envelope
1977First undergraduate course onapplying computers in nursing. Ronald JS. Computers and undergraduate nursing education: a report on an experimental introductory course. J Nurs Educ. 1979;18:4-9.
1980The term “Nursing informatics”is coined. Scholes M, Barber B, Bryant Y. The Impact of Computers on Nursing: An International Review. North Holland, Amsterdam: North-Holland; 1983.
1984First textbook published onusing computers in nursing. Ball MJ, Hannah KH. Using Computers in Nursing. Reston, VA: Reston Publishing; 1984.
1992ANA approves nursinginformatics as a new specialty. American Nurses Association Database Steering Committee. Nursing Data Systems: The Emerging Framework. Washington, DC: American Nurses Publishing; 1995.
1998School of Nursing Accrediting Agencies, AmericanAssociation of Colleges of Nursing, and NationalLeague for Nursing Accrediting Commission identifyessential informatics competencies and required theirinclusion in curricula. Ronald JS. Evolution of nursing informatics education. http://www2.amia.org/history/presentations/EvolutionOfInformatics.pdf. Accessed March 27, 2009.
2007A comprehensive vision for informatics innursing education and practice.Identi ed competencies needed in:basic computing, clinical informationmanagement, and information literacyTechnology Informatics Guiding Education reform. The TIGER initiative: evidence and informatics transforming nursing: 3-year action step toward a 10-year vision. http:// www.aacn.nche.edu/Education/pdf/TIGER.pdf. Accessed March 27, 2009.
Informatics education inmedicineFrom medical school to fellowship, board certi cation, andeverywhere in between
40+ years of trainingopportunities for informaticsspecialists
Gardner RM et al; AMIA Board of Directors. Core content for the subspecialty of clinical informatics. J Am Med Inform Assoc. 2009 Mar-Apr;16(2):153-7. Epub 2008 Dec 11. PMID: 19074296 Safran C et al; AMIA Board of Directors. Program requirements for fellowship education in the subspecialty of clinical informatics. J Am Med Inform Assoc. 2009 Mar-Apr;16(2):158-66. Epub 2008 Dec 11. Erratum in: J Am Med Inform Assoc. 2009 Jul-Aug;16(4):605. PMID: 19074295
In 1980s, early calls for physicianinformatics competencies.In 1999, AAMC recognized med schoolcurricular changes needed. Made recommendations across 5 informatics-roles: lifelong learner, clinician, educator, researcher, manager
Triola MM, Friedman E, Cimino C, Geyer EM, Wiederhorn J, Mainiero C. Health information technology and the medical school curriculum. Am J Manag Care. 2010 Dec;16(12 Suppl HIT):SP54-6. PubMed PMID: 21314222
Stead WW et al. Biomedical informatics: changing what physicians need to know and how they learn. Acad Med. 2011 Apr;86(4):429-34. PubMed PMID: 20711055.
Silverman H, Cohen T, Fridsma D. The evolution of a novel biomedical informatics curriculum for medical students. Acad Med. 2012 Jan;87(1):84-90. PubMed PMID: 22104049
Incorporating BiomedicalInformatics in PT educationA framework to “capture the sky”
Thanks for your email and your interest and efforts in this area - truly BMI is an interdisciplinary sport and I am excited to hear of your efforts to introduce this into your PT programs. --Howard SilvermanAcademic Medicine, Vol. 87, No. 1 / January 2012
“ A considerable number of technologies the students have a far better grasp than the instructors from their usage in previous course work or in their personal lives.“ Many items in question 4 are already known by all graduate students. We may refer them elsewhere for learning about technologies not used due to their lack of knowledge.“ Students must have a BS or BA degree before they are admitted into our program. Therefore, they all have had experiences in most of the above technology prior to coming to our program.
“ This seems like a funny thing to study. My students all drive cars, but I dont teach them about internal combustion engines. Technology is a tool and when used, it is expected that students will gain the expertise. We offer a PT degree rather than an informational technology degree.
Informatics underpins other competency domains: patient-centered care working in interdisciplinary teams employ EBP applying quality improvementStead WW et al. Biomedical informatics: changing what physicians need to know and how they learn. Acad Med. 2011 Apr;86(4):429-34. PubMed PMID: 20711055.
We recommend viewinginformatics as alongitudinal theme acrossall curricular elements.
Proposed Competenciesin Informatics photo via Justin Ornellas
Role of Life-long Learner Professional Practice Expectation 5: Professional DutySupport of life-long learning with biomedical informaticsrequires more than computer literacy.We need cognizance of the broad range of medical informationresources, devices, and technologies available and their relativevalue for particular needs, the know-how to use them, and themotivation to use them routinely.Connection to Vision 2020:“ While fully availing themselves of new technologies, as well as basic and clinical research, physical therapists will…
Role of Life-long Learner Professional Practice Expectation 5: Professional DutyCurrent Content Examples• Recognizes and values multiple methods to acquire knowledge and skills in support of lifelong learning and professional development• Maintains continued competence in clinical practice through a variety of lifelong learning strategiesAdditional Competency Examples• Recognize how to develop information habits to maintain currency in emerging technologies and biomedical devices.
Core Informatics CompetencyUnderstanding the domain fundamentals enough toadapt their roles and work processes to incorporateHIT for the greatest bene t.Competency Examples• De ne and describe the evolution of Biomedical Informatics• List and de ne the four major application areas of Biomedical Informatics • cite examples of the common theoretical foundations of these four areas• Describe why process redesign is important to care quality improvement • Explain eﬀective approaches to the review and redesign of clinical processes • Explain socio-technical and other barriers to eﬀective use of process redesign• Review ontologies and data standards, explain how they are used and why are they important
Clinical ReasoningCurrent Content Examples• Use current technology resources to gather information about health, personnel, supply and demand, models of health care delivery, and eﬃcacy of practice.Additional Competency Examples• Make critical use of decision support • Demonstrate knowledge of the available sources of decision support, which range from diagnostic expert systems to advisories issued from an EHR• Describe probabilistic clinical reasoning and its advantages and disadvantages• Discuss common heuristics that are employed in making judgments under uncertainty which lead to systematic and predictable errors.
Evidence-based Practice Professional Practice Expectation 9Current Content Examples• Consistently use information technology to access sources of information to support clinical decisions.• Manages knowledge and information using online databases, disease registries, electronic medical records, and other information technology systems to facilitate the delivery of health care (informatics).
We recommendestablishing ElectronicHealth Record (EHR)literacy as a separateexpectation.
“ Healthcare is an information business. The quality, effectiveness, and efficiency of care depend on our ability to manage information. You just cant do it without EHRs. Bill Tierney, AMIA 2011 Keynote
Electronic Health Record LiteracyClinicians must acquire information about the patient,make clinical decisions based on available information,and document and communicate ndings.Additional Competency Examples• Review the maturational history and functional evolution of EHRs• Demonstrate uency with EHRs for patient-speci c: • Retrieval of subsets of information • Documenting all aspects of patient/client management • Sharing information with other providers• Explain how EHRs can be used to develop, implement, and monitor compliance with patient care protocols and other best practices• Make critical use of decision support• Describe Personal Health Records (PHRs) and their pros/cons
We recommendestablishing use of HIT as aknowledge managementtool for advancing thescience of physical therapy.
We recognize that formal“research” activities areperformed by a relativelysmall proportion of physicaltherapists.
But, physical therapists needanalytic skills to leverage thetools for retrieval and analysisof aggregate data for qualityreporting, practiceimprovement, andbenchmarking.
HIT for Advancing the Science of PTAdditional Competency Examples• Determine what data exist relative to a clinical question or formal hypothesis, demonstrating the following: • The ability to use information resources to locate existing data sources. • local and external (e.g. national registry)• Develop a plan for data collection and analysis, including: • Selecting an appropriate database for collecting and organizing data • Represent data in a form that is useful and supports computer-based analysis• Analyze, interpret and report ndings, demonstrating the ability to: • Select an appropriate software tool for analysis of data and perform simple statistical analysis and portray the results graphically • Interpret the reports of statistical software analysis
Accountability Professional Practice Expectation 1Current Content Examples• Understands security protections such as access control, data security, and data encryption related to the use of information technology in practice• Directly addresses ethical and legal issues related to the use of information technology in practiceAdditional Competency Examples• Respect patient con dentiality and data security demonstrating the ability to use security-directed features of an electronic health record system
Communication Professional Practice Expectation 6Current Content Examples• Uses information technology such as word processing, presentation, data analysis software, e-mail, and electronic records to improve clarity and eﬃciency of communicationsAdditional Competency Examples• Demonstrate pro ciency with information and telemedicine technologies for • virtual teamwork • remote diagnostic / intervention techniques • clinician-patient communication• Eﬀectively employ written, electronic, and oral communication: • Use software to create visual materials that eﬀectively support oral presentations • Create a handout that includes simple graphics and tables for use in teaching or patient education • Collaborate across multiple sites using electronic mail, discussion lists, teleconferencing, and related communication technologies
Education Professional Practice Expectation 10Current Content Examples• Develop expertise in the use of technology available for patient/client or clinical staﬀ education and consultation.Additional Competency Examples• Select and use information resources for professional and patient education, demonstrating: • Practical knowledge of instructional technologies and resources available via the Internet, video teleconferencing, and other media. • The ability to eﬀectively leverage various computer-based instructional tools, including electronic tutorials and patient simulations.
danielvreeman.net/speaking photo via milos milosevic