Health Informatics

BIOL67361 Health Informatics 15 Semester 1 Postgraduate Taught Level 7 Evangelos Kontopantelis Unit coordinator School of Biological Sciences 1 FHEQ level (Framework for Higher Education Qualifications) ' Masters/Integrated Masters P4 ' European Credit Transfer & Accumulation System Rating : 7.5  Central to any efforts to build an efficient health care system, or in supporting evidence-based medicine, is the need to capture information around patient diagnosis and medical treatment. At the core of this activity is the development of electronic patient records. Good quality electronic patient records require us to have systematic and unambiguous tools for recording the health state of a patient, and the treatments they receive. This unit provides a basic introduction to the development and use of electronic patient records, their long history, and the challenges still to be overcome. Patient data is captured in many parts of the health service, in GP surgeries, in hospital labs, by different clinical teams. All this data needs to be brought together and shared - whether that be to build a record for a single patient, or provide an overview of activity across a region. This requires that data can be shared and integrated. However, the challenges in developing such systems are not purely technical. Issues around organizational and human factors are at least as difficult to develop effective solutions as developing an appropriate IT infrastructure. Indicative content:Information Governance: data and information quality, security and confidentiality<ul> <li> GDPR</li> <li> Codes of Practice</li> <li> Dealing with requests for information about patients/clients</li> <li> Information Commissioner,</li> <li> Paper based vs electronic records;</li> <li> Patient identifiable data and information,</li> <li> Secondary uses of data,</li> <li> Audit and research,</li> <li> Caldicott Guardians</li> <li> Consent</li> <li> Smart cards/records access</li> <li> The well informed patient, the expert patient,</li> <li> Encryption (principles)</li> <li> Safe havens</li> <li> Relationship and differences between data and information</li> <li> Qualities of good data</li> <li> Information system risks to patient safety</li> <li> Cost of data entry errors</li> <li> Secure information exchange between professionals</li> <li> Sharing and communication with patients and carers</li></ul>· Uses of clinical and health data and information<ul> <li> Patient identifiable and non-patient identifiable data and information</li> <li> Health research applications</li> <li> Public health,</li> <li> Service planning</li> <li> Cross sector care,</li> <li> Patient/client centred service,</li> <li> Information flows between health and social care and public health, third sector and private sectors</li> <li> Systematic approaches to improving patient care: secondary uses – SUS – QIPP and related initiatives</li> <li> Patient focused systems vs speciality, disease or procedure focused systems</li> <li> Big Data</li> <li> Transparency</li> <li> Information intermediaries</li> <li> Clinical audit</li> <li> Information for patient choice</li></ul><ul> <li> Health Records</li> <li> Paper vs electronic records</li> <li> Patient held records</li> <li> Structured and coded records - free text in records</li> <li> Consent models</li> <li> Confidentiality and security</li> <li> Impact of patient access on professionals and relationships, behavioural issues</li> <li> Record sharing – with patients and between professionals</li> <li> Electronic Health Records</li> <li> GP/primary care records</li> <li> · The Language of Health: Clinical Coding and Terminology</li> <li> Terminologies vs classifications.</li> <li> Coding systems - nature, clinical applications, limitations</li> <li> Accident and Emergency Coding Tables</li> <li> International Classification of Diseases (ICD)</li> <li> NHS dictionary of medicines and devices, OPCS Classification of Intervention </li></ul> Central to any efforts to build an efficient health care system, or in supporting evidence-based medicine, is the need to capture information around patient diagnosis and medical treatment. At the core of this activity is the development of electronic patient records. Good quality electronic patient records require us to have systematic and unambiguous tools for recording the health state of a patient, and the treatments they receive. This unit provides a basic introduction to the development and use of electronic patient records, their long history, and the challenges still to be overcome. Patient data is captured in many parts of the health service, in GP surgeries, in hospital labs, by different clinical teams. All this data needs to be brought together and shared - whether that be to build a record for a single patient, or provide an overview of activity across a region. This requires that data can be shared and integrated. However, the challenges in developing such systems are not purely technical. Issues around organizational and human factors are at least as difficult to develop effective solutions as developing an appropriate IT infrastructure. Indicative content:Information Governance: data and information quality, security and confidentiality<ul> <li> GDPR</li> <li> Codes of Practice</li> <li> Dealing with requests for information about patients/clients</li> <li> Information Commissioner,</li> <li> Paper based vs electronic records;</li> <li> Patient identifiable data and information,</li> <li> Secondary uses of data,</li> <li> Audit and research,</li> <li> Caldicott Guardians</li> <li> Consent</li> <li> Smart cards/records access</li> <li> The well informed patient, the expert patient,</li> <li> Encryption (principles)</li> <li> Safe havens</li> <li> Relationship and differences between data and information</li> <li> Qualities of good data</li> <li> Information system risks to patient safety</li> <li> Cost of data entry errors</li> <li> Secure information exchange between professionals</li> <li> Sharing and communication with patients and carers</li></ul>· Uses of clinical and health data and information<ul> <li> Patient identifiable and non-patient identifiable data and information</li> <li> Health research applications</li> <li> Public health,</li> <li> Service planning</li> <li> Cross sector care,</li> <li> Patient/client centred service,</li> <li> Information flows between health and social care and public health, third sector and private sectors</li> <li> Systematic approaches to improving patient care: secondary uses – SUS – QIPP and related initiatives</li> <li> Patient focused systems vs speciality, disease or procedure focused systems</li> <li> Big Data</li> <li> Transparency</li> <li> Information intermediaries</li> <li> Clinical audit</li> <li> Information for patient choice</li></ul><ul> <li> Health Records</li> <li> Paper vs electronic records</li> <li> Patient held records</li> <li> Structured and coded records - free text in records</li> <li> Consent models</li> <li> Confidentiality and security</li> <li> Impact of patient access on professionals and relationships, behavioural issues</li> <li> Record sharing – with patients and between professionals</li> <li> Electronic Health Records</li> <li> GP/primary care records</li> <li> · The Language of Health: Clinical Coding and Terminology</li> <li> Terminologies vs classifications.</li> <li> Coding systems - nature, clinical applications, limitations</li> <li> Accident and Emergency Coding Tables</li> <li> International Classification of Diseases (ICD)</li> <li> NHS dictionary of medicines and devices, OPCS Classification of Interventions and Procedures, Read Coded Clinical Terms, SNOMED CT</li> <li> Coding quality issues and risks</li> <li> Coding and patient accessible information</li> <li> Coding for management - importance of coded data for supporting business workflows and administration, e.g., Quality and Outcomes Framework (QOF) and Commissioning Outcomes Framework (COF).</li></ul>· ICT Systems for Clinicians, Patients and the Public<ul> <li> eHealth, Tele-health, tele-medicine</li> <li> Assistive technologies – applications, risks and issues</li> <li> Clinical and decision support systems</li> <li> Map of Medicine</li> <li> National Laboratory Medicine Catalogue</li> <li> On-line guidelines and knowledge bases</li> <li> National infrastructure e.g., SPINE, NWW, NHS Choices, patient portal(s)</li> <li> e-Prescribing</li> <li> Mobile working</li> <li> System design, system reliability, interoperability</li> <li> “Good informatics” vs “bad informatics”</li></ul> The content of the module is a development of the national curriculum framework ‘Learning toManage Health Information: A theme for clinical education 2012 – Making a difference’ (Department of Health 2012). This fourth edition of the framework was developed in partnership with representatives of a wide range of clinical professional bodies, health informatics professionals and health educators from across the UK. <div> The aim of this unit is to introduce health informatics knowledge and understanding of the skills and tools needed by all professionals in modern healthcare systems to provide safe, secure high quality, effective patient centred services. By the end of the module students should have an understanding of electronic patient records, why they are so important, and also just why it is so difficult to do well. They should also have some appreciation of the governance and data security problems surrounding the capture, use and sharing of such data.</div>   <ol> <li> Critically evaluate current literature on electronic patient records</li> <li> Discuss and justify the legislation, regulatory guidance and national and local protocols relating to the security, confidentiality and appropriate sharing of patient information.</li> <li> Discuss the basis and application and evaluate the limitations of the different clinical coding systems in use, and the importance of high-quality coded clinical data in communication and to patient safety.</li> <li> Apply information governance and security guidelines to information collection and use in healthcare systems</li> <li> Explain the use of clinical terms in record keeping and the role of terming on reporting and analysis.</li> <li> Identify the range, purposes, benefits and potential risks of sharing, integrating and aggregating clinical data and information.</li> <li> Evaluate the purpose, structures, use and storage of health and care records.</li> </ol> <ol> <li> Elicit information and requirements from various stakeholders</li> <li> Apply theories and concepts to research driven case-studies and own work</li> <li> Effectively communicate the decision-making process and how the decision arose surrounding a health informatics problem</li> </ol> <ol> <li> Self-direct their learning</li> <li> Reflect upon their learning</li> <li> Effectively work in an interdisciplinary team</li> <li> Communicate effectively both in written and verbal format to a range of stakeholders including the public.</li> </ol> e-Learning preparation material will impart basic and core knowledge whilst the face-to-face lectures and open discussions will introduce concrete examples and encourage attendees to draw upon their own work and experience.  Group, problem based learning will show a deeper understanding of the area and encourage collaborative working. The F2F contact will be delivered in one week.  0 Other 30% 2 Written assignment (inc essay) 50% 9 Set exercise 20% We give written feedback to students on this unit. MSc Genomic Medicine FT MSc Genomic Medicine FT PGDT Taught Component Optional MSc Genomic Medicine FT MSc Genomic Medicine FT (HEE) PGDT Taught Component Optional MSc Genomic Medicine PT MSc Genomic Medicine PT PGDT Taught Component Optional MSc Genomic Medicine PT MSc Genomic Medicine PT (HEE) PGDT Taught Component Optional PG Diploma Genomic Medicine FT PG Diploma Genomic Medicine FT PGDT Taught Component Optional PG Diploma Genomic Medicine FT PGDip Genomic Medicine FT(HEE) PGDT Taught Component Optional PG Diploma Genomic Medicine PT PG Diploma Genomic Medicine PT PGDT Taught Component Optional PG Diploma Genomic Medicine PT PGDip Genomic Medicine PT(HEE) PGDT Taught Component Optional PG Cert Genomic Medicine FT PG Cert Genomic Medicine FT PGDT Taught Component Optional PG Cert Genomic Medicine FT PGCert GenomicMedicine FT(HEE) PGDT Taught Component Optional PG Cert Genomic Medicine PT PG Cert Genomic Medicine PT PGDT Taught Component Optional PG Cert Genomic Medicine PT PG Cert Genomic Med PT (HEE) PGDT Taught Component Optional Genomic Medicine - CPD Genomic Medicine - CPD PGDT Taught Component Optional Genomic Medicine - CPD Genomic Medicine - CPD (HEE) PGDT Taught Component Optional MRes Genomic Medicine MRes Genomic Medicine PGDT Taught Component Optional Y The reading for this unit will focus on: (1) journals including International Journal for Medical Informatics; Health Informatics journal; and Journal of Medical Internet Research; (2) NHS documentation including policy documents; guidelines and standard; and (3) research from The Kings Fund (<a href="http://www.kingsfund.org.uk/">www.kingsfund.org.uk</a>) and Nuffield Trust (www.nuffieldtrust.org.uk).  Example texts include, but are not limited to:<ul> <li> <a href="http://www.ncbi.nlm.nih.gov/pubmed/16112893">Health information systems: failure, success and improvisation.</a> Heeks R.Int J Med Inform. 2006 Feb;75(2):125-37. Epub 2005 Aug 19.</li> <li> <a href="http://www.ncbi.nlm.nih.gov/pubmed/20691097">Barriers to the acceptance of electronic medical records by physicians from systematic review to taxonomy and interventions.</a>Boonstra A, Broekhuis M.BMC Health Serv Res. 2010 Aug 6;10:231. doi: 10.1186/1472-6963-10-231. Review.</li> <li> Understanding information governance. Research summary. Benedict Rumbold, Geraint Lewis and Martin Bardsley. August 2011 Nuffield Trust</li> <li> <ins cite="mailto:Evan%20Kontopantelis" datetime="2019-07-17T09:51"><a href="https://ico.org.uk/for-organisations/guide-to-data-protection/guide-to-the-general-data-protection-regulation-gdpr/">https://ico.org.uk/for-organisations/guide-to-data-protection/guide-to-the-general-data-protection-regulation-gdpr/</a></ins></li></ul>In addition, introductory health informatics texts may also be referenced including, but not limited to:<ul> <li> Coiera, E (2015). Guide to Health Informatics. (3rd Edition) London: CRC Press</li> <li> Shortcliffe, E. and Cimino, J Biomedical Informatics:Computer Applications in Healthcare and Biomedicine (Health Informatics). 3rd ed. London: Springer.</li> <li> Taylor, P., From Patient Data to Medical Knowledge. 2006: Blackwell Publishing Ltd.</li> <li> The EU General Data Protection Regulation (GDPR): A Practical Guide (Paperback). 2018: Springer.</li></ul> 0 0 150