23rd International Conference of the European Federation for Medical Informatics User Centred Networked Health Care - A. Moen et al. (Eds.) MIE 2011 / CD / Posters
Integrating the Electronic Health Record into Health Informatics Education Elizabeth BORYCKI 1, Andre KUSHNIRUK , Brian ARMSTRONG, Mu-Hsing KUO School of Health Information Science, University of Victoria, Victoria, British Columbia, Canada
Abstract. The paper describes the authors’ work in integrating electronic health record systems into health informatics (HI) education. Electronic health records promise to improve and streamline healthcare. Major national and international efforts are underway to increase their adoption. However, there have been few examples of their use in health informatics education. In this paper the authors describe their work in the integration of EHRs into HI education. Keywords. Health informatics, education, electronic health records, technology training, curriculum
Introduction The use of Electronic Health Record (EHR) systems is becoming more global. To improve student ability to effectively work with and understand EHRs, there is need to provide students with access and exposure to these systems in their education [1]. Work on competencies related to EHRs indicates that graduates of HI programs should understand interoperability issues, basic data standards, user interface design issues and implementation issues [2]. Despite the need for such education there are few reported examples of tightly integrating EHRs into health informatics educational programs [1]. This paper will provide examples from some of our experiences in integrating EHRs into health informatics education.
1. Integrating the EHR into Health Informatics Education and Training In response to this educational need, the authors have introduced the EHR into the classroom setting. This was done using the University of Victoria Electronic Health Record Educational Portal, a web-based portal that allows students to access and interact with a set of representative EHRs (i.e. Digital Anthrologix®, OpenVista®, OpenMRS, Indivo and a range of other systems) over the WWW (see 1,3 for technical and deployment details). Using the portal EHRs, we have developed a range of educational approaches for educating HI students. To date 200 undergraduate health informatics students have used EHRs in HI courses. One way in which we have 1
Corresponding Author: Elizabeth Borycki, School of Health Information Science; Email:
[email protected]
introduced EHRs into the classroom is by having students work with more than one EHR during some core courses in the undergraduate Health Information Science program at the University of Victoria to provide students with a range of formal analytical perspectives (i.e. technical, organizational, cognitive, socio-technical). For example, in a third year undergraduate course entitled “Human, Social and Organizational Aspects of Healthcare Information Systems” students have been asked to critically analyze several EHRs available on the portal using usability evaluation methods. The portal has also been used in an upper year HI undergraduate course entitled “Systems Analysis and Design in Healthcare”. The course introduced students to the principles of object-oriented systems analysis and design in the context of EHRs. Furthermore, the availability of open source EHRs offers the opportunity for students to design and create working EHR modules that can be interfaced with existing software on the portal, reinforcing their programming and software engineering competencies. We have also used EHRs in the classroom to teach interoperability to help students understand the interoperability issues. In the classroom context students were asked to use PHP to design a EHR similar to OpenVista® (after viewing and exploring several EHRs on the portal). Following this, the XML documents were used to import to other groups’ EHR’s using a MySQL database. As a consequence, students have developed a better understanding of how health data can be made interoperable among heterogeneous EHRs. EHRs have also been used to support individual student learning needs involving course based research projects as part of graduate level studies.
2. Discussion EHR use is becoming increasingly more global as internationally there has been a move towards EHR implementation. As a result, HI professionals are encountering a variety of complex problems in integrating EHRs in healthcare settings; for example, software, and hardware issues. Graduates of health informatics educational programs are being expected to design, implement and deploy EHRs. Students may have few opportunities to work with more than one EHR before graduating from an undergraduate or a graduate program. EHRs are a fundamental technology that needs to be integrated into course work in health informatics education. References [1] [2] [3] [4]
Borycki EM, Kushniruk AW, Joe R, Armstrong B et. al. The University of Victoria Interdisciplinary EHR Educational Portal. Stud Health Tech Inform. 2009: 143: 49-54. Canada’s Health Informatics Association. Health informatics professional core competencies. 2009. Armstrong B, Kushniruk A, Joe R, Borycki E. Technical and architectural issues in deploying electronic health records (EHRs) over the WWW. Stud Health Technol Inform 2009;143:93-8. Shortliffe EH, Cimino JJ. Biomedical Informatics: Computer Applications in Health Care and Biomedicine. Springer: New York, New York, 2006.
