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Public Health X Course Syllabus Jean Balgrosky, MPH, RHIA. Certificate in Health Care Management and Leadership.

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Certificate in Health Care Management and Leadership

Course Title:

____________________________________________________________________________ Health Care Information Systems and Technology

____________________________________________________________________________

Course Catalog Description:

____________________________________________________________________________ Successful development and implementation of integrated health information technology (HIT) is a major priority in health care organizations today. In addition to the overwhelming general need to stay current and improve service and quality of care, addition stimulus to the adoption of electronic health records (EHRs) is being provided through the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009. This law promotes the adoption and meaningful use of health information technology through the allocation of $36 billion for developing health information technology (HIT) over the next 6 years. Learn how HIT is used by health care delivery organizations, external research organizations, regulatory organizations, providers, and patients/consumers. This course covers HIT definitions; types of HIT systems in use today in health care organizations; HIT strategy, implementation and management; ethical

considerations and security; emerging and transformative technologies; and the technology fundamentals of electronic medical records (EMR), electronic health records (EHR), personal health records (PHR), and health information exchanges (HIE). The course also provides an HIT planning framework that makes an HIT architecture for a health care organization easy to understand and helps with planning the design, implementation, and support of clinical systems, financial/administrative systems, networks and connectivity technologies, data management, and interoperability of systems. HIT-related health care legislation, regulation and federal stimulus support, including HIPAA, the HITECH Act, interoperability, and Regional Healthcare Information Organizations (RHIOs) are also addressed.

Elective course in Certificate in Health Care Management and Leadership: This course is open to all students; certificate candidacy is not required. Students must have web access to retrieve course materials.

WELCOME

Instructor: Jean Balgrosky, MPH, RHIA

Email: jbalgrosky@ucla.edu Work Phone: 619-203-1687 Office Hours: tbd

Hello!

Welcome to the course. I’m looking forward to working with you as we explore the rapidly evolving world of information systems and technologies in health care, commonly referred to as healthcare information technology, or HIT. There are so many facets to this topic that it can be somewhat daunting to try to tackle or make sense of them by oneself. So my goal is to present the content of this course in a way that makes it less complicated for you, so that by the end of

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the course you feel confident in your grasp of the key concepts and fundamentals of HIT. I have worked as an HIT professional for 20+ years as chief information officer for 2 major health systems (a 13-hospital national health system serving 7 regions and a 5-hospital, 18-clinic regional health system), and spent every day of that time bridging the gap between non-technical and HIT professionals. I welcome the opportunity to explain HIT in terms that are meaningful to you and discuss this interesting topic with you so that you can take this knowledge forward and make use of it in your life and career.

I’m also looking forward to this class and working with you because we will have a chance to get to know about each other’s varied interests and backgrounds through this course, so let me begin by telling you a bit about my earlier background. It might help show that there are many different paths that one might take on the journey to working in the health information

technology field.

One might say I have been an early adopter or pioneer in the field of healthcare information technology (HIT) my entire career. Having received a bachelors of science degree from UCLA School of Public Health-Department of Health Services with a specialization in ―Medical Record Science‖ in 1974, I have been a Registered Health Information Administrator (RHIA) since 1975 (RHIA is the accreditation for professionals who manage managing medical/health records for health care delivery organizations). After earning my Masters of Public Health (MPH) in Management of Health Information Systems in 1981, I entered the workforce with key skills in health care management, computers/health information technology and management of medical records and then set my sights on what I foresaw would be the eventual computerization of those medical records. Well, that vision unfolded faster than I could have ever imagined. The advent of the electronic health record (EHR) has kept me on a fast-track ever since, in leadership positions managing HIT departments; and planning, implementing and supporting electronic health records, entire HIT architectures for health care delivery systems, and thousands of end-users of those systems.

As a result, I have more than 20 years experience in healthcare senior management and information technology leadership with a proven track record for introducing state-of-the-art health information technology, aligning systems and technology applications with evolving clinical and business needs and maximizing operational efficiencies for these healthcare systems. Many people talk about HIT ―solutions‖ or sell health care information technology products to organizations seeking to implement these technologies. Far fewer have actually had the challenging and sometimes harrowing experience of being responsible for ―delivering the IT goods‖ to an organization that wants the promise of HIT, but has no idea how to achieve it. I am proud of my hard work and successes in the trenches working side-by-side with other

committed individuals with the shared goal of making health care better through the use of technology. And I am eager to share what I have learned with you.

For eight years I was SVP & Chief information Officer (CIO) at Scripps Health, a 5-hospital, 18-clinic, 2600 physician health system; and for twelve years was CIO for Holy Cross Health System, a 13-hospital, national health system serving regional markets in eight state; and prior to that was director of information management and decision support systems for a three hospital system in Indianapolis, IN. Following the implementation of the electronic medical record at Scripps, I returned to UCLA School of Public Health to complete my PhD in Health Services with a cognate in health information technology, in preparation for teaching and doing research in the field of health information technology. I am currently writing my dissertation on ―Adoption of Electronic Health Records (EHRs) by Physicians for Use in their Practices‖. The

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past four years I have taught Health Services 251: Quality Improvement and Informatics at the UCLA School of Public Health, Department of Health Services.

Teaching is something I enjoy very much; it’s an art and discipline that to do well is a challenge. What I enjoy most is connecting with different minds around the same topic; trying to make sure everyone understands what is being taught in my class is very important to me. If ever there is an idea or topic that is confusing or unclear to you, please ask or approach me for clarification. I am certain we can find ways to communicate and clarify the concepts you will be learning in this class.

Having had the opportunity to lead major organizations through their own evolution in adopting information technology and seeing the incredible differences these technologies can make when implemented properly and coupled with process redesign, I am passionate about the EHR and information technology’s potential to transform healthcare delivery and research. I am equally enthusiastic about sharing what I have learned with others who are interested in or passionate about improving health care service and quality through the creative and successful use of information technology.

Throughout my career, I have served on boards and HIT advisory committees, including Microsoft’s Healthcare Advisory Committee and Hewlett-Packard’s Healthcare Advisory Board, as President of Healthcare Information Systems Sharing Group and a member of CHIME, HIMSS and other professional organizations. I also desire to help organizations that deliver care to those underserved in our communities; to that end, I currently serve as Chair of the

Information Technology Committee of the Board of Directors for San Diego’s North County Health Services, a network of thirteen community clinics serving north San Diego County. With the massive emergence of the EHR in this country, and now with major support from the federal government with the HITECH legislation, I plan to do research in the area of EHR adoption and participate at the national level in the advancement of information technology in healthcare. In the meantime, future careers in HIT will be available to anyone willing to learn and work hard. My goal is to get you started on that journey if you like, and teach you based on what I have learned as a CIO so you can begin to carve your own path based on your areas of interest in the exciting, emerging field of health care information technology.

Here’s to getting started! Jean

jbalgrosky@ucla.edu

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Instructor Expectations

Hello! I'm looking forward to working with you, learning about what you're doing and how you plan to use the course in your career. It’s an exciting prospect to share with you the new developments as well as the basics about today’s health information technology. As your instructor, my goal is for you to finish this course feeling confident in your basic grasp of this complex topic. I also hope we can explore areas that you might want to pursue for further study or work. I am here to provide advice as well as instruction to you, if you think you might be interested in pursuing a career in health information technology or other area of health care. Posting Responses: For the on-line portion of the class, please post your responses for assignments and discussions on the due dates each week as listed in the Syllabus. I plan to stay in regular touch with you and should be able to respond almost always within 24 hours if not well within that timeframe. I would suggest doing your work and developing any questions you have at a regular pace throughout the week, so that the questions come at a measured pace, not all at once just before the class session. (On a practical note, I drive two hours from Del Mar to come to UCLA so please take this into consideration if you need to reach me the afternoon before a class session. I won’t be on e-mail just prior to class, so if you really need to reach me at that time, in addition to e-mailing me, please call my cell phone at 619-203-1687.) Your on-line postings on the discussion board should incorporate your opinions and thoughts on the readings, responses to your peers, pertinent information from other things you’ve read, and examples from your experience. Please refer to the rubric below in this syllabus that describes what is helpful and desirable in posting content and style. The distinguishing feature of a well-written posting might include an analysis of what you read, what you experienced; or possibly a short interpretation of a chapter, article or a related assignment from another course.

Your posts should feature good writing, correct spelling and mechanics. We judge one another substantially by the quality, clarity and depth of our writing. Communication should be

professional and always use good etiquette. In the spirit of scholarly discussion, I expect responses that agree and disagree with others as long as they apply to the topic and are respectful. In our learning model, the heart of active learning occurs through the discussions that help you test your ideas, reinforce what you have learned, and share resources with others in the class.

Responses to your Postings: I will be in the on-line classroom almost every day. I will respond to questions within 24 hours in almost all instances. Put my name in postings to me (to Jean Balgrosky). Do the same for responses to everyone else. No messages are private - so please expand on any topic to add to the discussion.

As far as general communication is concerned, if you have a question about the material or an assignment, please e-mail me directly; and while attendance is an extremely important part of this class (since we only meet in person once every two weeks) or an issue arises or you are ill and cannot make it to class, feel free to call me (including evenings and weekends). If I am not available, please just leave a message and I will call you back at my earliest convenience. Of course, you can send email. I will respond as quickly as is practical, within 24 hours.

Other assignments: One time during the course, each student will do a one-page summary an 10-minute student-led discussion with the class of an article of your choosing (as long as it is related to health information technology, of course!)

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Also, for our main project, you will learn how to design a high-level HIT architecture for a health care organization. It will be fun!

If after reading an assignment, you do not understand what to do, please call me so that I can explain it and then I will also make sure the whole class receives the explanation. This is much better than feeling confused or turning in an assignment that you don’t feel good about.

Thank you for your thoughtful reading of the expectations; I welcome your comments and look forward to getting started in our class!

Jean

jbalgrosky@ucla.edu 619-203-1687

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Syllabus Outline and Schedule

Weekly Sessions

3/28 Session 1 – Course Overview and Introduction to Health Information Technology (HIT) (in-class)

4/4 Session 2 – Why does Health Information Technology (HIT) Matter? (on-line) 4/11 Session 3 – Health Information Technology (HIT) Strategy (in-class)

4/18 Session 4 – Organizational settings in which health information technology (HIT) is used (on-line)

4/25 Session 5 – Software applications in healthcare (in-class); take-home midterm distributed (in-class).

5/2 Session 6 – The role of government in healthcare and HIT (on-line)

5/9 Session 7 – Business Intelligence/Clinical Intelligence (BI/CI) & healthcare data. Take-home midterm due at beginning of class (6:30 pm, hard-copy. Guest speaker 6:30-7:30 pm (in-class)

5/16 Session 8 – Leadership and the Information Systems/Technology department (on-line) 5/23 Session 9 – Health information technology (HIT) service management: delivering and

managing HIT support (in-class)

5/30 Session 10 – Holiday! - Technology (on-line)

6/6 Session 11 – Special Topics: Implementing HIT in health care organizations, barriers to HIT adoption, change management, and other special topics (in-class)

6/13 Session 12 –Final Project Presentations and written reports handed in at beginning of class (in-class)

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Course Introduction

Use of healthcare information technology (HIT) has been actively developing for several decades. Continual modernization of our society through use of technology and other means; healthcare system costs spiraling out of control with little response to traditional measures; and publication of evidence reports such as ―To Err Is Human‖ (National Institute of Medicine-1997) that healthcare quality is seriously sub-par; all mean HIT is viewed as a crucial and urgent priority in enabling streamlined processes, reducing costs, improving clinical outcomes and enhancing patient and provider experiences. The healthcare industry has made major

investments in financial and other administrative systems, functional support systems such as laboratory, pharmacy and radiology, and early electronic medical records (EMR). Yet the track record for adoption of EMRs and electronic health records (EHRs) into mainstream medicine and healthcare remains starkly below expectations.

This problem has captured the attention of organizations, patients and providers, and federal and state governments. As of today, the promise of HIT is not being met, but the need for it is growing nonetheless. Thus, the federal government in its American Recovery and Reinvestment Act (ARRA) of 2009 is investing $36 billion to stimulate the implementation of EHRs in these settings: 1) in healthcare delivery organizations such as hospitals, physician offices and community clinics, and 2) in HIT training programs at community colleges and universities to provide the estimated additional 51,000-60,000 HIT professionals needed to meet the targeted workforce demand. The federal government is also requiring certain standards (e.g., data and security standards) and thresholds for implementation (e.g., ―meaningful use‖) be met in order for provider organizations to qualify for these stimulus and incentive funds.

This course will provide a basic foundation in HIT for those working or interested in health care. Emphasis will be placed on developing the knowledge and skills regarding HIT systems in healthcare delivery organizations. It will delve into HIT and simplify this complex topic for the student. The course covers the background and evolution of HIT; HIT strategy; how new systems architectures are planned, implemented and managed; and how HIT can be productively used by health care delivery organizations, external research organizations, regulatory organizations, providers, and patients/consumers. Fundamentals of technologies; data stewardship and data management; HIT support services; electronic medical records (EMRs), electronic health records (EHRs), and personal health records (PHRs); business intelligence/clinical intelligence (BI/CI) systems; interoperability and health information exchanges (HIE) and ―meaningful use‖ and other current federal stimulus incentives and requirements will be covered.

Learning Objectives

By the end of this course, you will gain:

1. A basic introduction to essential aspects of Health Information Technology (HIT), including definition, background, current uses, management, implementation issues; an

understanding of the relationship between organizational mission and goals with HIT strategy;

2. Ability to apply a conceptual framework for defining a high-level HIT architecture consistent with organizational scope and purpose;

3. Knowledge about and an appreciation for the importance of healthcare data: data types, quality, composition, management, and stewardship in the form of security, standards, privacy and confidentiality of health data and information;

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4. Familiarity with HIT software applications, technologies and infrastructure, and support processes;

5. Knowledge of federal stimulus efforts (American Recovery and Reinvestment Act (ARRA) Health Information Technologyfor Economic and Clinical Health

Act (HITECH))

and emerging directions such as electronic health records (EHR) and health information exchange (HIE); and

6. Skills and knowledge regarding HIT leadership, planning, and management.

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Course Grading Policies

Evaluation of Student Performance

This course is designed to provide you with an understanding of health information technology (HIT) and its management in health care organizations through a combination of lectures, assignments, on-line instruction and class discussion. Students are expected to prepare for each lecture by completing the assigned readings for that week. This preparation will be included in the class participation grade.

Grading:

Student grades will be assigned as follows:

Facilitation of In-Class Discussion and Class Participation (30% or 30 points): Students are expected to facilitate one in-class discussion on one article or publication (20 points) of their choosing, related to the current content of the course. Students will be required to submit a one-page summary and analysis of the article/publication at the beginning of the class session in which they are presenting, including a hard copy of the article for members of the class on the day of the discussion. Students will be graded on their presentation and the analysis submitted. Each presentation should be approximately 15 minutes long (10 minutes of

discussion/presentation and 5 minutes of questions and answers). In-class sessions will begin each time with this student-led discussion, and sign up for a date will take place the first class session (3/28th). Students are expected to attend class (i.e., please be sure to let me know ahead of time if you are unable to make it to class) and actively prepare for and participate in all class sessions and on-line sessions. (10 points)

Take Home Midterm (30% or 30 points): Students will complete a take-home midterm exam covering the material spanning the first half of the course. A take-home midterm exam will be distributed in class Session 5 (April 25th), and will also be posted on Blackboard. It will be due at the beginning of class Session 7 (May 13th).

Project (40% or 40 points): At the beginning (6:30pm) of the last class (June 13th), students will turn in the final project. The project assignment will be distributed in class Session 7 (May 13th), and will also be posted on Blackboard.

Letter grades will be assigned as follows: 98-100=A+, 93-97=A, 90-92=A-, 88-89=B+, 83-87=B, 80-82=B-, 78-79=C+, 73-77=C, 70-72=C-, below 70=F. Late assignments will be penalized at a rate of 5% per day. However, I understand that work and family emergencies occur. If you are going to be absent, please let me know in advance. There are no extensions for the class. All work must be turned in by the last day of class.

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Academic Policies

Electronic Devices: The use of pagers, cell phones, PDAs, and laptop computers can disrupt class meetings and limit the focus and effectiveness of the course. Please turn off your cell phone ringers during class. Laptops may only be used to take notes during class, not for e-mail Facebook or other on-line activities.

Students are expected to work independently on the midterm and final project. You may access any materials available in the textbook, readings, libraries, your home office and on the web. You may not consult with other students, colleagues or professors in performing the midterm work. If you have any questions on the take home midterm or final project, please email me at jbalgrosky@ucla.edu or call me at 619-203-1687. Your work should be composed by you and you alone, in your own words, unless a section is properly quoted, footnoted or referenced. I would much rather see a shorter answer written by you than a longer answer full of someone else’s thinking. Academic dishonesty and plagiarism will not be tolerated. Please refer to these policies at www.uclaextension.edu. Thank you.

STUDENT RECORDS

Students can access and update student records online by visiting www.uclaextension.edu and clicking on My.Extension on the top navigation bar and logging into their account. Student Services lets you view your grades, request an official transcript, change credit status on a current course, obtain enrollment verification, update your personal information, and much more.

ACCOMMODATIONS:

If you need any accommodations for a disability, please contact the UCLA Extension Disabled Student Services at: (310) 825-7851 or via e-mail access@uclaextension.edu.

ADA 508 Compliance Web Site Resources

Section 508 http://www.section508.gov ADA 508 The Law http://ada508.com/

Disabilities Act (ADA) Section 508 Compliance Web site http://www.access-board.gov/508.htm Access Board http://www.access-board.gov/sec508/e-learning.htm

U.S. Department of Labor The Americans with Disabilities Act of 1990

http://www.dol.gov/esa/regs/statutes/ofccp/ada.htm

U.S. Department of Justice 508 Home page http://www.usdoj.gov/crt/508/508home.html

U.S. Department of Justice ADA Regulations & Technical Assistance Materials

http://www.ada.gov/publicat.htm

W3C Web Accessibility Initiative (WAI) http://www.w3.org/WAI/

W3C Improving the Accessibility of Your Web Site http://www.w3.org/WAI/impl/improving Web Accessibility in Mind Articles http://www.webaim.org/articles/

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Discussion Rubric

This rubric will be used to assess the quality of your participation in the online discussion forums. Please use this tool as a guide when constructing your postings.

Unsatisfactory Basic Proficient Distinguished Mechanics of the Posting Uses incomplete sentences, is unstructured in its organization, and includes frequent or consistent errors in mechanics (grammar, spelling, usage) in each paragraph. The posting is unreadable and there is a distinct lack of tone.

Uses complete sentences and the posting is comprehensible. The organization could be improved to present a more coherent argument, statement, or question. Includes 2-3 mechanical errors grammar, spelling, usage) per paragraph. The tone is respectful.

Uses complete sentences, organization is evident, and the posting includes no more than one mechanical error (grammar, spelling, usage) per

paragraph. The tone is clear and

respectful

Uses complete

sentences, organization is clear and thoughtful, the posting is

grammatically correct, and free of spelling errors. The tone is clear and respectful. Participation in the Discussion Provides minimal comments and information to other participants in the forum. Provides comments, and some new information on a sporadic basis. Interacts with only 1-2 participants in the forum.

Provides comments, discussion,

questions, and new information on a fairly regular basis. Interacts with a few participants in the forum.

Provides comments, discussion, questions, and new information on a regular, active, and weekly basis. Shows a high degree of interaction with other participants in the forum. Content of Posting Writes a general or superficial posting that is unrelated to the discussion at hand and/or posts no comments.

Demonstrates a restricted

understanding of the concepts, topics, and ideas as evidenced by posting information that could be derived from prior posts and/or including highly general comments. Demonstrates an adequate understanding of the concepts, topics, and ideas as evidenced by posting superficial, or general statements in the forum. Includes a few details in the posting.

Demonstrates a solid understanding of the concepts, topics, and ideas as evidenced by thoughtful responses and questions that show a clear connection (are integrated) with the course material at hand. The posting shows depth, and includes many supporting details. Critical Thinking Evidenced by Posting Provides no evidence of agreement or disagreement with an existing discussion. Indicates agreement or disagreement with an existing discussion but provides no justification or explanation for comments. Indicates agreement or disagreement with an existing discussion including a limited explanation or justification. Provides comments, discussion, and questions without a clear connection to the course material at hand. Demonstrates a critical analysis of an existing posted idea or introduces a different interpretation to an existing concept or idea. Includes comments, discussion, and questions that have a clear connection (are integrated) with the course material at hand.

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Reflection Rubric

During your course, you will be asked to reflect on your work and how you will apply what you have learned. This rubric will help you assess your reflections.

Unsatisfactory Basic Proficient Distinguished Coherence &

Relevance

One cannot discern the learner’s perceptions and attitudes or what he or she learned.

Paper adequately describes the learner’s perceptions, attitudes and what she or he learned; however, gaps and omissions are present.

Paper describes the learner’s thoughts, perceptions, attitudes and what was learned; a few gaps or omissions are present.

Paper thoroughly describes the learner’s perceptions, attitudes and what he or she learned from the project.

Transformation It is not clear how the experiences

transformed the learner.

There are gaps in the learner’s description of how the experiences helped transform him or her into a scholar-practitioner.

Learner adequately describes how the experiences helped transform him or her into a scholar-practitioner.

Learner clearly describes how the experiences helped transform him or her into a scholar-practitioner.

The rubrics provide a way for you and your facilitator to agree on the level of performance. It provides the performance-based criteria that help to steer discussions so that they are effective and reflect on your learning experiences.

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Course Materials and Resources

Textbook Syllabus

Course Calendar Articles

External links

Discussion and Reflection Rubrics

REQUIRED READING The textbook for this class is:

Glandon, Gerald L., Detlev H. Smaltz, Donna J. Slovensky. Austin and Boxerman’s Information

Systems for Healthcare Management. Health Administration Press: Chicago, 2008.

Readings for each session will be assigned on a weekly basis and will typically be a selection of articles and reports representing core topics and demonstrate their application and use. Each week, please log-on to Blackboard (http://uclaextension.blackboard.com/entry.html) and download the next week’s reading materials using the links provided in this syllabus. They will either be in PDF format or a web link, so you will need Adobe Acrobat or Adobe Acrobat Reader, as well as a web browser installed on your computer.

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Course Calendar

Mon Tue Wed Thurs Fri Sat Sun

Week 1 3/28

>In-class session >Each student sign-up for in-class discussion

>download next week’s reading materials

Week 2 4/4

>Post on-line bio DUE >On-line session

>Read GSS Chapter 1 DUE >download next week’s reading materials > Week 3 4/11 >In-class Session >Student-led Discussion >Read Online readings DUE

>download next week’s reading materials Week 4 4/18 >On-line Session >Read GSS Chapter 3 DUE

>download next week’s reading materials Week 5 4/25 >In-class Session >Student-led Discussion > Take-home Midterm Distributed >Read GSS Chapter 8 DUE

>download next week’s reading materials Week 6 5/2 >On-line Session >Read GSS Chapter 5 DUE

>download next week’s reading materials Week 7 5/9 >In-class Session >Student-led Discussion >Read GSS Chapter 9 DUE >TAKE-HOME MIDTERM DUE BY 6:30PM

>download next week’s reading materials

Week 8 5/16

>Read on-line readings DUE

>On-line session >Read GSS Chapter 2 & 10 DUE

>download next week’s reading materials Week 9 5/23 >In-class Session >Read GSS Chapter 7 DUE >Student-led Discussion >Project Workshop

>download next week’s reading materials

Week 10 5/30

Holiday! >On-line session >Read GSS Chapter 6 DUE >download next week’s reading materials Week 11 6/6 >In-class Session >Student-led Discussion >Read GSS Chapter 4 DUE

>download next week’s reading materials Week 12 6/13 >Student presentations – Final Project

>FINAL PROJECTS DUE 6:30PM hard-copy in class and posted to Blackboard

DQ = Discussion Question A = Assignments

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Session 1 (In-Class) March 28: Overview of Course Overview and Introduction

Introductions and Review of Syllabus

History/evolution of health information technology (HIT) Current healthcare environment and HIT imperative

Lecture: Balgrosky References/Resources:

Blumenthal, D., Glaser, J. (2007). "Information Technology Comes to Medicine" N Engl J Med June 14, 2007, 356(24): 2527-34. content.nejm.org/cgi/reprint/356/24/2527.pdf

Post your Bio DUE Monday April 4

Please post a bio to the discussion forum that includes information about your position, organization, where you live, education, and experience with on-line and distance education, your technology skills, and experience with Blackboard. Please include something about your family and personal interests. If you like, post a photo so we can envision you as we work together.

Sign-up for Student Presentations...DueMonday March 28 (sign up in class) Download Week 2 Readings...Due Tuesday March 29

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Session 2 (On-line) April 4: Why does Health Information Technology (HIT) Matter?

Alignment between current challenges in healthcare and health information technology capabilities

Healthcare cost and quality issues Consumer empowerment

Knowledge management

Lecture: on-line Balgrosky Resources/References:

GSS: Chapter 1 – Connecting the Strategic Dots: Does Information Management/Information Technology Matter?

Blumenthal, D. (2009). ―Stimulating the Adoption of Health Information Technology‖ N Engl J Med April 9, 2009, 360(15):1477-9. http://content.nejm.org/cgi/content/full/360/15/1477 Blumenthal, D., Glaser, J. (2007). "Information Technology Comes to Medicine" N Engl J Med June 14, 2007, 356(24): 2527-34. content.nejm.org/cgi/reprint/356/24/2527.pdf

Hillestad, R. et al, (2005). ―Can Electronic Medical Record Systems Transform Health Care? Potential Health Benefits, Savings, And Costs.‖ Health Affairs, 24(5):1103-1117.

http://content.healthaffairs.org/cgi/reprint/24/5/1103

Laurie A Rinehart-Thompson, JD, RHIA, CHP (2009) "Redefining the Health Information Management Privacy and Security Role"

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2781727/

Read GSS: Chapter 1...Due Monday April 4 Read Week 2 readings...Due Monday April 4 Download Week 3 readings...Due Tuesday April 5

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Session 3 (In-class) – (April 18) HIT Strategy

Aligning HIT scope and investment with mission and goals of the organization; Architecting HIT to ―fit‖ and properly support the organization

Conceptual Model

Clinical indicator clearinghouses (e.g., NQF, AHRQ, etc.)

On-line Lecture materials: Balgrosky Resources/References:

GSS Chapter 3

Crossing the Quality Chasm: A New Health System for the 21st Century Institute of Medicine (2001) - Executive Summary and Chapter 7 – Information Technology.

http://www.nap.edu/openbook.php?record_id=10027&page=R1

(Copies of Crossing the Quality Chasm: A New Health System for the 21st Century are

available for sale from the National Academy Press; call (800) 624-6242 or (202) 334-3313 (in the Washington metropolitan area), or visit the NAP home page at www.nap.edu. The full text of this report is available at http://www.nap.edu/books/0309072808/html/ )

Davis, Mike HIMSS Analytics (2007). ―Stage 6 Hospitals: The Journey and the Accomplishments.‖ 2007 HIMSS Analytics.

www.himssanalytics.org/docs/stage6whitepaper.pdf

Agarwal, S et al. ―The US stimulus program: Taking medical records online‖

www.mckinseyquarterly.com/links/35235

or

http://www.mckinseyquarterly.com/High_Tech/Software/The_US_stimulus_program_Taking_me dical_records_online_2384?gp=1

Read GSS Chapter 3 and Week 4 readings...Due Monday April 18 On-line Session...Due Monday April 18 Download Week 5 Readings...Due Tuesday April 19

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Session 4 (On-line) April 11: Organizational settings in which HIT is used

In-patient, out-patient/ambulatory providers Patients/consumers

Payers, government

Regional Health Information Organizations (RHIOs)

External regulatory, reporting and research organizations (e.g., Joint Commission, AHRQ, NQF, Leapfrog)

Student-led Discussion Lecture: Balgrosky Resources/References:

Miller, R., I. Sim (2004) "Physicians’ Use Of Electronic Medical Records: Barriers And Solutions" http://content.healthaffairs.org/cgi/content/full/23/2/116

Jha, A. ―Use of Electronic Health Records in U.S. Hospitals‖ N Engl J Med 2009;360.

content.nejm.org/cgi/content/full/NEJMsa0900592

http://content.nejm.org/cgi/content/full/NEJMsa0900592

Migrating Toward Meaningful Use: The State of Health Information Exchange - A Report Based on the Results of the eHealth Initiative’s 2009 Sixth Annual Survey of Health Information

Exchange http://www.ingenixconsulting.com/content/File/Insight_HIEModel.pdf

Health Information Exchanges: Similarities and Differences HIMSS HIE Common Practices Survey Results White Paper HIMSS Health Information Exchange Best Practices Task Force March 2009

http://www.himss.org/content/files/RHIO/HIE_CommonPracticesWhitePaper20090330.pdf Readings...Due Monday April 11

In-Class Session...Monday April 11 Download Week 4 Readings...Due Tuesday April 12

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Session 5 (In-class) April 25: Software Applications in Healthcare

Clinical systems: Core clinical, CPOE, Ancillaries, Registration/Scheduling, Electronic Medical Records (EMR), Electronic Health Records (EHR), Personal Health Records (PHR)

Biomedical Imaging systems/PACS (Picture Archive Communication Systems) Business/administrative systems: Financial, Patient Accounting, HR, Materials

management

Decision Support systems: Clinical, Business Intelligence, Clinical Intelligence

Student-led Discussions

* Take Home Midterm Distributed (will also be posted on-line)

Lecture: Balgrosky Resources/References:

GSS Chapter 8 – Applications

Key Capabilities of an Electronic Health Record System Committee on Data Standards for Patient Safety Board on Health Care Services– Institute of Medicine (2003)

http://www.prorec.it/documenti/EHR_Report_Final.pdf

Saving Lives, Saving Money In Practice: Strategies for Computerized Physician Order Entry in Massachusetts Hospitals (2009) http://web3.streamhoster.com/mtc/cpoe20808.pdf and

http://www.masstech.org/ehealth/cpoe/cpoe08release.html

DesRoches, C. Electronic Health Records in Ambulatory Care—A National Survey of

Physicians N Engl J Med 2008;359:50-60

http://content.nejm.org/cgi/content/full/NEJMsa0802005

Medical Group Management Association - Electronic Health Records: Perspectives from the

Adopters October 2007. http://www.mgma.com/WorkArea/DownloadAsset.aspx?id=21086

Read GSS: Chapter 8 ...Due Monday April 25 In-class Session...Due Monday April 25 Download Week 6 Readings...Due Tuesday April 26

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Session 6 (On-line) May 2:– The role of government in healthcare and HIT

ARRA, HITECH, HIPAA, Confidentiality, Privacy, Security Stimulus for EHR adoption: rationale

―Meaningful Use‖

The need for information privacy, security and confidentiality

Lecture: Balgrosky Resources/References:

GSS Chapter 5: External Environment and Government Policy

Blumenthal, D. (2009). ―Stimulating the Adoption of Health Information Technology‖ N Engl J Med April 9, 2009, 360(15):1477-9. http://content.nejm.org/cgi/content/full/360/15/1477 Transforming Health Care: The President’s Health Information Technology Plan

www.starcareonline.com/Transforming_HealthCare_WhiteHousePaper.doc

Department of Health and Human Services American Recovery and Reinvestment Act Accelerating the Adoption of Health Information Technology

http://www.hhs.gov/recovery/reports/plans/onc_hit.pdf

Concise Guide to CCHIT Certification Criteria Certification Criteria: Ambulatory EHRs

http://www.cchit.org/sites/all/files/ConciseGuideToCCHIT_CertificationCriteria_May_29_2009.pd f

Read GSS: Chapter 5 and Week 6 readings...Due Monday May 2 On-line Session...Monday May 2 Download Week 7 Readings...Due Tuesday May 3

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Session 7 (In-class) May 9: Business Intelligence/Clinical Intelligence (guest lecture) & Healthcare data: the key to good information

Use of transaction data to create information- and knowledge-enabled organizations Data sources, types and composition

Data quality

Data privacy and security Data definitions and standards

Importance to knowledge-management Data creation, capture and uses

TAKE HOME MIDTERM DUE @ 6:30PM: PLEASE BRING HARD-COPY TO HAND IN AT BEGINNING OF CLASS

Lecture: guest lecturer - Ric Speaker; Balgrosky Student-led discussion

Resources/References:

GSS: Chapter 9 – The Knowledge-Enabled Organization

Laurie A Rinehart-Thompson, JD, RHIA, CHP (2009) "Redefining the Health Information Management Privacy and Security Role"

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2781727/

Take-home Midterm due 6:30 pm

Read GSS: Chapter 9 & Week 7 readings...Due Wednesday May 9 In-class session...Monday May 9

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Session 8 (On-line) May 16 – Leadership and the Information Systems (IS)/Information Technology (IT) department

Role of the CIO

HIT Value/benefits realization Common issues and challenges

Lecture: Balgrosky Resources/References:

GSS Chapter 2 – Leadership: the case of the Healthcare Organization CIO GSS Chapter 10 – IM/IT Value

Read GSS: Chapter 2...Due Monday May 16 Read GSS: Chapter 10...Due Monday May 16

On-line Session...Monday May 16 Download Week 9 Readings...Due Tuesday May 17

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Session 9 (In-class) May 23 – Health Information Technology (HIT) Service and Support of End-users: ―delivering the goods”

HIT department functions and roles Who are your customers?

Who are your suppliers/vendors?

Who are your collaborators inside your organization? Service support

Service delivery Change management

Student-led Discussions Lecture: Balgrosky

Distribute: Project Assignment Workshop for Final Project

Resources/References: GSS Chapter 7 - IM/IT Service Management

Read GSS: Chapter 7...Due Monday May 23 In-class Session...Monday May 23 Download Week 10 Readings...Due Tuesday May 24

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Session 10 (On-line) May 30 – Technology – basics of the technologies and devices that support HIT

architecture infrastructure hardware

standards, security

networking and telecommunications imaging

On-line lecture: Balgrosky Resources/References:

GSS Chapter 6 – IM/IT Architecture and Infrastructure Additional readings TBD

Holiday!May 30

GSS: Chapter 6...Due Monday May 31 Download Week 8 Readings...Due Wednesday June 1

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Session 11 (In-class) June 6 – Special Topics: Implementing HIT systems

Reasons for HIT project successes and failures Managing multiple priorities

Ethics in HIT management Barriers to adoption

Student-led Discussion Lecture: Balgrosky

Project Workshop: sign up for June 13 presentations

Resources/References: GSS Chapter 4 – The IM/IT Portfolio Management Office (PMO) Read GSS: Chapter 4...Due Monday June 6

In-class session...Monday June 6 Final Projects...Due Monday June 13

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Session 12 (In-class) June 13: Final Presentations

In-class PowerPoint presentations by each student

Hard-copy and e-copy written project report due by 6:30pm June 13, handed in at beginning of class in hard-copy and e-copy to me

Student Presentations

Upload Final Projects...DUE Monday June 13 Have a great summer!!!

References

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