Prototipo de multimedia educativa para la enseñanza-aprendizaje de los indicadores del recurso cama hospitalaria. Cuba, 2020 / Educational Multimedia Prototype for teach-learn Indicators of Hospital Bed Resource. Cuba, 2020

Introducción: En la Facultad de Tecnología de la Salud se estudia la carrera Sistemas de Información en Salud que incluye en su plan de estudios diversas asignaturas como Sistemas de Información de Estadísticas de Salud, en la que se incluye el estudio de los indicadores hospitalarios del recurso cama; materia que se imparte de forma tradicional y no tiene una herramienta tecnológica de apoyo que facilite el proceso educativo. Objetivo: Diseñar un prototipo de multimedia educativa que favorezca el auto-aprendizaje de los indicadores del recurso cama hospitalaria en la asignatura Sistemas de Información de Estadísticas de Salud de la carrera Sistemas de Información en Salud. Método: Se realizó un estudio de desarrollo tecnológico donde fueron encuestados estudiantes y se entrevistó a la profesora de la asignatura para la obtención de la información. Se utilizó la metodología de Proceso Unificado de Desarrollo y el Lenguaje Unificado de Modelado. Se emplearon las herramientas Visual Paradigm para el modelado, Axure para la creación del prototipo y Mediator para el futuro diseño de la multimedia. Resultados: Se identificaron los problemas de aprendizaje desde la visión de alumnos y profesores, lo que permitió diseñar el prototipo de multimedia educativa sobre los indicadores hospitalarios del recurso cama, que fue considerado útil y pertinente. Conclusiones: Se diseñó un prototipo de multimedia educativa que de manera combinada con el método actual de enseñanza facilitarán y efectuarán de forma dinámica las actividades en el proceso docente educativo(AU)

Introduction: Health Information Systems career is included In the Faculty of Health Technology; the career have in its curriculum subjects as Health Statistics Information Systems, in which the study of hospital resource bed indicators is carried out; the subject is taught in a traditional way and does not have a technological support tool that facilitates the educational process. Objective: To design an educational multimedia prototype that favors self-learning of the indicators of the hospital bed resource in the Health Statistics Information Systems subject of the Health Information Systems career. Method: A survey of students and interview of teachers permitted to obtain the information needed to carry out a study of technological development using Unified Development Process methodology and Unified Modeling Language; Visual Paradigm tools were used for modeling; Axure for prototyping and Mediator for future multimedia design. Results: there were identified learning problems from the perspective of students and teachers, which allowed the design of the educational multimedia prototype on hospital bed resource indicators, considering it useful and pertinent. Conclusions: The design of the educational multimedia prototype, combined with the current teaching method, will facilitate and dynamically carry out the activities in the educational teaching process(AU)

A Data-Driven Assessment of the U.S. Health Informatics Programs and Job Market.

BACKGROUND: Health Informatics (HI) is an interdisciplinary field, integrating health sciences, computer science, information science, and cognitive science to assist health information management, analysis, and utilization. As the HI field is broad, it is impossible that a student will be able to master all the diverse HI topics. Thus, it is important to train the HI students based on the offering of the various HI programs and needs of the current market. This project will study the U.S. HI programs, training materials, HI job market, the skillset required by the employers, competencies taught in HI programs, and comparisons between them. METHODS: We collected the training information for the 238 U.S. universities that offered MS, PhD, or postbaccalaureate certificate programs in HI or related professions. Next, we explored the HI job market by randomly checking 200 jobs and their required skillsets and domain knowledge. Then, we compared these skillsets with those offered by the HI programs and identified the gaps and overlaps for program enhancements. RESULTS: Among the 238 U.S. universities, 94 universities offer HI programs: 92 universities with MS (Master of Science), 43 with doctoral, 42 with both MS and doctoral, and 54 with certificate programs. The most offered HI courses are related to practicum, data analytics, research, and ethics. For the HI job postings, the three most technical skillsets required in HI job posting are data analysis, database management, and knowledge of electronic health records. However, only 58% of HI programs offer courses in database management and analytics. Compared with American Medical Informatics Association's recommended 10 fundamental domains, the HI curriculum generally lacks training in socio-technical systems, social-behavioral aspects of health, and interprofessional collaborative practice. CONCLUSION: There are gaps between the industry expectations of HI and the training received in HI programs. Advance level technical courses are needed in HI programs to meet industry expectations.

Digital Health during COVID-19: Informatics Dialogue with the World Health Organization.

BACKGROUND: On December 16, 2020 representatives of the International Medical Informatics Association (IMIA), a Non-Governmental Organization in official relations with the World Health Organization (WHO), along with its International Academy for Health Sciences Informatics (IAHSI), held an open dialogue with WHO Director General (WHO DG) Tedros Adhanom Ghebreyesus about the opportunities and challenges of digital health during the COVID-19 global pandemic. OBJECTIVES: The aim of this paper is to report the outcomes of the dialogue and discussions with more than 200 participants representing different civil society organizations (CSOs). METHODS: The dialogue was held in form of a webinar. After an initial address of the WHO DG, short presentations by the panelists, and live discussions between panelists, the WHO DG and WHO representatives took place. The audience was able to post questions in written. These written discussions were saved with participants' consent and summarized in this paper. RESULTS: The main themes that were brought up by the audience for discussion were: (a) opportunities and challenges in general; (b) ethics and artificial intelligence; (c) digital divide; (d) education. Proposed actions included the development of a roadmap based on the lessons learned from the COVID-19 pandemic. CONCLUSIONS: Decision making by policy makers needs to be evidence-based and health informatics research should be used to support decisions surrounding digital health, and we further propose next steps in the collaboration between IMIA and WHO such as future engagement in the World Health Assembly.

Recommendations for the safe, effective use of adaptive CDS in the US healthcare system: an AMIA position paper.

The development and implementation of clinical decision support (CDS) that trains itself and adapts its algorithms based on new data-here referred to as Adaptive CDS-present unique challenges and considerations. Although Adaptive CDS represents an expected progression from earlier work, the activities needed to appropriately manage and support the establishment and evolution of Adaptive CDS require new, coordinated initiatives and oversight that do not currently exist. In this AMIA position paper, the authors describe current and emerging challenges to the safe use of Adaptive CDS and lay out recommendations for the effective management and monitoring of Adaptive CDS.

The emerging role of clinical informatics fellows in service learning during the COVID-19 pandemic.

OBJECTIVE: The study sought to describe the contributions of clinical informatics (CI) fellows to their institutions' coronavirus disease 2019 (COVID-19) response. MATERIALS AND METHODS: We designed a survey to capture key domains of health informatics and perceptions regarding fellows' application of their CI skills. We also conducted detailed interviews with select fellows and described their specific projects in a brief case series. RESULTS: Forty-one of the 99 CI fellows responded to our survey. Seventy-five percent agreed that they were "able to apply clinical informatics training and interest to the COVID-19 response." The most common project types were telemedicine (63%), reporting and analytics (49%), and electronic health record builds and governance (32%). Telehealth projects included training providers on existing telehealth tools, building entirely new virtual clinics for video triage of COVID-19 patients, and pioneering workflows and implementation of brand-new emergency department and inpatient video visit types. Analytics projects included reports and dashboards for institutional leadership, as well as developing digital contact tracing tools. For electronic health record builds, fellows directly contributed to note templates with embedded screening and testing guidance, adding COVID-19 tests to order sets, and validating clinical triage workflows. DISCUSSION: Fellows were engaged in projects that span the breadth of the CI specialty and were able to make system-wide contributions in line with their educational milestones. CONCLUSIONS: CI fellows contributed meaningfully and rapidly to their institutions' response to the COVID-19 pandemic.

Clinical informatics subspecialists: characterizing a novel evolving workforce.

BACKGROUND: The growing complexity of data systems in health care has precipitated increasing demand for clinical informatics subspecialists. The first board certification exam for the clinical informatics subspecialty was offered in 2013. Characterizing trends in this novel workforce is important to inform its development. METHODS: We conducted an exploratory analysis of American Board of Medical Specialties data on individuals certified in clinical informatics from 2013 to 2019 to review trends and demographic characteristics of current subspecialists. RESULTS: 2018 physicians were certified in clinical informatics from 2013 to 2019. The annual number of awarded certifications declined after 2016. The majority of primary certifications held by clinical informaticians were in broad-based medical specialties relative to primarily procedural specialties. CONCLUSIONS: Disparities may exist within the clinical informatics physician workforce with respect to primary specialty certifications and geographic distribution. There remains a need for the creation of fellowship programs to sustain the growth of this workforce.

Informatics Instruction: An Informal Needs Assessment Survey.

Instruction is a competency included in the Medical Library Association's list of professional competencies for health sciences librarians, and is often included in many job requirements in this field. However, few opportunities for formal training are available, leaving most librarians to learn how to teach effectively on the job. This column examines some of the literature surrounding pedagogy for medical informatics librarians and invites readers to identify their needs for training as instruction librarians via an informal survey.

Health Systems Science in Medical Education: Unifying the Components to Catalyze Transformation.

Medical education exists in the service of patients and communities and must continually calibrate its focus to ensure the achievement of these goals. To close gaps in U.S. health outcomes, medical education is steadily evolving to better prepare providers with the knowledge and skills to lead patient- and systems-level improvements. Systems-related competencies, including high-value care, quality improvement, population health, informatics, and systems thinking, are needed to achieve this but are often curricular islands in medical education, dependent on local context, and have lacked a unifying framework. The third pillar of medical education-health systems science (HSS)-complements the basic and clinical sciences and integrates the full range of systems-related competencies. Despite the movement toward HSS, there remains uncertainty and significant inconsistency in the application of HSS concepts and nomenclature within health care and medical education. In this Article, the authors (1) explore the historical context of several key systems-related competency areas; (2) describe HSS and highlight a schema crosswalk between HSS and systems-related national competency recommendations, accreditation standards, national and local curricula, educator recommendations, and textbooks; and (3) articulate 6 rationales for the use and integration of a broad HSS framework within medical education. These rationales include: (1) ensuring core competencies are not marginalized, (2) accounting for related and integrated competencies in curricular design, (3) providing the foundation for comprehensive assessments and evaluations, (4) providing a clear learning pathway for the undergraduate-graduate-workforce continuum, (5) facilitating a shift toward a national standard, and (6) catalyzing a new professional identity as systems citizens. Continued movement toward a cohesive framework will better align the clinical and educational missions by cultivating the next generation of systems-minded health care professionals.

Early experiences with combined fellowship training in clinical informatics.

Given the ubiquitous nature of information systems in modern health care, interest in the pursuit of formal training in clinical informatics is increasing. This interest is not restricted to generalists-informatics training is increasingly being sought by future subspecialists. The traditional structure of Accreditation Council on Graduate Medical Education subspecialty training requires completion of both clinical and clinical informatics fellowship programs, and understandably lacks appeal due to the time commitment required. One approach to encourage clinical informatics training is to integrate it with clinical fellowships in order to confer dual-board eligibility. In this perspective, we describe 3 successful petitions for combined training in clinical informatics in order to support other programs and the American Board of Preventive Medicine in establishing pathways for training subspecialists in clinical informatics.

Patient-Centered Medical Home Graduate Internship, Benefits to a Practice Manager: Case Study.

Graduate Health Information Management students can and should be involved in collaborations with the Patient-Centered Medical Home at primary care clinics. In this case, the student is not from a Health Services Management background as it was in the first internship article, but rather from a Health Information Management background. This case study is the second of 2 Patient-Centered Medical Home internship studies where the value of an intern to a practice manager is demonstrated.

Soporte facilitador para la toma de imágenes microscópicas con dispositivos digitales / Support Facilitator for Taking Microscopic Images with Digital Devices

Introducción: La rápida evolución de la tecnología provoca la rápida obsolescencia de los equipos, esto constituye una desventaja dados los equipos tradicionales con que contamos en nuestro laboratorio. Técnicas como el procesamiento digital de imágenes han ampliado su propósito hacia el mejoramiento de las imágenes adquiridas y la búsqueda de información en ellas. Objetivo: Evaluar un soporte facilitador para la toma de imágenes microscópicas con dispositivos móviles digitales. Métodos: Se desarrolló una investigación de innovación tecnológica realizada en el período octubre-diciembre del 2017, en los laboratorios de Ciencias Básicas Biomédicas de la Universidad de Ciencias Médicas de Santiago de Cuba. Resultados: Se propone la generación de una herramienta o soporte que admita el acople de un dispositivo digital para la toma de imágenes, que permita el procesamiento, almacenamiento y análisis de imágenes microscópicas, para la creación de una base de datos digitales para uso académico por parte del personal del área de ciencias básicas biomédicas y como un medio que facilite el estudio de tejidos a los estudiantes de medicina. Desde el punto de vista económico, la integración de imágenes en los sistemas de información supondría una reducción significativa de costos. Conclusiones: Se aprovechan las ventajas de los dispositivos móviles para la digitalización de imágenes. Estos dispositivos pueden adaptarse a los microscopios y generar productos que permitan el fácil proceso de visualización y almacenamiento, siendo accesibles y de fácil uso. Facilitará el desarrollo de investigaciones en el campo de la histología(AU)

Introduction: The rapid evolution of technology causes rapid obsolescence of equipment, which is a disadvantage given the traditional equipment that we have in our laboratory. Techniques such as digital image processing have expanded their purpose towards the improvement of acquired images and the search for information in them. Objective: To evaluate a facilitating support for the taking of microscopic images with digital mobile devices. Methods: A technological innovation research conducted in the period October-December 2017, in the laboratories of Basic Biomedical Sciences at the University of Medical Sciences of Santiago de Cuba was developed. Results: We propose the generation of a tool that supports the coupling of a digital device for taking images. The tool allows the processing, storage and analysis of microscopic images, for the creation of a digital database for academic use by the personnel of the area of biomedical basic sciences, which will also serve as a means to facilitate the study of tissues to the Medicine students. From the economic point of view, the integration of images in the information systems would imply a significant reduction of costs. Conclusions: The advantages of mobile devices for the digitalization of images are exploited. These devices can be adapted to microscopes and generate products that allow easy viewing and storage process, being accessible and easy to use. It will facilitate the development of investigations in the field of histology(AU)

Five Years of Clinical Informatics Board Certification for Physicians in the United States of America.

OBJECTIVES: To review the highlights of the new Clinical Informatics subspecialty including its history, certification requirements, development of and performance on the certification examination in the United States. METHODS: We reviewed processes for the development of a subspecialty. Data from board certification examinations were collated and analyzed. We discussed eligibility requirements in the fellowship as well as practice pathways. RESULTS: Lessons learned from the development of the Clinical Informatics subspecialty, opportunities, challenges, and future directions for the field are discussed. CONCLUSIONS: There remains a need for fellowship programs and creation and maintenance of a professional home for the subspecialty with the American Medical Informatics Association. Ongoing attention to the currency of the core content is required to maintain an examination designed to test the key concepts within the field of Clinical Informatics.

Characteristics of the National Applicant Pool for Clinical Informatics Fellowships (2016-2017).

We conducted a national study to assess the numbers and diversity of applicants for 2016 and 2017 clinical informatics fellowship positions. In each year, we collected data on the number of applications that programs received from candidates who were ultimately successful vs. unsuccessful. In 2017, we also conducted an anonymous applicant survey. Successful candidates applied to an average of 4.2 and 5.5 programs for 2016 and 2017, respectively. In the survey, unsuccessful candidates reported applying to fewer programs. Assuming unsuccessful candidates submitted between 2-5 applications each, the total applicant pool numbered 42-69 for 2016 (competing for 24 positions) and 52-85 for 2017 (competing for 30 positions). Among survey respondents (n=33), 24% were female, 1 was black and none were Hispanic. We conclude that greater efforts are needed to enhance interest in clinical informatics among medical students and residents, particularly among women and members of underrepresented minority groups.

Developing an Assessment Tool for Enhancing Interprofessional Education of Patient Safety.

The increasing recognition of the value of effective interprofessional collaboration has promoted interprofessional education (IPE) among healthcare professionals. The IPE pilot program initiative at UTHealth matriculated students from the disciplines of biomedical informatics, biomedical sciences, dentistry, medicine, nursing and public health. There has been a pressing need for developing an assessment tool in reflecting how IPE participants recognize and understand the other disciplines including clinical informatics in nowadays' practice. This paper reports our development process of the assessment tool, which is still under an iterative, in-depth refinement and aiming at greater collaborations.

MicrobiologíaSoft, entrenador de Microbiología y Parasitología médica / Microbiology Soft, trainer for Microbiology and medical parasitology

Introducción: la microbiología y la parasitología médicas son las ramas de la microbiología que estudian a los microorganismos y a los parásitos que viven a expensas del hombre y producen enfermedades en él. Objetivo: confeccionar un software que favorezca la autopreparación de los estudiantes de la asignatura Microbiología y Parasitología Médica. Método: se realizó una investigación de desarrollo tecnológico en la Filial de Ciencias Médicas de Mayarí, en el período comprendido de febrero a julio de 2015. Para la validación del producto se utilizó la Metodología para la gestión tecnológica de los software educativos en la Universidad de Ciencias Médicas de Holguín planteada por Madariaga 2014.La muestra estuvo compuesta por 52 estudiantes de 2do año de Medicina. Resultados: el Software permitió elevar la preparación de los estudiantes de medicina en la asignatura de Microbiología y Parasitología Médica, todo el contenido relacionado con el tema abordadode manera organizada y actualizada, además de que posibilita adquirir los conocimientos de forma didácticapues cuenta con elementos necesarios para ello como lo son los videos, fotos, ejercicios interactivos y juegos didácticos. Conclusiones: se obtuvo un recursode aprendizaje multimedia que permite interactuar con elementos de la asignatura de Microbiología y Parasitología Médica con información actualizada, organizada, de fácil acceso y transportación, útil a estudiantes y profesores, lo que permite el perfeccionamiento del proceso docente educativo en las Ciencias Médicas utilizando las TIC(AU)

Introduction: microbiology and parasitology are the branches medical microbiology studying microorganisms and parasites living at the expense of man and cause disease in it. Objective: to develop a software that encourages self-preparation of students of the subject Microbiology and Medical Parasitology. Method: an investigation of technological development was held in the Medical Sciences Branch of Mayari, in the period from February to July 2015 period, the Methodology for technological management of educational software was used in the University for product validation of Medical Sciences Holguin posed by Madariaga 2014. Results: software allowed improve the preparation of medical students in the subject of Microbiology and Medical Parasitology, all content related to the topic addressed in an organized and updated way, plus it possible to acquire knowledge in a didactic because it has elements necessary for it such as videos, photos, interactive exercises and learning games. Conclusions: pedagogical basis on a learning resource that allows students to interact with specific elements of Microbiology and Medical Parasitology course was developed, the applicability thereof to the education of students with learning relevant results are validated(AU)

Nursing Informatics Competency Assessment for the Nurse Leader: The Delphi Study.

OBJECTIVE: The aim of this study was to identify nursing informatics competencies perceived as relevant and required by nurse leaders. BACKGROUND: To participate as a full partner in healthcare leadership among rapidly advancing health information technologies (HITs), nurse leaders must attain knowledge of informatics competencies related to their clinical leadership roles and responsibilities. Despite this increased need to engage in HIT-related decision making, a gap remains in validated informatics competencies specific to the needs of nurse leaders. METHODS: An environmental scan and 3-round survey using Delphi methods used with nurse leaders for competency identification were used. RESULTS: Between 26 and 41 participants responded to each Delphi round. Most nurse leaders acquired HIT knowledge through on-the-job training. We identified 74 competencies from an initial list of 108 competencies. CONCLUSION: This work can advance nursing practice to move beyond "on-the-job informatics training" to a more competency-based model of nursing informatics education and practice.

THE TRAINING OF NEXT GENERATION DATA SCIENTISTS IN BIOMEDICINE.

With the booming of new technologies, biomedical science has transformed into digitalized, data intensive science. Massive amount of data need to be analyzed and interpreted, demand a complete pipeline to train next generation data scientists. To meet this need, the transinstitutional Big Data to Knowledge (BD2K) Initiative has been implemented since 2014, complementing other NIH institutional efforts. In this report, we give an overview the BD2K K01 mentored scientist career awards, which have demonstrated early success. We address the specific trainings needed in representative data science areas, in order to make the next generation of data scientists in biomedicine.

Health Information and Global Health Inequity: Point-of-Care Knowledge Systems as a Foundation for Progress.

Point-of-care clinical knowledge systems play an increasingly important role in providing information for health care providers in high-resource settings, and there is evidence of strong interest among providers within low-resource settings. Unfortunately, systems developed for high-resource settings have a range of elements that make them suboptimal for low-resource settings. We discuss what a point-of-care clinical knowledge system designed for low-resource settings would ideally contain, and argue that such a system is worthy of further study and funding, towards the overarching goal of reducing global health inequity.

Un software educativo para la autoevaluación de Morfofisiología I / Educational software for self-assessment for Morphophysiology I

La asignatura de Morfofisiología I constituye un gran desafío para los estudiantes del primer año de Medicina, debido a que el momento en que se imparte coincide con la adaptación a la Educación Superior y porque la atención individualizada al estudiante se ha visto afectada por la elevada relación alumno/profesor, derivada de la masividad estudiantil. El uso adecuado de las Tecnologías de la Información y las Comunicaciones (TIC) pueden constituir una alternativa para contribuir a resolver esta problemática. El objetivo de esta investigación consistió en diseñar un software educativo (SWE) para la autoevaluación de todos los objetivos y contenidos del programa vigente de la asignatura. Se implementó un sitio web, programado por el autor en HTML. Contiene 530 preguntas, distribuidas en 29 entrenadores de 10 o 20 preguntas de test, de verdadero/falso, selección múltiple o mezcla de ambos, que incluyen imágenes cuando se considera necesario. Se incorporan las Guías de las Clases talleres y la de Seminarios y una colección de animados para apoyar aspectos de difícil comprensión de la asignatura. Funciona en las tablets, laptops, teléfonos inteligentes y computadoras de escritorios, que contengan un navegador de Internet como parte de su sistema operativo. Tiene un tamaño de 266 MB. Este SWE responde a las tendencias pedagógicas actuales de la evaluación centrada en el alumno. Constituye una posible solución al problema de la atención al estudiante en condiciones de masividad, aunque por supuesto contribuye al proceso de enseñanza aprendizaje en cualquier caso. En un ensayo piloto se corroboró que el empleo de SWE incrementa el rendimiento académico(AU)

Morphophysiology I is one of the most difficult subject for the first year medical students because this moment means an important change in their student life that needs adaptation to the Higher Education space, which includes a different approach to the teaching-learning process. The students need individual attention to learn adequately this difficult subject, but this is not possible due to the incidence of a high student population, joint to a high level in the students:professor ratio which make very difficult to attend to them effectively. The uses of information and communication technologies (ICT) could be a solution to resolve the problem that affects the university learning contexts. The objective of this study was to design an educational software for self-assessment of Morphophysiology I. It was dessigned a web site as teaching media. It was programmed by the author in HTML language. The software contains 530 questions, distributed in 29 tests for training students in two particular ways: true or false tests and multiple-choice selection with images incorporated when needed. The web site has booklets about seminars and training classes to help students to improve the summative assessment. It also includes animated video about some difficult comprehension aspects of Histology, Biochemistry and Embryology. The software functions perfectly in smartphones, tablets, and laptops or on personal computers. The software only requires an internet browser associated to operative system. Its size is 266 MB. The software introduces students and professors to new trends in pedagogical assessment: self-evaluation, continuous and formative evaluation that improves the learning skills of the students. The software is a possible solution to help student's attention in a virtual environment, without the direct professor's attention. Pilot assay in final exam of Morphophysiology l indicated that the development of self-assessment with the software designed renders considerable improvement in students' academic achievement in comparison to the traditional assessment systems(AU)