Big Data: Are Biomedical and Health Informatics Training Programs Ready? Contribution of the IMIA Working Group for Health and Medical Informatics Education

Applications of blockchain in ensuring the security and privacy of electronic health record systems: A survey

Due to the popularity of blockchain, there have been many proposed applications of blockchain in the healthcare sector, such as electronic health record (EHR) systems. Therefore, in this paper we perform a systematic literature review of blockchain approaches designed for EHR systems, focusing only on the security and privacy aspects. As part of the review, we introduce relevant background knowledge relating to both EHR systems and blockchain, prior to investigating the (potential) applications of blockchain in EHR systems. We also identify a number of research challenges and opportunities.

Teaching Hands-On Informatics Skills to Future Health Informaticians: A Competency Framework Proposal and Analysis of Health Care Informatics Curricula

Background

Existing health informatics curriculum requirements mostly use a competency-based approach rather than a skill-based one.

Objective

The main objective of this study was to assess the current skills training requirements in graduate health informatics curricula to evaluate graduate students’ confidence in specific health informatics skills.

Methods

A quantitative cross-sectional observational study was developed to evaluate published health informatics curriculum requirements and to determine the comprehensive health informatics skill sets required in a research university in New York, United States. In addition, a questionnaire to assess students’ confidence about specific health informatics skills was developed and sent to all enrolled and graduated Master of Science students in a health informatics program.

Results

The evaluation was performed in a graduate health informatics program, and analysis of the students’ self-assessments questionnaire showed that 79.4% (81/102) of participants were not confident (not at all confident or slightly confident) about developing an artificial intelligence app, 58.8% (60/102) were not confident about designing and developing databases, and 54.9% (56/102) were not confident about evaluating privacy and security infrastructure. Less than one-third of students (24/105, 23.5%) were confident (extremely confident and very confident) that they could evaluate the use of data capture technologies and develop mobile health informatics apps (10/102, 9.8%).

Conclusions

Health informatics programs should consider specialized tracks that include specific skills to meet the complex health care delivery and market demand, and specific training components should be defined for different specialties. There is a need to determine new competencies and skill sets that promote inductive and deductive reasoning from diverse and various data platforms and to develop a comprehensive curriculum framework for health informatics skills training.

Big Data in Public Health: Terminology, Machine Learning, and Privacy

The digital world is generating data at a staggering and still increasing rate. While these "big data" have unlocked novel opportunities to understand public health, they hold still greater potential for research and practice. This review explores several key issues that have arisen around big data. First, we propose a taxonomy of sources of big data to clarify terminology and identify threads common across some subtypes of big data. Next, we consider common public health research and practice uses for big data, including surveillance, hypothesis-generating research, and causal inference, while exploring the role that machine learning may play in each use. We then consider the ethical implications of the big data revolution with particular emphasis on maintaining appropriate care for privacy in a world in which technology is rapidly changing social norms regarding the need for (and even the meaning of) privacy. Finally, we make suggestions regarding structuring teams and training to succeed in working with big data in research and practice.

Health Systems Science Curricula in Undergraduate Medical Education: Identifying and Defining a Potential Curricular Framework

PURPOSE

The authors performed a review of 30 Accelerating Change in Medical Education full grant submissions and an analysis of the health systems science (HSS)-related curricula at the 11 grant recipient schools to develop a potential comprehensive HSS curricular framework with domains and subcategories.

METHOD

In phase 1, to identify domains, grant submissions were analyzed and coded using constant comparative analysis. In phase 2, a detailed review of all existing and planned syllabi and curriculum documents at the grantee schools was performed, and content in the core curricular domains was coded into subcategories. The lead investigators reviewed and discussed drafts of the categorization scheme, collapsed and combined domains and subcategories, and resolved disagreements via group discussion.

RESULTS

Analysis yielded three types of domains: core, cross-cutting, and linking. Core domains included health care structures and processes; health care policy, economics, and management; clinical informatics and health information technology; population and public health; value-based care; and health system improvement. Cross-cutting domains included leadership and change agency; teamwork and interprofessional education; evidence-based medicine and practice; professionalism and ethics; and scholarship. One linking domain was identified: systems thinking.

CONCLUSIONS

This broad framework aims to build on the traditional definition of systems-based practice and highlight the need for medical and other health professions schools to better align education programs with the anticipated needs of the systems in which students will practice. HSS will require a critical investigation into existing curricula to determine the most efficient methods for integration with the basic and clinical sciences.

Discussion of "The New Role of Biomedical Informatics in the Age of Digital Medicine"

This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "The New Role of Biomedical Informatics in the Age of Digital Medicine" written by Fernando J. Martin-Sanchez and Guillermo H. Lopez-Campos [1]. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the paper of Martin-Sanchez and Lopez-Campos. In subsequent issues the discussion can continue through letters to the editor.

Big Data in Health: a Literature Review from the Year 2005

The information stored in healthcare systems has increased over the last ten years, leading it to be considered Big Data. There is a wealth of health information ready to be analysed. However, the sheer volume raises a challenge for traditional methods. The aim of this article is to conduct a cutting-edge study on Big Data in healthcare from 2005 to the present. This literature review will help researchers to know how Big Data has developed in the health industry and open up new avenues for research. Information searches have been made on various scientific databases such as Pubmed, Science Direct, Scopus and Web of Science for Big Data in healthcare. The search criteria were "Big Data" and "health" with a date range from 2005 to the present. A total of 9724 articles were found on the databases. 9515 articles were discarded as duplicates or for not having a title of interest to the study. 209 articles were read, with the resulting decision that 46 were useful for this study. 52.6 % of the articles used were found in Science Direct, 23.7 % in Pubmed, 22.1 % through Scopus and the remaining 2.6 % through the Web of Science. Big Data has undergone extremely high growth since 2011 and its use is becoming compulsory in developed nations and in an increasing number of developing nations. Big Data is a step forward and a cost reducer for public and private healthcare.

Exploring challenges in implementing a health systems science curriculum: a qualitative analysis of student perceptions

OBJECTIVES

Although a critical component of educational reform involves the inclusion of knowledge of and skills in health systems science (HSS) (including population health, health system improvement and high-value care) many undergraduate medical education programmes focus primarily on traditional basic and clinical sciences. In this study, we investigated students' perceptions of the barriers to, challenges involved in and benefits of the implementation of a HSS curriculum.

METHODS

In 2014, we conducted 12 focus groups with 50 medical students across all years of medical school. Group interviews were audio-recorded and transcribed verbatim. We used thematic analysis to explore students' perceptions of a planned HSS curriculum, which was to include both a classroom-based course and an experiential component. We then identified themes and challenges from the students' perspective and agreed upon results and quotations.

RESULTS

Students identified four barrier-related themes, including (i) medical-board licensing examinations foster a view of basic science as 'core', (ii) systems concepts are important but not essential, (iii) students lack sufficient knowledge and skills to perform systems roles and (iv) the culture of medical education and clinical systems does not support systems education. Students also identified several perceived benefits of a systems curriculum, including acquisition of new knowledge and skills, enhanced understanding of patients' perspectives and improved learning through experiential roles. The major unifying challenge related to students' competing priorities; one to perform well in examinations and match into preferred residencies, and another to develop systems-based skills.

CONCLUSIONS

Students' intrinsic desire to be the best physician possible is at odds with board examinations and desired residency placements. As a result, HSS is viewed as peripheral and non-essential, greatly limiting student engagement. New perspectives are needed to effectively address this challenge.