Biomedical Informatics at Oregon Health & Science University
 By William Hersh, M.D., professor and chair, Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University
Biomedical informatics is the field concerned with the acquisition, storage and use of information in health care and biomedical research. Biomedical informatics is not just about technology; in fact, its focus is on information and its optimal use in the biomedical domain. As such, while some DMICE research and educational programs are technology-driven, others look at information and technology in the context of how they are used by people and in organizations.
The biomedical informatics program at OHSU is world-renowned in both education and research. Not content to be an “ivory tower” academic program, however, DMICE has undertaken a wide variety of activities that aim to reach out to local, national and international communities. Its research collaborators as well as students come from all over the world. A goal in the near future is the development of a center devoted to academia/industry collaboration, with a special focus on economic development for health/biomedical information technology in Oregon.
DMICE takes leadership roles and maintains full research portfolio
DMICE has a well-funded and diverse research portfolio. Its faculty and students publish in a wide variety of peer-reviewed journals, conference proceedings and other venues. Department faculty obtained more than $6 million in external research funding last year. DMICE is also substantially involved in OHSU-wide research initiatives, in particular, the new Oregon Clinical and Translational Research Institute (OCTRI), a collaboration with Kaiser Permanente that aims to accelerate research findings into clinical practice. Translational research is a new priority of the National Institutes of Health (NIH), and the Clinical and Translational Science Award (CTSA) program funds OCTRI. The CTSA program also has a strong commitment to using biomedical informatics to facilitate clinical and translational research. The NIH has established a national steering committee for biomedical informatics in translational research for which I was asked to serve as chair. In addition to being leading researchers, DMICE faculty are also involved in public policy and other leadership roles.
Here are some areas of focus for DMICE:
- Terminology and messaging standards for health-care data
- Information and care systems for chronic care management
- Computational biology and bioinformatics
- Information retrieval and search engines
- Text mining of scientific literature and medical records
- Evidence-based medicine and production of systematic reviews
Educating the next generation of researchers and professionals
A substantial volume of DMICE activity is focused on educating the next generation of biomedical informatics researchers and professionals. The DMICE program has been educating students since 1996 and is the largest in the country and perhaps the world. But quantity is not its major goal, and providing quality education for diverse audiences is key.
Someone considering spending part or all of his or her working time in health and biomedical informatics may find the decision regarding a career path and/or educational program to be somewhat daunting. This reflects the facts that:
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Informatics is still a maturing discipline
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There is no standard curriculum, program accreditation, or individual certification
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The role of information technology in health and biomedicine is still evolving.
Nonetheless, these are exciting times for the informatics field, with the growing recognition of the need for better use of IT in clinical settings as well as biomedical research.
OHSU programs offer flexibility and continue to expand
The programs at OHSU are organized in a building-block fashion. As such, coursework done at the lower levels can be carried forward to the more advanced degree programs. While all programs at OHSU are currently at the graduate level, that is, they require a bachelor’s degree, we are now developing a track in the related field of health information management, from which we hope to move into undergraduate education.
Most OHSU informatics programs are also available through distance learning. We have successfully offered most courses and programs online since 1999. The program has evolved to the point where online and on-campus offerings are considered equivalent and are not distinguished on a student’s transcript. Distance learning does not mean “distant” learning. We have standardized on a number of technologies that provide high-quality and interactive education. Our courses are also not correspondence courses, and require a sustained commitment of time for success. Almost all course activities are, however, asynchronous, meaning that students can access the material on their own schedule as long as they keep up with the overall class.
10X10 Program to train 10,000 health care professionals in biomedical informatics by 2010
One pathway into the OHSU program is the 10x10 Program. Run in partnership with the American Medical Informatics Association (AMIA), this program aims to train 10,000 health care professionals by the year 2010 in basic biomedical informatics so they can be local experts representing users in their communities, and pursue further studies if desired. The 10x10 course is an adaptation of the introductory course in the OHSU curriculum, with an addition of a 1-2 day in-person session covering additional material in an interactive manner. As such, the 10x10 course can be used for subsequent credit in the other OHSU programs.
The remainder of the programs are run from OHSU. The Graduate Certificate program focuses on the core of biomedical informatics. After the introductory course (which can be taken directly at OHSU or through the 10x10 program), students take more advanced courses in areas such as clinical systems, information retrieval and organizational behavior and management. They can also take additional electives as well as pursue practicum projects in their own communities.
Choice of master's and doctoral-level programs available
OHSU offers two master’s degree programs, which differ only in their culminating project. The Master of Science in Biomedical Informatics requires a master’s thesis, while the Master of Biomedical Informatics is a “professional master’s” and requires a less-intensive capstone project. The master’s degree programs have two “tracks,” one in medical informatics and the other in bioinformatics. A third track in health information management will be added in the coming year. The curriculum for each of the tracks is organized into “domains,” each of which is a general curricular area and has both required courses and choices from within a list. Students can enter the master’s degree programs directly or through the 10x10 or Graduate Certificate programs. Both programs are available on-campus or through distance learning. Students in either program can mix or match online and on-campus courses.
The Ph.D. program is a purely on-campus program, although Ph.D. students can take individual courses that are offered online. Consistent with the building-block approach, courses taken at lower levels of study are part of the Ph.D. program “knowledge base” and can be carried forward into the program. The Ph.D. program requires advanced study culminating in a dissertation consisting of independent research.
OHSU also offers a fellowship program funded by training grants from the National Library of Medicine (NLM) and Veteran’s Administration (VA). Three kinds of fellowship are available from the NLM training grant:
- Predoctoral - stipend and tuition support for some students in the Ph.D. program
- Postdoctoral - for those with doctoral (e.g., M.D. or Ph.D.) degrees who seek advanced training, with or without a degree (although most pursue a master’s degree)
- Librarian - a sabbatical-like opportunity for librarians seeking advanced training in informatics, with the option of a degree (typically the master’s degree)
The VA fellowship is for postdoctoral clinicians only and has a clinical service component.
The 140 alumni of the OHSU biomedical informatics program have obtained a variety of jobs in academic, industry and health-care settings. One adage learned from their experience is that the job one obtains on completing biomedical informatics education depends not only on the degree obtained but also on the individual’s background prior to undertaking study in the field. For example, most physicians and nurses will take jobs that draw on their clinical backgrounds, while those without clinical backgrounds, such as programmers, will more likely end up in development or management positions. However, the good news is that both clinician and non-clinician alumni of the program have successfully found jobs in many diverse settings.
As noted, these are exciting times for biomedical informatics, with all major leaders in health care and biomedical research recognizing the value of information technology. Opportunities abound for students who successfully complete their education in industry, academic, research and health-care settings. The OHSU program aims to continue its local and national leadership in research and education.
More information about DMICE, its programs, and its faculty at the following Web sites:
About the author
William Hersh, M.D., is professor and chair of the Department of Medical Informatics & Clinical Epidemiology at Oregon Health & Science University (OHSU) in Portland, Oregon, USA. Dr. Hersh is a leader and innovator in the medical informatics field both in education and research. More information about Dr. Hersh can be found on his Web site at www.billhersh.info.
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