Methods of Information in Medicine 39(2000), 267-277.
Updated version October 2000, with corrections in footnote of section 4.2
Recommendations of the
International Medical InformaticsAssociation (IMIA) on Education inHealth and Medical Informatics
International Medical Informatics Association,Working Group 1:
Health and Medical Informatics Education
Abstract: The International Medical Informatics Association (IMIA) agreed on internationalrecommendations in health informatics / medical informatics education. These should help to establishcourses, course tracks or even complete programs in this field, to further develop existing educationalactivities in the various nations and to support international initiatives concerning education in healthand medical informatics (HMI), particularly international activities in educating HMI specialists and thesharing of courseware.
The IMIA recommendations centre on educational needs for health care professionals to acquireknowledge and skills in information processing and information and communication technology. Theeducational needs are described as a three-dimensional framework. The dimensions are: 1)professionals in health care (physicians, nurses, HMI professionals, ...), 2) type of specialisation inhealth and medical informatics (IT users, HMI specialists) and 3) stage of career progression(bachelor, master, ...).
Learning outcomes are defined in terms of knowledge and practical skills for health careprofessionals in their role (a) as IT user and (b) as HMI specialist. Recommendations are given forcourses/course tracks in HMI as part of educational programs in medicine, nursing, health caremanagement, dentistry, pharmacy, public health, health record administration, andinformatics/computer science as well as for dedicated programs in HMI (with bachelor, master ordoctor degree).
To support education in HMI, IMIA offers to award a certificate for high quality HMI education andsupports information exchange on programs and courses in HMI through a WWW server of itsWorking Group on Health and Medical Informatics Education (http://www.imia.org/wg1).
Keywords: Health Informatics, Medical Informatics, Education, Recommendations, InternationalMedical Informatics Association, IMIA.
– 1 –
IMIA Recommendations on Education in Health and Medical Informatics Table of Contents
1 Introduction............................................................................................................3
1.1 Why Do We Need Health and Medical Informatics Education?..............................................31.2 IMIA-Recommendations for Health and Medical Informatics Education......................................................3
2 General Considerations........................................................................................4
2.1 Key principles of the IMIA-Recommendations.........................................................................42.2 Structural Outline of the IMIA-Recommendations....................................................................4
3 Recommendations for Learning Outcomes........................................................64 Recommendations for Courses/Course Tracks in Health and Medical Informatics as Part ofEducational Programs..............................................................................................10
4.1 General Remarks.......................................................................................................................104.2 Recommendations for Health and Medical Informatics Courses as Part of Medical,
Nursing, Health Care Management, Dentistry, Pharmacy, and Public Health Programs..104.3 Recommendations for Health and Medical Informatics Courses as Part of Health Record
Administration Programs.........................................................................................................114.4 Recommendations for Health and Medical Informatics Courses as Part of
Informatics/Computer Science Programs..............................................................................12
5 Recommendations for Dedicated Educational Programs in Health and
Medical Informatics.............................................................................................12
5.1 General Remark.........................................................................................................................125.2 Recommendations for Bachelor Programs in Health and Medical Informatics..................125.3 Recommendations for Master and Doctoral Programs in Health and Medical Informatics13
6 Recommendations for Continuing Education...................................................14
6.1 Continuing Education in Health and Medical Informatics.....................................................146.2 Life Long Learning....................................................................................................................14
7 Other Recommendations....................................................................................14
7.1 How to Commence with Health and Medical Informatics Education.........................................................147.2 Modes of Education...................................................................................................................147.3 Qualified Teachers.....................................................................................................................157.4 Recognised Qualifications........................................................................................................15
8 IMIA Support for Programs and Courses in Health and Medical Informatics.....................15
8.1 IMIA Certification.......................................................................................................................158.2 International Programs, International Exchange of Students and Teachers...............................................15
9 Information Exchange on Programs and Courses in Health and Medical
Informatics Supported by IMIA...........................................................................15
9.1 IMIA WG1 Database on Programs and Courses in Health and Medical Informatics...........159.2 IMIA WG1 Mailing List...............................................................................................................169.3 Developing and Sharing Courseware......................................................................................16
10 Concluding Remarks.........................................................................................16References..............................................................................................................16
– 2 –
IMIA Recommendations on Education in Health and Medical Informatics 1
1.1
Introduction
Why Do We Need Health and Medical Informatics Education?
Throughout the world, health care professionals often lack knowledge of the possibilities and limita-tions of systematically processing data, information and knowledge and of the resulting impact onquality decision-making. They are often asked to use information technologies of which they havelimited appreciation, in order to enhance their practices through better use of information resources.However, for systematically processing data, information and knowledge in medicine and in healthcare, health care professionals who are well-trained in medical informatics or health informatics areneeded1. It will only be through improved education of health care professionals and through anincrease in the number of well-trained workers in health and medical informatics that this lack ofknowledge and associated skills can begin to be reversed.
Health and medical informatics education is of particular importance at the beginning of the 21stcentury for the following reasons ([8], p.17):
1progress in information processing and information and communication technology is changing oursocieties;
2the amount of health and medical knowledge is increasing at such a phenomenal rate that we can-not hope to keep up with it, or store, organise and retrieve existing and new knowledge in a timelyfashion without using a new information processing methodology and information technologies;
3there are significant economic benefits to be obtained from the use of information andcommunication technology to support medicine and health care;
4similarly the quality of health care is enhanced by the systematic application of informationprocessing and information and communication technology;
5it is expected, that these developments will continue, probably at least at the same pace as can beobserved today;
6health care professionals who are well-educated in health or medical informatics are needed tosystematically process information in medicine and in health care, and for the appropriate andresponsible application of information and communication technology;
7through an increase in scope and the provision of high quality education in the field of health andmedical informatics, well-educated health care professionals world-wide are expected to raise thequality and efficiency of health care.
1.2IMIA-Recommendations for Health and Medical Informatics Education
There are different opportunities world-wide for obtaining an education in this field. In some coun-tries there are extensive educational components in health and medical informatics at different levelsof education and for the different health care professions. Many other countries have not, or at leastnot sufficiently, established such opportunities until now, with all the consequences concerning thequality and effectiveness of health care.
According to its aims and because of the situation just described, the International Medical Infor-matics Association (IMIA, [9], [15]) felt the need to develop international recommendations in healthand medical informatics education. These recommendations shall help to establish education in thisfield, to further develop existing educational activities in the various nations and to support internationalinitiatives concerning education in health and medical informatics.
Because a variety of educational and health care systems exist all over the world, programs,courses and course tracks in health and medical informatics may vary in different countries. In spite ofthis variability, basic similarities in health and medical informatics education can be identified and usedas a framework for recommendations. Such recommendations are also necessary for enabling aninternational exchange of students and teachers and for establishing international programs.
The IMIA recommendations, presented here, have taken into consideration the various existing,mainly national recommendations in health and medical informatics education (e.g. [1], [2], [4], [6],[12], [13], [14]). The IMIA recommendations should be regarded as a framework for national initiativesin health and medical informatics education, and for constituting international programs and exchangeof students and teachers in this field. They shall also encourage and support the sharing ofcourseware.
1 The meaning of the terms health informatics and medical informatics varies within and between different nations. Both
terms will be used here interchangeably in a broad and comprehensive manner, in terms of the discipline dealing with thesystematic processing of data, information and knowledge for optimal decision-making in medicine and health care. Inorder to recognize this point of view, the term health and medical informatics (HMI) will normally be used.
– 3 –
IMIA Recommendations on Education in Health and Medical Informatics 22.1General ConsiderationsKey principles of the IMIA-RecommendationsIn order to provide good quality health care, training and education in health and medicalinformatics is needed ([16], p. 537-547):for various health care professions,hin different modes of education,ewith different, alternate types of specialisation in health and medical informatics, andaat various levels of education, at respective stages of career progression. There must belqualified teachers to provide health and medical informatics courses which lead totrecognised qualifications for health and medical informatics positions.hIn more detail, ‘health’ means:hPractically all professionals in health care should, during their studies, be confronted with healthand medical informatics education: e.g. physicians, nurses, pharmacists, health care managers,health record administrators, and also health and medical informaticians who are graduates fromspecialised programs in health and medical informatics. Computer scientists/informaticians andother scientists (e.g. engineers), who intend to work in the fields of medicine and health care alsoneed health and medical informatics education.eVarious education methodologies are needed to provide the theoretical knowledge, practical skillsand mature attitudes that are required. In addition to traditional classroom-based models, there aremany different models of flexible, distance and supported open learning to be considered. Theexplosive growth of the Internet and World Wide Web are additionally having great impacts on alleducational methodologies, and in particular will favour flexible and distance learning. Inter-university collaborations might also facilitate curricular choice.aAlternate routes to different types of specialisation in health and medical informatics will depend oncareer choice. The majority of health care professionals (e.g. physicians, nurses) need to know howto efficiently and responsibly use information and communication technology, but only a few willchoose to have accredited specialisation in this field. They should, however, also be able to acquirean additional specialist qualification in health and medical informatics as part of their chosen careerdevelopment. Health and medical informatics specialisations may be different to suit the varioustypes of health care professionals. Finally, it should also be possible to acquire specialistqualifications in health and medical informatics via specific health and medical informaticsprograms leading to accreditation at different levels, e.g. master or Ph.D.lEvery profession in health care even at an early stage needs some core health and medical infor-matics knowledge. Different levels of education, respectively stages of career progression,(bachelor, master, doctor, ...) have different health and medical informatics education needsaccording to experience, professional role and responsibility. A junior professional uses informationdifferently compared to a senior professional. As well as there are specialised health and medicalinformatics university programs, health and medical informatics instruction should be integratedwithin other professional educational programs (medicine, nursing, informatics/computer scienceetc.). Thus educational components will vary in depth and breadth to suit specific student groups.Subsequent continuous education programs in health and medical informatics also need to beavailable.tThe content and delivery of health and medical informatics courses and programs must be of goodquality. Teachers of health and medical informatics courses must have adequate and specific com-petence in this field.hThere must be recognised qualifications in health and medical informatics for positions in this field.Accreditation of educational content and competence in health and medical informatics is required,to eventually have recognition on an international basis.The IMIA recommendations concentrate on the ‘dimensions’ h, a and, to a certain extent, l.Comments on the other components e, t and h, are given in sections 6 and 7.2.2Structural Outline of the IMIA-Recommendations
The IMIA recommendations centre on educational needs for health care professionals to acquireknowledge and skills in information processing and information and communication technology as it isneeded and used in medicine and health care. The educational needs are described as a three-dimensional framework with dimensions ‘professional in health care’, ‘type of specialisation in healthand medical informatics’ and ‘stage of career progression’ (figure 1). For these various educationalneeds learning outcomes are suggested (see section 3), either for courses1/course tracks2 in health 1 Course: Unit of study consisting of a set of lectures, exercises, ..., dedicated to a certain field, e.g. ‘introduction to hospital
information systems’, ‘medical decision making’.
2 Course Track: Set of courses, dedicated to a certain field as part of an educational program, e.g. ‘health informatics’ (as
set of courses in this field) in a nursing program.
– 4 –
IMIA Recommendations on Education in Health and Medical Informatics and medical informatics as part of educational programs (see section 4) or for dedicated programs1 inhealth and medical informatics (see section 5).
knowledge and skills needed in health and medical informatics ... by students in ...medicine nursing health care management pharmacy public health health record administration informatics/ computer science learning outcomes ... in programs of ...- medicine - nursing - health care management - dentistry - pharmacy - public health - health record administration - informatics/computer science - others(courses/course tracks in HMI as part of educational programs)and in - dedicated HMI programs(dedicated educational programs in HMI)eer progression ...dentistry health/medical informatics others ... to reach car doctor master bachelor ←IT user ... HMI specialist... to get a specialisation in HMI as ...Figure 1:Structural outline of the IMIA recommendations on education in health and medical informatics (HMI):
knowledge and skills needed in HMI by students in health care, to get a specialisation in HMI and toreach a career progression lead to learning outcomes in programs, and have to be transformed intoeducational components with appropriate depth and breadth.
Figure 1 shall point out, that if one is studying a certain discipline (e.g. medicine to receive abachelor degree), then the IMIA recommendations suggest, that in their study all these studentsshould get a minimum of education in health and medical informatics, so that they are able toefficiently use information and communication technology (IT users). This education will be formulatedin table 1, section 3, in the form of learning outcomes. On the other side, candidates may want toprepare for careers in health and medical informatics (HMI specialists). Table 1 in section 3 willindicate, which education should be given to them to become an HMI specialist. The study of HMI issomewhat different. Here we have to interpret figure 1 in the sense, that learning outcomes (also beinggiven in table 1 and further explained in sections 4 and 5) are defined to get a bachelor, master ordoctor degree in HMI. Per definition this predefines an HMI specialist. There are obviously differentways to become a qualified HMI specialist.
1 Program: An organised, structured set of course offerings aimed at preparing participants for specific career paths and
culminating in a degree, diploma or leaving certificate, e.g. program in ‘medicine’, ‘medical informatics’ (as dedicatedprogram).
←... lead to ...... and have to be transformed into educational components with appropriate depth and breadth– 5 –
IMIA Recommendations on Education in Health and Medical Informatics 3Recommendations for Learning Outcomes
It is not possible today to refer to standard curricula, but rather interesting differences exist bothwithin and between countries. A clear trend however in curriculum design is the coming together ofcompetence requirements in information processing, information systems and technologies andcompetence requirements in information management, i.e. how to effectively use information andcommunication technology to support appropriate decision-making and evidence based practice. Thistrend also relates to the evolution of concepts of the multi-disciplinary information sharing that isneeded for successful decision-making and quality management both in health care and in otherdomains.
For education in health and medical informatics two kinds of major learning outcomes can beidentified. They specify the
1.Learning outcomes for all health care professionals in their role as IT users: Enabling health careprofessionals to efficiently and responsibly use information processing methodology andinformation and communication technology. These learning outcomes need to be included in allundergraduate curricula, leading to a health care professional qualification. On the other hand thereare:
2.Learning outcomes for health and medical informatics specialists: Preparing graduates for careersin health and medical informatics in academic, health care (e.g. hospital) or industrial settings.These learning outcomes need to be included in all curricula, leading to a qualification as specialistin health and medical informatics.
Clearly for the health professional gaining knowledge and skills in health and medical informatics,various levels can exist concerning depth and breadth of educational components.
The learning outcomes define the levels of knowledge and practical skills needed. The desiredoutcomes determine the educational components either in courses/course tracks in health andmedical informatics as part of educational programs or as dedicated programs in health and medicalinformatics.
Table 1 contains the list of learning outcomes, recommended by IMIA. These are specified aslevels of knowledge and practical skills. There is a distinction between three levels of knowledge andskills: 1) introductory knowledge/skills, 2) intermediate knowledge/skills and 3) advancedknowledge/skills. Knowledge and skills which are described as optional are recommended if theresearch profile of the university/school offering a program includes these fields and if it fits well into aprogram. The knowledge and skill levels are classified into three domain areas of knowledge and skill:1.Methodology and technology for the processing of data, information and knowledge in medicineand health care.
2.Medicine, health and biosciences, health system organisation.3.Informatics/computer science, mathematics, biometry.
– 6 –
IMIA Recommendations on Education in Health and Medical Informatics ITUser
(1) Methodology and Technology for the Processing ofData, Information and Knowledge in Medicine and Health Care
Reasons for the necessity of systematically processing data,information and knowledge in medicine and health careBenefits and current constraints of using information andcommunication technology in medicine and health care
Value of high quality data for successful patient and institutional management.Need for an organisational information strategy and trained personnelEfficient and responsible use of information processing tools, tosupport health care professionals’ practice and their decision makingKnowledge/Skill - Domain- Level
HMI
Specialist
1.1a1.1b1.1c1.1d1.2
1.3aGeneral characteristics of health information systems1.3bManagement of information systems in health care
1.3cArchitectures and examples of health information systems,
especially hospital information systems, office/practice informationsystems, to support health care professionals and managers ofhealth care institutions
1.3dArchitectures and examples of information systems to support
patients and the public1.3eArchitectures and examples of information systems to support
policy makers and managers of community/district/regional healthcare services
1.4Use of application software for documentation, personal communi-cation including Internet access, for publication and basic statistics
1.5Information literacy: library classification and systematic health
related terminologies and their coding, literature retrieval methodsHRA1.6aAppropriate documentation and health data management principlesHRA
including ability to use health and medical coding systemsHRA1.6bConstruction of health and medical coding systems and their
representation principles1.7Structure, design and analysis principles of the health record
including notions of data quality, minimum data sets, general
applications of the electronic health record
1.8aAppropriate decision making, using and constructing guidelines
and critical paths
1.8bConstructing tools for decision support and their application to
patient management, acquisition, representation and engineeringof medical knowledge
1.9Principles of practice evaluation and evidence based practice
HRAHRA
...
Recommended level of knowledge: : introductory: intermediateRecommended level of skill: : introductory: intermediate,large size: recommended for all professionals in health care,small size: recommended for certain professionals in health care: advanced: advanced
Table 1a:Recommended learning outcomes in terms of levels of knowledge and skills for professionals in
health care either in their role as IT users or as health and medical informatics (HMI) specialist.Obviously, between the specialisation of a health care professional as IT users and a health careprofessional as a HMI specialist, various levels concerning depth and breadth of learning outcomesexist. Additional recommendations, specific for a certain educational program, will be added insections 4 and 5.
HRA recommended for health records administrators
– 7 –
IMIA Recommendations on Education in Health and Medical Informatics Knowledge/Skill - Domain
...
ITUser
- Level
HMISpecialist
Methodology and Technology for ... (continued)
1.10Health telematics approaches, electronic commerce in health1.11Data analysis using primary and secondary data sources, analysisof business (operational) processes, biostatistics and epidemiology1.12Medical signal processing1.13Medical image processing
1.14Bioinformatics (optional)
1.15Medical physics, including radiotherapy (optional)1.16Medical robotics (optional)1.17Biomedical Modelling (optional)
P P
P,SP
P,SPP,SP
P,SP
1.18Ethical issues including accountability of health care providers and managers andHMI specialists and the confidentiality, privacy and security of patient data1.19Standards in health and medical informatics1.20Informatics methods and tools to support education (incl. flexible and distance lear-ning), use of relevant educational technologies, incl. Internet and World Wide Web
(2) Medicine, Health and Biosciences, Health System Organisation
2.1Fundamentals of human functioning and biosciences (anatomy, physiology, Xmicrobiology and clinical disciplines such as internal medicine, surgery etc.) X2.2Fundamentals of what constitutes health, from physiological, sociological, psycholo-gical, nutritional, emotional, environmental, cultural, spiritual perspectives and its
assessment2.3Diagnostic and therapeutic strategies2.4Organisation of the health system
2.5Health administration, health economics, health quality and resource management,
public health services and outcome measurement
X
X
X
X X
X
X X
...
Recommended level of knowledge: : introductory: intermediate: advancedRecommended level of skill: : introductory: intermediate: advanced,large size: recommended for all professionals in health care,small size: recommended for certain professionals in health care; see respective footnoteTable 1b:Recommended learning outcomes in terms of levels of knowledge and skills for professionals in
health care either in their role as IT users or as HMI specialist. Obviously, between the specialisationof a health care professional as IT users and a health care professional as a HMI specialist, variouslevels concerning depth and breadth of learning outcomes exist. Additional recommendations, specificfor a certain educational program, will be added in sections 4 and 5.
P recommended for physicians
P,SP recommended for physicians and for HMI professionalsX Minimum knowledge and skills in medicine, health and biosciences, health system organisation,
recommended e.g. for students of dedicated HMI programs, of health record administration programs andof computer science/informatics students at bachelor and master level.
– 8 –
IMIA Recommendations on Education in Health and Medical Informatics Knowledge/Skill - Domain
...
ITUser
- Level
HMISpecialist
(3) Informatics/Computer Science, Mathematics, Biometry
3.1Basic informatics terminology like data, information, knowledge, hardware, software,computer, networks, information systems, information systems management3.2Using personal computers, text processing and spread sheet
software, easy-to-use database management systems3.3Ability to communicate electronically, including electronic data
exchange, with other health care professionals3.4Methods of practical informatics/computer science, especially on programming
languages, software engineering, databases, database management systems,information and system modelling tools, information systems theory and practice,decision support, knowledge engineering, (concept) representation and acquisition,networking, telecommunications, general issues concerning the human-computerinterface, cognitive aspects of information processing
3.5Methods of informatics/computer science theories
3.6Methods of informatics/computer science technologies including
virtual reality, multimedia3.7Change management principles and terminology and methodology
of project management3.8Mathematics: algebra, analysis, logic, numerical mathematics,
probability theory and statistics3.9Biometry, including study design, evaluation methods
B/M B/M
B/M B/M B/M B/M
B/M
B/M
Recommended level of knowledge: : introductory: intermediate: advancedRecommended level of skill: : introductory: intermediate: advanced,large size: recommended for all professionals in health care,small size recommended for certain professionals in health care; see respective footnoteTable 1c:Recommended learning outcomes in terms of levels of knowledge and skills for professionals in
health care either in their role as IT users or as HMI specialist. Obviously, between the specialisationof a health care professional as IT users and a health care professional as a HMI specialist, variouslevels concerning depth and breadth of learning outcomes exist. Additional recommendations, specificfor a certain educational program, will be added in sections 4 and 5.
All health care professional graduates should, in their role as IT users, have the levels of know-ledge and skills mentioned for IT users. Analogously, those professionals in health care, being healthand medical informatics specialists, should have the levels of knowledge and skills specified for them.In order to achieve the learning outcomes mentioned above, their educational components shouldbe considered for inclusion into the respective educational programs.
The levels of knowledge and skills mentioned may particularly work well for developed,industrialised countries, with high levels of access to, and use of, information technology, and whichhave highly developed health care infrastructures. Developing countries may at the beginning have theneed to adapt them with regard to the level of technology. The principles of health and medicalinformatics, however, can still be taught, applied and developed in the absence of high levels ofinformation and communication technology.
Recommendations, either specific for certain courses or course tracks in health and medicalinformatics as part of educational programs or specific for dedicated educational programs in healthand medical informatics, are mentioned in sections 4 and 5. B/M recommended for bachelor programs in HMI, based on an informatics-based approach to HMI (see
section 5), necessary knowledge and skills for entering a master program in HMI, based on aninformatics-based approach to HMI
– 9 –
IMIA Recommendations on Education in Health and Medical Informatics 4
4.1
Recommendations for Courses/Course Tracks in Health and MedicalInformatics as Part of Educational Programs
General Remarks
Educational course components in health and medical informatics should be tailored to thestudent's advancement and where possible be made relevant for and used to support a given stage ofstudent progression. For example, teaching about the patient record for students of medicine shouldbe introduced after the student has gained some clinical experience, but not too late so that studentscan benefit from this knowledge in the latter stages of their clinical training.
Due to the afore-mentioned large variety, there exist different perspectives for health and medicalinformatics education. For health and medical informatics specialists we especially can distinguishbetween a more informatics-based and a more health care-based approach to health and medicalinformatics education, with a variety of combinations in-between.
The objective of an informatics-based approach to health and medical informatics is to focus on theprocessing of data, information and knowledge in health care and medicine with a strong emphasis onthe need for advanced knowledge and skills of health and medical informatics, of mathematics, as wellas of theoretical, practical and technical informatics/computer science. Health care problems,however, can be treated cooperatively with physicians and other health care professionals. In such anapproach to health and medical informatics education knowledge and skills of informatics/computerscience predominate.
The objective of a health care-based approach to health and medical informatics is to focus on theprocessing of data, information and knowledge in health care and medicine requiring, apart fromknowledge in health and medical informatics, also knowledge in medicine or of other health sciencesto such an extent, which can only be imparted within the scope of a medical or health science educa-tion. In such an approach to health and medical informatics education knowledge and skills ofmedicine and of other health sciences predominate.
The recommendations, given in section 4.2 and 4.3 for health and medical informatics specialistsare recommendations for health care-based approaches to health and medical informatics. Therecommendations in sections 4.4 and 5.2 are oriented towards an informatics-based approach. Withrespect to educational progression, especially for a bachelor, master, and doctoral degree, the generaldistinctions in depth and breadth should be considered as mentioned in section 5.
4.2
Recommendations for Health and Medical Informatics Courses as Partof Medical, Nursing, Health Care Management, Dentistry, Pharmacy,and Public Health Programs
Courses/Course Tracks for IT Users
In order to achieve the levels of knowledge and skills in health and medical informatics as recom-mended in section 3 for IT users, the total student workload for educational components in health andmedical informatics should comprise at least 2 ECTS credits1 (see [3]). Specific examples from thework of the respective health professionals should be used. Emphasis should particularly be given topractical training.
The additional recommendations of this section may also apply to the programs of otherprofessions in health care such as medical laboratory technicians, medical librarians, radiologytechnicians, dieticians, occupational therapists etc. or for the programs allied health/clinicalresearchers studied. These people also need to know about the potentials and the risks of informationprocessing in health care and be able to efficiently use methods and tools of information processingand information and communication technology.
Courses/Course Tracks for Health and Medical Informatics Specialists
In order to achieve the levels of knowledge and skills in health and medical informatics, asrecommended in section 3 for specialists, the student workload associated with these educational 1 In the European Credit Transfer System (ECTS, [3]) a full academic year’s student workload is 60 credits.
Four ECTS credits can correspond, e.g., to approx. 40 hours of lectures, exercises and practical training atuniversities. A course, charged with four ECTS credits, may e.g. consist of a 3 hours/week lecture given inone semester with 14 weeks of lecturing.
– 10 –
IMIA Recommendations on Education in Health and Medical Informatics components in health and medical informatics should be at least 60 ECTS credits, i.e. one year of fulltime studies. This is similar to dedicated master programs in health and medical informatics.
In addition to the ‘core’ knowledge and skills obtained in each program, the relative amount ofstudent workload for the three knowledge and skills areas inside the health/medical informatics coursetrack should approximately be as indicated in table 2.
ProgramMedicine,Nursing,Health CareManagement,
Dentistry,Pharmacy,Public Health
40
51560
Knowledge/Skill Area
(1)(2)(3)Σ
methodology and technology for the processing of data, information andknowledge in medicine and health care
medicine, health and biosciences, health system organisationinformatics/computer science, mathematics, biometry
Table 2:
Recommended student workload in ECTS credits for the three knowledge and skill areas of
health/medical informatics course tracks inside programs of medicine and other health sciences.
For all health care professionals area (2) should focus on health system organisation, area (3) onpractical informatics and project management. For nurses it should be possible that specialisation canbe included in a post registration nursing curriculum. For health care managers knowledge andpractical skills of information systems architectures and information systems management shouldparticularly comprise enterprise functions for administration, controlling, quality management andexecutive decision making.
4.3
Recommendations for Health and Medical Informatics Courses as Partof Health Record Administration Programs
Within the past decade the discipline of health record administration (also denoted as healthinformation management) has often enhanced its scope from document handling to managing healthcare information. Also the scope of practice has changed considerably.
For educating health record administrators, two different levels of education are recommended:-A first level should cover introductory concepts and principles and assumes an introductory skilllevel. Students at this level take e.g. a two- or three year prescribed course of study at a collegelevel resulting (e.g. in the U.S.) in an associate’s degree.
-At a second level a deeper understanding of knowledge and more advanced skills, developingproblem solving and critical thinking skills in more depth is assumed. Students at this level take e.g.a three- or four-year prescribed course of study resulting in a bachelor degree. Further studies mayfollow.
Courses/Course Tracks for IT Users
Health record administration students at the mentioned first level can be regarded as IT users. Therecommendations on levels of knowledge and skills are the same as for IT users, mentioned in section4.2. Particular emphasis should be given to information literacy, health terminology, coding systems,the electronic health record, and evaluation methodology. There should be introductory knowledge andskills in the knowledge/skill-domain medicine, health and biosciences, health systems organisation.Courses/Course Tracks for Health and Medical Informatics Specialists
Students of health record administration programs, respectively health information managementprograms, who lead to bachelor and master degrees should have the knowledge and skills of HMI
– 11 –
IMIA Recommendations on Education in Health and Medical Informatics specialists, as mentioned in section 4.2. Again, special emphasis should be given to informationliteracy, health terminology, coding systems, the electronic health record, and evaluation methodology.
4.4
Recommendations for Health and Medical Informatics Courses as Partof Informatics/Computer Science Programs
Courses/Course Tracks for Health and Medical Informatics Specialists
In order to achieve the levels of knowledge and skills in health and medical informatics,recommended in section 3 for specialists, the length of studies for educational components in healthand medical informatics should be at least 60 ECTS credits, i.e. one year of full time studies.
In addition to the ‘core’ knowledge and skills of informatics/computer science, the relative amountof student workload for the three knowledge and skills areas inside the health/medical informaticscourse track should approximately be as indicated in table 3.
ProgramInformatics/Computer Science
40
15560Knowledge/Skill Area
(1)(2)(3)Σmethodology and technology for the processing of data, information andknowledge in medicine and health care
medicine, health and biosciences, health system organisationinformatics/computer science, mathematics, biometry
Table 3:
Recommended student workload in ECTS credits for the three knowledge and skill areas of a
health/medical informatics course track inside informatics/computer science programs.
The student workload in (3) comprises knowledge and skills in biometry and evaluation methods.Applying methods and tools of informatics in health care institutions and for concrete problems indiagnosis, therapy, nursing and health care management should be emphasised. This helps to learn toknow the health care environment as informatics or computer science student. Health informationsystems management should include the development and implementation of software and hardwarecomponents of health information systems. In medical signal and image processing technical andinformatics aspects should particularly be considered.
5
5.1
Recommendations for Dedicated Educational Programs inHealth and Medical Informatics
General Remark
The aim of all dedicated programs in health and medical informatics is to prepare graduates for ca-reers in health and medical informatics in academic, health care (e.g. hospital) or industrial settings.
5.2
Recommendations for Bachelor Programs in Health and MedicalInformatics
For programs leading to a bachelor degree in health informatics or medical informatics, curriculashould be application-related, serving the purpose of a direct preparation for the future professionalactivity. In addition they should offer a good foundation for studying in a master program in this field orin related ones.
The objective of such a type of education is to impart specialised knowledge in the field of healthand medical informatics as well as skills in a practice-oriented application of the acquired knowledge.The intention is to provide a practice-related education to qualify for translating expertise gained in thefield of health and medical informatics into practical activity, in conformity with the state of knowledge.As compared with the comprehensive formal methodological foundation of a master program, it is thepractice-oriented application that predominates.
– 12 –
IMIA Recommendations on Education in Health and Medical Informatics In order to achieve the levels of knowledge and skills in health and medical informatics asrecommended in section 3, and in order to achieve a broad depth and breadth of all educationalcomponents, the length of study for educational components in health and medical informatics shouldbe at least three years. This corresponds to a student workload of at least 180 ECTS credits.
For an informatics based approach to health and medical informatics, the relative amount ofstudent workload for the three knowledge and skills areas for the bachelor program should beapproximately as indicated in table 4. This composition can be varied from very strong technical IT skillacquisition to less IT skill and a stronger health application focus, depending on the desired learningoutcomes.
ProgramHealth/MedicalInformatics/(bachelor)
50
20110180
Knowledge/Skill Area
(1)(2)(3)Σ
methodology and technology for the processing of data, information andknowledge in medicine and health care
medicine, health and biosciences, health system organisationinformatics/computer science, mathematics, biometry
Table 4:
Recommended student workload in ECTS credits for the three knowledge and skill areas of a
health/medical informatics bachelor program.
5.3
Recommendations for Master and Doctoral Programs in Health andMedical Informatics
For programs leading to a master or doctoral degree (e.g. Ph.D.), it is the comprehensive formalmethodological foundation for health and medical informatics that predominates, at a formal level.
The objective is to provide an education of scientific character that includes theory, specialisedknowledge and practical skills. Graduates shall, apart from a practice-oriented application of methodsand tools from health and medical informatics, be enabled to independently participate in research andin the methodical advancement within the field of health and medical informatics. In contrast tobachelor programs, these higher degrees include formal penetration and abstraction as well as theafore-mentioned qualification of graduates independently contributing to the methodical and scientificadvancement that predominates.
In order to achieve the levels of knowledge and skills in health and medical informatics asrecommended in section 3, and in order to achieve the desired broad depth and breadth of theeducational components previously defined, the length of study should be at least one year full time fora master degree, corresponding to at least 60 ECTS credits. Ph.D. studies or Ph.D. work shouldusually last three years.
The relative amount of study time for the three knowledge and skills areas for the master programshould approximately be as indicated in table 5.
ProgramHealth/MedicalInformatics/(master)
40
101060Knowledge/Skill Area
(1)(2)(3)Σmethodology and technology for the processing of data, information andknowledge in medicine and health care
medicine, health and biosciences, health system organisationinformatics/computer science, mathematics, biometry
Table 5:
Recommended student workload in ECTS credits for the three knowledge and skill areas of a
health/medical informatics master program.
– 13 –
IMIA Recommendations on Education in Health and Medical Informatics It is expected that master students have successfully finished either (a) a bachelor program inhealth and medical informatics, (b) a bachelor or master program in medicine or another healthscience, or (c) in computer science. For cases (b) and (c) additional complementary courses ininformatics/computer science (for case (b)) or medicine, health and biosciences, health systemorganisation (for case (c)) should be offered.
For programs leading to a doctoral degree, comprehensive own research should be carried outindependently by the student in addition to the requirements previously mentioned. Knowledge andskills should also have additional depth or breadth. This should also be considered for the learningoutcomes of sections 3 for depth and breadth of educational components when transforming them toeducational components in doctoral programs.
6
6.1
Recommendations for Continuing Education
Continuing Education in Health and Medical Informatics
To prove sufficient qualification in health/medical informatics both in relation to the academiceducation or continuing education in health and medical informatics and in relation to a successful atleast four-year professional activity (operational qualification), a certificate of ‘Health Informatics’ or‘Medical Informatics’ should be offered.
Furthermore, for physicians, who usually have well established forms of continuing education, thereshould be offered the possibility of receiving, in addition to their medical degree, the supplementaryqualification of ‘Medical Informatics’ or ‘Health Informatics’. This additional qualification can be issuedby the national medical associations. The same holds for nurses, for whom in many countries alsoforms of continuing education are very well-established.
In order to offer courses in health and medical informatics for continuing education, it is recom-mended that institutions are established to provide such courses. These institutions might be insideuniversities or, e.g. as academies of health/medical informatics established by associations in healthand medical informatics.
6.2Life Long Learning
Working in the field of health and medical informatics and even using information andcommunication technology requires life long learning. Therefore opportunities for continuing educationshould be offered for HMI specialists as well as IT users of the various health professions. The abilityof ‘learning to learn’ will become of particular importance.
7
7.1
Other Recommendations
How to Commence with Health and Medical Informatics Education
Health and medical informatics affects all health care professionals. To commence education inthis field IMIA recommends that education in health and medical informatics for all types of health careprofessionals, including the different types of specialisation and levels of education is considered. Incountries, where no education in health and medical informatics exists, the following steps arerecommended.
First of all teachers have to be educated (‘teach the teachers’), courseware has to be prepared andinstitutes for health informatics or medical informatics have to be established within universities,usually inside medical or health sciences faculties. A broad education in the use of informationprocessing and information and communication technology for health care professionals, especiallyphysicians and nurses, should have the first priority. Thus, introductory courses especially for medicaland nursing students should be offered first. Other types of education, as mentioned above, shouldthen follow.
7.2Modes of Education
Certain modes of education should be chosen, considering the specific profile and possibilities ofthe respective universities. Besides lectures it is of importance that practical exercises within healthcare institutions (e.g. in hospitals) are offered. Besides ‘traditional’ lectures and exercises withinuniversities, and given the explosive growth of the Internet and World Wide Web, different models offlexible, distance and supported open learning should be actively pursued. Problem-oriented learning
– 14 –
IMIA Recommendations on Education in Health and Medical Informatics might particularly support the relevance of health and medical informatics as it requires integration ofinformation and a cross-disciplinary understanding.
7.3Qualified Teachers
Courses and programs in health and medical informatics must be of good quality. Teachers ofcourses in health and medical informatics must have adequate and specific qualifications in this field.It must be possible to obtain such qualifications for lecturing in health and medical informatics, usuallyfrom universities.
7.4Recognised Qualifications
Education of students in health and medical informatics, which goes beyond introductory courses inthe use of information and communication technology, only makes sense if positions for thesegraduates exist or are created. The qualifications of such health and medical informatics graduatesmust be recognised and there should be positions as specialists in health and medical informatics.
8
8.1
IMIA Support for Programs and Courses in Health and MedicalInformatics
IMIA Certification
To support education of high quality in the field of health and medical informatics, IMIA offers helpby providing expert advice to persons and institutions in this field, as far as the resources of IMIAallow. This might especially be needed when commencing with educational activities and whennational institutions are not yet established to do this.
Health and medical informatics courses inside programs and in specialised programs in this fieldcan upon request add to the description of their course track or program the phrase ‘endorsed by theInternational Medical Informatics Association’ and can use the IMIA logo in this context.
This is conditional to the IMIA recommendations being fulfilled and once the quality of the program,including organisational integration and resources, has been assessed by IMIA appointed experts.Single courses can not be considered, only course tracks or programs.
The fulfilment of the recommendations and the assessment of the quality of the program will beexamined by a committee usually consisting of 4 IMIA WG1 members or other persons, experiencedin HMI education, and will be approved by the IMIA president and the chairperson of IMIA WG1. Themembers of this committee will be nominated jointly by the IMIA president and by the chairperson ofIMIA WG1.
After approval, a written certificate, signed by the IMIA president, the chairperson of IMIA WorkingGroup 1 on Health and Medical Informatics Education, and by the committee members, will be given tothe respective organisation.
Requests should be submitted to the chairperson of IMIA Working Group 1.
8.2International Programs, International Exchange of Students and Teachers
IMIA encourages and recommends international activities in educating health and medical infor-matics specialists. IMIA also recommends the international exchange of students and of teachers inthis field. It encourages the establishment of international programs to support this and to exchangecourseware. Programs should be built up in a modular way, and international credit transfer systemssuch as the ECTS ([3]) should be used in the respective national programs to support theseinternational perspectives.
9
9.1
Information Exchange on Programs and Courses in Healthand Medical Informatics Supported by IMIA
IMIA WG1 Database on Programs and Courses in Health and MedicalInformatics
IMIA’s Working Group 1 on Health and Medical Informatics Education (IMIA WG1) has establisheda WWW site to provide up-to-date information about its work ([10]). The main feature of the site is a
– 15 –
IMIA Recommendations on Education in Health and Medical Informatics database providing information on health and medical informatics programs and courses world-wide([7]). To be able to have a database of high quality and value IMIA encourages all teachers andinstitutions to submit information about courses and programs on HMI education offered and to setpointers to their own WWW sites.
9.2IMIA WG1 Mailing List
In addition, IMIA WG1 operates a mailing list to facilitate communication between all persons inter-ested in health and medical informatics education world-wide. For subscription, a message has to besent to ‘listserv@urz.uni-heidelberg.de‘. The body of the message should read ‘SUBSCRIBE IMIA-WG1‘. Messages to the IMIA WG1 list have to be sent to ‘imia-wg1@urz.uni-heidelberg.de‘.
9.3Developing and Sharing Courseware
IMIA encourages the development and sharing of courseware of high quality for courses in healthand medical informatics. This will help to further establish courses in this field. Examples for suchinitiatives are the IT Eductra project of the European Union ([11]) or the WWW sites of the Handbookof Medical Informatics ([16]). IMIA encourages the use of its IMIA WG1 WWW server and list serverfor the dissemination of information about such courseware.
10Concluding Remarks
These recommendations provide a beginning framework for individual curriculum development.Individual countries may wish to develop more detailed or better defined curricula guidelines to suittheir specific needs and educational system. This could include specific minimum level competenciesrequired for each level and knowledge/skill domain. Such national efforts are expected to inform futurereviews of these guidelines. The IMIA WG1 may in the near future develop teaching credentiallingcriteria to serve as a guide for teachers wishing to participate in health and medical informaticseducation.
Acknowledgements
These recommendations are the result of numerous meetings, mainly of IMIA WG1, and have been discussedand modified by many groups of IMIA and its national associations. They were endorsed by the IMIA GeneralAssembly at November 11th, 1999 in Washington.
Significant contributions to the recommendations came from John Arokiasamy (Malaysia), Marion Ball (USA),Denise Barnett (United Kingdom), Margaret Bearman (Australia), Jan van Bemmel (The Netherlands), JudithDouglas (USA), Paul Fisher (Canada), Robert Garrie (USA), Lael Gatewood (USA), William Goossen (TheNetherlands), Andrew Grant (Canada, HEALNET), Joseph Hales (USA), Arie Hasman (The Netherlands),Reinhold Haux (Germany), Evelyn Hovenga (Australia), Merida Johns (USA), Petra Knaup (Germany), FranzJosef Leven (Germany), Nancy Lorenzi (USA), Peter Murray (United Kingdom), Roderick Neame (UnitedKingdom), Denis Protti (Canada), Michael Power (South Africa), Janise Richards (USA), Ernst Schuster(Austria), Wendy Swinkels (Australia), Jim Yang (Norway), Lynn Zelmer (Australia), Jana Zvárová· (CzechRepublic).
The recommendations have been edited by Reinhold Haux (chairman of IMIA WG1), Andrew Grant, ArieHasman, Evelyn Hovenga and Petra Knaup (secretary of IMIA WG1).
References
[1][2][3][4][5]
Council of Europe Committee of Ministers (1995): Recommendations No. R (90) 21 of theCommittee of Ministers to Member States on Training Strategies for Health InformationSystems. In: [5], 3-6.
Enabling People Programme & English National Board for Nursing, Midwifery and HealthVisiting (1997): Information for Caring: integrating informatics into learning programmes fornurses, midwives and health visitors. Birmingham: Institute of Health and Care Development.European Credit Transfer System: http://europa.eu.int/comm/education/socrates/ects.html.
HASMAN A, ALBERT A (1997): Education and Training in Health Informatics: Guidelines forEuropean Curricula. Int J Med Informatics 45, 91-110.
HASMAN A, ALBERT A, WAINWRIGHT P, KLAR R, SOSA M (eds) (1995): Education and Trainingin Health Informatics in Europe. State of the Art - Guidelines -Applications. Amsterdam: IOSPress.
– 16 –
IMIA Recommendations on Education in Health and Medical Informatics [6]
HAUX R, DUDECK J, GAUS W, LEVEN F J, KUNATH H, MICHAELIS J, PRETSCHNER D P,THURMAYR R, WOLTERS E (1992): Recommendations of the German Association of MedicalInformatics, Biometry and Epidemiology on Education in Medical Informatics. Meth Inform Med31, 60-70.
HAUX R, FRANK J, KNAUP P (1997): The IMIA WG1 database on health and medical informaticsprograms and courses: a call for participation. Meth Inform Med 36, 233-4. Reprint in: VANBEMMEL, J.H., MCCRAY, A.T. (eds). IMIA Yearbook of Medical Informatics 1998, 528-9.Stuttgart: Schattauer.
HAUX R, SWINKELS W, BALL MJ, KNAUP P, LUN KC (eds) (1998): Health and medicalinformatics education: transformation of health care through innovative use of informationtechnology for the 21st century. Int J Med Informatics, 50, 1-300.
International Medical Informatics Association (IMIA). WWW server: http://www.imia.org.
International Medical Informatics Association (IMIA), Working Group 1 (WG1) on Health andMedical Informatics Education. WWW server: http://www.imia.org/wg1.IT EDUCTRA: http://www.fundesco.es/it-eductra.
NACNEP, National Advisory Council on Nurse Education and Practice (1997): A nationalinformatics agenda for nursing education and practice. Report to the Secretary of theDepartment of Health & Human Services. Washington DC: US Department of Health andHuman Services, Division of Nursing.
Physicians for the Twenty-First Century (The GPEP Report). Association of the American Medi-cal Colleges, Washington, 1984.
VAN BEMMEL JH, FESTEN C (eds) (1987): Medical Informatics: Renewal in Medicine (In Dutchwith English Summary). Amsterdam: Committee from Medicine of the Royal NetherlandsAcademy of Arts and Sciences.
VAN BEMMEL JH, MCCRAY AT (eds): IMIA Yearbook of Medical Informatics. Stuttgart:Schattauer. Annual appearance.
VAN BEMMEL JH, MUSEN MA (eds) (1997): Handbook of Medical Informatics. Heidelberg:Springer. WWW sites: http://www.mieur.nl/mihandbook, http://www.mihandbook.stanford.edu.
[7]
[8]
[9][10][11][12]
[13][14][15][16]
Address of Correspondence:
International Medical Informatics Association (IMIA)
Working Group 1: Health and Medical Informatics EducationInternet: http://www.imia.org/wg1
Chairman:Prof. Dr. Reinhold HauxSecretary:Dr. Petra KnaupUniversity of Heidelberg
Institute for Medical Biometry and InformaticsDepartment of Medical InformaticsIm Neuenheimer Feld 400D-69120 HeidelbergGermany
http://www.med.uni-heidelberg.de/miPhone:++49/6221/56-7483Fax:++49/6221/56-4997
E-Mail:{Reinhold_Haux, Petra_Knaup}@med.uni-heidelberg.de
– 17 –
因篇幅问题不能全部显示，请点此查看更多更全内容