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Education and training in health informatics
computer methods and prograrns in biomedicine ELSEVIER
Computer Methods and Programs in Biomedicine 45 (1994) 41 43
Education and training in health informatics A. Hasman Department ~[ Medical lnJormatics, Universi O, ~!f Limburg, P.O. Box 616. 6200 MD Maastricht, The Netherlands
Abstract
In this contribution the AIM Concerted Action Education and Training in Health lnformatics (EDUCTRA) is discussed. The activities of the Concerted Action and the results of a survey conducted in 1993 concerning the state-of-the-art of education and training in health informatics in healthcare are presented. Key words': Education: Training; Health informatics; AIM; curriculum
I. Introduction
2. Focus of concerted action
In June 1992 a 2-day workshop was held in Brussels in order to prepare a 3-year A I M Concerted Action on Education and Training in Health Informatics ( E D U C T R A ) . The objective of a Concerted Action is to coordinate existing research and development activities in the European Community. Since the topic education and training in health informatics was considered too broad to be covered by a single Concerted Action it was decided to focus on education and training in health informatics of professionals (including physicians, nurses, managers, etc.). Also it was decided that the Concerted Action would not investigate the quality of education tools like authoring systems (systems with which authors can design lessons). Neither will the availability and quality of existing courseware that is used by professionals and students to educate them in fields other than health informatics and information technology (IT) be evaluated.
Since IT can only be used efficiently and effectively by people who have had some training in the use of this technology and who have also been introduced into the broader aspects of health informatics, it is mandatory that professionals receive training and education in this field. The participants in the workshop unanimously agreed about the need to carry out a Concerted Action in the context of the A I M p r o g r a m m e in order to: • obtain an overview of existing educational and training programmes in the area of health informatics; • identify potential gaps in the training and education of health care professionals and patient groups in the various countries: • propose, on the basis of this investigation, actions to remedy these gaps; and to • investigate the potential of transferring existing training programmes to other countries.
0169-2607/94/$07.00 ~.. 1994 Elsevier Science Ireland Ltd. All rights reserved SSDI 0169-2607(94)01540-V
42
A. Hasman / Comput. Methods Programs Biomed. 45 (1994) 41-43
A European Concerted Action is appropriate because it is expected that in the member countries comparable educational and training needs will be identified that can be solved easier via a cooperative action. Three different tracks were defined. In Track I the representatives of the member~states will survey the status of training and education in IT in their country. This survey should provide an overview of the current situation. On the basis of this survey major gaps in the educational and training programmes will be examined in-depth and further activities will be defined. In Track II possible training needs for patient groups in the area of telematics will be analyzed. On the basis of a position paper it will be decided whether further activities in this area will be carried out. In Track III existing educational programs will be combined into a software package. The programs are submitted by the representatives of the various countries. The programs are about understanding the principles and use of IT in health care. The package will be sent to various centres in Europe. During a period of a year the use of this package will be monitored. 3. Results
The state-of-the-art in education and training in health informatics in Europe has been surveyed in Track I. The representatives of 12 countries (Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Portugal, Spain, The Netherlands, United Kingdom) performed the survey in their own country. The survey describes the situation for different types of healthcare staff in 1993. Healthcare staff comprises physicians, nurses, administrators, managers, technicians, etc. In almost all countries taking part in the survey healthcare professionals lack knowledge with regards to the possibilities and limitations of computer systems. Because of this lack of knowledge computer systems are often regarded either as a solution for all problems or as a threat. The lack of training may also cause a sensation of 'lost
time' when healthcare professionals are nevertheless trying to use computer systems, which may eventually result in a refusal to use computers. The amount of knowledge about IT varies not only by country but even by region within countries, can be different for different professional groups and understandably depends on the age of the professional. In almost every country health care workers use stand-alone PCs. Courses in the use of database management packages, word processors, etc. are usually offered. GPs are increasingly using PCs (over 30% in Belgium, over 50% in The Netherlands). In Germany about 25% of all ambulatory care practices work with PCs, mainly for reimbursement purposes, and this figure will rise to 95% by 1996 because of new laws and regulation. It can be concluded that in all countries surveyed the use of PCs for dedicated applications is appreciable. Local area networks are used on a large scale in only some countries. In most countries hospitals and other health care institutions have installed information systems for administrative purposes. In a number of countries the larger hospitals have also installed computer systems for the provision of medical services. In most countries medical schools provide some courses in health informatics. In nursing schools some courses in h ~ l t h informatics are offered but usually the number of hours is small. It can be concluded that the situation Concerning health informatics at the universities is far from ideal. In a large number of countries there are no departments of health informatics. Courses are offered but are frequently devoted to the technical use of computers. Graduate students enter professional life without having had an introduction to the possibilities and the limitations of information systems. In Germany [1] and the Netherlands [2] recommendations for curricula are available. At post-graduate level courses in IT and health informatics are of variable content and quality. This may be a consequence of the limited number of health informatics teachers. In Athens an Erasmus programme in health information sciences is given. This programme appears to be successful. [3]
A. Hasman / Comput. Methods" Programs Biomed. 45 (1994) 41 43
A n i m p o r t a n t task for the Concerted A c t i o n is to provide guidelines for a curriculum for various groups o f professionals. The role o f vendors in education and training is small. Usually a n u m b e r o f employees is trained in the use o f their systems. These employees become the trainers o f the remaining employees. Education and training is provided via various delivery m e t h o d s ranging from training by peers, c o m p u t e r aided instruction to distance learning.
4. Conclusions F r o m the above it will be clear that most healthcare professionals have an inadequate knowledge o f the principles o f health informatics. It was concluded that one o f the tasks for the Concerted Action would be to define guidelines for a curriculum for various groups o f professionals. By having such guidelines courses that have
43
been developed in one c o u n t r y can also be used (after translation) in other countries. The first proposal for such guidelines will be discussed in J a n u a r y 1994. The suite o f teaching p r o g r a m s as made available by Track I l I will support the curriculum. It still has to be decided whether Track II will be continued.
References [1] R. Haux, J. Dudeck, W. Gaus et al., Recommendations of the German Association for medical informatics, biometry and epidemiology for education and training in medical informatics, Methods Inform. Med. 31 (1992) 60 70. [2] Committee for Medicine, Medical Informatics: Renewal in Medicine (in Dutch with summary in English), (Royal Netherlands Academy of Arts and Sciences, Amsterdam, 1987). [3] J. Mantas, Erasmus Programme in health information sciences, Conference on training strategies for health information systems, pp. 34 39. (Council c,f Europe, Slrasbourg France, 1991).
Computer Methods and Programs in Biomedicine 45 (1994) 41 43
Education and training in health informatics A. Hasman Department ~[ Medical lnJormatics, Universi O, ~!f Limburg, P.O. Box 616. 6200 MD Maastricht, The Netherlands
Abstract
In this contribution the AIM Concerted Action Education and Training in Health lnformatics (EDUCTRA) is discussed. The activities of the Concerted Action and the results of a survey conducted in 1993 concerning the state-of-the-art of education and training in health informatics in healthcare are presented. Key words': Education: Training; Health informatics; AIM; curriculum
I. Introduction
2. Focus of concerted action
In June 1992 a 2-day workshop was held in Brussels in order to prepare a 3-year A I M Concerted Action on Education and Training in Health Informatics ( E D U C T R A ) . The objective of a Concerted Action is to coordinate existing research and development activities in the European Community. Since the topic education and training in health informatics was considered too broad to be covered by a single Concerted Action it was decided to focus on education and training in health informatics of professionals (including physicians, nurses, managers, etc.). Also it was decided that the Concerted Action would not investigate the quality of education tools like authoring systems (systems with which authors can design lessons). Neither will the availability and quality of existing courseware that is used by professionals and students to educate them in fields other than health informatics and information technology (IT) be evaluated.
Since IT can only be used efficiently and effectively by people who have had some training in the use of this technology and who have also been introduced into the broader aspects of health informatics, it is mandatory that professionals receive training and education in this field. The participants in the workshop unanimously agreed about the need to carry out a Concerted Action in the context of the A I M p r o g r a m m e in order to: • obtain an overview of existing educational and training programmes in the area of health informatics; • identify potential gaps in the training and education of health care professionals and patient groups in the various countries: • propose, on the basis of this investigation, actions to remedy these gaps; and to • investigate the potential of transferring existing training programmes to other countries.
0169-2607/94/$07.00 ~.. 1994 Elsevier Science Ireland Ltd. All rights reserved SSDI 0169-2607(94)01540-V
42
A. Hasman / Comput. Methods Programs Biomed. 45 (1994) 41-43
A European Concerted Action is appropriate because it is expected that in the member countries comparable educational and training needs will be identified that can be solved easier via a cooperative action. Three different tracks were defined. In Track I the representatives of the member~states will survey the status of training and education in IT in their country. This survey should provide an overview of the current situation. On the basis of this survey major gaps in the educational and training programmes will be examined in-depth and further activities will be defined. In Track II possible training needs for patient groups in the area of telematics will be analyzed. On the basis of a position paper it will be decided whether further activities in this area will be carried out. In Track III existing educational programs will be combined into a software package. The programs are submitted by the representatives of the various countries. The programs are about understanding the principles and use of IT in health care. The package will be sent to various centres in Europe. During a period of a year the use of this package will be monitored. 3. Results
The state-of-the-art in education and training in health informatics in Europe has been surveyed in Track I. The representatives of 12 countries (Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Portugal, Spain, The Netherlands, United Kingdom) performed the survey in their own country. The survey describes the situation for different types of healthcare staff in 1993. Healthcare staff comprises physicians, nurses, administrators, managers, technicians, etc. In almost all countries taking part in the survey healthcare professionals lack knowledge with regards to the possibilities and limitations of computer systems. Because of this lack of knowledge computer systems are often regarded either as a solution for all problems or as a threat. The lack of training may also cause a sensation of 'lost
time' when healthcare professionals are nevertheless trying to use computer systems, which may eventually result in a refusal to use computers. The amount of knowledge about IT varies not only by country but even by region within countries, can be different for different professional groups and understandably depends on the age of the professional. In almost every country health care workers use stand-alone PCs. Courses in the use of database management packages, word processors, etc. are usually offered. GPs are increasingly using PCs (over 30% in Belgium, over 50% in The Netherlands). In Germany about 25% of all ambulatory care practices work with PCs, mainly for reimbursement purposes, and this figure will rise to 95% by 1996 because of new laws and regulation. It can be concluded that in all countries surveyed the use of PCs for dedicated applications is appreciable. Local area networks are used on a large scale in only some countries. In most countries hospitals and other health care institutions have installed information systems for administrative purposes. In a number of countries the larger hospitals have also installed computer systems for the provision of medical services. In most countries medical schools provide some courses in health informatics. In nursing schools some courses in h ~ l t h informatics are offered but usually the number of hours is small. It can be concluded that the situation Concerning health informatics at the universities is far from ideal. In a large number of countries there are no departments of health informatics. Courses are offered but are frequently devoted to the technical use of computers. Graduate students enter professional life without having had an introduction to the possibilities and the limitations of information systems. In Germany [1] and the Netherlands [2] recommendations for curricula are available. At post-graduate level courses in IT and health informatics are of variable content and quality. This may be a consequence of the limited number of health informatics teachers. In Athens an Erasmus programme in health information sciences is given. This programme appears to be successful. [3]
A. Hasman / Comput. Methods" Programs Biomed. 45 (1994) 41 43
A n i m p o r t a n t task for the Concerted A c t i o n is to provide guidelines for a curriculum for various groups o f professionals. The role o f vendors in education and training is small. Usually a n u m b e r o f employees is trained in the use o f their systems. These employees become the trainers o f the remaining employees. Education and training is provided via various delivery m e t h o d s ranging from training by peers, c o m p u t e r aided instruction to distance learning.
4. Conclusions F r o m the above it will be clear that most healthcare professionals have an inadequate knowledge o f the principles o f health informatics. It was concluded that one o f the tasks for the Concerted Action would be to define guidelines for a curriculum for various groups o f professionals. By having such guidelines courses that have
43
been developed in one c o u n t r y can also be used (after translation) in other countries. The first proposal for such guidelines will be discussed in J a n u a r y 1994. The suite o f teaching p r o g r a m s as made available by Track I l I will support the curriculum. It still has to be decided whether Track II will be continued.
References [1] R. Haux, J. Dudeck, W. Gaus et al., Recommendations of the German Association for medical informatics, biometry and epidemiology for education and training in medical informatics, Methods Inform. Med. 31 (1992) 60 70. [2] Committee for Medicine, Medical Informatics: Renewal in Medicine (in Dutch with summary in English), (Royal Netherlands Academy of Arts and Sciences, Amsterdam, 1987). [3] J. Mantas, Erasmus Programme in health information sciences, Conference on training strategies for health information systems, pp. 34 39. (Council c,f Europe, Slrasbourg France, 1991).