Informatics

Educational Plan:A competency based development of knowledge and skills in Information Technology through systems design, implementation and assessment, committee participation and readings to achieve competence, proficiency and the foundation for mastery. 

Educational Methods:

Clinical Information and Didactics

• Contact Dr. David Liebovitz prior to the start of the rotation.
• Schedule: 9AM – 5PM, 259 East Erie, 7th Floor
• Expectations for Informatics Elective include attendance at Morning Report, Grand Rounds and Noon Conference.
• Ambulatory Clinics will remain scheduled during this 1 to 2 month rotation.
• You may be scheduled for Night float duties, Air Call or Vacation during this block.  Please check your schedule in advance.

Goals and Objectives: The goals of the Informatics Elective are for the resident physician to gain a greater understanding of the use of information technology in clinical care, research, quality improvement, patient safety and medical education.  Review SBP and PBLI competencies, click here.

PGY1-3

• Use information technology to support patient care decisions and patient education
• Analyze practice experience and perform practice-based improvement activities using a systematic methodology
• Appraise, and assimilate evidence from scientific studies related to their patients’ health problems
• Obtain and use information about their own population of patients and the larger population from which their patients are drawn
• Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness
• Use information technology to manage information, access on-line medical information; and support their own education
• Facilitate the learning of students and other health care professionals
• Know how their patient care and other professional practices affect other health care professionals, the health care organization, and the larger society and how these elements of the system affect their own practice
• Describe how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources
• Practice cost-effective health care and resource allocation that does not compromise quality of care
• Participate in the process of implementing a system wide change in clinical care underway in the computerized practitioner order entry project.
• Represent housestaff concerns as they relate to order entry and finalize a strategy for incorporating housestaff into the design process.
• Define housestaff needs for electronic resources and an approach for making these resources easier to use.
• Review basic database and web integration tools.
• Review decision support options for prioritization and integration of into the patient care process.
• Develop specific rules and alerts including using primary literature and critical appraisal techniques while developing an article database.
• Attend operational committee meetings with the Medical Director of Clinical Decision Support.

­­­­­­­­­­­­­­Top References:

1. Bates DW, Leape LL, Cullen DJ et al. Effect of computerized physician order entry and a team intervention on prevention of serious medication errors. Jama 1998; 280 (15):1311-6.
2. Hunt DL, Haynes RB, Hanna SE et al. Effects of computer-based clinical decision support systems on physician performance and patient outcomes: a systematic review. Jama 1998; 280 (15):1339-46.
3. Nightingale PG, Adu D, Richards NT et al. Implementation of rules based computerised bedside prescribing and administration: intervention study. Bmj 2000; 320 (7237):750-3.
4. Bates DW. Using information technology to reduce rates of medication errors in hospitals. Bmj 2000; 320 (7237):788-91.
5. Raschke RA, Gollihare B, Wunderlich TA et al. A computer alert system to prevent injury from adverse drug events: development and evaluation in a community teaching hospital. Jama 1998; 280 (15):1317-20.
6. Nebeker JR, Hoffman JM, Weir CR et al. High rates of adverse drug events in a highly computerized hospital. Arch Intern Med 2005; 165 (10):1111-6.
7. Galanter WL, Didomenico RJ, Polikaitis A. A trial of automated decision support alerts for contraindicated medications using computerized physician order entry.J Am Med Inform Assoc 2005; 12 (3):269-74.
8. Rosenbloom ST, Grande J, Geissbuhler A et al. Experience in implementing inpatient clinical note capture via a provider order entry system.J Am Med Inform Assoc 2004; 11 (4):310-5.
9. Embi PJ, Yackel TR, Logan JR et al. Impacts of computerized physician documentation in a teaching hospital: perceptions of faculty and resident physicians. J Am Med Inform Assoc 2004; 11 (4):300-9.
10. Bates DW, Teich JM, Lee J et al. The impact of computerized physician order entry on medication error prevention.J Am Med Inform Assoc 1999; 6 (4):313-21.
    • 1999 IOM Report Brief: To Err Is Human
    • 2001 IOM Report Brief: Crossing The Quality Chasm
    • 2003 IOM Report Brief: Patient Safety
    • Introduction to Informatics
    • Informatics in Medical Education

NMH Articles

1. Bobb A, Gleason K, Husch M, Feinglass J, Yarnold PR, Noskin GA. The epidemiology of prescribing errors: the potential impact of computerized prescriber order entry.  Arch Intern Med. 2004 Apr 12;164(7):785-92.
2. Gleason KM, Groszek JM, Sullivan C, Rooney D, Barnard C, Noskin GA.  Reconciliation of discrepancies in medication histories and admission orders of newly hospitalized patients.  Am J Health Syst Pharm. 2004 Aug 15;61(16):1689-95. No abstract available.
3. Scarsi KK, Fotis MA, Noskin GA. Pharmacist participation in medical rounds reduces medication errors. Am J Health Syst Pharm. 2002 Nov 1;59(21):2089-92.

Articles of Note for Rotation

1. Nebeker JR, Hoffman JM, Weir CR, Bennett CL, Hurdle JF. High rates of adverse drug events in a highly computerized hospital. Arch Intern Med. 2005 May 23;165(10):1111-6.
2. William L. Galanter, Robert J. Didomenico, and Audrius Polikaitis. A Trial of Automated Decision Support Alerts for Contraindicated Medications Using Computerized Physician Order Entry. J Am Med. Inform. Assoc. 2005;12(3):269-274.
3. Rosenbloom ST, Grande J, et all. Experience in Implementing Inpatient Clincal Note Capture via a Provider Order Entry System. J Am Med Inform Assoc. 2004;11:310-316.
4. Embi PJ, Yackel TR, Logan JR, Bowen JL, Cooney TG, Gorman PN. Impacts of computerized physician documentation in a teaching hospital: perceptions of faculty and resident physicians.  J Am Med Inform Assoc. 2004 Jul-Aug;11(4):300-9. Epub 2004 Apr 2.

Collection by Dr. David Liebovitz and Thomas Westfall

For an extended list of references with direct article links, sign in to the Galter Health Library website at:

http://www.galter.northwestern.edu/guides/expand/resident-reading-lists