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AMA Urges Med Schools To Cover Health IT Basics

Posted on November 17, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Despite the nearly universal use of health IT tools in medical practice today, the majority of med students make it through their medical school experience without having much exposure to such tools. In an effort to change this, the AMA is launching a new textbook designed to give med students at least a basic exposure to critical health IT topics.

To create the textbook, the AMA collaborated with its 32-school Accelerating Change in Medical Education Consortium. The collaboration generated a new “pillar” of medical education it dubs Health Systems Science, which members concluded should be taught alongside of basic and clinical sciences. This follows a recent study by the AMA concluding that its practicing physician members are quite interested in digital health.

In addition to covering key business concepts such as value in healthcare, patient safety, quality improvement, teamwork/team science and leadership, socio-ecological determinants of health, healthcare policy and health care economics, the textbook also addresses clinical informatics and population health.  And an AMA press release notes that many schools within the Consortium will soon use the textbook with the students, including Penn State College of Medicine and Brown University’s Warren Alpert Medical School.

The Brown program, for example, which received a $1 million AMA grant to support the change in this curriculum, has created a Primary Care-Population Medicine program. The program awards graduates both a Doctor of Medicine and a Master of Science in Population Medicine. The AMA describes this program is the first of its kind in the US.

It’s interesting to see that the AMA has stepped in and funded this project, partly because it seems to have been ambivalent about key health IT tools in the past, but partly because I expect to see vendors doing something like this. Honestly, now that I think about it, I’m surprised there isn’t a Cerner grant for the most promising clinical informatics grad, say, or the eClinicalWorks prize sponsoring a student’s medical training. Maybe the schools have rules against such things.

Actually, this is a rare situation in which I think getting vendors involved might be a good idea. Of course, med students wouldn’t benefit particularly from being trained exclusively on one vendor’s interface, but I imagine schools could organize regular events in which med school students had a chance to learn about different vendors’ platforms and judge the strengths and weaknesses of each on their own.

I guess what I’m saying is that while obtaining an academic understanding of health IT tools is great, the next step is to have med students get their hands on a wide variety of health IT tools and play with them before they’re on the front lines. That being said, adding pop health any clinical informatics is a step in the right direction

What Do Med Students Need To Know About EMRs?

Posted on August 16, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Recently, I was asked to write an introduction to EMRs, focusing on what medical students needed to know in preparation for their future careers. This actually turned out to be a very interesting exercise, as it called for balancing history with the future, challenges with benefits and predictable future developments with some very interesting possibilities. Put another way, the exercise reminded me that any attempt to “explain” EMR technology calls for some fancy dancing.

Here’s some of the questions I tackled:

  • Do future doctors need to know more about how EMRs function today, or how they should probably function to support increasingly important patient management approaches like population health?
  • Do med students need to understand major technical discussions – such as the benefits of FHIR or how to wrangle Big Data – to perform as doctors? If so, how much detail is helpful?
  • How important is it to prepare med students to understand the role of data generated outside of traditional patient care settings, such as wearables data, remote monitoring and telemedicine consults? What do they need to know to prepare for the gradual integration of such data?
  • What skills, attitudes and practices will help physician trainees make the best use of EMRs and ancillary systems? And how should they obtain that knowledge?

These questions are thornier than they may appear at first glance, in part because there no hard-and-fast standards in place as to how doctors who’ve never run a practice on paper charts should conduct themselves. While there have been endless discussions about how to help doctors adopt an EMR for the first time, or switch from one to the other, I’m not aware of a mature set of best practices available to med students on how next-gen, health IT-assisted practices should function.

Certainly, offering med school trainees a look at the history of EMRs makes sense, as understanding the reasons early innovators developed the first systems offers some interesting insights. And introducing soon-to-be physicians to the benefits of wearable or remote monitoring data makes sense. Physicians will almost certainly improve the care they deliver by understanding EMRs then, now and their near-term evolution as data sources.

On the other hand, I’m not sure it makes sense to indoctrinate med students in today’s take on evolving topics like population health management or interoperability via FHIR. These paradigms are evolving so rapidly that pinning down a set of teachable ideas may be a disservice to these students.

Morever, telling students how to think about EMRs, or articulating what skills are needed to manage them, might actually be a bad idea. I’m optimistic enough to think that now that the initial adoption frenzy funded by HITECH is over, EMRs will become far more usable and physician-shapeable over the next few years, allowing new docs to adapt the tool to them rather than adapt to the tool.

All that being said, educating med students on EMRs and health IT ancillary tools is a great idea. I just hope that such training encourages them to keep learning well after the training is over.