Pathology Informatics: Residency Curriculum for Now and the

Pathology Informatics: Residency Curriculum for Now and the

Pathology Informatics: Residency Curriculum for Now and the Future West and Midwest Chairs and Administrators Regional Conference October 21 - 24, 2014 2014 APC/API/CAP . All rights reserved. Informatics Training in Pathology The landscape of medical practice is changing Appropriate exposure to and training in informatics will be essentialDeveloping a strong informatics component for residency training programs will help advance the transformational future of the practice of medicine. Sinard JH, Powell SZ, Karcher DS. Pathology training in informatics: Evolving to meet a growing need. Arch Pathol Lab Med 2014 (April);138:505-511. 2014 APC/API/CAP. All rights reserved.

2 What is PIER? Pathology Informatics Essentials for Residents Collaborative joint project of APC, API and CAP Instructional resource guide and toolkit Support for PRODS to address unmet needs for pathology informatics training Mapped to ACGME milestones in informatics for pathology residents 2014 APC/API/CAP. All rights reserved. 3 PIER Developed by Pathology Informatics Experts and PRODS Core Team Drs. Walter Henricks and Liron Pantanowitz (co-leaders) Dr. Donald Karcher

Priscilla Markwood Ann Neumann Sue Plath Working Group Dr. Raymond D. Aller Dr. Suzanne Zein-Eldin Powell Dr. Philip J. Boyer Dr. Michael Warren Riben Dr. Victor Borisovich Brodsky Dr. Rodney A. Schmidt Dr. Alexis B. Carter Dr. John H. Sinard Dr. Rajesh C. Dash Dr. Enrique Terrazas

Dr. Michael D. Feldman Dr. J. Allan Tucker Dr. John R. Gilbertson Dr. J. Mark Tuthill Dr. James H. Harrison, Jr Dr. Myra L. Wilkerson Dr. Anil V. Parwani 2014 APC/API/CAP. All rights reserved. 4 Benefits Residents Program Directors Receive uniform, high quality training in a flexible and timely manner

Gain essential pathology informatics knowledge and skills Be well-prepared to apply pathology informatics to collect, manage and share key medical information with colleagues and patients Receive: Up-to-date content suitable for AP &/or CP Scalable design based on program characteristics and needs User-friendly toolkit for flexible implementation Content updates/releases Relevant performance outcomes mapped to ACGME milestones 2014 APC/API/CAP. All rights reserved. 5

PIER Release Plan Release 0 Introduced at July 2014 APC Annual Meeting Illustrated design, content and support features Release 1 Available now on APC PIER web page Will be alpha tested starting in November Available for use by all residency programs during alpha testing 2014 APC/API/CAP. All rights reserved. 6 PIER Scope and Sequence 7 The PIER Essentials Align to ACGME Informatics Milestones SBP7: Informatics: Explains, discusses, classifies, and applies clinical informatics (APCP) Has not

Achieved Level 1 Level 1 Level 2 Demonstrates familiarity with basic technical concepts of hardware, operating systems, and software for general purpose applications. Understands lab specific software, key technical concepts and subsystems on interfaces, workflow, barcode

applications, automation systems (enterprise systems architecture). Level 3 Applies informatics skills as needed in project management (data management, computational statistics). Level 4 Level 5 Participates in operational and strategy meetings, apprentices

troubleshooting with IT staff, applies informatics skills in laboratory management and integrative bioinformatics (able to aggregate multiple data sources and often multiple data analysis services). Is proficient in medical informatics systems. Able to assess and purchase a laboratory information system for anatomic and/or clinical pathology laboratories. Able to utilize medical informatics in the direction and operation of the laboratory.

Comments: 2014 APC/API/CAP. All rights reserved. 8 PIER Scope and Sequence PIER Essentials 1 PIER Essentials 2 LIS Components & Functions Specialized LISs & Middleware Data & Communication Standards Digital Imaging Basics of the Health Care Information Ecosystem Informatics in Pathology Practice Information Systems Fundamentals Importance of Databases Introduction to Data Standards Data Availability & Security Basic Proficiency ACGME Milestone Level 2 Instructional Hours: 8-10

Entry-Level Proficiency ACGME Milestone Level 1 Instructional Hours: 4-6 PIER Essentials 3 Pathologist Role in LIS & EHR Projects LIS Installation & Configuration Information Systems & Laboratory Performance Data Security, Regulatory & Accreditation Requirements PIER Essentials 4 LIS Management & Oversight Order and Results Management Laboratory Data for Quality Improvement & Research Laboratory Data & Enterprise Health Care Analytics Advanced Proficiency ACGME Milestone Level 4 Instructional Hours: 10-14 Intermediate Proficiency ACGME Milestone Level 3

Instructional Hours: 10-12 2014 APC/API/CAP. All rights reserved. 9 PIER Essentials 1 PIER Essentials 1 Informatics in Pathology Practice Information Systems Fundamentals Importance of Databases Introduction to Data Standards Data Availability & Security Entry Level Proficiency ACGME Milestone Level 1 Instructional Hours: 4-6 2014 APC/API/CAP. All rights reserved. 10

PIER Essentials 2 PIER Essentials 2 LIS Components & Functions Specialized LISs & Middleware Data & Communication Standards Digital Imaging Basics of the Health Care Information Ecosystem Basic Proficiency ACGME Milestone Level 2 Instructional Hours: 8-10 2014 APC/API/CAP. All rights reserved. 11 PIER Essentials 3 PIER Essentials 3

Pathologist Role in LIS & EHR Projects LIS Installation & Configuration Information Systems & Laboratory Performance Data Security, Regulatory & Accreditation Requirements Intermediate Proficiency ACGME Milestone Level 3 Instructional Hours: 10-12 2014 APC/API/CAP. All rights reserved. 12 PIER Essentials 4 PIER Essentials 4 LIS Management & Oversight Order and Results Management Laboratory Data for Quality Improvement & Research Laboratory Data & Enterprise Health Care Analytics Advanced Proficiency ACGME Milestone Level 4 Instructional Hours: 10-14

2014 APC/API/CAP. All rights reserved. 13 Scope of Content In Scope PIER topics cover what all pathologists need to know for practice Content will be maintained to accommodate changing technologies Out of Scope Statistics Bioinformatics Programming 2014 APC/API/CAP. All rights reserved. 14 PIER Resource Toolkit 15 Overview

PIER Scope and Sequence Identifies the what to teach PIER Resource Toolkit Identifies the how to teach Programs have unique needs and approaches Toolkit helps PRODS scale topics Provides implementation options to meet program needs Helps PRODS make good training decisions 2014 APC/API/CAP. All rights reserved. 16 Organization There are 3 key tools for each of the PIER Essentials: Essentials Map Resource Options Outcomes Achievement Checklist 2014 APC/API/CAP. All rights reserved. 17

Essentials Map Top area Main topics Rationale Outcomes for achievement Topic content Lower area Implementation strategies Scheduling/progress tracker 2014 APC/API/CAP. All rights reserved. 18 Essentials 1 Map: Top Area Topic Title Informatics in Pathology Practice Information Systems Fundamentals

Importance of Databases Rationale The practice of pathology relies on the creation, management, and accurate and timely communication of clinical laboratory information. Understand the relevance of informatics in pathology practice. Computers are essential tools that pathologists use in the management of information for laboratory practice and patient care. Databases provide core structure and tools that enable pathologists to manage and analyze large amounts of information.

Use correct terminology to describe the major types and components of computer hardware, software, and computer networks. Conversant in the fundamentals of databases, including data types, fields, records, database structure, and mechanisms for querying data; understands how data storage affects data retrieval options. 1. Hardware 1. Database terminology Outcomes for Achievement Describe the difference between information

technology (IT) and informatics and recognize how pathologists contribute to informatics initiatives. Content Explain the salient differences and similarities among pathology informatics, bioinformatics, public health informatics, health care information technology and health knowledge informatics. 1. Definition of informatics 2. Relevance of informatics in pathology 2. Software 3. Different types of informatics

4. Communications 3. Networks 5. Internet / Web Introduction to Data Standards Data Availability & Security Standards enable sharing of data among different health care information systems (ie, interoperability), which is necessary for patient care. Define the types and roles of standards used in pathology, at a basic level. Pathologists are ultimately responsible for the access to and safety of pathology information.

2. Structured vs. Unstructured data 1. Messaging protocols 3. Types of databases 3. Interoperability 4. Use of databases 4. Introduction to coding systems 4. The practice of informatics in pathology 2014 APC/API/CAP. All rights reserved. 2. Data models Understand the elements of data availability as a key part of security.

1. Data protection and confidentiality 2. Data availability & integrity 3. Data backup & recovery 19 Resource Options Lists content sources to support self-study or to inform the development of didactic materials Identifies recommended PIER resources, practical exercises and other optional resources Provides a detailed scheduling and progress tracker 2014 APC/API/CAP. All rights reserved. 20 Outcomes Achievement Checklist

Documents progress and accomplishments Completion of Essentials documents completion of corresponding ACGME informatics milestone level Final sign-off goes into residents file 2014 APC/API/CAP. All rights reserved. 21 Alpha Testing and Deployment Testing Goals Obtain feedback on PIER materials Obtain feedback on implementation challenges and success tips Deployment Goals Gather additional tools and resources that can be shared across programs Build a cadre of programs that endorse PIER to foster deployment to additional institutions

over time 2014 APC/API/CAP. All rights reserved. 22 Alpha Test Residency Programs Baystate Medical Center Cleveland Clinic George Washington University Medical University of South Carolina University of Buffalo University of Kentucky University of New Mexico University of Miami University of Pittsburgh University of Southern California University of Toledo University of Washington University of Vermont Vanderbilt University

2014 APC/API/CAP. All rights reserved. 23 Alpha Test Residency Programs Baystate Medical Center Cleveland Clinic George Washington University Medical University of South Carolina University of Buffalo University of Kentucky University of New Mexico University of Miami University of Pittsburgh University of Southern California University of Toledo University of Washington University of Vermont Vanderbilt University

2014 APC/API/CAP. All rights reserved. 24 Our Hope: Widespread PIER Adoption and Implementation PIER seeks to ensure that all pathology residents acquire the informatics knowledge and skills needed for the modern practice of pathology We need your leadership for pathology residency programs to achieve this outcome together 2014 APC/API/CAP. All rights reserved. 25 Q&A Bookmark PIER materials at: http://www.apcprods.org/PIER/ 26

Presentation Follow Up Direct any post meeting questions to Sue Plath, CAP Education Manager at [email protected] 2014 APC/API/CAP. All rights reserved. 27 Thank You For Your Interest And Support 2014 APC/API/CAP . All rights reserved.

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