This course provided an exposure to the clinical environment throughout the health center. It was designed for students not previously involved in clinical medicine, as well as those trained in medicine outside the U.S. The course featured problem-based learning and traditional medical informatics task domains. It also covered medical terminology and basic pathophysiology.

Topics included the clinical setting, eliciting information from patients, synthesizing the history and physical examination, establishing diagnosis, treatment planning, integrating evidence-based medicine, and using an intelligent medical record in a complex environment.

The goals for this course were to:

• Understand the clinical environment in which problem solving occurs
• Understand the process of acquiring both narrative and structured content and assimilating both into a medical record
• Understand the techniques used by clinicians to formulate clinical hypotheses when caring for patients
• Understand how precise use of an electronic medical record facilitatesclinical thought and decision making
• Stimulate thought for how future technologies and care approaches may better utilize information management
• Use these new skills in practice scenarios

Problem Solving in Clinical Medicine: From Data to Diagnosis, Paul Cutler, MD, 3rd Edition, 1998 (ISBN: 0-683-30167-5)

Group Project: Improving Access to Care in An Underserved Community

Team Presentation

This project posted as a work sample for this course demonstrates the application of health information technology in providing care to an underserved community, improving access to care while reducing cost and increasing the safety and effectiveness of the care. It shows a comprehensive understanding of the many types of issues that must be considered when delivering patient care. Further, it shows how technology can be integrated to support each step in the care process.  The works shows deep knowledge in the area of medical informatics and a good grasp of issues relating to healthcare applications.  Most important, it shows how this knowledge can be used to affect an important overall healthcare need, improving access to care.

This course helped me understand the role of evidence in the practice of medicine and the logic associated with assessing a medical problem. The sensitivity and specificity characteristics of a diagnostic test were explained and the process of developing a differential diagnosis was examined.

We reviewed the techniques used by clinicians to formulate clinical hypotheses when caring for patients and learned to think like doctors. We even learned some practical wisdom that doctors usually gain in medical school. For example, “When you hear the sound of hooves, think horses, not zebras.”

We studied the different roles performed by various types of care providers and how they worked together in the care process. We learned the principles behind how doctors create documentation for an episode of care, techniques like the SOAP note. We gained an appreciation for the value of both narrative as well as structured content in an electronic health record, understanding the value of the story as well as the quantitative and qualitative findings. We explored the role of EMR applications in supporting the clinical care environment.

I gained a real appreciation for how valuable the backgrounds of my clinical colleagues’ are in addressing the medical care use cases where the technology may be applied. Their specialized knowledge and the workflow they follow is a critical part of the care process and something that technologists like me need to spend time understanding in detail. I think the work demonstrated in this project shows the type of results that can be attained when a strong team of clinical and technical people work together with a clear goal in mind.