HPM 940, Section 001
Leadership in Health Informatics
2 Credit Hours
Fall 2015
Department of Health Policy and Management
Gillings School of Global Public Health
Instructor:
Office:
Email:
Phone:
Christopher M. Shea, PhD, MPA
1104F McGavran-Greenberg
[email protected]
919-966-1938
Course Overview
This 2-credit course provides an overview of leadership opportunities and challenges related to
informatics. Ultimately, the course aims to prepare students to identify information gaps in their own
organizations and lead efforts to address these gaps.
Generally speaking, health informatics initiatives aim to promote effective information use for the
purpose of improving the health of individuals and communities. Therefore, these initiatives have
implications for various stakeholder groups, including consumers/patients, practitioners, administrators,
and policy makers. This course aims to prepare students to consider informatics initiatives from various
stakeholder perspectives and to assess these initiatives in the context of health organization strategy
and operations.
The goals of this course are to (1) provide an overview of clinical, consumer, and public health
informatics initiatives; (2) enable students to identify potential benefits of informatics initiatives as well
as implementation challenges; and (3) provide students with frameworks and tools to facilitate effective
implementation and use of information resources. Because implementation processes and outcomes
for informatics initiatives are context dependent, students will be encouraged to consider the
opportunities and challenges of initiatives for different types of organizations and environments. Doing
so requires an understanding of several factors, such as available resources, information needs, and
workflows as well as the needs and priorities of those whom the organization serves.
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Learning Objectives and HPM Competencies
Course Learning Objectives
DrPH Competencies
1. Identify strategic and operational
informatics priorities, information
gaps, and instances of inadequate
information use.
2. Identify stakeholders (e.g.,
administrators, clinicians,
consumers) of a given informatics
initiative and describe the
implications for each stakeholder
group.
3. Apply theory, frameworks, and tools
to analyze potential implementation
challenges for health informatics
initiatives given the purpose of the
initiative and the setting in which it
is being implemented.
4. Design approaches to promote
effective implementation of a
specific informatics initiative within
a particular organizational setting.
1. Apply theoretical and evidence-based
perspectives from multiple disciplines in the
design and implementation of programs, policies,
and systems.
2. Develop health surveillance systems to monitor
population health, health equity, and public
health services.
3. Develop teams for implementing health
initiatives.
4. Collaborate with diverse groups.
5. Influence others to achieve high standards of
performance and accountability.
6. Guide organizational decision-making and
planning based on internal and external
environmental research.
7. Develop capacity-building strategies at the
individual, organizational, and community level.
8. Implement strategic planning processes.
9. Use informatics principles in the design and
implementation of information systems.
10. Evaluate organizational performance in relation
to strategic and defined goals.
11. Develop tools that protect the privacy of
individuals and communities involved in health
programs, policies, and research.
Resources
The required textbook for the course is:
Hoyt, R.E.; Yoshihashi, A. (eds.). Health Informatics: Practical Guide for Healthcare and Information
Technology Professionals (6th ed.). Lulu.com: 2014.
The course Sakai site enables you to access additional course readings (under “Resources”) and submit
assignments. Please be sure that you have access to the site and that your email address is correct.
Requirements and Expectations
Students are expected to complete required readings prior to class. Class sessions will include some
combination of lecture, guest speaker, and group discussion. Students are expected to actively listen
when others are speaking and to participate in discussions. Ultimately, the success of this course
depends on the efforts of everyone involved. Diligently preparing for class sessions, actively engaging
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with course material, and effectively communicating with each other are ways in which we can each
enhance the value of the course.
Evaluation / Grading
Participation
Active participation is vital to the success of this course. Participation involves engaging with the
required readings prior to the class meeting and actively participating in discussion during class. Each
student will be responsible for facilitating one class discussion. In most cases, two students will work
together to facilitate during the same class session. Facilitating the class discussion involves identifying a
real-world example (e.g., from the news media), generating discussion questions based on the example
and assigned readings, and leading the discussion during the class session. The example and questions
should be posted to the “Discussions and Private Messages” folder in Sakai no later than noon on
Sunday prior to the class meeting.
Case Analyses
There will be two written case analyses due for the class. The purpose of each case analysis is to apply
ideas, frameworks, and/or tools from the readings to a particular case or scenario. The written analyses
should be structured based on the questions and/or format provided in the instructions for each case.
Final Paper
Each student will complete a final paper related to informatics. Students who pursue one of the first
three options will be eligible to earn an “H” in the course. Students who pursue the fourth option will
be eligible for a “P” in the course but will not be eligible for an “H”.
If a student wishes to pursue an “H” in the course, he or she must complete one of the following three
types of papers:
1. Organizational Informatics Analysis: This paper would focus on your organization. The intent is to
identify informatics opportunities and challenges for the organization and analyze these opportunities
and challenges using ideas, frameworks, and/or tools discussed in class. The analysis should provide an
overview of how the organization is structured and resourced, external factors it must adapt to,
informatics initiatives/priorities that are being (or have been) assessed, and implementation issues for
its informatics priorities. The analysis should focus on priorities that are strategically and/or
operationally important for the organization to pursue its mission and goals. The analysis may include
informatics priorities that have been addressed already or that need to be addressed. For informatics
priorities already addressed, the analysis should both describe the current system/approach and discuss
strengths and limitations of the current system/approach. For priorities not currently addressed, the
analysis should discuss at least one option for addressing the priority and the relevant implementation
issues for that option. Below are some topics to consider when developing the paper:


General overview of internal characteristics (e.g., mission, organizational structure, staffing
models) and external environmental factors (e.g., federal/state policy, accreditation
requirements, competitors)
Informatics opportunities/priorities—both operational and outcomes related (e.g., internal
information needs, state/national Informatics initiatives, population health outcomes)
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Implementation issues and challenges for the identified informatics priorities (e.g.,
technological, ethical, human and financial resources, coordination with other entities).
Strategies employed (or that could be employed) to promote successful information system
implementation and/or information use in the organization.

2. Literature Review: This paper would review and synthesize the literature to report what is known
about a particular question. You might approach this as a “scoping review” (not a systematic literature
review) to identify the nature of the literature related to a research question. Scoping reviews are
similar to systematic reviews with respect to search methodology and approach to describing a body of
literature. However, systematic reviews use methodologies to assess the quality of articles included in
the review, whereas scoping reviews typically do not. Also, systematic reviews typically can arrive at
conclusive results, whereas scoping reviews may not. In summary, you would provide a preliminary
assessment of the size and scope of available literature by employing and documenting a systematic
search methodology (e.g., databases and key words used), using inclusion criteria for articles in the
review, and synthesizing what is known and not known about the research question of interest. There is
no magic number for how many articles to include (could be say 5-15), but given the short turnaround
and the word limit for the paper, you should choose a research question that is feasible for your review
(i.e., think in terms of a narrow scope and include only empirical—quantitative and qualitative—articles,
not conceptual or opinion pieces). This could be an opportunity to build upon your literature review for
your dissertation. Below is a general structure that this paper could follow:
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Introduction—e.g., what is the general topic? what is the specific problem of interest? what
are the implications of the problem? what question(s) will your review focus on?
Methods—e.g., key words and databases used, inclusion criteria for articles
Results—e.g., how many articles you found, how many were included in the review
Discussion—e.g., synthesis of findings about key aspects of (or topics related to) the
research question, implications for various stakeholders
3. Conceptual Paper: This paper would be informed by relevant literature and have the purpose of
advancing thinking about a particular issue, problem, framework, or theory. For example, such a paper
may apply an existing theory/framework to a particular problem that has yet to be examined via the
theory/framework. Or it may adapt a framework/theory for a new purpose or context. Ultimately, the
paper may advance our understanding of an informatics-related problem through careful application of
a theory/framework, advance our understanding of the usefulness of a theory/framework by applying it
in a novel way, or advance our understanding of the limitations of a theory/framework and offer ways to
strengthen it. The theory/framework used does not have to be one covered in this course, but the
paper should have an informatics-related focus. Below is a sample structure that this type of paper
could follow:



Introduction—e.g., what is the general topic? what is the specific problem of interest? what
are the implications of the problem? what is the purpose of your paper?
Conceptual Framework—e.g., describe the theory/framework (or theories/frameworks) that
you are focusing on, identify key works that informed the theory/framework, describe how
theory/framework has been applied previously, describe the limitations of the
theory/framework.
Discussion—e.g., discuss how the theory/framework can be applied in a new way, adapted
or improved, discuss new insights for doing so, implications for various stakeholders
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Length Requirement for “H” Papers: The structure and content of the final paper will depend on the
type of project completed. The paper should not be longer than 2,000 words (excluding tables, figures,
appendices, references). Papers should be double-spaced.
A student who does not wish to pursue an “H” but wishes to pursue a “P” in the course must complete
the following type of paper:
4. Reflection Paper: This paper would be an overall reflection upon how topics covered in course
readings and discussions apply to issues the student is interested in (from a practice and/or research
perspective). The reflection would not cover every topic in the course but instead would focus on topics
most pertinent to the student’s interests. The reflection should cover 3 topics, discussing key
concepts/ideas and how they apply to the issue(s) of interest to the student. For example, the reflection
may identify ways in which the student’s thinking about the issue has changed as a result of the course
readings/discussion, or it may identify questions related to the topic that the student would like to
consider beyond this course.
Length Requirement for “P” Papers: The reflection paper should be between 500-750 words.
NOTE: Simply writing one of the first three types of papers does not ensure that the student will
receive an “H” in the course. However, students who write the fourth type of paper (i.e., a Reflection
Paper) are not eligible to earn an “H” in the course.
Grading Components
% of
Grade
40%
40%
20%
Component
Case Analyses (2 @ 20% each)
Final Paper
Participation
Your final grade will be computed as the weighted average of your scores on the course requirements.
The following scale will be used to convert numeric scores into letter grades:
94 – 100
H
80 – 93
P
70 -79
L
69 or below
F
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Recognizing, Valuing, and Encouraging Diversity
The importance of diversity is recognized in the mission statement of HPM. In the classroom, diversity
strengthens the products, enriches the learning, and broadens the perspectives of all in the class. Diversity
requires an atmosphere of inclusion and tolerance, which oftentimes challenges our own closely-held
ideas, as well as our personal comfort zones. The results, however, create a sense of community and
promote excellence in the learning environment. This class will follow principles of inclusion, respect,
tolerance, and acceptance that support the values of diversity.
Diversity includes consideration of: (1) life experiences, including type, variety, uniqueness, duration,
personal values, political viewpoints, and intensity; and (2) factors related to “diversity of presence,”
including, among others, age, economic circumstances, ethnic identification, family educational
attainment, disability, gender, geographic origin, maturity, race, religion, sexual orientation, social
position, and veteran status.
Disability Accommodation
UNC-CH supports all reasonable accommodations, including resources and services, for students with
disabilities, chronic medical conditions, a temporary disability, or a pregnancy complication resulting in
difficulties with accessing learning opportunities.
All accommodations are coordinated through the UNC Office of Accessibility Resources & Services (ARS),
http://accessibility.unc.edu; phone 919-962-8300 or email [email protected]. Students must
document/register their need for accommodations with ARS before any accommodations can be
implemented.
UNC Honor Code
The principles of academic honesty, integrity, and responsible citizenship govern the performance of all
academic work and student conduct at the University as they have during the long life of this institution.
Your acceptance of enrollment in the University presupposes a commitment to the principles embodied
in the Code of Student Conduct and a respect for this most significant Carolina tradition. Your reward is
in the practice of these principles.
Your participation in this course comes with the expectation that your work will be completed in full
observance of the Honor Code. Academic dishonesty in any form is unacceptable, because any breach
in academic integrity, however small, strikes destructively at the University's life and work.
If you have any questions about your responsibility or the responsibility of faculty members under the
Honor Code, please consult with someone in either the Office of the Student Attorney General
(966-4084) or the Office of the Dean of Students (966-4042).
Read “The Instrument of Student Judicial Governance” (http://instrument.unc.edu).
Course Evaluation
HPM participates in the UNC-CH’s online course evaluation system, enabled at the end of the semester.
Your responses will be anonymous, with feedback provided in the aggregate. Open-ended comments
will be shared with instructors, but not identified with individual students. Your participation in course
evaluation is an expectation, since providing constructive feedback is a professional obligation.
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Feedback is critical, moreover, to improving the quality of our courses, as well as for instructor
assessment.
Class Meeting Schedule
The class schedule may be revised as needed to accommodate activities and readings that would add
value to the learning experience.
Session 1
Aug 11
Course Overview
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Defining health informatics
Rationale for the course
Overview of course goals and approach
Review syllabus and schedule
Readings Due:
By noon on Aug 14th, email your top-three choices for class session to
facilitate.
Assignment Due:
Session 2
Aug 25
Introduction to Health Informatics Concepts and Frameworks
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Readings Due:
The Data, Information, Knowledge Framework
Introduction to three domains of informatics: clinical, public health,
and consumer
Opportunities and challenges related to data analytics
1. Hoyt - Ch.1, “Overview of Health Informatics”
2. Brown, G.D.; Pasupathy, K.S. ; Patrick, T.B. (2013). Introduction to
Health Systems Informatics. In Brown, G.D.; Patrick, T.B; Pasupathy,
K.S. (Eds.). Health Informatics: A Systems Perspective. Chicago:
Health Administration Press.
3. Hoyt - Ch. 2, “Healthcare Data, Information, and Knowledge”
4. Hoyt – CH. 3, “Healthcare Data Analytics”
Assignment Due:
Session 3
Readings Due:
HPM 940.001
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Sept 8
Public Health Informatics
 Define purpose and scope of public health informatics
 Differentiate public health, clinical, and consumer informatics
 Current efforts in public health informatics
1. Yasnoff, WA et al. (2000). Public Health Informatics: Improving and
Transforming Public Health in the Information Age. Journal of Public
Health Management & Practice, 6(6): 67-75.
2. Hoyt – Ch. 21, “Public Health Informatics”
3. Edmunds, M et al. (2014) "The Future of Public Health Informatics:
Alternative Scenarios and Recommended Strategies," eGEMs
(Generating Evidence & Methods to improve patient outcomes): 2(4),
Article 3. http://repository.academyhealth.org/egems/vol2/iss4/3
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Assignment Due:
Session 4
Team 1: Case Example and Discussion Questions
Sept 15
Readings Due:
Electronic Health Records and “Meaningful Use”
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Functions of electronic health records
Meaningful Use history and goals
Health information exchange opportunities and challenges
Implications for Clinical, Consumer Health, and Public Health
informatics
1.
2.
3.
4.
Hoyt - Ch. 4, “Electronic Health Records”
Hoyt – Ch. 5, “Health Information Exchange”
Hoyt – Ch. 15, “Disease Management and Disease Registries”
Natural Language Processing in electronic health records
http://www.kevinmd.com/blog/2011/09/natural-languageprocessing-electronic-health-records.html
Suggested Resource

Assignment Due:
Session 5
Team 2: Case Example and Discussion Questions
Sept 29
Implementation Science
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Readings Due:
Team 3: Case Example and Discussion Questions
Oct 13
Project Management
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HPM 940.001
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Implementation Science concepts and theories
Implementation outcomes vs. organizational and client outcomes
Relevance of implementation science for health IT implementation
1. Damschroder, LJ et al. (2009). Fostering implementation of health
services research findings into practice: a consolidated framework for
advancing implementation science. Implementation Science, 4:50.
2. Michie, S et al. (2005). Making psychological theory useful for
implementing evidence based practice: a consensus approach
3. Weiner, BJ (2009). A theory of organizational readiness for change.
Implementation Science.
Assignment Due:
Session 6
CMS Meaningful Use website: http://www.cms.gov/Regulations-andGuidance/Legislation/EHRIncentivePrograms/Meaningful_Use.html
Stakeholder analysis
Project variables and constraints
EHR selection and implementation
Determinants and measures of information system success
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Readings Due:
1. Boyde, J. (2012). Introduction. In A Down-To-Earth Guide to SDLC
Project Management. In A Down-To-Earth Guide to SDLC Project
Management.
2. Federal Health IT Strategic Plan 2015-2020:
http://www.healthit.gov/sites/default/files/federal-healthITstrategic-plan-2014.pdf
3. Meshing, C. (2013). Why tech projects fail: 5 unspoken reasons.
Information Week. http://www.informationweek.com/itleadership/why-tech-projects-fail-5-unspoken-reasons/d/did/1109399
4. Goldstein, A. & Eilperin, J. (2013). HealthCare.gov: How political fear
was pitted against technical needs. The Washington Post, Nov. 2,
2013.
Assignment Due:
Session 7
Team 4: Example and Discussion Questions
Oct 20
Modeling Workflows & System Success
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Readings Due:
Quality improvement and informatics
Information systems planning processes: aligning IT and strategy
Defining business processes and modeling workflows
1. Sharp, A. & McDermott, P. (2009). Business processes – What are
they, anyway? In Workflow Modeling: Tools for Process
Improvement and Application Development, 2nd ed. Norwood, MA:
Artech House, Inc.
2. Sharp, A. & McDermott, P. (2009). The approach in a nutshell. In
Workflow Modeling: Tools for Process Improvement and Application
Development, 2nd ed. Norwood, MA: Artech House, Inc. McLean, E.R.
(2003).
3. DeLone, W.H.; McLean, E.R. (2003). The DeLone and McLean model
of information systems success: a ten-year update. J of Mgmt Info
Syst: 19 (4): 9-39.
Assignment Due:
Team 5: Example and Discussion Questions
Case Analysis #1
Session 8
Oct 27
Privacy, Security, and Ethics in Health Informatics
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
Readings Due:
HPM 940.001
Fall 2015
Privacy and security considerations
Ethical considerations in consumer health informatics
Patient portals and patient-reported outcomes
1. Hoyt – Ch. 8, “Health Information Privacy and Security”
2. Hoyt – Ch. 9, “Health Information Ethics”
3. RWJF – Data for Health: Learning what works (Executive Summary).
http://www.rwjf.org/content/dam/farm/reports/reports/2015/rwjf4
18628/subassets/rwjf418628_1
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Assignment Due:
Session 9
Team 6: Example and Discussion Questions
Nov 3
Decision Support and Telemedicine
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Readings Due:
Alerts as a type of decision support
Evaluating decision support tools
Telemedicine opportunities and implementation challenges
1. Mccoy, AB et al. (2012). A framework for evaluating the
appropriateness of clinical decision support alerts and
responses. J Am Med Inform Assoc 2012;19:346e352.
2. Elwyn G. et al. (2009).Assessing the Quality of Decision Support
Technologies: Using the International Patient Decision Aid
Standards instrument (IPDASi) PLoS ONE, 3 March 2009. 4(3),
e4705
3. Hoyt – Ch. 18, “Telemedicine”
Assignment Due:
Team 7: Example and Discussion Questions
Case Analysis #2
Session 10
Nov 10
Readings Due:
Class Choice Topics
TBD
Assignment Due:
Assignment Due:
Jan 4
9AM
(EDT)
Final Paper
Session 11
Jan ?
On-Campus Course Wrap-up
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