Ebook: Health Telematics Education

In Europe, coordinated activities in healthcare informatics education started in the late 1980s with the establishment of European Courses in Health Telematics. At the same time the European Commission foresaw the need for spreading the knowledge of IT in the Healthcare Sector. Therefore the EC, since then, have supported the initiatives that aim to create awareness, stimulate diffusion, educate and train the users (healthcare professionals) in the application of Information Technology to the Healthcare Sector.

Such an initiative is the NIGHTINGALE project which is an essential project in the planning and implementation of strategy in training the nursing profession in using and applying healthcare information systems. The fact that the project is focusing on the user needs related to the telecommunication and informatics area of the nursing profession, which is the largest profession in the healthcare providers group, makes it unique.

The NIGHTINGALE project will contribute towards the appropriate use of the developed telematics infrastructure across Europe by educating and training nurses in a harmonising way across Europe in the upcoming field of nursing informatics. For achieving this objective the NIGHTINGALE project established a series of European Conferences on Health Telematics Education, and Workshops by experts (users, developers, and policymakers).

In 1996, the following NIGHTINGALE Conferences and Workshops took place:

• First European Conference on ‘Health Telematics Education’ (HTE'96), that was held on 5-7 September 1996, in Corfu, Greece.

• First Users and Policymakers Workshop on ‘Educating Nurses for the Telematics Era’, on 4-6 May 1996, in Heemskerk, The Netherlands.

• First Developers and Multimedia Workshop on ‘Courseware Development for Training Nurses in Informatics: State of the Art and Current Perspectives’, on 30 August-1 September 1996, in Lyon, France.

• Second Users and Policymakers Workshop on ‘Developing Curriculum in Nursing Informatics’, on 8 September, in Corfu, Greece.

The proceedings of the above mentioned NIGHTINGALE Conferences and Workshops are included in this volume.

I would like to thank all the members of the NIGHTINGALE Consortium for organising the Conference and the Workshops, the Chairman of the Working Group 6 of EFMI Prof. Arie Hasman wholeheartedly for his constructive support, the members of the NIGHTINGALE Users and Developers Groups, the members of the IT EDUCTRA project for participating and supporting the initiative, the speakers and those who provided effort in producing these proceedings, especially Dr. Marianna Diomidus, Mr. Petros Dounavis, Mrs. Arianne Josemans-Maandag, Miss Emily Karistinou, Mr. Ioannis Malliotakis, and Miss Anna Paidi. I would like to thank specially Miss Emily Karistinou for her careful compiling of the Proceedings.

The Editor

Prof. John Mantas

The NIGHTINGALE Project which started on the 1st of January, 1996, after the approval of the European Commission, and has a 36 month duration is essential in planning and implementation of strategy in Training the Nursing Profession in using and applying healthcare information systems.

NIGHTINGALE will contribute towards the appropriate use of the developed Telematatics infrastructure across Europe by educating and training nurses in a harmonising way across Europe in the upcoming field of Nursing Informatics.

NIGHTINGALE will cooperate with all European actions and projects in the area of training health care professionals to provide consensus curriculum development in Nursing Informatics. The most essential part and contribution of this development will be provided by the Users' Group that is comprised of nursing professionals, nursing systems professionals and health policy makers in the area of nursing education represented from all European Union member states. The Users' Group will be the monitoring and dissemination body of the work performed, where workshops and conferences will be the major platform of the consensus process

NIGHTINGALE will develop courseware material based on the curriculum development process using multimedia technologies. Computer based training software packages in Nursing Informatics will be the basis of the training material and the corresponding courses. CD-ROM based training and reference material will be also provided in the courses whereas the traditional booklets, teaching material and textbooks can play an adequate role in training.

NIGHTINGALE will disseminate all information and courseware material freely to all interested parties through the publications of the proceedings of the Conferences, through the establishment of the World Wide Web Server in Nursing Informatics for Europe (http://www.dn.uoa.gr/nightingale), which will become a depository of Nursing Information knowledge across Europe as well as a dissemination node of Nursing Informatics throughout the European members states for the benefit and welfare of the European citizen.

This paper gives a brief overview of the project IT EDUCTRA which stands for \underbar{I}NFORMATION \underbar{T}ECHNOLOGIES \underline{EDU}CATION AND \underline{TRA}INING. This project is within the Telematics for Healthcare work sector of the Telematics Applications Programme (1994-1998), and inside the 4th R&D Framework Programme. Based on previous initiatives and experiences, such as DELTA, AIM, and ERASMUS programmes, this project aims at improving the education and training opportunities in healthcare informatics, by employing trainers with relevant background and by providing demonstration and diffusion of adequate multimedia materials across Europe.

Health Informatics is an emerging and important multi-disciplinary field that involves not only Informatics but also Medicine, Nursing, Engineering, Biology and other related subjects. A coordination of this field at a postgraduate level becomes important now in Europe where other European Community programs such as the “Telematics for Health Care” will require at the 4th Framework Programme (94-99) adequate human resources of higher potential and knowledge. This European M.Sc. course meets all the above objectives.

The Curriculum was developed according to the results of the ERASMUS Workshop which was held in Athens on 13-15 September, 1990 under the ERASMUS Contract number ICP-90-G-0009/12. The implementation now runs under the contract ICP-95-G-1038/12.

This paper provides a topic analysis, describes the characteristics of a curriculum, target groups, competencies, modes of delivery, use of educational technology and steps for curriculum development.

An overview of Nursing Informatics curricula in educational institutions and clinical nursing practice facilities is presented. The educational strategies vary depending on the educational method used to teach Nursing Informatics. With the emerging technologies namely the information superhighway, Internet, the educational strategies are changing. The new technologies offer new methods of teaching Nursing Informatics not only in educational institutions, but also from the educational institutions via telecommunication networks to distant multiple clinical practice settings.

This paper is about three aspects:

* Why is it necessary to carry out a EU initiative to promote implementation of Nursing Informatics?

* Nursing Informatics in “the learning organization”

* The need for standards (TC 251)

This paper discusses the key factors which must be addressed when considering a decision to disseminate training materials to a wider audience than first planned. There are many dimensions which may need considering in such a development :

• setting local parochial issues into a generic context

• extending profession-specific materials to meet the needs of the healthcare team

• rolling out hospital-based training to be applicable to a community situation

• distilling international messages from national literature

• transferring traditional learning concepts into an open learning environment

• moving from paper-based text books to capitalise on contemporary media

• developing content to be applicable to many audience levels

Each of the issues and scenarios presents its own challenge; strengths inherent in the originating medium must be at least preserved and hopefully enhanced, the effects of weaknesses must be minimised when material is transferred. When considering the business case for producing the upgraded material it may even be necessary to re-originate rather than patch and polish.

The experience of authoring and producing a well-distributed series of open learning materials, developing material for learning to externally prescribed formulae and to rigorous academic curricular qualification standards will be applied to each of the issues. Some of the factors which were originally identified in developing traditional materials still have an effect when designing and delivering innovative new technology-based material. The broadening out of learning methodologies has to meet the requirements of the transition :

• from historic formal ‘chalk and talk’ to encompass vocational-centred ad hoc personal developments

• from sequential textbook format to browsing the Web

• from teacher-led to self-study with integral navigation guidance embedded

The projects used to illustrate the challenges and how they may be met include the UK-originated RAINBOW open learning materials, the NHS Health PICKUP management development courses, professionally recognised under-graduate diploma and the multi-national IT EDUCTRA health informatics education, training and awareness project.

Computer mediated learning put new demands on the organisation of the learning process, the teaching methods and the test and examination procedures. In the various educational programmes at Aalborg University employing computer mediated learning we have experimented with these issues. In the programme for health informatics a remote testing of the learning effect during the courses has been experimented. In the following the programme for health informatics will be presented, and the experiments will be described and discussed.

In the Article is argued for, that the teacher makes his/her mind clear on which definitions and values of Informatics and Nursing Informatics he/she is relying on, before he/she chooses methods of introducing Nursing Informatics to Nursing Students. It has great influence on which methods to choose, and which outcome to expect, whether the teacher consider Nursing Informatics is about data - information and knowledge or he/she consider Nursing Informatics is about data - information - knowledge and wisdom.

This paper describes the Finnish situation concerning health care informatics and telematics and the planned strategy for university level education program in social and health care information technology. As a response to the global discussion of the Information Society, The Finnish Government set up a the national Committee for the Information Society in Health and Social Care Services to develop a strategy to take advantage of this challenging and promising technology. The Committee published its report in April 1996 and one of the central guidelines in the strategy was to promote information technology know-how, research and education. According to these needs, The Institute for Extension Studies of Tampere University considers plans to set up a two year based Education Program of Health Care Informatics and Telematics starting 1997.

The restrictions implied in the reductionist (mechanistic) method, still predominant even at the advanced levels of textbook medicine, have caused grate disproportionalities across all areas of medicine. This has given rise to severe problems in health care. For example, highly comprehensive knowledge has been accumulated on the smallest components of the organism, such as molecules and cells, whereas insufficient consideration is given to the integrative functions of the human organism as a biopsychosocial entity and its interactions with the natural and social environment, despite its major importance to human health. If those limitations and their critical consequences are to be overcome, modern medicine will have to be enlarged by the systemic approach. This will decisively depend on new methods of integrative information and knowledge processing and system-analytical diagnostics on the basis of modern information technologies. Health informatics, therefore, has to play a specific role in the development of a systemic approach and its introduction to medicine and health care. This is a new responsibility for which the health informatics expert must be effectively prepared in the course of education. An account is given of a concept for appropriate teaching of the underlying principles, including an integrative presentation of the human organism as an information-processing system and as source of information in permanent interaction with the natural and social environment. This concept provides for ways and means to devise new, reasonable diagnostic strategies and to build a properly tuned system of health-supporting, preventive, therapeutic and rehabilitative measures. Individual health must be supported, last but not least, by social and political action. The systemic approach quite obviously may as well provide a key for major cost containment in health care.

This paper addresses the problem of searching and accessing electronically stored documents, especially medical literature. Our approach combines meta-information about the documents with domain knowledge about the topics of the documents. A graphical browser is used to uniformly present the relations between the domain and the documents. In addition to browsing-oriented search also query-oriented search is supported. An application to the medical domain is discussed, as well as how the approach relates to the World Wide Web.