Ebook: Education and Training in Health Informatics in Europe

In 1990, the Committee of Ministers of the Council of Europe issued a recommendation (Recommendation No. R(90)21) to the governments of member states to ensure that all professionals involved in healthcare receive as soon as possible appropriate education and training in health informatics. The EDUCTRA (Education and Training in Health Informatics) Concerted Action, established in 1992 under the auspices of the AIM (Advanced Informatics in Medicine) European programme, and consisting of representatives of all member states, conducted a Europeanwide survey. This survey showed that the above Recommendation had received little attention in most member states. It also revealed considerable gaps (i) in the knowledge of healthcare professionals with respect to the basic principles of health informatics, and (ii) in the adequate use of modern information technology.

This book is divided into four parts. The first part reproduces the original Recommendation No. R (90)21, outlines the concerted European efforts in education and training in health telematics made by the European Commission, Directorate General XIII Health Telematics, and describes the state of the art of education and training of health informatics in Europe as the result of the EDUCTRA survey.

The second part of the book provides general guidelines for European curricula in health informatics, as they were developed and elaborated by the members of the EDUCTRA Concerted Action (1992-1994). It also gives an alternative, systematic view of health informatics for teaching and training purposes. It concludes with the description of the ELITE computer program developed by another taskforce of the EDUCTRA group.

The third part of this volume entails descriptions and applications of curricula in health informatics in European states. Some are already existing education or training curricula for medical students, nurses, allied health professionals or healthcare staff. Others are merely proposals for future application. Yet other curricula apply on a European scale and have transnational educational objectives. The various applications are presented by EU countries in alphabetical order.

The fourth part of the book gives a glossary of terms and acronyms used in health informatics. It has been kindly provided by CEN/TC 251, the European Technical Committee for standardisation in health informatics.

This book is intended to give health professionals, teachers and trainers not only a comprehensive overview of the current needs in health informatics in Europe but also the necessary guidelines, materials, tools and applications for improving education and training in health informatics in Europe within the coming years.

The editors of this book warmly thank all the authors for their valuable contribution and also the members of the EDUCTRA Concerted Action for their important work. They express their gratitude to the European Commission, DGXIII Health Telematics, for their financial, managerial and strategic support. Finally, the editors are most indebted to Margot Hijnens for her expert secretarial help.

A. Hasman

A. Albert

P. Wainwright

R. Klar

M. Sosa (Editors)

July 1995

This chapter gives a historical overview of the concerted efforts of the European Community in education and training in health informatics and telematics. In particular, it describes how the EDUCTRA Concerted Action was initiated, conducted and completed within the 3rd European framework programme for Research and Development in Health Telematics. The chapter concludes with a short outline of the 21st century Information Society and the advent of the Internet. The increasing needs for education, training and re-training in the new society are emphasized and they are considered as a major challenge facing European health professionals and citizens in the future.

The paper describes the state of the art of education and training of health informatics in Europe as the result of a survey conducted by EDUCTRA, a Concerted Action of the AIM programme of the European Commission. It is shown that healthcare professionals have inadequate knowledge of the basic principles of health informatics and that education of healthcare students is largely insufficient to fill the wide gaps observed.

Guidelines are suggested for European curricula in Health Informatics that apply to both healthcare professionals and health administrative staff. These guidelines are the results of in-depth discussions and thoughts of the EU-EDUCTRA Concerted Action. Emphasis is placed on the way information is generated in the health domain. The guidelines also consider the various actors, their position and role in the healthcare structure. Characteristics of and operations on health information are discussed. Data quality control, ethical issues, benefits and potential caveats related to health information are also outlined. The chapter concludes with a list of possible applications.

Guidelines for European Curricula in Health Informatics have been suggested by the EU-EDUCTRA Concerted Action. This chapter briefly outlines the way the guidelines should be used. A distinction is made between education and training purposes. The level of the courses and the healthcare professional target groups involved are also discussed.

In this contribution the discipline of health informatics is described in a systematic way. It is recognized that health informatics deals with modelling of various processes and structures existing in the healthcare domain. Different processes are distinguished and their underlying computational and informational mechanisms are described. The chapter ends with an overview of the structure of applications as suggested by van Bemmel.

The design of the ‘ELITE’ program is discussed. This PC based program was designed to provide an easy-to-use introduction to Information Science and Technology for professionals working in healthcare.

In Belgium, the initiative of the Ministry of Public Health to develop new “patient-based” hospital management systems, using a selection of relevant medical and resource data (medical, nursing and financial record summaries), to be coded uniformly, gave an exceptional opportunity to the Centre for Medical Informatics at the University of Louvain, not only to develop and test the tools locally, but also to disseminate them. Research and teaching units in a University are rarely exposed to design and implement training programmes and methodologie courses to be used by a large variety of categories of personnel, as well as by all hospitals in a country. The ICD-9-CM coding system was translated and extended. Coding rules were published and taught to medical record analysts and physicians, before being inserted in computer aided systems. Courses and degrees were created at the Faculty of Medicine, for data interpretation and patient management (biomedical informatics, clinical research, quality of care development, hospital management, decision making). New experiences are in progress such as knowledge based decision support to define choices for hospital strategies (Saint-Luc 2000 project). Foreign countries have also access to this educative programme.

The paper describes the contents and objectives of an educational programme in health informatics recently established at Aalborg University (Denmark). The programme emphasizes problem-oriented and project-organised distance learning.

A course running since 1989 in Finland introduces medical informatics to nurses and healthcare administrators. The objectives and content are briefly outlined.

Most medical schools in France have a chair position in Biostatistics and Medical Informatics to coordinate the teaching of these two disciplines both within the regular curriculum of medical studies and as a specialized teaching. This paper describes the current medical informatics specialized program offered in France in several Medical schools. The program comprises since 1968 a Master of Science and a Ph.D degree. Despite several reforms and in-depth program revisions the curriculum remains organized at the Master Level as a set of modules of 100 hours teaching with a large freedom for the medical faculties to define the content of the courses and for the students to organize their studies and combine medical informatics, biomathematics and biostatistics training. Since 1990, an intensive one year full-time course called “Advanced Study Diploma in Medical Informatics” is offered with a strong research orientation. This program seems a good strategy to form medical informatics specialists who have initially received a broader education in informatics and statistics.

In the fields of health care and medicine there is an immense demand for a systematic application of methods of information processing and for the use of computers. Obviously, to that end well-trained scientists and qualified personnel must be available. With the present recommendations on education and training in medical informatics the German Association for Medical Informatics, Biometry and Epidemiology (GMDS) proposes structure and contents of medical informatics curricula and courses. The recommendations describe a 2-dimensional educational framework with different edu-cational levels in one dimension and various types of educational needs and orientation in the other one. The recommendations comprise at the university level education as well specialized curricula covering the total spectrum of medical informatics as well as informatics curricula with medical informatics as integrated applied subject or subsidiary subject, respectively. Besides these informatics-oriented approaches medical-oriented programs of education in medical informatics are recommended, e.g. post-graduate education in medical informatics for physicians based on foundations in medical informatics as part of their initial training in medicine. At the level of polytechnical schools curricula of medical documentation and infonnatics and at the level of professional schools training in medical documentation are recommended. The report is a translation of its German original. Although considered by the GMDS as recommendations for the Federal Republic of Germany, the text may also contribute to the development of an international, especially European framework of training in medical informatics.

The specialized university curriculum for medical informatics at the University of Heidelberg/School of Technology Heilbronn described in this paper is one of the oldest educational approaches in the field of medical informatics, and has been successful for more than 20 years with more than 600 graduates (Diplom-Informatiker der Medizin). It is based on the concept of medical informatics as an independent medical discipline of its own, and covers the total spectrum ranging from health care economics, biosignal and medical image processing, model building in medicine, to information and knowledge processing in medicine. It is a program of 4.5 years duration with a strong emphasis on the methodological foundations of medical informatics and on practical education in a number of specific laboratories. Thirty-five students are admitted each semester, and in total about 390 students enrolled. The faculty consists of 17 full-time members and about 25 part-time lecturers.

This chapter merely lists the official subject matters in Medical Informatics for German medical students in the second part of the physician’s examination. The topics are taught during the 6th clinical (10th total) semester as part of the more general subject matters “Medical Statistics and Informatics”, release October 1990.

This paper presents efforts in developing and implementing a Master’s level curriculum in health informatics. This initiative was approved and financed by the Erasmus Bureau of the European Commission. The curriculum development process was based on the results of a workshop that was organised in Athens and the continuous feedback from both students and teachers after the initial implementation of the curriculum as a pilot course. During the next phase of the programme more than twenty European Universities joined our efforts in implementing the course, which now runs for the fourth consecutive academic year.