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Computer literacy is one of many requirements to use informatics successfully, but knowing how to use a computing device (personal computer, tablet, or smartphone) is not the same as having skills in informatics, ie, using that device to improve health, health care delivery, public health, or research. We concurred that one fundamental skill currently being taught in many medical schools for 21st century clinicians was something taught in many medical schools since the late 20th century, namely, how to find information to apply to patient care.

Clinicians must also know how to formulate a clinical question as an answerable one, and then be able to select the appropriate resource and make optimal use of it. This includes knowing what content is in different search systems. Clinicians should also have an understanding of the major commercial publishers as well as what professional societies offer.

Once clinicians know how to use a search site, they must be able to phrase an appropriate query and know how to maximize the search using advanced query features. To take maximum advantage of available knowledge resources, it is necessary to understand the advanced search features that are available, whether in general web resources such Ketamine HCl (Ketamine Hydrochloride)- Multum Google or dedicated biomedical what is behavioral psychology resources such as PubMed.

Once information is retrieved, clinicians must know how to critically appraise the information retrieved and decide, if warranted, to apply it to the patient or population.

As with searching, the type of appraisal varies with the search engine used. With output from general search engines like Google, the trustworthiness of the information must be assessed. Clinicians must also know Ketamine HCl (Ketamine Hydrochloride)- Multum to make optimal use of patient data and information. They must know how to use informatics to achieve the triple aim of better health, better care, and lower cost. Ketamine HCl (Ketamine Hydrochloride)- Multum must be facile with all aspects of the EHR, able to easily Ketamine HCl (Ketamine Hydrochloride)- Multum from one vendor system to another and to understand the critical role of health information exchange in making any single record as complete as possible.

This requires coordination of care, in not just providing medical procedures, nursing interventions, therapies, etc in isolation, but also teamwork and communication. Rather, it Ketamine HCl (Ketamine Hydrochloride)- Multum a source of data, organized into coherent information that allows the health care team to deliver the best, safest, and most cost-effective care. This means that the 21st century clinician must have a basic understanding of informatics issues, such as capturing data that is correct and complete as well as consistent in its expression.

They must also know Ketamine HCl (Ketamine Hydrochloride)- Multum to work with clinical leaders to select, implement, and improve quality measures. This should be introduced as part of the larger learning health system. Patients want health care that adapts the Ketamine HCl (Ketamine Hydrochloride)- Multum features of other modern industries, allowing them the ability to view their own data and interact with their clinicians and health care system (eg, online scheduling of appointments, prescription refills, and even consultations that are appropriate via the Internet or other electronic media).

Complementary to life coach patient-centric view, clinicians must also understand population-based care30 and the informatics underlying it.

When a new test or treatment is determined to be highly effective, the clinician must be able to quickly identify patients who are candidates for it. They must also be able to identify outliers in their populations who require intervention, such as those with excessively high blood pressure or blood sugar, missed appointments or screen tests, or those at risk for hospital (re)admission.

Another area where 21st century clinicians must understand the key issues is in bioinformatics, especially as it relates to personalized medicine. He or she should have a Ketamine HCl (Ketamine Hydrochloride)- Multum understanding of genome-wide association studies and their ramifications. They must understand the differences between and the value of experimental and observational studies.

Ideally, students will screen participated in research while in their training. But even if not, they should understand issues such as data quality, study design, and the limitations that come from the sharp focus perspective of a clinical study. Students should participate in the learning health system laid out in the vision of groups like the IOM. Based on the above narrative, our group of diverse clinician-educators developed through an iterative process a set of 13 competencies in clinical informatics (Table 1).

Each competency was mapped to one or more of the six ACGME general competency domains. We then developed more detailed learning objectives and milestones within each competency. We also categorized each learning objective for its presence in the early (at the beginning), middle (during the preclinical portion), or late (during clinical experiences) portion of the curriculum. Abbreviations: ACGME, Accreditation Council for Graduate Medical Education; CDS, clinical decision support; HIE, health information exchange; HIPAA, Health Insurance Portability and Accountability Levonorgestrel Tablet (Plan B One-Step)- FDA. As seen in Table 2, we have designated where the specific learning activities will be placed in the Ketamine HCl (Ketamine Hydrochloride)- Multum portions of the curriculum from orientation through preclinical sciences, clinical experiences, and intersession in the fourth year.

Our analysis has shown there are a substantial number of informatics competencies glyceryl oleate a large body of associated knowledge that the 21st century clinician needs to learn and apply.

From a pedagogical standpoint, there are also issues in how to organize, deliver, and assess this content. Certainly, one approach is to provide this content as a separate course, isolated from the rest of the curriculum.

However, a better approach would be to tightly and comprehensively integrate informatics concepts longitudinally into the learning curriculum since clinical informatics is emerging as a core competency of medical practice, applicable in all basic science disciplines and clinical specialties.



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