The course program comprises the following:
- 10 weeks of course work, delivered online from OHSU. Each unit is offered and completed weekly.
- 2 class-room-based, face-to-face tutorials in Singapore conducted by Prof William Hersh and Dr KC Lun
- 2 virtual tutorials, via Zoom, conducted by Dr KC Lun and invited experts on health informatics.
- Course breaks to allow participants to work on course assignments.
- Assignments comprise unit assessment (quiz) and individual course project
- 3-hour open-book, invigilated, written examination
Objectives
The goal of the 10×10 International Course on Health Informatics (also known as Gateway to Health Informatics) is to provide a detailed overview of biomedical informatics and artificial intelligence (AI) to those who will work at the interface of healthcare and information technology (IT). The course also aims to provide an entry point for those wishing further study (and/or career development) in the field. It provides a broad understanding of the field from the vantage point of those who implement, lead, and develop IT solutions for improving health, healthcare, public health, and biomedical research. It provides up-to-date details on current events in the field, including electronic health records, data standards and interoperability, clinical decision support, machine learning, population health, patient engagement, and telehealth. It also describes and sets the context for newer technologies, such as SMART on FHIR, large language models (LLMs), generative AI, and wearables. Although the course has a clinical orientation, many non-clinicians working in health IT environments have found the course accessible and the knowledge gained invaluable to their professional development.
The 10×10 course gets its name from its original goal when launched in 2005 of educating 10,000 healthcare and related professionals in the US in biomedical and health informatics by 2010. The goal of 10,000 individuals came from an assertion by former AMIA President Dr. Charles Safran that the US needed at least one physician and one nurse trained in medical informatics in each of the country’s 6000 hospitals. The needs are equally strong beyond the US in the rest of the world, including in Singapore, and for professionals beyond physicians and nurses. The goal of 10×10 was operationalized by Dr. William Hersh of Oregon Health & Science University (OHSU). The OHSU offering of 10×10 was the original offering in the program and has had the largest enrollment. The success and continued interest in the course have led us to continue it beyond the original 2010 goal. Since the program was launched in 2005, over 3300 people, mostly from the US but also from a variety of international locations, have completed the course. About 10-15% of those graduating have gone on to further graduate study in the field, mostly at OHSU.
INSTRUCTOR
The lead instructor for the course is William Hersh, MD. The best way to reach him is via email (hersh@ohsu.edu). The course is co-taught by KC Lun, PhD. KC is reachable via email (lunkc@gatewaypl.com).
COURSE COORDINATION
The course is offered in two parts:
- A 10-unit Web-based component starting Monday 6 January 2025. The Web-based portion is provided through readings, lectures, interactive discussion, and self-assessment tests.
- Two virtual tutorial sessions via Zoom and two in-person tutorial sessions and a final examination, to be held at a venue in Singapore arranged by Gateway Consulting (see detailed schedule below).
The course is an adaptation of the on-line Introduction to Biomedical Informatics and Artificial Intelligence class currently taught in the OHSU biomedical informatics education program. This survey course provides a broad overview of the field, highlighting the key issues and challenges for the field. The course is taught in a completely asynchronous manner, i.e., there are no “scheduled” classes. However, students must keep up with the course materials so they can benefit from the interactive discussion with faculty and other students. The course uses the following teaching modalities:
- Voice-over-PowerPoint lectures – Lectures are provided in MP4 format via the OHSU learning management system. The content is easily accessed by any type of modern device connected to the Internet.
- Interactive threaded discussion – Students engage in discussion on important issues using the on-line threaded discussion forums. An on-line faculty moderator helps keep the discussion on track.
- Optional reading assignments – The syllabus suggests optional readings from a textbook for students.
- Homework/quizzes – Each of the units is accompanied by a 10-question multiple-choice self-assessment that aims to have the student apply the knowledge from the unit.
The on-line part of the course is accessed via OHSU’s Sakai learning management system (LMS). At the onset of the course, each student is provided a login and password by the OHSU distance-learning staff, who also provide technical support for the course. The course has no required textbook; with all assigned readings either freely available on-line or provided by OHSU. Students are expected to keep up with the materials and should anticipate spending 4-8 hours per unit on the course. All on-line activities are asynchronous, so there is no specified time that a student must be on-line. Students must complete all of the self-assessment tests, the course project, and participate in class discussions to receive the AMIA 10×10 Certificate of Completion.
WHEN PROBLEMS ARISE
It is critical to contact the appropriate person when problems arise:
- For basic Sakai problems (cannot log in, something not apparently working) and course issues (e.g., unit or discussion forum not posted when it should be), contact the Sakai Help Desk at 877-972-5249 or sakai@ohsu.edu. The Sakai Help Desk hours are 8 a.m. – 10 p.m. Pacific Mon-Fri and 12-5 p.m. Pacific on weekends. The Sakai Help Desk is closed on all OHSU-observed holidays.
- For questions about course content (e.g., do not understand a topic or disagree with homework quiz answer), contact the Teaching Assistant (TA), who will be announced at the beginning of the course.
When appropriate, all issues will be elevated to Dr. Hersh. While Dr. Hersh does not maintain scheduled office hours, he is readily accessible via email and will respond within 24-48 hours. Appointments to discuss course matters by phone or in person can be arranged via email.
COURSE INTERACTION
The course aims to provide a great deal of interaction among the faculty, students, and teaching assistants. On-line discussion begins for each unit with the instructor posing 2-3 questions per unit. Students are also encouraged to post questions or comments about any topic in the course or the field in the general discussion forum at any time. The instructor aims to guide and fill in details of the discussion but not dominate it.
COURSE PROJECT
Students must complete a course project to obtain the Certificate of Completion. The goal of the project is to identify an informatics problem in your local setting (e.g., where you practice or work, or otherwise have access) and propose a solution based on what is known from informatics research and best practice. (If you do not have access to a health care setting, you can do the project in another setting, such as a company or organization. The instructor can help if you have a challenge with this.) The problem and solution should be written into a succinct 2-3 page (please no longer!) document that should include references that justify the framing of the problem and the proposed solutions.
The Course Projects for the Singapore Course will be marked solely by Dr KC Lun. In view of the sensitivity of some Course Project contents, participants are assured that all Course projects are viewed and marked solely by Dr Lun. Only the Project grades will be shared with Prof William Hersh and his OHSU team.
In view of the above, all Course Project submissions should be sent directly to lunkc@gatewaypl.com. Course Project submissions SHOULD NOT be uploaded to SAKAI
Students will present their project to their colleagues at one of the 2 in-person tutorials that they must attend before the Final Examination.
CURRICULUM AND DATES
The following table (dates tentative) outlines the curriculum with unit number, topic, date posted, and date due. The due date for each unit is when the next cycle of material is posted. We are lenient about giving extensions but participants are strongly encouraged not to fall behind, since it is difficult to catch up once one is too far behind.
| Week starting | Unit | Topic | Duration
(in hrs) |
| 6 January, 2025 | 1 | Overview of Fields and Motivating Problems | 3 |
| 13 January, 2025 | 2 | Computing Concepts for Biomedical Informatics | 3 |
| 20 January, 2025 | 3 | Electronic and Personal Health Records (EHR, PHR) | 3 |
| 27 January, 2025 | Free time to work on assignments (quizzes) | ||
| 3 February, 2025 | 4 | Standards and Interoperability | 3 |
| 8 February 2025 (Sat, 9 am-1.00 pm) | Tutorial 1 (conducted by KC Lun) with Live Zoom Meeting with Bill Hersh in Portland, OR | 4 | |
| 10 February, 2025 | 5 | Artificial Intelligence | 3 |
| 17 February, 2025 | 6 | Advanced Use of the EHR | 3 |
| 24 February, 2025 | Free time to work on assignments (quizzes) | ||
| 3 March, 2025 | 7 | EHR Implementation, Security, and Evaluation | 3 |
| 10 March, 2025 | 8 | Information Retrieval (Search) | 3 |
| 30 March 2025 (Sat, 9 am-1.00 pm) | Tutorial 2 (conducted by KC Lun & invited tutors) | 4 | |
| 31 March, 2025 | Free time to work on assignments & Course Project | ||
| 7 April, 2025 | 9 | Research Informatics | 3 |
| 14 April, 2025 | 10 | Other Areas of Informatics | 3 |
| 21 April, 2025 | Free Time to complete Course Project | ||
| 1 May 2025 (Thu 9 am – 1 pm) | Revision Class for Final Examination (conducted by Bill Hersh) | 4 | |
| 2 May 2025 (Fri, 9 am – 1 pm) | Course Project Presentation by students (conducted by Bill Hersh & KC Lun) | 4 | |
| 5 May 2025 (Mon 9 am – 12 pm) | Final Examination (written & open-book) | 3 |
READINGS
The course has no required textbook. There is an optional textbook, which is edited by the course instructor and that students may want to consider: Hersh WR, Ed. (2022). Health Informatics: Practical Guide, 8th Edition. The book has a Web site and is available from Lulu.com in eBook and paper versions. The reading assignments from the book are optional, and no material will appear on the homework quizzes or final exam that is not also covered in the class. But some students prefer to also read a textbook when learning. The appropriate chapter readings for each unit in the course are as follows:
| Unit | Topic | Textbook Chapter(s) |
| 1 | Overview of Field and Problems Motivating It | 1, 2 |
| 2 | Computing Concepts for Biomedical and Health Informatics | 3, 23 |
| 3 | Electronic and Personal Health Records (EHR, PHR) | 4, 7 |
| 4 | Standards and Interoperability | 5 |
| 5 | Data Science and Artificial Intelligence | 6, 8, 21 |
| 6 | Advanced Use of the EHR | 9, 10 |
| 7 | EHR Implementation, Security, and Evaluation | 11, 12, 13, 22 |
| 8 | Information Retrieval (Search) | 14 |
| 9 | Research Informatics | 15, 16 |
| 10 | Other Areas of Informatics | 17, 18, 19, 20 |
DETAILED COURSE OUTLINE
1. Overview of Fields and Problems Motivating Them
1.1 Definitions and Historical Perspectives of Biomedical and Health Informatics (BMHI)
1.2 Definitions and Historical Perspectives of Artificial Intelligence (AI)
1.3 Problems in Healthcare Motivating BMHI and AI
1.4 Who Does BMHI and AI?
1.5 Resources for BMHI and AI: Organizations, Information, Education
2. Computing Concepts for Biomedical and Health Informatics
2.1 Types of Computers
2.2 Data Storage in Computers
2.3 Computer Hardware and Software
2.4 Computer Networks
2.5 Software Engineering
3. Electronic and Personal Health Records (EHR, PHR)
3.1 Clinical Data
3.2 History and Perspective of the Health (Medical) Record
3.3 Examples of the EHR
3.4 EHR Data Entry
3.5 Clinical Decision Support
3.6 Personal Health Records
4. Standards and Interoperability
4.1 Standards and Interoperability: Basic Concepts
4.2 Identifier and Transaction Standards
4.3 Message Exchange Standards
4.4 Terminology Standards
4.5 SMART on FHIR
5. Artificial Intelligence
5.1 Machine Learning and Data Science
5.2 Predictive AI
5.3 Generative AI
5.4 Natural Language Processing
5.5 Trustworthy AI
6. Advanced Use of the EHR
6.1 Patient Safety and Medical Errors
6.2 Healthcare Quality Measurement and Improvement
6.3 Health Information Exchange (HIE)
6.4 Population Health
6.5 From Meaningful Use to Promoting Interoperability
7. EHR Implementation, Security, and Evaluation
7.1 Clinical Workflow Analysis and Redesign
7.2 EHR System Selection and Implementation
7.3 Telemedicine and Telehealth
7.4 Privacy and Security
7.5 Evaluation of the EHR
8. Information Retrieval (Search)
8.1 Information Retrieval
8.2 Knowledge-based Information
8.3 Content
8.4 Indexing
8.5 Retrieval
8.6 Research: Evaluation and Future Directions
9. Research Informatics
9.1 Overview of Biomedical Research
9.2 Clinical Research Informatics
9.3 Overview of Basic Molecular Biology
9.4 Translational Bioinformatics
9.5 From Clinical Genetics and Genomics to Precision Medicine
9.6 Omics Data in the EHR and Other Information Systems
10. Other Areas of Informatics
10.1 Nursing Informatics
10.2 Consumer Health Informatics
10.3 Public Health Informatics
10.4 Imaging Informatics
10.5 Evidence-Based Medicine
ACADEMIC HONESTY
Course participants are expected to maintain academic honesty in their course work. Participants should refrain from seeking past published solutions to any assignments. Literature and resources (including Internet resources) employed in fulfilling assignments must be cited. See http://www.ohsu.edu/xd/education/library/research-assistance/plagiarism.cfm?WT_rank=1# for information on code of conduct for OHSU and http://www.ohsu.edu/xd/education/teaching-and-learning-center/for-students/index.cfm for more information on citing sources and recognizing plagiarism.
In an effort to uphold the principles and practice of academic honesty, faculty members at OHSU may use originality checking systems such as Turnitin to compare a student’s submitted work against multiple sources. To protect student privacy in this process, it will be necessary for students to remove all personal information, i.e. student name, email address, student u-number, or any other personal information, from their documents BEFORE submission.
BEYOND 10×10
The goal of the AMIA 10×10 program is to train clinicians and others in informatics so they can be knowledgeable participants in IT implementations in their local settings. The 10×10 program alone will not make one a full-time professional in informatics (any more than a semester of medicine or nursing will make one a physician or nurse!). The program is being structured, however, to allow those who complete the course to carry the credits forward into other graduate programs in informatics. The details need to be arranged with each individual program.
Since the course is an adaptation of the introductory course in the OHSU Health & Clinical Informatics Graduate Program, those who complete the 10×10 course will be able to obtain credit for the course in the OHSU program. This credit is taken by passing the optional final examination at the end of the 10×10 course. Upon enrolling in the OHSU Graduate Certificate or Master of Science program, students passing the final examination will be awarded three credits in the OHSU graduate program. (OHSU is on an academic quarter system, with each quarter consisting of 11 weeks of instruction. A three-credit course is comparable to a course with three contact hours per week plus additional work for reading assignments, homework, and projects.) Most of OHSU’s informatics courses are taught on-campus and on-line, and each course is considered equivalent whether it is taught live or via distance.
More details about the individual certificate and degree programs are available on the OHSU Department of Medical Informatics & Clinical Epidemiology Web site, but the following table provides an overview of the programs.
| Program Name | Description | Admission Requirements | Graduation Requirements |
| Graduate Certificate | Core courses in informatics | Bachelor’s degree in any field | 24 credits (generally 8 3-credit courses) |
| Master of Science Nonthesis | “Professional” master’s degree with capstone project | Bachelor’s degree in any field plus introductory courses in Computer Science and Anatomy & Physiology | 49 credits (43 credits of instruction plus 6 credits of capstone project) |
| Master of Science with Thesis | “Research” master’s degree with master’s thesis | Bachelor’s degree in any field plus introductory courses in Computer Science and Anatomy & Physiology | 55 credits (43 credits of instruction plus 12 credits of master’s thesis) |
| Doctor of Philosophy (PhD) in Biomedical Informatics | PhD program for advanced leaders and research in the field | Bachelor’s degree in any field plus introductory courses in Computer Science and Anatomy & Physiology | 135 credits, including dissertation |
The Web site also has information about OHSU’s various fellowship programs, funded by the US National Library of Medicine and others.
STUDENT ACCESS
OHSU is committed to providing equal access to qualified students who experience a disability in compliance with Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act (ADA) of 1990, and the ADA Amendments Act (ADA-AA) of 2008. If you have a disability or think you may have a disability (physical, sensory, chronic health, psychological or learning) please contact the Office for Student Access at (503)494-0082 or studentaccess@ohsu.edu to discuss eligibility for academic accommodations. Information is also available at www.ohsu.edu/student-access. Because accommodations may take time to implement and cannot be applied retroactively, it is important to have this discussion as soon as possible. All information regarding a student’s disability is kept in accordance with relevant state and federal laws.