American College of Physicians: Internal Medicine — Doctors for Adults ®

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Start here for medical computing tips and resources

From the January 1999 ACP-ASIM Observer, copyright 1999 by the American College of Physicians-American Society of Internal Medicine.

By Chris Dwyer

If you're like most internists, you didn't learn much about medical informatics in medical school or residency training, so you don't know exactly what you're supposed to be keeping up with or even where to get started.

The good news is that a number of medical organizations, Web sites and universities are offering everything from traditional CME courses to online curriculum to help physicians learn more about medical computing—and change the way they manage medical information.

Many physicians are already exchanging e-mail with colleagues, going online to search the literature and surfing the Web, but experts say that internists really should be doing more. Russ B. Altman, FACP, assistant professor of medical informatics at Stanford University, said that clinicians should take advantage of medical computing to broaden their knowledge base. He suggested accessing electronic consensus statements and guidelines, which are often available online from organizations such as ACP-ASIM, as well as information on travel medicine, which is available from the CDC's Web site (www.cdc.gov.).

If you're ready to take even greater advantage of technology, Dr. Altman suggested learning to master systems that detect drug interactions and help physicians produce differential diagnoses for particularly challenging patients. While many large health systems have made such technology standard in inpatient settings, internists in ambulatory environments usually must purchase this software themselves, either individually or as part of an integrated patient record system.

Before you make that kind of purchase, however, you'll need a good overview of medical computing technology, which is where many of the new resources for physicians can help. Organizations like The Informatics Institute in Bethesda, Md., provide a comprehensive medical informatics curriculum for physicians.

Marshall Ruffin, ACP-ASIM Member, the organization's president, explained that giving physicians this type of knowledge is critical in today's changing practice environment. "Under fee-for-service, internists made money by performing more services," he said. "With risk-sharing—caring for 100,000 patients on a budget—you make money by controlling costs." In this environment, Dr. Ruffin explained, physicians who automate their patient records have an important advantage over their paper-based counterparts: They can increase their profitability by analyzing their performance.

Here are some other resources to help you get started:

  • ACP-ASIM Annual Session Medical Informatics Program

    Each year, Annual Session offers more than 30 lectures and workshops on medical computing that are taught by internists from both academia and private practice. In addition to general computing courses (including hands-on workshops that teach fundamental tasks like using a mouse), Annual Session offers courses on how to electronically access medical knowledge and computerized medical records systems. This year's Annual Session will also feature two in-depth pre-Session computing courses, including a two-day program on using computers in clinical practice and a one-day workshop on selecting, implementing and using electronic medical records systems.

  • American Medical Association Physicians Accessing the Internet (PAI) project (www.ama-assn.org/public/pai)

    Started in 1996 as an introductory course to teach physicians how to access and use the Internet, PAI now provides on-site courses. Interested individuals and organizations apply; if an application is accepted, PAI schedules a four-hour hands-on workshop at the grant recipient's site and provides all necessary equipment and faculty. AMA recently expanded PAI (with assistance from Intel Corporation) and added a PAI Symposium, which offers beginner and intermediate workshops and a focused look at how Internet solutions can help improve practice.

  • The Informatics Institute (tii.ruffin.com)

    Created by the American College of Physician Executives, this Bethesda, Md., organization offers introductory courses in informatics, as well as sessions on how to use off-the-shelf productivity applications for decision support, outcomes management and physician profiling. The Institute also has a special program on how to use information systems under managed care, in which students learn about trends in health care delivery and the impact of these trends on how providers collect, manage and share information. Students are usually physician executives and leaders of group practices who want to learn how to select and implement electronic medical records and practice management systems effectively.

  • Using Computers to Solve Clinical Problems (www.ohsu.edu/bicc-informatics/cme/)

    For internists who want to learn how to use computers to improve their access to medical knowledge in clinical settings, Oregon Health Sciences University in Portland, Ore., offers a two-day CME course each spring with both novice and advanced tracks. The beginner track starts with computer basics and continues with workshops on clinical software tools, including the Web, patient education software and decision support software. Students with computer experience begin by learning about clinical software tools and move on to advanced topics such as using evidence-based medicine techniques, telemedicine and databases.

  • Short courses. Internists who want to learn about medical informatics concepts in more depth may wish to attend one of two "short courses" led each summer by prominent members of the medical informatics community. Medical Informatics (medicine.ucsd.edu/mbl_info/) is offered annually in Woods Hole, Mass., by the National Library of Medicine (NLM) to a small group of medical educators, librarians and administrators who apply for NLM fellowships. The Stanford University Medical Informatics Introductory Short Course (scpd.stanford.edu/pd/misc.html) is offered at Stanford twice each summer and online (scpd.stanford.edu/pd/online.html). Both courses are aimed at beginners in medical informatics and introduce conceptual and technical components of the discipline while developing general computing skills.

Chris Dwyer is Medical Informatics Program Associate in ACP-ASIM's Education Division. He can be reached at medinfo@acponline.org.

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