Medical Informatics: Looking into the Future in Medical Education

Collaborating on a medical informatics/internal medicine project are, from left to right: Audrey Corbett, M.D.; Juell Homco, Ph.D., MPH; Blake Lesselroth, M.D.; and medical student Auston Stiefer.

“Medical informatics, as the name suggests, is a cross-disciplinary specialty that focuses upon information management to improve clinical quality and patient outcomes,” said Blake Lesselroth, M.D. “Technology can be an important part of the solution, but healthcare is a humanistic endeavor. The information needs of the practitioner, patient and health system should guide our work.” Lesselroth, Vice Chair of the Department of Medical Informatics and Associate Professor of Internal Medicine at the OU-TU School of Community Medicine, is an experienced clinician and informatician who believes that exposing learners to informatics can improve their practice and community health outcomes.

Lesselroth’s areas of expertise include clinical decision support, quality improvement methods, and human-computer interactions. His vision and work are closely aligned with those of Juell Homco, Ph.D., MPH, the department’s Director of Research and Community Analytics. Homco leads OU-TU’s Business Intelligence team and guides the department’s research portfolio. Under the leadership of Chair David Kendrick, M.D., MPH, Lesselroth and Homco guide the department’s education and scholarship efforts.

Fundamentally, the science of informatics is about creating learning health systems — responsive and community-centered healthcare processes and solutions. While medical informatics may conjure thoughts of high-tech, low-touch activities, the science is transforming healthcare by magnifying its person-centered impact. Therefore, Lesselroth and Homco work with experts from a wide range of backgrounds, including medicine, public health, computer science, engineering, design, and the humanities.

On a global scale, every academic pursuit was altered by the COVID-19 pandemic. Like many at OU, the Department of Medical Informatics quickly adapted and embraced virtual platforms to support health professional education. “As the pandemic grip tightened, we were able to take on additional students who could not participate in traditional clinical rotations,” Lesselroth said. “As a result, more students are becoming fluent in the science of informatics.”

Typically, their students learn the practical role for informatics through lectures, mini-preceptorships and mentored projects. Homco explained: “During the electives and selectives, we work with learners to identify projects that match their skills, interests and career goals. This may be one of several reasons why students have been very successful with scholarship. We saw many projects become publications, poster presentations at national conferences, many held virtually.”

Lesselroth credits Homco for establishing a successful program before he arrived at the School of Community Medicine. Originally, rotations were designed for medical

students. Recently, they were expanded to include physician assistant students and residents. “It’s particularly exciting that we’re teaching medical students from both campuses,” Lesselroth said.

The department also is working with other educators to insert health systems science in existing curricula, including a new course titled Health Systems Science in Practice. The course incorporates didactics, skills labs, simulations with standardized patients, quality improvement workshops, and experiential practicums at the Bedlam Clinic and other student-led continuity clinics.

“Our goal is to ensure students are prepared to succeed in an environment that is data-rich. Healthcare professionals may find themselves left behind, unable to participate meaningfully in conversations about how measures are designed, how we gather and interpret data and, finally, how we apply it to transform patient care. Dr. Homco’s efforts focus on empowering our learners to do that,” Lesselroth said.

With the COVID-19 pandemic came a heightened focus on telemedicine, which also has a place in the curriculum of the Department of Medical Informatics. A grant from the U.S. Health Resources and Services Administration (HRSA) funds several of the department’s educational initiatives, including health systems science modules and an evolving telemedicine curriculum.

“Teaching about telemedicine will help future clinicians use the technology effectively,” Lesselroth said. “We can improve access to care, particularly for rural communities. We can also learn more about the patient’s home environment and social determinants of health, an area where Dr. Homco’s research is on the forefront.”

He cited important differences in a virtual appointment format. “Many assume a webcam and a smartphone is all it takes – and everybody has that. Even if that were true, there are other barriers: Do patients have a data plan? Do they have internet availability? Are they in a safe and private place where communication is possible? So, ‘webside manner’ and telemedicine safe practices are skills we must teach and model. The activities funded by the HRSA grant will help ensure our graduates leave this institution able to deliver high-quality and person-centered telemedical care.”

Lesselroth said traditional medical systems often don’t meet the needs of vulnerable populations. “We have a severe access-to-care problem in the United States,” he said. “In a largely rural state like Oklahoma, there are many obstacles to good health, including poverty, housing instability, and education inequality. When thinking about telemedicine, we need to think carefully about technology infrastructure and how to make it available. Otherwise, the expansion of telemedicine can increase this access-to-care gap.”

For Medical Informatics as a whole, Lesselroth calls it both a technical science and a social science. “Informaticians think about technology the way an artist thinks about a canvas. A canvas is an ideal support for a great painting. However, most artists don’t spend their time stretching canvases. Instead, they focus on the paint, technique and subject. In informatics, the technology is often the canvas; the computer, the software and the internet — these are the support. How we use information to improve patient care is the artistic process. It requires vision, expertise, and an understanding of the audience,” he said. “It isn’t enough to understand the technology. We must understand the end user, the environment of practice, and the needs of our community.”