Issue link: https://beckershealthcare.uberflip.com/i/479065
48 Physician Affairs providers, patients and trainees use the information to improve overall health. "There is a real challenge in getting people to fill the applied analytics posi- tions in healthcare because you have to have some understanding and back- ground in healthcare as well as analytics," says Ms. Passiment. Giving all fu- ture physicians some training in the data analytics portion of informatics could help address this challenge. NYU School of Medicine, which also received Accelerating Change in Medi- cal Education funding, is working to add data analytics into its traditional doctoring course, called "Practice of Medicine." "NYU is using big data," says Dr. Skochelak with the AMA. "And I mean big data." Big as in 5 million de-identified patient records. NYU students are learning to approach big clinical data sets and analyze them to measure providers' performance. They're challenged to think critically about healthcare and ask their own questions of the data, which is compiled from a publically available database called SPARCS, or the Statewide Planning and Research Coopera- tive System. Launched in 1979, the New York State database houses hospi- tal admission and discharge information, patient diagnoses, treatments and charges, and outpatient services information. NYU combined this with CDC nutrition surveys and NYU Langone Medical Center's own patient data, pro- viding students with access to millions of de-identified records. The big data then becomes a learning tool. For example, in a pilot class NYU launched last summer, students were asked, "What do you think is the most likely reason a person is hospitalized in the state of New York?" Most guessed chest pain or pneumonia, Dr. Skochelak says. They were sur- prised to learn the number one reason for hospitalization in New York is actually childbirth. They were even more surprised when they saw the fluc- tuation in cost for this service across the state. Delivering a baby costs $2,000 to $3,000 in rural areas, but up to $22,000 in Manhattan, Dr. Skochelak says. Students are challenged to think about why this discrepancy exists and track their own patient and population management activities and queries. "What our students love most about this is the fact that it's real," says Dr. Triola. "It's not a textbook exercise; it's real clinical data. It's the environment students will be training in and potentially working in." By October 2014, administrators were so impressed by the pilot they wanted the whole class to have the lesson, Dr. Skochelak says. It is now a core part of the medical curriculum and the entire first year class has taken the course, entitled "Healthcare by the Numbers." Adding data analytics to the curriculum helps move NYU toward competency- based education, Dr. Triola says. It helps students acquire the tools they need to continue to learn throughout their careers. So, even though medical students are now tackling data analytics and other IT skills in addition to anatomy and biochemistry, Dr. Triola doesn't believe medical school needs to be longer. "What I do think we need to do is begin using some of these technologies to make medical education more of a continuum," he says. Applying IT to learning processes Nashville-based Vanderbilt University School of Medicine did just that, by not only incorporating technology into what professors teach, but also into how students learn. Vanderbilt calls it Curriculum 2.0. The new curriculum applies not only to clinical outcomes or patient records, but to students and their learning trajectories. It documents achievements, competen- cies, faculty ratings and assessments in a portfolio for each student. It is also popu- lated with hospital notes students enter in the EMR during their clerkships, auto- matically capturing their panel of patients, so they can use it as a teaching space. Vanderbilt provides each student with a portfolio coach, who they keep throughout their time in school. Students are scheduled to periodically meet with their coaches to talk about their progress and performance. "It allows us to ask students, 'How can we help you be the very best that you can be?' For high performers, we can ask, 'Given where you are, what else can you do?'" says Kim Lomis, MD, associate dean of undergraduate medical education and associate professor of surgery at Vanderbilt. The advantage of this system is that it allows students to progress through medical school in a flexible way, Dr. Skochelak notes. Students advance through competencies based on performance, rather than time. This works well for some students who may need more — or less — time in medical school. Physical therapists who decide to go back to medical school, for ex- ample, could potentially acquire all the necessary competencies in a time frame shorter than the traditional four-year period, she says. More importantly, it helps ensure students are building skills like communi- cation, skills that could potentially fall through the cracks in a lecture hall- structured, knowledge-based curriculum, according to Dr. Lomis. "It's very much in the spirit of patient safety. It's making sure people are pre- pared for the roles they're going into," she says. Vanderbilt's Curriculum 2.0 is more focused on team-based, active learning and puts students into the workplace sooner, Dr. Lomis says. Instead of the tra- ditional two years of basic science, students go into clinics in their second year and the school weaves the remaining science courses through all four years. "The new curriculum is not only focusing on content, but also on teaching students how they will learn throughout their whole career," she says. * * * Technology and technology-based learning strategies are helping medical schools like IU, NYU and Vanderbilt shift into collaborative, interactive learning environ- ments, which may be better suited for a new generation of physicians. "Students are used to a much more networked, engaged sharing environment and healthcare is not yet like that," says Ms. Passiment. "It's a much more structured tech environment. It's clunky for a lot of learners. It's challenged them to create their own workaround, which allows us to see what the next generation of care will look like." n