Congratulations on completing the four courses so far in the Health Informatics specialization. We hope you've enjoyed the content. It's been great seeing some of your posts in the discussion forums and spot checking various submissions. Thank you to those of you who've reached out individually with feedback and stories to share. Now that you've completed the four courses, it's time for the capstone. Harold, would you like to talk a little bit about what exactly a capstone is? Sure. The main goal of the capstone is for you to show what you've learned. The other goals of the capstone is for you to have a concrete product that you can show others to say, "Hey, this is what I learned at the Johns Hopkins Health Informatics specialization", and third, to provide you a framework that if you're going to do something like this in real life, you'd have something to fall back and use as a basis for what you do in real life. Yeah. I think that's a great summary. A capstone is really a culminating project, and it's intended to help you build off of the lessons you've learned and the skills you've acquired in a really authentic, as much as we can context. When our graduate students work on capstones, there's really a wide range of projects. Yeah. I thought I'd just let you know about a couple of them that our students have done both for you to hear how they resonate with what you've learned in this course, as well as there'll be some similarity between what you'll be doing in this project as for what they've done in the graduate courses. So for instance, we have one was organizational and patient barriers for diabetes patients to follow through on their eye exams. In this project, the student interviewed and tracked the barriers to patients leaving the offices and going to specialists offices. It's a workflow that you'll be working on in this project. A project that you probably will not be doing in this capstone will be a project where we worked out a decision model for what decision support needs to be able to accomplish in dizziness in the emergency room. We discussed the decision models in the decision support course, but just to show you that they are useful in real life. We've had a number of courses on dashboards, where we worked out what the reports word what, what the dashboards would be, in one particular, looked at government health care systems and the idea there being that, that would combine both the leading change, issues that you learned about governance with the data sciences things in the dashboards and reports. So really, Harold, a wide range of capstones that the students get to work on each year. We have campus based students, we have online students, and partnering them with faculty preceptors and having them report back to peers as well as to us, it's really one of the highlights each and every year. I think I've enjoyed working with students who are tackling projects involving electronic health record simulation, and ways to leverage the simulation environment for purposes of teaching. I know that you've had some great opportunities to work with students involving a variety of different datasets. Right. PCORI? Right. So and these are the sorts of experiences we're trying to convey to you in this capstone experience. Yeah. So I think that's a great segue that brings us to the capstone project that you'll be working on over the course of modules I, II, III, and IV in course five. You'll be introduced to an authentic case prompt. Now, let's step back for a moment, I want to talk about when we first welcomed you to the Health Informatics Specialization. You'll recall we discussed a variety of disciplines that fall within the umbrella of Biomedical Informatics and more specifically, Health Informatics. So Biomedical Informatics, just to recap, has a wide range of disciplines. There's Bioinformatics, Imaging Informatics. We've focused on Health Informatics here, which really encompasses Clinical Informatics, Public Health Informatics, and something that's a relatively more recent domain that's been added is Population Health Informatics. Harold, I know you were part of a publication from Johns Hopkins along with Dr. Kerr Ozzie about the research and development plan on Population Health Informatics. That is one of the readings the students will complete. Dr. Kerr Ozzie and Dr. Weiner have been national if not international leaders in what this Population Health Informatics is all about. We've chosen this as the basis of your capstone for number of reasons. Number one, it's a new area and number two, it is an intersection of Public Health and Clinical Care. Number three, looking at social determinants of health, well, you may find the same barriers in your mind that we will be discussing in the course of this capstone. So maybe you'll learn something about the social determinants of health. Finally, and this is a settled thing, I suspect many of you want to be working with each other day with work clinical data. We don't get to talk about ethics and privacy and confidentiality a lot in this course, but those are the basis of why we can't give you EHR data, no institution is going to give us even the identified dataset for you to play around with, and making those publicly available. So we want to get you to publicly available data and we wanted to make you aware of the complexity of even using EHR data. Yeah. I think that's a really good preface, and just know that when we talk about SDOH or Social Determinants Of Health, the reason they're at the forefront of everyone's minds is in some ways due to the triple aim, which you've heard about during the course of the specialization. So IHI's Triple Aim, some will talk about the Quadruple Aim. But let's focus on the Triple Aim, improving the health of populations, improving the experience of care for patients, and reducing the per capita cost of providing that care, that focus on populations rather than just the individual person when it comes to improving health outcomes has really been catalyzed further by the HITECH Act, by the Affordable Care Act, and many other initiatives: research, development, public sector, private sector, and a big part of this is knowing that medical determinants of health are thought to contribute to 20 percent of outcomes. It's that other part of the patient's lifestyle, the members lifestyle, outside of the medical sector. So what they're doing in the community, the social impacts of care, whether they're dealing with issues of food insecurity, transportation, access to care, issues of safety and utilities, all of that could have a huge impact on the outcomes of populations at a whole. We, through the course of this capstone, also want you to get familiar with some publicly available datasets that might help you in making the business case to your superiors, to an organization, to a client, for why social determinants of health and population health informatics is so important. One last thing is that, certainly, at least in the United States, we do worry about health disparities, and how different subpopulations within the United States are not experiencing the same level of care or the same level of outcomes. So all these issues get wrapped up together. So I think it was important for us to explain the philosophy behind the capstone that we've chosen. But with that general preface out of the way, it's time to talk a little bit about the authentic case promptly. So go ahead and describe the case, and then we'll talk about some of the mechanics that the students will experience. Excellent. So for the capstone, you're going to be put into the role of a Senior Director of Informatics at a non-profit organization, okay? So this non-profit organization applied for a large grant recently with CMMI, so the Center for Medicare and Medicaid Innovation, the non-profit organization did not get the grant. However, despite not getting the CMMI grant, the leadership is still very interested in moving towards a population health management approach. Unfortunately, as you read on the website, the leadership has pushed a certain strategy and rates of adoption, satisfaction, uptake have not been well. This is a pattern we see a lot, where the leadership wants to do something, they go through it in a ham handed way, doesn't get followed through, and there's a lot of yelling and screaming. Yeah. Absolutely. I think that's a good summary. That's basically the conclusion too much stories. But now you are the Senior Director of Informatics who's here as the knight in shining armor to save the day, right? What we're going to have you do is read through some of the background and visit some of the clinic sites. You're going to see some of the counts to get a sense of why the clinics have not had high rates of adoption, and we're going to have you identify a problem statement. All right. So overall, when you're done, you'll have a report that says, here's what's going on now, here's how it could be or should be, and this provides the leadership of this non-profit a plan to go forward, informatics based as it is, to go and follow through on this vision. One thing I don't think you stressed enough is that this notion of switching to a population-based approach is really where everybody's trying to go, where the government is trying to get us to go, and so this is not just an exercise. But this is really a real situation I think people will be facing. Absolutely. We hope it's a good active learning experience for you. In the videos, you'll be seeing descriptions of each step. For each module, there'll be one, two, and some cases three or third small deliverable, I will be articulating what the deliverable is. As you go through each week creating deliverables, when you submit, you'll see the rubric they'll be using at the end to do the formal evaluation. So each week, you do a deliverable, it's formative evaluation, you're not judged on it. When you're all done, you're going to go back, you'll be changing some of the things you submitted early both on the basis of the rubric. But also, you'll learn more about the problem as you go through it and submitting it. To make it all make sense together, I'm going to need to modify some of the early things. When you're done, you'll have a nice coherent report that you can be proud of and that you can show others as well. Yeah. So again, thanks for joining us in this Health Informatics Specialization, and we'll talk to you again soon. Take care.
