Academic Computing/Educational Computing

Definition Current Status Options/Future Goals Recommendations

Main Points:

• At CMH, Academic Computing lacks an coordinating body to provide planning and leadership
• Academic Computing has no routine budget source with the CMH structure
• CMH IT is capable of supporting improved Academic Computing but will need leadership and budgetary resources from the Department and FPP.
• Improved Academic Computing will bring CMH in line with resources at comparable institutions.

Definition of Academic Computing

Academic computing is a broad term encompassing the use of computing technology for academic pursuits: teaching/learning, research, and collaboration. This domain subsumes parts of other domains (clinical systems, network resources, intranet and internet links) but must be considered on its own. A successful academic computing structure must be prospectively built, not pieced together from existing structures.

Current Status

Academic computing does not exist as a cohesive entity at CMH at the present time.  That is not to say that there is not activity in this area.  Individuals and division have developed internal resources led by interested faculty and/or staff.  Often this has been aided by the support from within the hospital's IT department.  What we lack is a structure and leadership from the academic side of the table. Some reasons that more has not been done before include:  

• CMH exists as a physically and technologically distinct entity from the main academic structure of the medical school, which would be the natural source of academic computing support.  Northwestern University Information Technology (NUIT) provides robust academic computing to the undergraduate and graduate schools, including the medical school and its Chicago campus departments.  Given CMH's autonomy, we receive no direct NUIT support, although some links exists with CMIER allowing access to Internet2. All academic computing ventures at CMH have existed within the hospital's IT department, an entity whose primary mission is not academic computing but rather supporting the business/clinical applications necessary to run the hospital.
• Without a specific academic computing structure, there is no coordination or planning of projects and no routine budgetary process to this work.  While the Academic Technology Advisory Committee (ATAG), chaired by Dr. Michael Miller, has been working for a number years, this is an advisory body and is not intended as a planning or budgeting group in its current form. The budgetary process flows through the IM Steering Group which does have members (Dr. Miller) with an academic portfolio.
• There has not been a significant demand for a coordinated academic entity, since those with the greatest interest to date have had their needs meet on an ad hoc basis. 

Despite these limitations, a number of academic computing ventures exist at CMH.  The Residency Intranet is hosted by IT on one of its servers for free (a generous act) and maintained by a member of the Division of Emergency Medicine.   This site offers resident contact information, schedules, work information, and educational and research links.  A feature of ResNet is a residency and fellowship procedure log.  There is a divisional web site for Pediatric Emergency Medicine, maintained in the same fashion as , which offers clinical information (referral MD, hospital, links to CMH documents) and educational/reference links.   As an example of an alternative approach, Dr. Binns has developed chicagolead.org, a lead poisoning web site targeting a mixed public and academic audience. The Child Health Data Lab maintains an external web site as well, chdl.org, apparently administered by Dr. McLone.  

Not all educational efforts are web based.  Some faculty members use their network drive as a means to store, share, or deliver PowerPoint files.  These files can be accessed anywhere within the institution.

A future opportunity for academic/educational computing exists in the series of clinically-oriented databases (dermatology, etc.) that are being developed.  IT has provided a database support person, Irina Kolodny, to help with this effort.  She is currently supported by ad hoc funding from the FPP and has been a valuable resource to a number of faculty members. As of the time of this writing, her funding for the next year has not been confirmed. This points out the inconsistent funding structure for academic computing currently.

All of the above entities are internal (intranet) resources.  No academic-focused external ventures exist, due to manner in which our current CMH internet web site is administered.  www.childrensmemorial.org is a well-designed, information-packed website supported and maintained by the Marketing Department.  As a marketing site, it excels.  As an academic site, it has improved but offers limited academic information:  departmental faculty biographies and research interests, along with contact information.  Changes to the site require substantial oversight from Marketing and are not easily made.  There is not a www.northwestern.edu/pediatrics site that would be analogous to the academic home of the Department of Medicine: www.northwestern.edu/medicine.  This is an important distinction.  An academic website has different goals; different oversight and content control needs, and would be aimed at a different audience.  Colleagues, researchers, and potential resident and fellow applicants generally look for an “edu” address for our site.  Currently, navigating to the northwestern.edu site for pediatrics takes an internet browser to the Marketing website.

A clarification is important.  Academic computing and academic computing support are not precisely the same.  CMH IT provides all academic offices with PCs and printers, provides ongoing hardware and software support for these devices, and maintains a high-speed network that connects these PCs to the hospital network and internet.  This support in recent years has been very good; with upgrades to both hardware and software that has brought the typical pediatric department member equipment up to date.  Efforts to provide remote access to physicians will enhance both clinical and academic productivity.  Coordination with CMIER has led to changes in network structure that removed limitations that impacted research activities at CMIER.  Clearly, there is an interest within IT to accommodate academic programs.  If the Department can develop a clear academic computing plan, we can then work with a receptive IT department to implement it.

Options/Future Goals

 Aim: CMH will develop an Children's Computing Resource Center (CCRC) to support academic computing.

Goal #1: The CCRC will provide planning, budgeting, and oversight for academic computing at CMH.  It will be necessary for the CCRC to server as the central organizing entity for academic computing.   A Director of Academic Computing would oversee a technical staff (as outlined above) and chair the Pediatric Technology Group.   This committee would recommend projects and their associated budget needs to the Chair and to the funding body(ies) at CMH such as FPP.   A regular, predictable Children's Computing Resource Center budget will be necessary to support the basic functions of the CCRC outlined in the other goals listed below; supplementary expenditures for special projects would be presented as needed.   The CCRC would also receive income for research grants that utilize academic computing resources; this would be a direct cost would be above and beyond grant budget indirect cost (overhead).  

Goal #2:  Develop a Data Management organization.

Data in the computing age is the coin of the realm. Managing the creating, storage, manipulation, and distribution of data will be critical for the business, education, research, and collaboration missions of the institution and the Department. As of this time, no person or structure fulfills this mission at CMH. We recommend that a Data Manager be hired whose responsibilities will include:

• Develop and maintain the data dictionary: a comprehensive anthology of every database field and table within the CMH's many databases (Epic data repository, research databases,educational databases).
• Work with IT and hospital staff to ensure that faculty and staff have meaningful access to these data resources through the Childfren's Computing Resource Center, which will serves in a clearinghouse role. This will involve creation of a system by which a researcher may request data, have this data extracted from our databases, and delivered to the research if he or she meets established criteria.  The Data Manager will develop and enforce a system of business rules governing who may obtain and contribute data to this system.
• Participate in research and other projects as the expert in extracting meaningful research data from clinical and other data sets and the combining of multiple data sets into a useable research data set.
• Data Quality, Security, and Integrity: the Data Manager will work with hospital IT to ensure that the multiple databases are maintained in a secure fashion consistent with current rules (e.g. HIPAA).  This is specific requirement of NIH-sponsored research.

NEEDS: At minimum, a full-time data manager with experience with clinical data systems, common large databases, and research concepts.  Support would include the staff to develop the projects that the data manager designs - i.e. develop the commands to pull data from a specific database, etc.

Goal #3: Programming Support

With the advent of the electronic medical record based on the EPIC system, we will need to develop a large number of customized SmartForms These are customized data entry and access forms that work within the EPIC EMR and allow for the use of existing data and the creation of new data fields not built into Epic's data dictionary. With these forms, written in Visual Basic, a programmer can develop customized forms for specific projects (research or clinical). The Pediatric Technology Group would exercise oversight over the proper use of these forms to prevent their uncontrolled growth without purpose. The point of this feature is NOT to allow each practitioner his or her own personal data forms but to allow specific projects to have powerful, customized forms for specific needs.

NEEDS:  A programmer versed in Visual Basic would be required to develop and implement these SmartForms. 

Goal #4:   Support Academic Computing Needs of Faculty Members

 The CCRC will provide support for academic projects of faculty members.   Examples of possible project types include:

• Educational database development - image libraries, EKG repositories

• Educational content development - to move beyond PowerPoint an enable faculty to develop web-based audiovisual presentation, Flash (Macromedia) content, and general education web content.  Longer term, development of a content management server would allow end-users (physicians) to develop educational projects online without any web design knowledge.  Administration and support of this type of structure would fall under the CCRC.

NEEDS:   A database designer would be necessary; Irina Kolodny is currently fulfilling this task within IT.    A data server (SQL Server - Microsoft) license would also be required.   High storage needs such as image and video files would require the purchase of substantially more storage capacity in the terabyte range.

Goal #5:   Provide for a robust intranet and internet presence for the Department (and potentially for our surgical/specialty partners located at CMH).   This will included a hospital intranet with pages for each division, the Department as a whole, medical education/residency, etc.  Intranet pages for a specific division might include a mix of educational content (lectures, images/image databases, links to outside resources, reading lists), information (office locations, contact information), clinical information (protocols, patient management information, forms, call schedules), and research content (ongoing protocols, subject recruitment information, access to intranet-based research websites).  

The Department intranet site would host similar content - schedules, contact information, etc.   Additionally, the intranet could serve as a robust means of collecting evaluations of both faculty and trainees.   As part of the residency program's effort to comply with the American Council for Graduate Medical Education's (ACGME) core competency requirement, a more mature resident evaluation process is being developed.   Many medical schools and residencies programs are moving to an electronic means of collecting trainee ratings as these systems ease the burden of collecting large volumes of data and provide a means to remind (nag) faculty to respond to evaluation requests.      The current procedure log also would aid with the ACGME requirements.

The CCRC will also develop an Academic Extranet - www.northwestern.edu /pediatrics or pediatrics.northwestern.edu.    In conjunction with Marketing, the academic portions of the current web site could be moved to this new site.   The goal of pediatrics.northwestern.edu would be:

•  Provide the Department of Pediatrics with a internet presence that is academic in nature.

•  Host divisional and departmental pages that provide:

•  Current Staff listings, their research interest and projects/grants

•  Training program information and applications or application process

•  Information for rotating residents and medical students (reading lists, rotation guidelines)

NEEDS:   To accomplish this goal, the CCRC will have both personnel and technological needs.   A project/intranet manager will be necessary to oversee the intranet and internet sites.   Initially, it may be possible to have this manager also be the web site designer; as the CCRC grows, it will be necessary to hire a specialist to fill this role.    The web site will need to be hosted on a server with substantial backup and maintenance support and the bandwidth to handle the workload.    This is currently within the means of CMH IT but will come with a cost in hardware and software (licenses).     Some form of web content management server (e.g. Microsoft Content Server, Macromedia's Contribute) would be vital to allow faculty members to develop simple web sites on their own and automatically submit these sites for review.     Lastly, as content is created by our Department and divisions, an editing/oversight process will need to be developed.   While the project manager can coordinate the process, a person or group of faculty will need to be part of the CCRC structure: the Content Committee.   This body will have control over all content to ensure that all information is up-to-date and appropriate.   Such a process will need to be efficient so as not to become “red-tape” and impede the development of valuable content.  

Recommendations:

1) Develop an Children's Computing Resource Center (CCRC) to support academic computing.

·        The Children's Computing Resource Center will provide planning, budgeting, and oversight for academic computing at CMH.   A Director of Academic Computing would oversee a technical staff (as outlined above) and chair a Departmental Pediatric Technology Group.   This committee would recommend projects and their associated budget needs to the Chair and to the funding body(ies) at CMH such as FPP.   A regular, predictable Children's Computing Resource Center budget will be necessary to support the basic functions of the CCRC outlined in the other goals listed below; supplementary expenditures for special projects would be presented as needed.  

2)  Develop a Data Management organization.

• This entity will manage the creation, storage, manipulation, and distribution of data for the business, education, research, and collaboration missions of the institution and the Department.

3) Develop a Programming Support Staff

• Staff to aid in database development,SmartForms creation for the Epic EMR, etc.

4) Support Academic Computing Needs of Faculty Members

• The CCRC will provide support for academic projects of faculty members.  

5) Provide for a robust intranet and internet presence for the Department.

• Hospital academic intranet with pages for each division, the Department as a whole, medical education/residency.  
• Academic Extranet - www.northwestern.edu /pediatrics or pediatrics.northwestern.edu.    In conjunction with Marketing, the academic portions of the current web site could be moved to this new site.  

Mark Adler, MD