Report to the Dean
Office of Medical Informatics
Richard Rathe, MD
Associate Dean for Information Technology
November 2007
Overview
The Office of Medical Informatics (OMI)
was created by the Dean in 1990 to enhance the education and patient
care missions of the College of Medicine (COM).
OMI is part the of Chapman Education Center and
synergistic with the Office of Medical Education (OME). The Director is currently
the Associate Dean for Information Technology and
reports to the Senior Associate Dean for Academic
Affairs. We support undergraduate, graduate and continuing medical education;
the physician assistant program; and to a lesser degree, the graduate school
(IDP).
While focused primarily on education, the office has College and Health Science
Center (HSC) wide roles. The following diagram summarizes
our major services (orange) in context (see also the historical
timeline and previous reports from 1995 and 2003).
Arrows indicate a direct line of support. [Note that some minor lines have
been omitted for clarity.] Core services are described below.

Core Services
- Web
Servers/Course Content/ModuleCore - The content we help mange is heterogeneous
and lives on several servers. We have primary responsibility for medinfo.ufl.edu, www.med.ufl.edu,
and related sites. We currently host three different content
management services: Filer, Page Publisher (commercial), and ModCore.
- FIND/IdentityCore -
Contact information and identity management for the entire college
and portions of the greater HSC. Designed to provide services to both human
users and computer systems. Includes robust role-based
authorization and ID photographs that
are shared with other approved systems within the COM.
- ECal/CommunicationCore -
Calendar, scheduling, and notification services. Includes People
Tasks Meetings (PTM,
a new service to enhance and coordinate group activities), Confab (discussion
lists), Replay (student lecture
recordings), and Togo (email-based announcement
and file sharing utility).
- EvalSuite/EvaluationCore -
Our major legacy system, which has been in continuous use since 1996.
Includes XAM (high-stakes
testing software) currently used by four HSC colleges. We are in the
process of replacing EvalSuite with the portfolio-based EvalCore.
EvalCore will provide advanced support for all forms of assessment and educational
portfolios.
- Testing
Center - We support and manage the HSC Testing Center (CG-28) jointly
with OME. The facility is available to all HSC colleges and used extensively
by Medicine, Nursing, and Dentistry. Our role includes: hardware purchases,
installation, and repair; operating system configuration and updates; testing
software (XAM);
security and cheating prevention; exam construction and preview by faculty;
and coordination with the other colleges who use the facility.
- Technical/Computer Support - In addition
to the above, we provide technical assistance for COM faculty and students,
as well as other miscellaneous services such as video
capture and media preparation.
We work closely with Teaching Labs to ensure that the classrooms and equipment
are properly configured; the HSC laptop support office; and the IT Center.
We are also the primary, but unintentional, source of Apple technical support
in the HSC.
Philosophy
The Office of Medical Informatics adheres to the following precepts:
- We focus on the customer, and remain
flexible whenever possible. We provide a service,
and success is measured by happy, enthusiastic users.
- We abide by recognized, open standards whenever
possible. The HTML/ CSS specification developed by w3.org is a good example.
Information technology is not a monoculture and closed, proprietary systems
are ultimately counterproductive.
- It is not enough to merely automate a process. Automation
without process redesign often leads to negative outcomes. Technology
should be applied to transform systems and solve problems. "The
enlightened user understands that computer technology is a vehicle for
creating change." - Joseph Izzo
- Economies of scale, multiple use, and reuse
should be design goals whenever possible. End users, such as students
or physicians, should always be part of the design process. Ongoing feedback
from users is essential for quality improvement.
- The primary focus of medical education should
be patient care — not technology. There is no need to devote
large amounts of curricular time on "computers skills" in isolation.
Students will become "literate" by using computers to perform tasks
related to their course of study.
- Patient care, not financial services, should
drive the design of clinical systems. These systems should provide
the clinician with a simple, unified view of patient data from various
sources. Data should be collected as close to the source as possible.
The quality of clinical data is directly related to its use for patient
care.
Staff
Richard Rathe, MD (Director)
Dr. Rathe has more than twenty years of experience with computers in medicine.
He is an former fellow of Medical Informatics at the Harvard
School of Public Health. He has directed OMI since its inception in 1990.
He is the author of several major software programs (XAM, EvalCGI,
etc.) and works to advance the utility and usability of software within the
COM. His current projects include:
- People
Tasks Meetings (aka PTM) - A program that facilitates collaborative work
by managing tasks and meeting agendas.
- Patient
Note Engine - A joint project with the NBME.
- Casebase - A case-based quiz engine.
- Togo - A confidential email/document
distribution system.
- Responder - A web/laptop-based audience
response system.
- Signup - An online tool for event
registration.
In his role as Associate Dean for Information
Technology, Dr. Rathe serves on several important committees at the
College, HSC, and Campus levels. He is the current chair of the HSC Instructional
Support Committee. At various times he has played important roles with
patient care systems and Shands Hospital. He is currently involved with
the COM Ambulatory
Electronic Medical Record project.
Mark Dinsmore (Systems Administration)
Mr. Dinsmore came to us from a successful Internet company (Thinkwell) of
which he was a founding officer. He is a highly effective systems administrator
and programmer. His current projects include:
- Managing nine servers: medinfo.ufl.edu, eval.medinfo.ufl.edu,
applications server, database server, development server, development
database server, media server, backup server, and test center support
server.
- Sophisticated hardening to prevent hacking and "traps" for malicious
web robots.
- Creation and maintenance of OS image files for the 170
TC computers (for updates/repairs via the network). Troubleshoots problems
with individual computers as they occur.
- Working with HealthNet to clean up/fix
periodic problems with HSC network.
- Database administration and optimization.
- Programming support for various ongoing projects such as MedCat (fourth
year catalog and registration system).
Gene Cornwall, MEd (Online Testing and Lab Manager)
Mr. Cornwall came from an educational software background. He is a key support
person for the HSC Testing Center (and
to a lesser degree the other HSC Colleges and the satellite testing facility
in Jacksonville). He works closely with the new Head
Proctor to ensure that examinations are smooth, efficient, and secure.
His duties include:
- Initial contact with faculty and preparation
of exam materials.
- Working with faculty to preview and revise their
exam forms.
- Front line help if there are problems
with exams or equipment.
- Care and replacement of computers in the first and second year MDLs.
- Works directly with Teaching Labs to
ensure that classroom changes and configurations are optimized for our students
and faculty.
- Works with the Office of Continuing Medical
Education to support both internal and external programs.
Carlos Morales (Webmaster)
Mr. Morales is a talented web designer and photographer. He works broadly
across several COM units and departments. His responsibilities include:
- Development and maintenance the main COM
website. This includes sub-sites for CME, Office of Educational Affairs,
Office of Program and Faculty Development, Admissions, etc.
- Development and maintenance of the Medical
Education website.
- Development and maintenance of reusable
web templates and materials that can be used by departments and other
COM entities.
- Direct web support for the new Emerging
Pathogens Institute.
- Coordination with all COM/HSC web developers, including periodic meetings.
Dan McCoy (Lead Programmer)
Mr. McCoy joined us last year from the College of Dentistry. While there he
was responsible for ECO (their course
management system) and online examinations using XAM. His current projects include:
- ModuleCore, the first component for
our new suite of educational software.
- A new quizzing function integrated
with ModCore.
- Part of the team that will reengineer our calendars and
communications.
- Primary backup for exams and the Testing Center.
Charles Poulton (Audiovisual Specialist)
Mr. Poulton has been capturing, editing and producing A/V materials for the
COM for more than ten years. His duties vary based on need; the following are
representative:
- Capture and manage high quality ID photographs for students and faculty.
He then uploads these into FIND where they are available to authorized users
and web sites.
- Capture high quality audio and video from educational events (CME, Grand
Rounds Online, etc.). He then converts some of these to fully
interactive modules for the web.
- Edit, prepare, and reformat materials for various COM websites and programs.
- Assist with re-purposing materials that come from outside the COM.
Synergy with Other Units
We work synergistically with several OME staff:
- Ms. Karle - Works directly with raw
EvalSuite and other data on our servers to generate reports and upload
to non-OMI databases. She attends our meetings and we work together on
a daily basis.
- Ms. Downing - Has responsibility
for course, faculty, peer, and other evaluations managed through EvalSuite.
She is the counterpart to Mr. Cornwall for non-exam materials.
- Ms. Derfinyak - As Head Proctor she
has recently taken over some responsibilities from Mr. Cornwall. She
attends our meetings and works with us on a daily basis.
- Various others based on the need and the class involved (eg, fourth year
registration; orientation for new faculty, residents, and students, etc.).
For the past five years we have had an continuous collaboration with the Office
of Continuing Medical Education to capture and produce an Grand
Rounds Online series.
We have recently undertaken a substantial collaboration with the Department
of Radiology to develop state-of-the-art GME curricular tools. The first
set of services have entered beta-testing and will be fully operational by
early 2008. We anticipate offering these services to all
UF program directors by June 2008.
Gaps in Services, Potential Synergies and Areas Needing
Improvement
Within OMI
- Our legacy flat file databases are
both a strength and a weakness. They are a strength because these systems have
been long-lived, easy to manage, and easy to change. They become a weakness
when we need to transform or report the data in unanticipated ways. We are
moving toward a more robust foundation using the relational database MySQL for
most new systems. This comes at the expense of greater complexity, the higher
skill levels required, and a longer development cycle.
- The lack of an administrative assistant for
our group is becoming more apparent as we have more people working on
more projects simultaneously. (This was one stimulus for the development
of PTM.) The current plan is to give Ms. Derfinyak more responsibility in
this area (in collaboration with OME).
Between OMI and Other COM Units
- OMI and OME have gone down different development paths, with data stored
in different database systems (MySQL
vs. Oracle). This was the result of rational people making rational but
independent decisions over time. In the beginning, COMPTrac was hosted
by the IT Center, where Oracle was already available. MySQL was the obvious
choice for OMI since it is free to universities. I thought that server-to-server
communication would be the answer, but thus far progress in this area
has been slow. I think this 10% due to lack of experience and 90% due
to lack of programmer time. Building interfaces is often left out of
project planning and we are no exception. I
propose that we have a series of meetings between OMI, OME, and possibly
OSA to
better define what needs to be done and how we plan to accomplish it.
- Support for housestaff is divided
between the Office of GME, IT Center, OMI, and Shands Hospital. We are
currently working with the Department of Radiology to
develop curricular tools, calendars, media services, etc. appropriate
for residents. We are nearing the first milestone of this effort and
I plan to meet with Dr. Flynn in the near future.
Between COM and HSC
- Several years ago the COM and VPHA IT groups were merged into what has become
the IT Center, and a decision was made to drop
all support for Macintosh computers. This was short sighted in my opinion,
and has created an unintended burden on OMI as the de facto Mac help
desk. I
propose that a minimal level of OSX support be added back to the IT Center's
repertoire, including: access to networks, file servers and print queues;
assistance with email; basic OS repair and reinstallation from CD/DVD;
and possibly backup services.