MSc in Global eHealth Programme Restructure Proposal · wishing to undertake PPD, such as those in the NHS and the eHealth business sector, which will help to further boost income

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MSc in Global eHealth

Programme Restructure

Proposal

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Global eHealth MSc Programme Team

Director: Dr Claudia Pagliari

Co-Director: Liz Grant

Co-ordinator: Dr Neneh Rowa–Dewar

Administrator: Gayle Fitzpatrick

Proposal to restructure the Global eHealth MSc Programme

We would like the Committee to consider our proposal to restructure the Global eHealth

Masters programme for the 2016/17 academic year.

The Global eHealth programme has had a successful 18 months with positive student and

external examiner feedback regarding its interdisciplinary, up-to-date and interactive

content, its methods of delivery, its cadre of expert tutors and the individual support

available to students. The proposed changes will therefore not affect programme content,

teaching or support. We believe the following structural changes we propose will further

improve the student experience and income to the programme, as well as providing

greater opportunities for cross-programme collaboration.

Our students currently study two concurrent 10 credit, 10-week courses each term (see

Figure 1). In order to improve course manageability for our students – most of whom hold

down full time jobs in addition – we propose to change this structure to two consecutive

10 credit, 5-week courses (see Figure 2).

We also propose to change three of our compulsory courses to elective courses, so that

our students have the flexibility to choose relevant modules from compatible programs if

they so wish.

In addition, we would like to change the titles of two of our courses, to better reflect their

content. Details of the proposed changes are described in the remainder of this document.

A change from concurrent to consecutive courses will address student feedback

regarding the challenges involved in dividing their attention and effort between two

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courses at the same time. Whilst we aim to stagger the timing of end of course

assignments, concurrent courses also means submission dates occur within a period of

two weeks; an additional challenge for our professional and part time student cohort.

Two of our current students have opted for intermittent study of one course at a time in

their second year in order to address this issue, which means that it will take them longer

to complete their studies. It will also mean a loss of income per year to the programme.

The proposed restructure will also allow us to offer an increased number of our courses

to students of other programmes with a similar 5 week 10 credit structure, for example

the MPH and Global Health Challenges PG Cert, which has the potential to increase both

programme income and student choice. Our students will benefit from the increased

choice of these and courses from other UoE Masters’ programmes. The courses some of

our students might be interested in from the MPH and Global Health Challenges Cert

include courses on Globalisation and NCDs, Maternal Health and Mental Illness and we

have agreed this reciprocal and collaborative arrangement with the respective

Programme teams. The three Global eHealth courses we would like to make elective for

our students are Managing Change, Patient eHealth and User-Centered Design, which

appear in term 2 of Year 1 and term 3 of Year 2 (see Figure 2). We anticipate that the

majority of our students will still select these, but we wish to give them increased choice

before their Dissertation year.

A further advantage of this re-structure is a modest decrease in the course delivery costs.

Whilst the costs of development and annual revision and will remain unchanged,

reducing the number of weeks per course will reduce our weekly tutoring costs by half.

In addition, we believe that 5 week courses will be more attractive to external students

wishing to undertake PPD, such as those in the NHS and the eHealth business sector,

which will help to further boost income to the programme.

The potential to increase programme income by attracting students from other UoE MSc

programmes and external PPD students, and reducing tutoring costs, will be particularly

important when we will no longer receive the financial start-up support from the Digital

Education Initiative later this year.

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Finally, we propose to change two of our course titles to reflect the updated materials and

terminologies common to the field. These courses are currently named ‘Consumer Health

Informatics’ and ‘Health Informatics: History, Scope and Guiding Vision’, Further

explanation of the title changes is contained in the individual revised course outlines

provided in the remainder of this proposal. Please note that the learning objectives,

content and assessment methods will not change in any of the courses. Rather, two

weeks’ worth of content has been incorporated into each single week, with some re-

ordering of certain weeks to maintain a clear and logical flow.

Please do not hesitate to contact us about any queries.

Kind Regards,

Claudia Pagliari, Liz Grant, Neneh Rowa-Dewar and Gayle Fitzpatrick,

The Global eHealth Programme team.

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(Figure 1 Current Programme Structure)

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(Figure 2 Proposed Programme Structure 2016/17)

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MSc in Global eHealth: 5 week course outlines

Year 1: Term 1

Introduction to Global eHealth

Short Description*: This course considers the emergence and use of health information technology in high, medium and low income countries and the technological, social, cultural, political and structural factors influencing this. It pays particular attention to the challenges and opportunities presented by eHealth in supporting public health and patient care in low income countries, and its implications for wider development. Students will be encouraged to consider the policy context of eHealth in different countries and the World Health Organisation’s eHealth strategy, as well as broader issues around inequalities, globalisation and capacity building.

Keywords: Global eHealth

Default Delivery Period*: Term 1

Course Type*: 10 credit

Summary of Intended Learning Outcomes*:

Students completing this course will:

Identify the key features and trajectories of eHealth policies in low, medium and high income countries

Be able to describe a range of socio-political, economic and cultural influences on the appropriateness and effectiveness of eHealth

Appreciate the need for contextual awareness when planning eHealth design, procurement or evaluation

Examine innovative uses of ICT for obtaining and sharing data for public health and research and the role of ICT in strengthening health systems.

Analyse some of the challenges of ehealth interventions in lower income settings e.g growing the workforce and conducting an evaluation.

Special Arrangements: Delivered via online distance learning

Components of Assessment (inc. % weightings)*:

Collated forum postings in response to PBL questions: 30%. Essay: 70%.

Syllabus/Lecture List: Week 1) The context of global eHealth Patterns of health and disease, structure and funding of health systems, relationships between poverty, technology

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and health; Gender and equity issues; diversity of information infrastructures. Week 2) International eHealth policies and strategies The WHO eHealth strategy; Emergence of eHealth in different parts of the world; Addressing international standards for eHealth. Policy assignment - summarise the eHealth strategy in one selected country. Reports shared with others using the forum. (Facilitated.) Week 3) Understanding eHealth needs in LMIC Potential of eHealth for LMIC; using mHealth to address the urban-rural divide; Consumer eHealth in developing nations; Issues for Electronic Health Records Implementation; Sociological and cultural factors affecting eHealth emergence & adoption. Understanding innovation in low resource settings. Case studies of eHealth ‘workarounds’ and mHealth innovations. Week 4) Informatics Challenges for Global Health The importance of effective information management for health systems strengthening and global health surveillance. Challenges for effective data capture, aggregation and exchange in LMIC. Innovating with geospatial and social technologies for disease tracking. Globalisation of eHealth data and services, cross-border healthcare and their pros- and cons-. Ethical issues. Week 5) Workforce Issues in eHealth Managing the clinical brain drain in developing nations; Addressing the information gap; Growing the Health Informatics workforce; eLearning for capacity building; using ICT to augment and distribute the medical workforce.

Study Pattern/Course Structure:

The course will be divided into 5 sessions, each lasting a week. Most sessions will contain written materials and presentations, accompanied by guided reading in the form of links to journal articles with problem-based learning questions.

Discussion of the content and reading materials will be posted to an online forum, along with students’ answers to the PBL questions.

Students will be expected to produce 2500 word essay by the end of the course.

Benchmark Statements Assessed:

Can describe the WHO approach to eHealth facilitation, monitoring and evaluation.

Is able to describe key features of eHealth infrastructure in high and low resource settings

Is aware of the ways in which different technological solutions are suited to different context

Can describe the key technical, systemic and sociological challenges for eHealth progress in LMIC

Teaching Load* (% taught from each School):

MGPHS (CPHS) 100%

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Reading Lists: World Health Organisation eHealth Strategy 2016 (in press) Health Affairs 2010. Special Issue dedicated to eHealth for lower income countries. Additional papers and grey literature, as pertinent to each topic.

Convenor of Board of Examiners:

Convenor of Global eHealth Board.

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Introduction to Health Informatics: History Scope and Guiding Vision

Proposed new name: Health Informatics: Foundation, Emerging Trends and Influencing Factors.

Name Change justification

As a field, Health Informatics is strongly influenced by innovations in a number of

other fields including computer science (hardware, devices and software), data

and telecommunications, information management science, and within the fields

of knowledge that are health, healthcare and medicine. Innovation in any one of

these fields drives, or makes possible innovation in Health Informatics. In this

sense, the field of Health Informatics and its history and scope is still actively

evolving and there is no pre-determined vision as such.

The title change for the course is proposed to more accurately reflect the focus

and purpose of the course. The purpose is to provide the student with the

opportunity to explore the field of Health Informatics to develop an understanding

of the emerging trends and factors influencing its ongoing evolution, and to

develop a working definition as a platform for further, more in-depth and

advanced study in this and related fields.

Short Description*: This course explores the origins, key components and current state of Health Informatics. It also introduces the building blocks of Health Informatics at theoretical and applied levels. The course takes a systems approach to and critical analysis of the complex adaptive systems needed for effective healthcare delivery.





On completion of this course, the student will be able to:

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Apply critical systems thinking to health informatics problems

Appraise the mechanisms for organising information and critically evaluate knowledge management methods

Evaluate the stages in Health Informatics development and the scope and diversity of the field

Critically discuss the role of a socio-technical perspective on the development and future evolution of the electronic health record and other structures within Health Informatics

Critically discuss factors influencing the development of Health Informatics


Components of Assessment (Inc. % weightings)*:

Collated forum postings in response to discussion posts: 30%. Essay:70%

Syllabus/Lecture List: Week 1) Introduction to Health Informatics The focus of this week will be an introduction to the Health Informatics and eHealth, including terms and terminologies, systems thinking and theory, and planning and planning frameworks as a basis for considering the role of health informatics in healthcare. Week 2) Health Information Systems Modern health care delivery is underpinned by the collection and organisation of data and information, and the generation of knowledge. This week will focus on the concepts underpinning Health informatics structures such as patient record systems including Usability: the interface between a system and the Users; and Interoperability, the interfaces between different systems that are needed to view, share, input, extract and/or exchange the data. Week 3) Perspectives, Evolution & Change This week will focus on the perspectives of the participants in the healthcare experience, the theories and models used in the recognition and management of change, and a survey of the emerging trends and factors influencing the evolution of the field of Health Informatics. Week 4) Ethics, Governance and Legislation The focus of this week is the challenges and issues for the Health Informatics professional inherent in the requirements to comply with legislation, and in the application of the principles of ethics and governance to the collection, storage and use of patient information. Week 5) Course Consolidation and Assessment The focus of this week will be the summative written assessment(s).


The course will be divided into 5 sessions, each lasting a week. Most sessions will contain written materials and presentations,

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accompanied by guided reading in the form of links to journal articles with problem-based learning questions.


Students will be expected to produce 2500 word essay by the end of the course.


MGPHS (CPHS) 100%

Reading Lists:



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Term 2

Health Informatics: core technologies and systems

Short Description*: An introduction to the technical underpinnings of eHealth, namely the architectures and systems used to manage and exchange patient and administrative data within and across healthcare institutions. Covers key concepts such as standards, databases, interoperability, health information exchange, clinical coding and enterprise resource planning, as well as particular types of system, such as electronic health records, picture archiving and communications systems and, laboratory information systems. These are discussed with reference to institution-centred and system-wide approaches, as well as highlighting key issues for lower income settings such as the use of open source software.






Be familiar with Discuss a range of health information architectures and infrastructures and identify the main software issues affecting system interoperability

Identify the fundamental principles and methods of electronic Health Information Exchange for patient care.

Describe the key clinical informatics applications in hospital settings (lab reporting, CDSS, CPOE, clinical document exchange, imaging etc.) and how these are connected.

Critically discuss the political, economic and technical challenges to health systems integration.

Examine the different contextual factors affecting the types of information systems that are feasible and the different infrastructure requirements pertinent to different types of setting.




Syllabus/Lecture List: Week 1) Key concepts for information systems Data, information and knowledge; systems and subsystems; architecture and infrastructure, data and systems interoperability. Week 2) Hospital Information Systems (HIS) and Electronic Health Records (EHR)

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Hospital information Systems, trans-institutional IS, EHRs Week 3) Data and Interchange standards, Interoperability and Health Information Exchange Nomenclatures and classifications, messaging standards for improving the usefulness and transferability of health information. Models of health information exchange in different parts of the world, illustrating macro- and micro-system level elements. Integrated health information systems. Week 4) Laboratory Information Systems, Prescribing Decision Support Systems and Picture Archiving and communication (PACS) systems. Fundamentals of different hospital based systems, uses and architectures. Week 5) Contrasting Architectures, Challenges, Open source vs Proprietary systems in advanced and LMIC countries. Different systems architectures including data storage, interchange. Benefits and challenges of Health information

systems in low-resource settings. Contrasting open-source and proprietary systems.




Students will be expected to produce a 2000 word essay by the end of the course.


Has the fundamental knowledge to be able to engage in meaningful discussions with information systems specialists in health care organisations about issues in information management and systems.

Is aware of the importance of systematic information management, clinical coding, and interoperability standards for effective care integration as well as system-wide knowledge management.

Is aware of the changing requirements of health information systems as technologies change (e.g. cloud computing) and expectations change (e.g. care integration, patient entitlement to access)

Understands the key issues mitigating the implementation of health information infrastructures in low resource settings and the role of open source.


MGPHS (CPHS) 100%

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Reading Lists: Book: As for Introduction to Health Informatics 1 Also: Winter et al. (2011) Health Information systems. Architectures and Strategies. Springer World Health Organization/Health Metrics Network (2008) Framework and standards for country health information systems. 2nd Edition. WHO: Geneva. Available: http://www.who.int/healthmetrics/documents/hmn_framework200803.pdf. Accessed 11 January 2010



http://www.who.int/healthmetrics/documents/hmn_framework200803.pdf

http://www.who.int/healthmetrics/documents/hmn_framework200803.pdf

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mHealth in High and Low Income Settings

Short Description*:

This course examines the emergence of mHealth from a global perspective. It considers the rapid emergence of mobile technologies in low resource settings and how this is helping to bypass eHealth approaches based on fixed line infrastructures, as well as examining the uses of mHealth in high income countries. It also critically evaluates the hype surrounding mHealth in the global business community and the extent to which this is supported by evidence.

Through comparing and contrasting examples of mHealth deployments in a range of global settings the course challenges students to think beyond the technology to the functions it is serving and to consider the relevant sociotechnical issues around service packaging and systems redesign.

Participation of important international mHealth researchers and implementers will help to ground the course in practice.


Default Delivery Period*:

Term 2




Contrast mobile technology environments and markets in different parts of the world

Consider the technology ‘leapfrogging’ phenomenon in low income countries

Identify issues around gender and social equity that call for new forms of communication.

Analyse mHealth deployment for HIV and maternal care in Africa and preventive health interventions in high income regions.

Assess mHealth failures; what went wrong and the lessons learned.

Special Arrangements:

Delivered via online distance learning


Collated forum postings in response to online discussion questions: 30%.Essay: 70%.

Syllabus/Lecture List:

Week 1) mHealth in Global Context: aims, tools and use cases

Introduces the idea that mobile technologies are simply tools, not solutions

and provides a people centred understanding of the real challenges and gaps

in how care is organized and delivered in high and low income countries.

Week 2) Interpreting the Evidence Base, Understanding Pitfalls in

Practice

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Discussing the evidence base to encourage students to be critical of studies

that treat mHealth as a “black box.” Practitioners need to know more than

health outcomes in order to make use of such evidence because in practice,

even evidence-based interventions are subject to a wide array of

implementation pitfalls. High-profile mHealth success stories are introduced,

the concepts of "pilotitus" and "scaling up," are critically examined. By the end

of this week students will have a sense of common types of difficulty or failure,

as well as a few of the key players and projects that “loom large” among

practitioners and policy makers.

Week 3)Designing Effective mHealth Interventions

Discussed a shift in focus from the content of interventions to the processes

by which they are designed, adapted for and delivered in particular settings.

Focuses on how human centered designers adapt mHealth interventions to

local health systems.

Week 4)Operations, Project Management & Sustainable Financial Models

This week draws on a variety of disciplines to discuss adaptive and iterative

approaches to implementing, monitoring and re-designing mHealth initiatives.

Common types of revenue and mechanisms by which mHealth programs are

funded are then discussed, with an emphasis on the funding requirements at

each stage of the project life cycle.

Week 5) mHealth Research & Policy

Discusses the policy implications of viewing technologies as tools for

strengthening complex health systems, rather than as silver-bullet solutions.

What can policy makers do to foster mHealth projects that are well designed,

adapted to local circumstances, and evidence-based?

While there are more questions than answers when it comes to policy for new

and emerging fields, in the final week of this course we will introduce key

debates and encourage students to connect the concepts from prior weeks to

policy matters affecting the field today.





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Understands the range of mobile tools and platforms used in healthcare

Recognises the different functionalities afforded by mobile tools for organisations, professionals and patients.

Can describe where the evidence is strong and weak and what needs to be done to improve this.

Is aware of the cultural and social factors influencing the suitability of mHealth tools and their implications for design

Understands the ethical and legal issues surrounding mHealth governance.

Can visualise the key steps involved in project managing an mHealth deployment in a low income country.


MGPHS (CPHS) 100%

Reading Lists: Links to relevant reading will be included in each section. Since this is a relatively new area, the course will draw more on open media discussions than traditional published research, although this will also be included. Below are some examples. International Telecommunications Union reports (updated periodically) http://www.itu.int/net/pressoffice/press_releases/2012/77.aspx#.UnPlz51FCP8 Publication list from the mHealth Alliance http://www.mhealthalliance.org/media-a-resources/publications Website containing multiple source materials and blogs: http://www.mhealthinfo.org/ The growth of mHealth in low resource settings. Journal of Mobile Technology in Medicine special issue (2013) http://www.journalmtm.com/2013/the-growth-of-mhealth-in-low-resource-settings/ Analysis of mHealth practice and research at the US National Institutes of Health http://obssr.od.nih.gov/scientific_areas/methodology/mhealth/ Wold Health Organisation Tobacco Free Initiative. mHealth solutions http://www.who.int/tobacco/mhealth/projects/en/



http://www.itu.int/net/pressoffice/press_releases/2012/77.aspx#.UnPlz51FCP8

http://www.mhealthalliance.org/media-a-resources/publications

http://www.mhealthinfo.org/

http://www.journalmtm.com/2013/the-growth-of-mhealth-in-low-resource-settings/

http://www.journalmtm.com/2013/the-growth-of-mhealth-in-low-resource-settings/

http://obssr.od.nih.gov/scientific_areas/methodology/mhealth/

http://www.who.int/tobacco/mhealth/projects/en/

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Term 3

Telehealthcare and Telemedicine

Short Description*: Describes and analyses the role of information and communications technologies in enabling remote patient care, health professional collaboration at a distance, and in supporting patient-self management. This is considered with reference to technological, clinical, sociological and policy perspectives. Non-communicable diseases and global health challenges are core themes.

Keywords2: Global eHealth





Provide a historical overview of the main applications of telemedicine and telehealth and the key policy drivers for telehealthin the 21st century

Discuss the often complex legal, regulatory, accountability and reimbursement issues surrounding telehealth

Recognise the value of critically examining user contexts for effective telehealth design, and how this can be achieved.

Identify and address a range of sociotechnical factors that influence the success or failure of implementation projects

Apply principles and methods of evaluation to telehealth projects.



Collated forum postings in response to online discussion questions: 30%.Essay: 70%.

Syllabus/Lecture List: Week 1) Why Telehealth? Case Studies in Supporting

People with Long-Term Conditions

In this week, we will introduce key concepts in telehealth and

telemedicine and illustrate them with two case studies (Whole

Systems Demonstrator (UK), Moodgym (Australia)) and a

systematic review covering telemedicine world-wide.

Week 2) Remote Consultation and Education

In this week, we will look at remote consultations, in particular

video and email consultations (UK), and discuss how

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telemedicine can be used to provide support and education to

health care workers in remote areas (e.g. Venezuela).

Week 3) Implementation

In this week, we will look at the issues involved in

implementing telehealth. Telehealth and telemedicine can be

very complex interventions, and their exact implementation

will vary from site to site. We will also discuss sociotechnical

factors that affect how telehealth is designed and deployed.

Week 4) Evaluation

In this week, we will discuss evaluation methods using the

Telescot programme as an example. We will look at

traditional outcome measures, qualitative analyses, and

relevant health economics measures.

Week 5) Telehealth in Context: Policy and Sociotechnical

aspects

Using the case studies discussed in the previous weeks, we

will examine the policy context and drivers and ethical

implications.






Is aware of the full range of telehealth applications

Demonstrates awareness and correct interpretation of the key academic research and discussion papers

Is able to comment insightfully on the challenges to achieving

effective telehealth design and implementation.


MGPHS (CPHS) 100%

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Reading Lists: Selection of open access books in telemedicine and telehealth available via INTECH Open http://www.intechopen.com/subjects/telemedicine Systematic reviews: McLean, Pagliari et al (2013) The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview. PLoS One. 2013; 8(8): e71238. 10.1371/journal.pone.0071238 Reeder, Demeris et al (2013) Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: A systematic review. IJMI 82, 565-579 http://dx.doi.org/10.1016/j.ijmedinf.2013.03.007 Academic reviews: Wootton & Bonnardot (2010) In what circumstances is telemedicine appropriate in the developing world? JRSM Short Rep. 2010 October; 1(5): 37. 10.1258/shorts.2010.010045 Greenhalgh T, Procter R, Wherton J, et al. The organising vision for telehealth and telecare: discourse analysis. BMJ open 2012;2. doi:10.1136/bmjopen-2012-001574 Health Services Research: Steventon et al. (2012) Effect of telehealth on use of secondary care and mortality: findings from the Whole System Demonstrator cluster randomised trial. BMJ 344. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3381047/ McKinstry, Pagliari et al (2013) Telemonitoring based service redesign for the management of uncontrolled hypertension: multicentre randomised controlled trial BMJ 346. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3663293/

Fairbrother P, Ure J, Hanley J, et al. Telemonitoring for chronic heart failure: the views of patients and healthcare professionals - a qualitative study. Journal of clinical nursing Published Online First: 4 March 2013. doi:10.1111/jocn.12137



http://www.intechopen.com/subjects/telemedicine

http://dx.doi.org/10.1371%2Fjournal.pone.0071238

http://dx.doi.org/10.1016/j.ijmedinf.2013.03.007

http://dx.doi.org/10.1258%2Fshorts.2010.010045

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3381047/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3663293/

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The Business of eHealth

Short Description*:

This novel course is designed to familiarise students with the commercial environments in which eHealth is playing a part. It considers the emergence and differentiation of the eHealth marketplace, including different types of technology, intended users and settings, suppliers and customers.

It will explore and contrast large-scale infrastructure deployments for healthcare organisations (e.g. electronic health records and decision support systems, emergence of cloud platforms), telehealth for supporting remote patient care, mHealth innovations for ambulatory support or information (e.g. wearables), the online marketplace of health products and services, and the emerging market for reusable data assets, as well as the uses of social media in health.

It will also present key considerations for effective business case planning, product design, procurement, project planning and implementation, drawing on management theories while recognising the need for evidence-based eHealth.

Keywords2: eHealth. Business. mHealth. Telehealth. EHR. Big Data. Deployment. Value. Planning.


Term 3

Course Type*: Online distance learning


Explain the business case and value propositions for eHealth

Ability to critically evaluate marketing hype

Appreciation of key considerations for procurement

Describe user-centred design and effective change management

Ability to develop an effective project implementation plan




Reflective report: 30%

Essay: 70%


Week 1) The Global Business Environment for eHealth This will examine the commercial ecosystem of eHealth, reflecting on key sectors, technologies and players, forecasts for growth and investment and the evolution of the ‘Digital Economy’. It will also consider the place of eHealth within policy frameworks, such as the European Commission’s Digital Agenda, and the government investment decisions this is driving. It will also consider the business propositions driving different eHealth markets, including the role of incentives from national and regional governments,

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enterprise agencies and the commercial sector. It will ask where the value lies for different players and reflect on whether the promises driving the industry are being backed by evidence of effectiveness. It will also reflect on the legal and regulatory environment affecting the flow of data and the development of innovations. Weeks 2-3) Sector Analysis Telehealthcare This will focus on the market for remote monitoring devices for long term condition management and care of the elderly, as well as technologies for managing rural and remote populations. mHealth & apps This will consider the rise of the broader consumer market for digital devices, tools and services. This will be illustrated using examples of mobile condition monitoring and self-care support, wellness and fitness apps, and mobile tools for professional education or decision support. eHealth infrastructures This will consider the major national and enterprise-wide investments in information infrastructures for the management of healthcare institutions, healthcare systems and for patient care. Big data and analytics This will examine the infrastructures and systems to enable the ‘secondary uses’ of linked data on a large scale for research and policy, and the business opportunities presented by innovative analytics services drawing on advanced data sciences. It will reflect on the commercial players, potential beneficiaries and business models in evidence today. The rise of the personalised and precision medicine market will be considered in some depth. Social and online media Social media are also giving rise to vast amounts of data, often curated by groups acting in cyberspace. This section will consider the use of social media for health information dissemination, marketing of health products, as well as for corporate image management. Week 4) Effective design and integration This session will encourage participants to look beyond the stated aims of an eHealth intervention and consider how it will be received by users and integrated into the intended contexts. It will examine the benefits of user-centred design on product and project success and consider how eHealth innovations are becoming integrated with other digital services and their implications for different stakeholders in the value chain. Week 5) eHealth project management An overview of core principles of effective project planning and management, including the unique challenges of ICT project delivery in high and low income settings. Considers barriers to adoption and scaling in complex systems, analysing what went wrong in previous failed programmes and businesses. Also examines the legal and regulatory factors affecting the eHealth innovations sector.

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5 weekly sessions, involving written and recorded lectures peppered with expert interviews and problem-based learning questions, supported by a guided reading list.

Assessment will be based on forum activity and quality related to the PBL questions; short answer questions emailed to the tutors and a 2000 word essay submitted at the end of the course.


Understands the eHealth market ecosystem and its relationship to policy and commerce

Appreciates the tensions between future-focused innovation, business development and evidence-based health

Acknowledges key principles of effective business case design, project planning, implementation and evaluation


MGPHS (CPHS) 100%

Reading Lists: The novel nature of this course means that there are few standard text books which cover the content. Since it aims to analyse a rapidly changing field the sessions will prioritise reading from current online sources, such as industry and expert blogs. A number of potentially valuable reports are available only as paid-for documents developed by market research companies and industry tracking agencies, such as Gartner. We will attempt to negotiate access to these. We will also spend time gleaning open-access information from different parts of the world. Examples: Global Digital Economy - E-Health and M-Health - Insights, Stats and Analysis - http://www.budde.com.au/Research/Global-Digital-Economy-E-Health-and-M-Health-Insights-Stats-and-Analysis.html#sthash.nUBLhJ1D.dpuf European Commission. Information Society Unit. Digital Economy Research Programme. http://is.jrc.ec.europa.eu/pages/ISG/isT.html Australian Government. Department of Broadband, communications and the digital economy. eHealth (2013)

http://www.archive.dbcde.gov.au/2008/01/facilitation/e-health

Students will also be expected to sign-up to the LinkedIn Digital Health and Digital Health UK groups in order to make connections with innovators in the field.



http://www.budde.com.au/Research/Global-Digital-Economy-E-Health-and-M-Health-Insights-Stats-and-Analysis.html#sthash.nUBLhJ1D.dpuf



http://is.jrc.ec.europa.eu/pages/ISG/isT.html

http://www.archive.dbcde.gov.au/2008/01/facilitation/e-health

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Year 2

Term 1

Public Health Informatics

Short Description*:

An introduction to the technical underpinnings of eHealth, namely the architectures and systems used to manage and exchange patient and administrative data within and across healthcare institutions. Covers key concepts such as standards, databases, interoperability, health information exchange, clinical coding and enterprise resource planning, as well as particular types of system, such as electronic health records, picture archiving and communications systems and, laboratory information systems. These are discussed with reference to institution-centred and system-wide approaches, as well as highlighting key issues for lower income settings such as the use of open source software.



Term 1




Identify the main global public health challenges faced by health systems today

Recognise the value of digital information management systems for supporting healthcare systems, and their role in the monitoring and evaluation of public health.

Discuss the political, economic and technical challenges to health systems integration.

Critically discuss the current and future role of the internet and social media in public health

Examine ethical dilemmas related to digital information, tools and services






Week 1) Public health challenges today Sets the scene by summarising the challenges faced by health systems and populations in different parts of the world. Considers differential economics, disease burdens and social and gender equity, as well as access to basic services and the internet. Week 2) Public Health information infrastructures

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Highlights the value of digital information management systems for supporting cost-effective, safe and robust healthcare systems, and in the monitoring and evaluation of public health. Week 3) Core principles of epidemiology Introduces core principles and techniques of epidemiology, set in the contexts of information-rich and information-poor health systems. Week 4) The internet and public health The students are guided through a discussion of how the internet and social media are and could in the future play a part in public health practice, including topics such as health surveillance in cyberspace, mHealth and tele-health. Students will consider how the internet and social media inform epidemiology and public health needs as well as how interventions can be delivered using the internet and social media. Week 5) Ethical and societal dilemmas Digital information, devices, tools and services can help to improve societal imbalances and population health, but they also create ethical challenges. For example the reuse of personal data (health records, geolocation, and social network signals) has implications for rights and privacy while virtual and robotic assistants and personal monitoring generate new questions about autonomy and the self.


The course will be divided into 5 sessions, each lasting a week. Most sessions will contain written materials and presentations, accompanied by guided reading in the form of links to journal articles with problem-based learning questions. Discussion of the content and reading materials will be posted to an online forum, along with students’ answers to the PBL questions.



Understands where eHealth/health informatics and Public Health intersect and is able to explain this to others Is familiar with core concerns of public health and the core principles of epidemiology Is aware of the value of information infrastructures for improving the capacity of public health systems to manage patients and improve outcomes Can describe innovative uses of digital media for public health communication, health behaviour change and health monitoring. Understands the need for and challenges of public health informatics in the 21st century.


MGPHS (CPHS) 100%

27

Reading Lists: Book: O-Carroll et al (2010) Public Health Informatics and Information Systems. Springer http://www.amazon.co.uk/Public-Health-Informatics-Information-Systems/dp/1441930183#_ Online Journal of Public Health Informatics. http://ojphi.org/index Paul M.J. & Dredze M (2011) You Are What You Tweet: Analyzing Twitter for Public Health. Proceedings of the Fifth International AAAI Conference on Weblogs and Social Media http://www.aaai.org/ocs/index.php/ICWSM/ICWSM11/paper/viewFile/2880/3264 Yasnoff, W.A., O’Carroll, P.W., Koo, D., Linkins, R.W. and Kilbourne, E.M. (2000) Public health informatics: improving and transforming public health in the information age. J Public Health Management Practice, 6(6), 67-75. http://www.uic.edu/sph/prepare/courses/ph420/resources/PHInformatics.pdf

Up-to-date articles and web links will be selected each time the course runs.


Convenor of Global eHealth Board

http://www.amazon.co.uk/Public-Health-Informatics-Information-Systems/dp/1441930183#_

http://www.amazon.co.uk/Public-Health-Informatics-Information-Systems/dp/1441930183#_

http://www.aaai.org/ocs/index.php/ICWSM/ICWSM11/paper/viewFile/2880/3264

http://www.aaai.org/ocs/index.php/ICWSM/ICWSM11/paper/viewFile/2880/3264

http://www.uic.edu/sph/prepare/courses/ph420/resources/PHInformatics.pdf

http://www.uic.edu/sph/prepare/courses/ph420/resources/PHInformatics.pdf

28

Managing Change

Short Description*: Successfully implementing eHealth projects depends on managing behavioural and attitudinal change in the intended users and the organisations in which they work. This course highlights the importance of understanding organisational contexts, workflows and routines, as well as user cultures and preferences, when designing and planning eHealth projects. It introduces key theories and methods from the management and organisational sciences relevant to process redesign, change management and effective project leadership, drawing on examples from the eHealth sector. Later weeks focus on real projects involving the of eHealth technologies in high and how income settings and what these tell us about the need to actively manage and evaluate change.





On completion of the course students should be able to:

Discuss and evaluate the key management theories

and models pertinent to organisational change

management

Apply these to support the adoption of new eHealth

technologies

Communicate the core principles of leadership,

management and change to others.



Collated forum postings in response to PBL questions: 30%.Essay: 70%.

Syllabus/Lecture List: Week 1) The meaning and organisational science of change Considers the sociotechnical complexity of eHealth projects,

exploring ‘change’ in terms of behaviours, cultures and

fundamental change in healthcare processes. Discusses the

core elements and principles of leadership, and ‘change

management’ as understood in the management sciences

and barriers to eHealth adoption.

29

Week 2) Theoretical models, planning and managing

change

Delves deeper into the theories of leadership, management

and change, reflecting on their relevant to eHealth projects.

Considers the practical tasks required for eHealth

implementation and formal methods for describing these.

Week 3)User Engagement

Investigates the importance of engaging users and opinion

leaders, and the value of continuous evaluation and redesign

during e-health implementation

Week 4)Change Management in Africa and the Middle

East

Compares and contrasts the challenges of managing change

in developing countries in different locations highlighting

similarities and unique aspects in different locations

Week 5)Change Management in the US and final thoughts

Provides an overview of the role of incentives in driving

change in a developed country and a summation of lessons

learnt through the course.






Understands the core concepts, theories and principles of leadership and change management and is able to apply these to eHealth.

Understands what is needed to develop a strong project plan which takes account of sociotechnical complexity and the need for active change management.

Shows potential to deliver a robust implementation plan for a new eHealth project or programme.


MGPHS (CPHS) 100%

30

Reading Lists:


Global eHealth Board. Convener. Claudia Pagliari

31

Term 2

Consumer Health Informatics

Name change: Patient e-Health

Justification:

The revision of the title for this course is proposed to reflect changing terminology in the field of patient care and information management and widening scope of activity in this area.

Short Description*: This course focuses on eHealth tools and services for

patients and members of the public, in an area traditionally

referred to as Consumer Health Informatics. It considers the

information needs of the lay person and how our increasing

access to digital media on the internet, though mobiles and

social networks is influencing healthcare delivery. Key

underpinning issues include information provenance and

changes in the balance of decision making between clinicians

and informed patients. It also considers the new role of

citizens and ‘expert patients’ as co-producers and curators of

health information, advocates for new forms of treatment and

mediators of health decision making.





On completion of the course students should be able to:

describe a broad range of digital tools for aiding

healthcare decisions and informing knowledge

amongst patients and healthy citizens

demonstrate a critical understanding of the core

principles of health communication theory and

behaviour change

to assess how lay people and experts judge the

validity of health information and advice

Evaluate the use of technology to promote and

maintain wellness and consider how technology has

changed patients interactionwith health services.

32

describe how citizen-centred digital health is changing

health decision making at local and national levels

through a discussion of the differing needs of citizens

n lower versus higher income settings.

evaluate a range of consumer health informatics tools.



Collated forum postings in response to PBL questions: 30% (10% activity, 20% quality).Essay: 70%

Syllabus/Lecture List: Week 1)The development of patient e-health, health

models and decision making

Focuses on the factors that have influenced the development

of patient e-health. Also investigates health belief models,

patient decision making and decision aids

Week 2)Patient e-Health applications

Summarises established e-Health applications such as digital

health information and explores the use of new technologies

for further enhancement of patient e-Health e.g. Wearables,

remote monitoring.

Week 3)Personal Health Records and interaction with

services

Discusses the ways in which patients’ have traditionally

obtained access to, or actively managed, their health records

and how online records and patient portals are set to change

this.

Week 4)Social Media, Digital Wellness and Fitness

agenda

Considers the social group or network as an active player in

health and the rise in the digital wellness fitness agenda

Week 5)Patient e-Health Developing Countries and final

thoughts

Challenges western concepts of patient-centeredness and

patient empowerment and considers the citizen in terms of

their technological access, health needs and economic, social

33

and political constraints and provides a summary of the

patient e-health course.






Understands the history and development of Consumer Health Informatics as a discipline

Can describe how the emergence of the digital society and recent forms of information and communication delivery are presenting new opportunities for the citizen and the patient. Recognises the contextual dependence of consumer health informatics.


MGPHS (CPHS) 100%

Reading Lists: Nelson R & Ball M eds. (2010) Consumer Informatics: Applications and Strategies in Cyber Health Care. Springer. Journals e.g. : Journal of Medical Internet Research http://www.jmir.org/ (Open access) Articles e.g.: Kreps G.L., Neuhauser L. (2010) New directions in eHealth communication: Opportunities and challenges Patient Education and Counseling, 78 (3) , pp. 329-336. http://www.pec-journal.com/article/S0738-3991(10)00022-4/abstract Reading sources will be updated each time the course runs.



http://www.jmir.org/

http://www.pec-journal.com/article/S0738-3991(10)00022-4/abstract

http://www.pec-journal.com/article/S0738-3991(10)00022-4/abstract

34

Ethics and Governance in eHealth

Short

Description*:

This course introduces the ethical, legal and regulatory context of eHealth. It

considers key ethical principles in healthcare research and how ethical

principles have been adopted in the field of ICT. Ethical dilemmas in eHealth

research and practice are presented with reference to examples of eHealth

interventions and projects in which the exchange, sharing and linkage of data

from systems and devices create risks for trust, privacy or patient safety.

Subsequent lectures introduce students to the key principles of information

governance and responsible innovation, with a particular, but not exclusive,

emphasis on the ways in which patient data are being re-used for medical

research. This will cover UK, European and wider principles and regulatory

devices for the protection of personal data privacy, technological standards for

cyber-security and international medical device directives. These will be set

within a broader consideration of the ethical and societal implications of ICTs

for wellness, health and science, with reference to national and global

contexts, As part of their assessment students will be expected to undertake

a forensic assessment of a selected health IT programme from one or more of

these perspectives.

Keywords2: Ethics, Health Information Governance, eHealth.

Default Delivery

Period*:

Term 2


Summary of

Intended

Learning

Outcomes*:

It is intended that students completing this course will be able to:

Debate and discuss the key ethical challenges facing eHealth at the

current time.

Demonstrate an understanding of the dynamic legal and regulatory

environment surrounding different types of eHealth innovation or

research problem.

Evaluate and assess the ethical and societal issues affecting projects

in this area

Develop the capacity to offer advice to others about the legal and

regulatory implications of their projects.

Special

Arrangements:


Components of

Assessment

(inc. %

weightings)*:

Collated forum postings: 30% Essay: 70%

35

Syllabus/Lecture

List:

Subsequent lectures

introduce students to

the key principles of

information

governance, including

the Caldicott principles,

the data protection act,

standards for security

and privacy and

international medical

device directives.

Students will be

expected to undertake

a forensic assessment

of one health IT

programme from one or

more of these

perspectives

Week 1) Introduction to healthcare ethics

Introduces established principles of ethical practice in medicine and

healthcare, including issues around informed consent, confidentiality and the

avoidance of harm.

Week 2) Ethics in ICT

How the IT and telecommunications sectors have approached the issue of

ethics in software design and how the ICT sector manages to balance

privacy protection with business flows.

Considers ethical dilemmas in eHealth with reference to examples of

interventions and projects in which the exchange, sharing and linkage of data

from systems and devices create risks for trust, privacy or patient safety.

Describes key principles of information governance, including data

guardianship and the Caldicott principles, the data protection act, standards

for security and privacy. Considers the trade-offs between Freedom of

Information (including Open Data) and data protection.

Week 3) Governance of data-driven health research

Focuses on the re-use of stored personal data for research purposes,

including concepts such as data linkage, safe havens, and

pseudonymisation, illustrated with reference to ‘big data’ projects in the UK

and elsewhere. The Ethics of online research will also be considered,

including digital surveys and data gleaning from web searches and

discussion threads. Where do the boundaries of privacy and consent lie?

Week 4) Cyber-risks and security

This session will introduce students to the ‘need-to-know’ principles and

methods of information security and data breach management. It will

consider international and local examples of significant data breaches and

their implications, examine the global marketplace for stolen healthcare data,

and run through the major approaches that are being taken by healthcare

organisations and individual citizens to safeguard their information.

Week 5) Innovation and the regulation of eHealth

Discusses the need for eHealth tools to comply with appropriate guidelines

regulations. This includes the European and US Medical Device Directives,

which prioritise patient safety, and international standards which emphasise

consistency and interoperability. It will consider the issue of ‘governability’ in

the context of global online markets and new devices, and examine both

established and emerging technologies and services, including examples

such as direct-to-consumer genetic testing converged with personal health

monitoring technologies, with reference to notions of personal control and

human rights.

Forensic case studies

Students will be expected to choose an example of a current eHealth project

or innovation to scrutinise in detail, drawing on a range of information sources

and the principles communicated in this course.

Study

Pattern/Course

Structure:

Divided into 5 sessions, each lasting a week. Most will contain written materials

and presentations, accompanied by guided reading in the form of links to

journal articles with problem-based learning questions

36

Discussion of the content and reading materials will be posted to an online

forum, along with students’ answers to the PBL questions. Discussion boards

will be moderated by the course tutors.

Students will be expected to produce a 2000 word essay by the end of the

course.

Benchmark

Statements

Assessed:

Can list and explain core ethical principles for medical practice and research

Can translate these to the context of eHealth, drawing on principles from the

ICT sector in addition to the above.

Is aware of the main oversight bodies for ethical compliance in eHealth

research and practice and the laws and penalties affecting data users.

Is able to judge the need for a new product to comply with relevant medical

device directives and what is required in terms of design or data management.

Shows an interdisciplinary perspective on eHealth ethics and governance,

drawing on concepts from social science, philosophy, law and technology

studies.

Teaching Load*

(% taught from

each School):

MGPHS (CPHS) 100%

Reading Lists: Book: Carlisle et al (2012) eHealth Ethical, Legal and Governance

Challenges. Springer.

Currently free to download on an individual user basis:

http://download.springer.com/static/pdf/620/bok%253A978-3-642-22474-

4.pdf?auth66=1386418246_ca534cd551aa0e2a2d470d24ef26eddd&ext=.pdf

Journal of eHealth Law and Policy http://www.e-comlaw.com/ehlp

Specific journal articles to be selected nearer the time of course delivery.

Convenor of

Board of

Examiners:


http://download.springer.com/static/pdf/620/bok%253A978-3-642-22474-4.pdf?auth66=1386418246_ca534cd551aa0e2a2d470d24ef26eddd&ext=.pdf

http://download.springer.com/static/pdf/620/bok%253A978-3-642-22474-4.pdf?auth66=1386418246_ca534cd551aa0e2a2d470d24ef26eddd&ext=.pdf

http://www.e-comlaw.com/ehlp

37

Term 3

User Centred Design

Short Description*: This course explores the principles in user-centred and participatory design. It includes how human factors relate to accessibility, requirements engineering, the social context of technology, the user experience and involvement. Students will also be introduced to different tests of usability.



Term 2




Identify why it is important to involve users in technology design.

Explain the different terms used to describe principles and processes of user involvement in design, and their theoretical and disciplinary underpinnings.

Explore the main techniques used to assess usability and capture requirements in laboratory and field settings.

Identify the most valuable types of user involvement at different phases of the technology lifecycle.

Evaluate the conceptual and design challenges presented by emerging social / virtual technologies.




Collated forum postings: 30%

Essay: 70%


Week 1) What can users do? Human factors; physiological and cognitive aspects; inclusive design; accessibility Week 2) What do users need? Requirements engineering; what people say they need versus what they actually need; qualitative and ethnographic methods Week 3) How can users collaborate? Computer-Supported Cooperative Work; distributed working; social context of technology Week 4) How can we tell technology is usable? Usability testing; heuristic evaluation; task analysis; user experience Week 5) How can we involve users in the process?

38

Summary of principles of user-centred design and participatory design that have been discussed in the previous weeks; preparation for assignment


Divided into 5 sessions, each lasting a week. Most will contain written materials and presentations, accompanied by guided reading in the form of links to journal articles with problem-based learning questions. The final session will be devoted to assignment preparation, facilitated by the course tutors.




Recognises the importance of capturing user perspectives and involving users in the design process

Is able to describe a range of methods for improving the usability of interactive computer-based systems

Is able to apply this knowledge to the analysis of eHealth tools and services.


MGPHS (CPHS) 100%

Reading Lists: Rogers Y, Sharp H & Preece J (2011) Interaction Design: Beyond Human Computer Interaction (3rd ed.) Wiley & Sons. Dix (2010) Human–computer interaction: A stable discipline, a nascent science, and the growth of the long tail. Interacting with Computers 2 (1)13-27 http://www.sciencedirect.com/science/article/pii/S0953543809000952 Timely journal articles, science and technology blogs and industry reports will be selected each time the course is run.



http://www.sciencedirect.com/science/article/pii/S0953543809000952

39

Research and Evaluation in eHealth

Short Description*:

Introduces the main research paradigms used in eHealth, their appropriateness for addressing different types of research problems and core principles and techniques for studying and evaluating eHealth. The course is compulsory for all students intending to proceed to the MSc, in preparation for the final year project. Specialist methodology options are available elsewhere in the programme (e.g. User-Centred Design) and our sister programmes in Public and Global Health (e.g. Qualitative Research, Systematic Reviewing), however guidance from project supervisors will also help to supplement this core learning for the purposes of specific projects.

Keywords: eHealth, Evaluation, Research Methods


Term 2




Examine and contrast the various research and evaluation approaches in e-health and their appropriateness for different research questions.

Demonstrate an understanding of the importance of rigour and ethical considerations in the research process.

Design a research study applying their knowledge about research methods and evaluation..

Examine and contrast the various research and evaluation approaches in e-health and their appropriateness for different research questions.

Demonstrate an understanding of the importance of rigour and ethical considerations in the research process.

Design a research study applying their knowledge about research methods and evaluation.




Collated forum postings in response to PBL questions: 30%.Essay: 70%.


Week 1) Research and evaluation in eHealth Introduces the purposes of research inquiry and evaluation, as typically practiced in the health sciences. These are discussed with reference to the different types of research problem characterising eHealth and the challenges of evaluating systems in practice. Students will be encouraged

40

to consider the whole technology lifecycle from concept to scaling, the types of questions that arise in each stage and for different types of technology or intervention, and the methods that are most suited to answering them. It includes inductive/exploratory research and deductive/evaluative approaches In addition to methods of usability and accessibility assessment, including quantitative and qualitative approaches in the lab and field, and how these are used to test and improve eHealth tools and software. The importance of iterative design, evaluation and improvement will be considered. Week 2) Qualitative Methods Provides a broad introduction to philosophies and traditions characterising qualitative research in studies of technology and innovation, including those derived from qualitative health research and Science and Technology studies. Interview methods: Directs students to guidelines for developing an interview protocol and undertaking the interview process, using examples from eHealth. Considers issues such as bias, consent, transcription and anonymisation. Also considers group-based interview methods, such as the focus group and deliberative public consultations, alongside relevant concepts such as group influence and snowball recruitment. Observational methods: Considers anthropological methods used in eHealth research and explores the concept of the researcher as participant, as well as more structured observational methods of data capture using checklists and automated logging.. Analysing qualitative data Introduces different methods of organising, sorting and deriving meaning from narrative data and the frameworks that can assist this process and improve reliability. This will involve group-work to develop a common coding scheme and discussion of the challenges of balancing subjective phenomenology and reliability. Week 3) Quantitative designs Comparative designs: Different types of controlled study for assessing the impacts and effectiveness of eHealth interventions and the methodological difficulties involved, such as effective blinding and changing interventions during real-world evaluations. Correlational designs: The use of routinely collected population-level data and survey data for associational research. Survey Methods: Key principles of effective survey design, dissemination and data analysis. Week 4) Key statistical methods An introduction to the main statistical techniques likely to be necessary for a masters-level project, including parametric and non-parametric tests of difference, methods of correlation and regression, and meta-analysis, as well as the appropriate preparation and presentation of descriptive statistics. Week 5) Systematic review methods Introduces the concept of the systematic evidence review as empirical research and highlights the stages involved, with reference to published articles. Considers the use of systematic review principles for the introduction to the final year project, as well the more rigorous requirements for a systematic review project.

41


The course will be divided into 5 sessions, each lasting a week. All sessions will contain written materials accompanied by guided reading in the form of links to journal articles.

Students will be expected to discuss the topics and reading materials on the online forum. Whole-class tasks will help to illustrate key methods and their challenges.

Students will be assessed using short answer questions linked to problem based learning questions embedded within each session. These will be collated and supplemented by a reflective overview at the end the course. Students will be expected to produce a 2000 word essay by the end of the course.


Understands the need for different forms of research at different phases of the technology lifecycle

Is able to formulate a clear and testable set of research questions

Grasps the principles and techniques necessary to undertake exploratory or evaluative eHealth research

Is able to understand a range of designs and analyses described in published research

Is in a position to begin designing a novel piece of research for the final year project


MGPHS (CPHS) 100%

Reading Lists: Wyatt J & Friedman C (2010) Evaluation methods in biomedical informatics. Springer. O-Leary Z (2013) The essential guide to doing your research project. Sage. Pagliari C (2007) Design and Evaluation in eHealth: Challenges and Implications for an Interdisciplinary Field. J Med Internet Res 9(2):e15 http://www.jmir.org/2007/2/e15/



http://www.jmir.org/2007/2/e15/

MSc in Global eHealth Programme Restructure Proposal · wishing to undertake PPD, such as those in the NHS and the eHealth business sector, which will help to further boost income

Documents