28^th International Conference on Pediatrics Health August 12-13, 2019 Rome, Italy

Ahmad Baghal is Faculty in the Department of Biomedical Informatics and Director of the Arkansas Clinical Data Repository (AR-CDR) at the University of Arkansas for Medical Sciences (UAMS). He is Health Informaticist with wealth of skills in healthcare and computer technologies acquired across a wide range of professional roles, Postdoctoral Fellowships and Graduate Education in medicine, computer science and biomedical Informatics. He led implementation of clinical Enterprise Data Warehouse and accelerated utilization of several medical and public health projects.

The aim of implementing Clinical Enterprise Data Warehouse (cEDW) at the University of Arkansas for Medical Sciences (UAMS) was to provide researchers dedicated data source for the conduct of clinical and translational research. Retrospective data analysis has increasingly enhanced breadth and wealth of knowledge of diseases and triggered development of novel treatments to improve patients outcomes. Acute Kidney Injury (AKI) is serious medical condition with detrimental health effects, poor outcomes and high mortality rate. It affects 15% of hospitalized patients and incidence of 1% among the general population. However, little is known about predictors of patients’ outcomes: Survival, chronic kidney disease or death. UAMS, in collaboration with four other medical centers, embarked on a study to identify modifiable factors that lead to poor outcomes among AKI patients. The cohort definition included patients who received renal dialysis, had no diagnosis of end stage renal disease and had no history of kidney transplant or chronic kidney disease stage 5 at time of first dialysis. Data points including demographics, diagnoses, procedures, comorbidities, laboratory results and medications, would be extracted from respective medical centres cEDW and because of the different cEDW implementations between the sites, it was expected data harmonization challenges would be raised. The real challenge was extracting and organizing renal dialysis treatment modalities, intermittent haemodialysis and continuous renal replacement therapy, data points from each respective centre cEDW’s flow sheets. Not only some centers used paper-based documentation of modalities, but understanding of clinical workflows was critical in producing complete and meaningful data for analysis.

Ahmad Baghal is Faculty in the Department of Biomedical Informatics and Director of the Arkansas Clinical Data Repository (AR-CDR) at the University of

Arkansas for Medical Sciences (UAMS). He is Health Informaticist with wealth of skills in healthcare and computer technologies acquired across a wide range

of professional roles, Postdoctoral Fellowships and Graduate Education in medicine, computer science and biomedical Informatics. He led implementation of

clinical Enterprise Data Warehouse and accelerated utilization of several medical and public health projects.

The aim of implementing Clinical Enterprise Data Warehouse (cEDW) at the University of Arkansas for Medical

Sciences (UAMS) was to provide researchers dedicated data source for the conduct of clinical and translational

research. Retrospective data analysis has increasingly enhanced breadth and wealth of knowledge of diseases and

triggered development of novel treatments to improve patients outcomes. Acute Kidney Injury (AKI) is serious medical

condition with detrimental health effects, poor outcomes and high mortality rate. It affects 15% of hospitalized patients

and incidence of 1% among the general population. However, little is known about predictors of patients’ outcomes:

Survival, chronic kidney disease or death. UAMS, in collaboration with four other medical centers, embarked on a study

to identify modifiable factors that lead to poor outcomes among AKI patients. The cohort definition included patients

who received renal dialysis, had no diagnosis of end stage renal disease and had no history of kidney transplant or chronic

kidney disease stage 5 at time of first dialysis. Data points including demographics, diagnoses, procedures, comorbidities,

laboratory results and medications, would be extracted from respective medical centres cEDW and because of the different

cEDW implementations between the sites, it was expected data harmonization challenges would be raised. The real

challenge was extracting and organizing renal dialysis treatment modalities, intermittent haemodialysis and continuous

renal replacement therapy, data points from each respective centre cEDW’s flow sheets. Not only some centers used

paper-based documentation of modalities, but understanding of clinical workflows was critical in producing complete

and meaningful data for analysis.

Ahmed Makki works as an Assistant Professor of Surgery at Medical School- Department of Surgery. He works as Examiner of the Royal College of Surgeons in Ireland. I.D. 2121, Examiner of the Royal College of Surgeons of Edinburgh. I.D. 2121, Fellow of the Royal College of Surgeons in Ireland, Fellow of the Royal College of Surgeons of Edinburgh, Fellow of the Royal College of Surgeons of Glasgow and Fellow of the Royal College of Surgeons of England. He has several credentials like Membership of the Royal College of Physicians & Surgeons of Glasgow, Fellowship of the Royal College of Surgeons in Ireland, Fellowship of the Royal College of Surgeons of Edinburgh, Fellowship of the Royal College of Surgeons of Glasgow and Fellowship of the Royal College of Surgeons of England.

In medical practice there is confusion between integrative medicine and integrated medical education, to eliminate this unintended confusion, we have to define each of them clearly. By integrative medicine we mean combination between the western medicine and the complementary alternative medicine, which is based on 5 domains: Biologically based approaches, manipulative therapies, mind-body interventions, alternative medicine and energy therapy, while integrated medical education is a planned interdisciplinary unit of medical educational experience. The set of medical courses and their contents that students learn under guidance of the university to achieve the graduate competencies is known as medical curriculum which has several faces as explicit, implicit, up to extra-curricular

set. The medical curriculum structure may take the form of Discrete, Linear, Pyramidal or Spiral structure. Harden in 1984 had suggested that integration as one of the keys for assessing the degree of innovation in medical curricula through the SPICES strategy, which includes student cantered learning, problem based-learning, integration and community based with systemic approach. In 2000, he proposed harden ladder which explains the 11 blocks that lead to the integration in medical courses ranging from isolation up to multi, inter, tran disciplinary approaches. This entire study illustrates the steps of initiating integrated medical course in details, with illustration of the advantages and disadvantages of integration in medical education. The study also highlights the phases of evaluation and how to improve the existing integrated course via improving content, evaluation methods as well as the outcome of medical education.