As is often the case, the ultimate reality will likely fall somewhere in the middle. Clearly the Web provides an unprecedented vehicle for knowledge dissemination. But education is so much more than a student absorbing knowledge. There is also the in-depth application of that knowledge for real-world purposes. I cannot help but wonder, for example, whether the Coursera natural language processing (NLP) course will enable a student to be able to implement a system that can detail with all the nuances of the narrative text generated by clinicians in the electronic health record. One thing that clinical informatics has taught us is the lack of predictability of technological interventions in healthcare settings.
Of course we have shown to our satisfaction at Oregon Health & Science University (OHSU) that pretty much all types of learning can be delivered online. But we have also learned that an education involves more than learning. Early on in our foray into distance learning, I was struck how we had developed, without deliberately trying to do so, a virtual community. When students join our program, they not only get access to our courses, but also our faculty, their student colleagues, and our connections to the larger informatics world, including our connections to industry. Even the staff in our office provide a conduit for their new journey into careers and other activities in the field.
But I am also, in a sense, part of this MOOC world, due to the Office of the National Coordinator for Health IT (ONC) Curriculum Project that has absorbed a great deal of my professional time, effort, and passion over the last couple years. All of this potential for disruptive innovation of informatics education therefore comes at a time of critical juncture for our field. We have been fortunate to have, for the first time in the history of our field, substantial federal investment, not only in the form of subsidized education for students, but also in the development of the ONC curricular materials. The verdict is still out on what impact the curricular materials will have on informatics education and training in the long run. But with the ARRA funding for them winding down, we are at a critical juncture in finding ways to sustain them (if we believe they are important) once the grant for them ends at the end of 2012.
In conclusion, I view the potential for disruptive innovation in higher education as a challenge and an opportunity. While I am not worried it will make my world dissipate like camera film or bank tellers, I do know the ride will be bumpy. But in the end, I am confident that education will be improved and possibly more cost-effective. I am also confident of the continued role I will play in advising students and others about directions and opportunities for our field. And if things ever do settle down, we can move on to the real challenge for disruptive innovation, which is the healthcare industry!
References
[1] Christensen, C. (1997). The Innovator’s Dilemma: When New Technologies Cause Great Firms to Fail. Boston, MA. Harvard Business School Press.
[2] Christensen, C. (2012). Disruptive Innovation, in Soegaard, M. and Dam, R., eds. Encyclopedia of Human-Computer Interaction. Aarhus, Denmark. The Interaction-Design.org Foundation.
[3] Lewin, T. (2012). Instruction for Masses Knocks Down Campus Walls. New York Times. March 4, 2012.
[4] Markoff, J. (2012). Online Education Venture Lures Cash Infusion and Deals With 5 Top Universities. New York Times. April 18, 2012.
[5] Brooks, D. (2012). The Campus Tsunami. New York Times. May 3, 2012.
[6] Friedman, T. (2012). Come the Revolution. New York Times. May 15, 2012.
[7] Hersh, W., Junium, K., et al. (2001). Implementation and evaluation of a medical informatics distance education program. Journal of the American Medical Informatics Association, 8: 570-584.
[8] Hersh, W. and Williamson, J. (2007). Educating 10,000 informaticians by 2010: the AMIA 10×10 program. International Journal of Medical Informatics, 76: 377-382.
[9] Hersh, W. (2007). The full spectrum of biomedical informatics education at Oregon Health & Science University. Methods of Information in Medicine, 46: 80-83.
[10] Hersh, W. (2010). The health information technology workforce: estimations of demands and a framework for requirements. Applied Clinical Informatics, 1: 197-212.
This article post first appeared on The Informatics Professor on May 19, 2012.  Dr. Hersh is a frequent contributing expert to HITECH Answers.