Digital Health Education for the Future: The SaNuRN (Santé Numérique Rouen-Nice) Consortium's Journey.

SaNuRN is a five-year project by the University of Rouen Normandy (URN) and the Côte d'Azur University (CAU) consortium to optimize digital health education for medical and paramedical students, professionals, and administrators. The project includes a skills framework, training modules, and teaching resources. In 2027, SaNuRN is expected to train a significant portion of the 400,000 health and paramedical professions students at the French national level. Our purpose is to give a synopsis of the SaNuRN initiative, emphasizing its novel educational methods and how they will enhance the delivery of digital health education. Our goals include showcasing SaNuRN as a comprehensive program consisting of a proficiency framework, instructional modules, and educational materials and explaining how SaNuRN is implemented in the participating academic institutions. SaNuRN is a project aimed at educating and training health-related and paramedics students in digital health. The project results from a cooperative effort between URN and CAU, covering four French departments. The project is based on the French National Referential on Digital Health (FNRDH), which defines the skills and competencies to be acquired and validated by every student in the health, paramedical, and social professions curricula. The SaNuRN team is currently adapting the existing URN and CAU syllabi to FNRDH and developing short-duration video capsules of 20 to 30 minutes to teach all the relevant material. The project aims to ensure that the largest student population earns the necessary skills, and it has developed a two-tier system involving facilitators who will enable the efficient expansion of the project's educational outreach and support the students in learning the needed material efficiently. With a focus on real-world scenarios and innovative teaching activities integrating telemedicine devices and virtual professionals, SaNuRN is committed to enabling continuous learning for healthcare professionals in clinical practice. The SaNuRN team introduced new ways of evaluating healthcare professionals by shifting from a knowledge-based to a competencies-based evaluation, aligning with the Miller teaching pyramid and using the Objective Structured Clinical Examination and Script Concordance Test in digital health education. Drawing on the expertise of URN, CAU, and their public health and digital research laboratories and partners, the SaNuRN project represents a platform for continuous innovation, including telemedicine training and living labs with virtual and interactive professional activities. The SaNuRN project provides a comprehensive, personalized 30-hour training package for health and paramedical students, addressing all 70 FNRDH competencies. The program is enhanced using AI and NLP to create virtual patients and professionals for digital healthcare simulation. SaNuRN teaching materials are open-access. The project collaborates with academic institutions worldwide to develop educational material in digital health in English and multilingual formats. SaNuRN offers a practical and persuasive training approach to meet the current digital health education requirements.

Sharing Digital Health Educational Resources in a One-Stop Shop Portal: Tutorial on the Catalog and Index of Digital Health Teaching Resources (CIDHR) Semantic Search Engine.

BACKGROUND: Access to reliable and accurate digital health web-based resources is crucial. However, the lack of dedicated search engines for non-English languages, such as French, is a significant obstacle in this field. Thus, we developed and implemented a multilingual, multiterminology semantic search engine called Catalog and Index of Digital Health Teaching Resources (CIDHR). CIDHR is freely accessible to everyone, with a focus on French-speaking resources. CIDHR has been initiated to provide validated, high-quality content tailored to the specific needs of each user profile, be it students or professionals. OBJECTIVE: This study's primary aim in developing and implementing the CIDHR is to improve knowledge sharing and spreading in digital health and health informatics and expand the health-related educational community, primarily French speaking but also in other languages. We intend to support the continuous development of initial (ie, bachelor level), advanced (ie, master and doctoral levels), and continuing training (ie, professionals and postgraduate levels) in digital health for health and social work fields. The main objective is to describe the development and implementation of CIDHR. The hypothesis guiding this research is that controlled vocabularies dedicated to medical informatics and digital health, such as the Medical Informatics Multilingual Ontology (MIMO) and the concepts structuring the French National Referential on Digital Health (FNRDH), to index digital health teaching and learning resources, are effectively increasing the availability and accessibility of these resources to medical students and other health care professionals. METHODS: First, resource identification is processed by medical librarians from websites and scientific sources preselected and validated by domain experts and surveyed every week. Then, based on MIMO and FNRDH, the educational resources are indexed for each related knowledge domain. The same resources are also tagged with relevant academic and professional experience levels. Afterward, the indexed resources are shared with the digital health teaching and learning community. The last step consists of assessing CIDHR by obtaining informal feedback from users. RESULTS: Resource identification and evaluation processes were executed by a dedicated team of medical librarians, aiming to collect and curate an extensive collection of digital health teaching and learning resources. The resources that successfully passed the evaluation process were promptly included in CIDHR. These resources were diligently indexed (with MIMO and FNRDH) and tagged for the study field and degree level. By October 2023, a total of 371 indexed resources were available on a dedicated portal. CONCLUSIONS: CIDHR is a multilingual digital health education semantic search engine and platform that aims to increase the accessibility of educational resources to the broader health care-related community. It focuses on making resources "findable," "accessible," "interoperable," and "reusable" by using a one-stop shop portal approach. CIDHR has and will have an essential role in increasing digital health literacy.

WikiMeSH: Multi Lingual MeSH Translations via Wikipedia.

OBJECTIVE: The aim of this paper is to propose an extended translation of the MeSH thesaurus based on Wikipedia pages. METHODS: A mapping was realized between each MeSH descriptor (preferred terms and synonyms) and corresponding Wikipedia pages. RESULTS: A tool called "WikiMeSH" has been developed. Among the top 20 languages of this study, seven have currently no MeSH translations: Arabic, Catalan, Farsi (Iran), Mandarin Chinese, Korean, Serbian, and Ukrainian. For these seven languages, WikiMeSH is proposing a translation for 47% for Arabic to 34% for Serbian. CONCLUSION: WikiMeSH is an interesting tool to translate the MeSH thesaurus and other health terminologies and ontologies based on a mapping to Wikipedia pages.

Translating ICD-11 into French using lexical-based approach: a preliminary study.

To translate the 11th edition of the International Classification of Diseases (ICD-11) into French, we proposed a lexical approach using Natural Language Processing techniques. This method relies on the 56 biomedical terminologies and ontologies included in the Cross-lingual Health Multiple Terminologies and Ontologies Portal. From a sample of 336 ICD-11 terms, the algorithm translated 164 (49%) terms into at least one French term each.

A search engine to access PubMed monolingual subsets: proof of concept and evaluation in French.

BACKGROUND: PubMed contains numerous articles in languages other than English. However, existing solutions to access these articles in the language in which they were written remain unconvincing. OBJECTIVE: The aim of this study was to propose a practical search engine, called Multilingual PubMed, which will permit access to a PubMed subset in 1 language and to evaluate the precision and coverage for the French version (Multilingual PubMed-French). METHODS: To create this tool, translations of MeSH were enriched (eg, adding synonyms and translations in French) and integrated into a terminology portal. PubMed subsets in several European languages were also added to our database using a dedicated parser. The response time for the generic semantic search engine was evaluated for simple queries. BabelMeSH, Multilingual PubMed-French, and 3 different PubMed strategies were compared by searching for literature in French. Precision and coverage were measured for 20 randomly selected queries. The results were evaluated as relevant to title and abstract, the evaluator being blind to search strategy. RESULTS: More than 650,000 PubMed citations in French were integrated into the Multilingual PubMed-French information system. The response times were all below the threshold defined for usability (2 seconds). Two search strategies (Multilingual PubMed-French and 1 PubMed strategy) showed high precision (0.93 and 0.97, respectively), but coverage was 4 times higher for Multilingual PubMed-French. CONCLUSIONS: It is now possible to freely access biomedical literature using a practical search tool in French. This tool will be of particular interest for health professionals and other end users who do not read or query sufficiently in English. The information system is theoretically well suited to expand the approach to other European languages, such as German, Spanish, Norwegian, and Portuguese.

The Foundational Model of Anatomy in OWL 2 and its use.

OBJECTIVE: The objective is to represent the Foundational Model of Anatomy (FMA) in the OWL 2 Web Ontology Language (informally OWL 2), and to use it in a European cross-lingual portal of health terminologies for indexing and searching Web resources. Formalizing the FMA in OWL 2 is essential for semantic interoperability, to improve its design, and to ensure its reliability and correctness, which is particularly important for medical applications. METHOD AND MATERIAL: The native FMA was implemented in frames and stored in a MySQL database backend. The main strength of the method is to leverage OWL 2 expressiveness and to rely on the naming conventions of the FMA, to make explicit some implicit semantics, while improving its ontological model and fixing some errors. Doing so, the semantics (meaning) of the formal definitions and axioms are anatomically correct. A flexible tool enables the generation of a new version in OWL 2 at each Protégé FMA update. While it creates by default a 'standard' version of the FMA in OWL 2 (FMA-OWL), many options allow for producing other variants customized to users' applications. Once formalized in OWL 2, it was possible to use an inference engine to check the ontology and detect inconsistencies. Next, the FMA-OWL was used to derive a lightweight FMA terminology for a European cross-lingual portal of terminologies/ontologies for indexing and searching resources. The transformation is mainly based on a reification process. RESULT: Complete representations of the entire FMA in OWL 1 or OWL 2 are now available. The formalization tool is flexible and easy to use, making it possible to obtain an OWL 2 version for all existing public FMA. A number of errors were detected in the native FMA and several patterns of recurrent errors were identified in the original FMA. This shows how the underlying OWL 2 ontology is essential to ensure that the lightweight derived terminology is reliable. The FMA OWL 2 ontology has been applied to derive an anatomy terminology that is used in a European cross-lingual portal of health terminologies. This portal is daily used by librarians to index Web health resources. In August 2011, 6481 out of 81,450 health resources of CISMeF catalog (http://www.chu-rouen.fr/cismef/--accessed 29.08.12) (7.96%) were indexed with at least one FMA entity. CONCLUSION: The FMA is a central terminology used to index and search Web resources. To the best of our knowledge, neither a complete representation of the entire FMA in OWL 2, nor an anatomy terminology available in a cross-lingual portal, has been developed to date. The method designed to represent the FMA ontology in OWL 2 presented in this article is general and may be extended to other ontologies. Using a formal ontology for quality assurance and deriving a lightweight terminology for biomedical applications is a general and promising strategy.

Performance evaluation of Unified Medical Language System®'s synonyms expansion to query PubMed.

BACKGROUND: PubMed is the main access to medical literature on the Internet. In order to enhance the performance of its information retrieval tools, primarily non-indexed citations, the authors propose a method: expanding users' queries using Unified Medical Language System' (UMLS) synonyms i.e. all the terms gathered under one unique Concept Unique Identifier. METHODS: This method was evaluated using queries constructed to emphasize the differences between this new method and the current PubMed automatic term mapping. Four experts assessed citation relevance. RESULTS: Using UMLS, we were able to retrieve new citations in 45.5% of queries, which implies a small increase in recall. The new strategy led to a heterogeneous 23.7% mean increase in non-indexed citation retrieved. Of these, 82% have been published less than 4 months earlier. The overall mean precision was 48.4% but differed according to the evaluators, ranging from 36.7% to 88.1% (Inter rater agreement was poor: kappa = 0.34). CONCLUSIONS: This study highlights the need for specific search tools for each type of user and use-cases. The proposed strategy may be useful to retrieve recent scientific advancement.

[Searching French institutional health information sources: catalogue and index of French-language medical sites (CISMeF)]. / Recherche des sources d'information institutionnelle de santé françaises: le "Catalogue et index des sites médicaux francophones" (CISMeF).

The Catalogue and index of French-language medical sites (CISMeF) is a medical portal that provides users with results as pertinent as possible according to their requirements, expectations, and context of use. Indexing and single-term research are based on theMedical subject headings(MeSH) thesaurus. The integration of new medical terminology for indexing the catalogue's resources is intended to minimize false-negatives during searches and to contextualize the users' needs. The creation of a drug information portal makes more targeted research possible, with numerous entries according to user (physicians, pharmacists, chemists, and pharmacologists). For simplicity's sake, the catalogue's index of resources by different nomenclatures is not entirely displayed. The choice of display is left to the user, with MeSH only as the default. These multi-nomenclature tools should be applicable as well to electronic patient records. In this case, the objective is to improve patient care by better searches and identification of the information required during consultations and hospitalization.

Web impact factor: a bibliometric criterion applied to medical informatics societies' web sites.

Several methods are available to evaluate and compare medical journals. The most popular is the journal Impact Factor, derived from averaging counts of citations to articles. Ingwersen adapted this method to assess the attractiveness of Web sites, defining the external Web Impact Factor (WIF) to be the number of external pages containing a link to a given Web site. This paper applies the WIF to 43 medical informatics societies' Web sites using advanced search engine queries to obtain the necessary link counts. The WIF was compared to the number of publications available in the Medline bibliographic database in medical informatics in these 43 countries. Between these two metrics, the observed Pearson correlation was 0.952 (p < 0.01) and the Spearman rank correlation was 0.548 (p < 0.01) showing in both cases a positive and strong significant correlation. The WIF of medicalm informatics society's Web site is statistically related to national productivity and discrepancies can be used to indicate countries where there are either weak medical informatics associations, or ones that do not make optimal use of the Web.

Webmastering in academic institutions: a new job opportunity.

In cyberspace, the health webmaster could be regarded as a virtual editor-in-chief, in charge of content and design. In this circumstance, he/she must follow quality criteria when building any resource. At the Rouen University Hospital (RUH), we have chosen "Net Scoring" as an effective tool to aid the design of a quality Web site. "Net Scoring" contains a list of 49 criteria which fall into eight categories: credibility, content, links, design, interactivity, quantitative aspects, ethics, and accessibility. The webmaster is the key element of the editorial board process. He/she must regularly monitor the Web site in order to retrieve information about whether the site is used and by whom: the method most commonly used is log analysis. At the RUH, an average of 9,000 unique machines visit our Web site each working day. Webmaster is a new job opportunity in academic institutions, in particular for medical informaticians and medical librarians both whom are information science professionals.