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					     “Turning it Over”, A
      Paradigm Shift for
    Research and Training
            Kimball, AM, Garcia, PJ,
             Curioso, WH, Blas M,
           Robertson,L, Chronister, L.
              Fuller, S, Holmes, K
University of Washington (USA), Universidad Peruana Cayetano Heredia (Peru)
            Turning it Over
   What are the requirements to “turn
    key” a productive research and
    training scholar program?
   What are the incentives?
   What are the obstacles?
   Should it become a “norm”? Why or
    why not?
    UPCH, Peru: A Well Networked
   UPCH has multiple partners
    and collaborations spanning
    20 years
   Including UW, NMRCD, Johns
    Hopkins, and other US and
    European universities, and
    individual investigator grants
    with NIH and other funding
   This asset was key to our
    turnkey approach
International Research and Training
Program in Health Informatics, built on
connections made through IARTP.
Relatively new discipline
1999 - 2004
$ 675,000

Amauta Global Health Informatics
Research and Training Center
2004 – 2009
$ 1’250,000
                      Short Courses:
                           - 2000 (MI)
Short Courses:             -2001 (MI)        Long-term
     - 2000 (MI)      - 2005 (MI and BIO)
      2001 (MI)       - 2008 (MI and BIO)
                                            - MSc (UW)
 2005 (MI and BIO)
                                             - MPH (UW)
- 2008 (MI and BIO)
                                            - PhDs (UW)

2000 Medical Informatics                            26
2001 Medical Informatics                            30
2005 Medical and Bio Informatics                    43
2008 Medical and Bio Informatics                    103
                                            Total   202
Masters and PhDs at UW
MSc Biomedical and Health Informatics                6
MPH                                                  2
PhDs                                                 2
                                            Total   10
Short-Term trainees and fellows
1 Librarian, 1 Physician in Health Information
   1fellow in GIS                                    3

    Year                N*               Pre-test           Post-test
                                         Mean%              Mean %
   2000                 25                  53                  71
   2001                 30                  48                  67
2005 MI                 18                 49.7                59.7
2005 BIO                21                 33.6                51.2
2008 MI                 50                  47                  54
2008 BIO                39                  64                  82
Percentage for Participant´s Performance on their Knowledge before (Pre-
test) and after (Post-test) the Courses
     Long-Term Master Training
     Former Trainees         Period                Training

Jorge Candiotti, MD, MPH,   2000-     MSc in Biomedical and Health
MS                          2002      Informatics
Silvia Pessah, MD, MPH,     2000-     MSc in Biomedical and Health
MS                          2002      Informatics
Adriel Olortegui, MD, MS    2001-     MSc in Biomedical and Health
                            2003      Informatics
Jesus Peinado, MD, MS       2001-     MSc in Biomedical and Health
                            2003      Informatics
Franz Calvo, MD, MPH        2002-     MSc in Biomedical and Health
                            2004      Informatics
                                      Certificate in Informatics
Walter Curioso, MD, MPH     2003-     Master in Public Health
                            2005      Certificate in Informatics
Magaly Blas, MD             2005-     Master in Public Health
                            2008      Certificate in Informatics
Mabel Raza, Ing             2007-     MSc in Biomedical and Health
                            2009      Informatics
                 Short-Term Training
      Trainee         Period   Training            Affiliation

Henry Chavez, Lic   2002-2002 Short-      Information processing
                              term        system at the library of
                                          Medicine at University
                                          Cayetano Heredia
Carlos Collantes,   2002-2002 Short-      Attending. Physician
MD                            term        Department of Surgery.
                                          Dos de Mayo Hospital.
                                          Lima, Perú
Elisa Solano, Ing   2008-2008 Short-      Geographical Information
                              term        System

Maritza Puray,      2005-2006 Post-doc    Researcher lab in Iquitos
Master                                    Peru
         Long-term PhD Training

Former Trainee Perio         Training                Affiliation
Walter Curioso,   2008- PhD in            Health Informatics Unit at School
MD, MPH           Curren Biomedical and   of Public Health and faculty
                  t      Health           instructor at Universidad Peruana
                         Informatics      Cayetano Heredia. Currently in
                                          Training at the University of
Magaly Blas, MD   2007-   PhD in          Researcher and instructor at the
                  2009    Epidemiology    Epidemiology Unit, STD / HIV from
                                          Universidad Peruana Cayetano

Mabel Raza, Ing   2010- PhD IN          Currently admitted for training at
                  Curren Biomedical and the University of Washington
                  t      Health
         Collaborative Supports
   Partners program for
    PH US students built
    bridges of trust with
    supervisors in Peru
   Videoconferencing
   Global Health
    application and
   Re-entry grants
   Successful FIRCA
    applications (Curioso,
         “How” we collaborate…
   Partnership: everyone participating adds value and the
    best solutions result from joint engagement
   Openness: each participant needs to focus on what they
    encounter rather than what they expect
   Uniqueness: every location has a set of norms that
    determine "how things are done," every sponsor brings
    guidelines requiring compliance
   Series of steps: enhance understanding of external
    expectations and internal current capacity, mutual support
    systems, modify collaborative traditions to share best
    practices and talents, train the trainers, outreach and
    marketing the new vision
         Where are we going…
   Self-sufficiency: the outcome sought by the
    partnership is self-sufficiency - both in
    competitiveness and local choice of focus
    (research and academic)
    Sustainability: clarity about the strategy
    required to achieve the vision and the
    requiredstructures (people, resources, systems,
    networks, status) that last beyond the project
    period- Transform thinking from a project to
    project survival approach to building a research
    systemthat is able to build resources and be at
    choice about what research questions are
The key to turn key is not entirely
      academic capacity
                     UPCH and UW
                      leadership in Research
                      administration and
                      support was also key

                     The structure of UPCH
                      since its foundation
                      promotes research

                     Admin support from
                      UW insights in Global
                      Support project (risk
          QUIPU- UPCH Lead
   Presents absolute advantage in Andean
    networking for broader impact
   Presents relative advantage in cost
    effectiveness of investment
   Turn key results appear to be on track
    with productivity and training
   Overall regional assessment (report
    pending) will provide additional insights
    for mapping future. (This is ready and
    submitted for publication)
QUIPU Meeting   (Lima, Peru March 2010)
March 2010, Lima, Peru
Developing Capacity in Health Informatics in a Resource Poor Setting: a
Case Study from Peru
Ann Marie Kimball1, Walter H. Curioso1, 2, Yuzo Arima*1, Sherrilynne Fuller1, Patricia J.
Garcia2, Jose Segovia-Juarez2, Jesus M. Castagnetto2, Fabiola Leon-Velarde2, King K.

Evaluation of a joint Bioinformatics and Medical Informatics international
course in Peru
BMC Medical Education 2008, 8:1 doi:10.1186/1472-6920-8-1
Walter H Curioso, Jacquelyn R Hansen, Arturo Centurion-Lara, Patricia J Garcia, Fredric
M Wolf, Sherrilynne Fuller, King K Holmes, Ann M Kimball

Informatics for Peru in the New Millennium
Bryant Thomas Karras M.D. a, Ann Marie Kimball M.D. a, Virginia Gonzales Ed.D. a,
Nedra A. Pautler MS, MA a, Jorge Alarcón, M.D. b, Patricia Garcia, M.D. c, Sherrilynne
Fuller, Ph.D.
                 In Sum…
   Moving the agenda of Informatics into a
    South South collaborative mode appears
   Obstacles for generalization beyond this
    case may include administrative
    infrastructure as importantly as academic
   Aspirational incentives for northern
    universities are in place but financial
    incentives are not in place and could be
   The move has benefitted the collaboration
           …And we go on
   UW/UPCH consortium awarded a
    Frameworks Signature grant to train
    postdoctoral global health students
    in Leadership, Policy, Management
   Focused on exchange, case based
   Brings in 4 UW schools…
   Stay tuned…..
Definition of Success

Open up trust for the value of research
 without borders (i.e., between
 institutions, as regional consortia, across
 national borders)

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