Online Courses

The BCH Department of Medical Education produces online CME in partnership with OPENPediatrics. Online CME that is distributed on the OPENPediatrics platform is commercial. Commercial Online CME may be produced in conjunction with an in-person course, or it may be designed and developed as an online-only course. Non-commercial RSS for internal audiences only can also be produced, but that is hosted on the DME website.

Process for Developing Online Courses

The process for developing online courses, summarized in this flow chart, has five main phases. Each phase is handled primarily by either the DME or OP, although the groups work closely together throughout each phase of the project.

Phase Primary Owner Activity
1. Project Initiation DME Project is reviewed and assessed for marketability and copyright liability (see copyright section).
2. Pre-production DME
  • Speaker orientation
  • Image copyright review
  • Slide Formatting
  • Citation Formatting
  • Image research & revisions
  • Reference review, research and revision
3. Production OP Record & Edit presentation.
4. Course Build OP Develop course in OPENPediatrics platform.
5. Quality Assurance & Release OP Editorial Review and Approval Technical Review.

Speaker Deliverables


Online course development places demands on authors/speakers that in-person courses do not. The dependencies that impact our ability to publish an online course on time and within budget include:

  • Ownership, rights or permissions for commercial publication of images used in the presentation
  • Ability of author to meet deadlines for content deliverables (see below)
  • Author availability for recording and content reviews
  • Author Responsiveness to queries

Speaker Deliverables

  • Course description & Objectives
  • Presentation slides
  • Citations
  • Assessment questions
  • Responses to image rights questionnaire


Project timelines for online courses vary widely with the dependencies described above. Assuming no significant delays due to those dependencies, the time frame for single 30-60 minute didactic presentation is 10 weeks.

Copyright Overview

What is Copyright?

Copyrigh is a form of intellectual property law that protects original works of authorship, including literary, dramatic, musical, and artistic works, such as poetry, novels, movies, songs, computer software, and architecture.

Copyright gives the originator of such work the exclusive legal right to print, publish, perform, film, or record literary, artistic, or musical material, for a fixed number of years.
The copyright holder can assign the copyright to another person or organization.
Copyright does not protect facts, ideas, systems, or methods of operation, although it may protect the way these things are expressed.
A Work is under copyright protection the moment it is created and fixed in a tangible form.

How Does Copyright Apply to my Presentation?

Most speaker include images in their presentations. Images may include photos of clinical conditions, diagnostic images (e.g., scan, scopes, sonograms), charts, graphs, tables, etc. Copyrighted images used in presentations published on OPENPediatrics require

  • Ownership, license, public domain, or permission to use the image for commercial purposes
  • Removal of Protected Health Information
  • Consent from anyone who can be identified in a photo (or the parent/guardian of minors).
    NOTE: consent is not required for anyone who has been de-identified, e.g., by blurring or blacking out eyes.

Access does NOT equal permission!

Just because images are freely available online doesn’t mean they are not copyrighted.

CME on OPENPediatrics does NOT qualify for Fair Use due to the fact that it is a commercial product distributed to an external audience.

Images incorporated in a presentation that is published online for a fee may – or may not – be subject to copyright. There are several considerations for determining whether or not an image is subject to copyright, as illustrated by this decision tree.

Policy Governing Use of Images


 Just because materials are freely available online doesn’t mean they are not copyrighted! Use of creative work owned by others in enduring online commercial products puts OPENPediatrics and Boston Children’s Hospital at risk for copyright infringement.


OPENPediatrics requires the following for display of any visual content such as tables, charts, graphs, photos, scans, illustrations, etc. on our site:

  1. Rights, license, or permission to use the work for commercial purposes, (see usable images below).
  2. Removal of Protected Health Information from diagnostic images (scans, sonograms, etc.)
  3. Consent from anyone who can be identified in a photo (or the parent/guardian of minors). NOTE: consent is not required for anyone who has been de-identified, e.g., by blurring or blacking out eyes.
  4. Source information for the work in question, including URL (if applicable) and author/owner (if known).

 Conditions under which copyrighted images may be used

  • You created and own the image
  • BCH owns the image – e.g., you or a BCH colleague created/ a BCH colleague in the course of clinical activity
  • Explicit permission to use in commercial products has been granted through
    • paid license
    • Creative Commons or other license.
  • The image is in the public domain
    • some works created by the government
    • works published in the US prior to 1923, and maybe after, depending on publication details

Images that are NOT subject to copyright

  • Diagnostic imagery (output from monitors, radiological images, sonograms, scopes etc.)
    • PHI must be removed.
  • Representations of plain data that has not been creatively enhanced.
    • Plain bar charts, pie charts, scatter plots and other presentations of data may be OK to include, but we will need source information to make this determination and cite appropriately.

 Permissions Process

A structured process is necessary to ensure we adhere to copyright guidelines, and reduce project timelines. For any material that you did not create or photograph yourself (“third-party content”), or do not have license or permission to publish online for commercial purposes:



The images is NOT essential for communicating presentation content (e.g. decorative images, comics)

Remove image from presentation.

Images is essential to the substance of your presentation

Try and obtain permission for use from copyright holder, or

Work with OP to create an substitute image

Note: these are resource intensive processes.

How to Find Open Access/ Creative Commons materials

Google Search:

  • Select Images under the search bar to limit your search to images.
  • Then click “Tools,”>”Usage Rights”>”labeled for reuse”.
  • Be sure to save the URL of each item.

Creative Commons search: Be sure to save the URL of each item.

OPENi (Open Access Biomedical Image Search Engine):

Hardin MD Public Domain Medical Gallery:

History of Medicine

CDC Public Health Image Library (PHIL)

MedPix (searchable online open access medical image database):