Subspecialty Training in Clinical Informatics

0

Clinical informatics is a new medical subspecialty that focuses on medical data, clinical processes, and computational systems applied to the practice of medicine.1,2 In other words, how we can use computers to maximize patient care, improve outcomes, decrease costs, and improve efficiency of care. The subspecialty was approved by the American Board of Medical Specialties in 2011, with the first board certification exam given in 2013 through the American Board of Preventive Medicine.

Clinical informatics is interdisciplinary and draws on elements from clinical medicine, the health care system, and information technology. While there is some overlap, it is not simply “doctors using computers,” medical computer programming, genomics, or epidemiology. Instead, clinical informatics strives to improve the practice of medicine by integrating medical data, clinical processes, and computational systems intelligently. Ideally, the use of clinical informatics can help identify people with certain diseases earlier, maximize their care, and improve coordination of care among a team of medical professionals.

Physicians who specialize in clinical informatics assess the information needs of providers, patients, administrators, nurses, regulators, and researchers. They analyze clinical processes and implement clinical information systems that augment those processes. They provide leadership and expertise in the evaluation, procurement, customization, development, and management of information technology. They work with a myriad of different hospital computer systems, including electronic health record systems, decision support systems, practice management tools, network and communication systems, imaging systems, telehealth systems, clinical research systems, public health systems, and genomic systems. They find employment as chief medical information officers (CMIOs), researchers, educators, and in industry — all of which are in high demand and with job growth four times as fast as the health care field in general.3,4

Training Requirements

The creation of this new subspecialty has standardized the training requirements for those entering the field. These fellowship programs, as approved by the Accreditation Council for Graduate Medical Education (ACGME), must be at least 24 months in length, with fellows dividing their time between informatics activities, didactics, research, and clinical work in their primary specialties.5,6

Applicants for fellowship must have completed a residency in at least one of the member boards of the American Board of Medical Specialties. In addition, they must hold an unrestricted medical license in the United States or Canada.7 Applicants do not need to have a technical background and there is no prerequisite training in computer science or any related discipline. However, they need to demonstrate a strong interest and aptitude for clinical informatics.

Prerequisite Activities

When considering this subspecialty, it is recommended that applicants engage in activities throughout medical school and residency that solidify their interest and demonstrate their commitment to the field. Some preliminary suggestions on how to get involved in clinical informatics are listed below.

  • Participation. The American Medical Informatics Association (AMIA) is the premier academic society for biomedical and health informatics and has been the driving force behind the new clinical informatics subspecialty (www.amia.org). You can get involved in the AMIA through their student working group, annual fall symposium, career mentorship program, and educational activities. Other professional societies include the IEEE Engineering in Medicine and Biology Society (www.embs.org), the ACM Special Interest Group on Bioinformatics, Computational Biology, Biomedical Informatics (www.sigbioinformatics.org), and the Healthcare Information and Management Systems Society (www.himss.org).
  • Experience. A good way to gain experience in clinical informatics is to do an elective rotation as a medical student or resident. Depending on your interests, you have a number of options. You can do a research elective where you perform a literature review on a relevant topic, develop a training curriculum, design a new computational tool, or evaluate a clinical process. Alternatively, you can complete a practical elective where you might join an informatics team that is implementing, installing, or evaluating a new electronic health record system. Participation in institutional informatics governance committees is another useful venue to gain experience and show interest.
  • Education. Clinical informatics is an interdisciplinary specialty that draws from clinical medicine, the health care system, and information technology. You can take a class at a local university in one of these related disciplines. In addition, you can participate in the clinical informatics grand rounds at your school. If your program does not have one, there are several clinical informatics grand rounds available online.
  • Literature. It is important to keep up with the clinical informatics literature. This includes the Journal of the American Medical Informatics Association, which is the principal journal in the field. Other important journals include the International Journal of Medical Informatics, the Journal of Biomedical Informatics, Methods of Information in Medicine, the Journal of Medical Internet Research, and Computers in Biology and Medicine.
  • Activities. If your medical school or residency program has a special interest group in clinical informatics, get involved. If it does not have one, consider creating one yourself. Another suggestion is to talk to your chief resident and offer to present articles on clinical informatics at your program’s journal club or give a lecture on the topic. At the national level, you can get involved in informatics policy at the National Learning Consortium through the Office of the National Coordinator for Health Information Technology (www.HealthIT.gov).

All of these activities can be used to learn more about the new subspecialty of cinical informatics. They can help practicing physicians who may want to break into the informatics workforce. In addition, for those seeking board certification, they can be used as prerequisite activities for subspecialty fellowship training.

The subspecialty was approved by the American Board of Medical Specialties in 2011, with the first board certification exam given in 2013 through the American Board of Preventive Medicine.

REFERENCES

  1. Detmer DE, Lumpkin JR, Williamson JJ. Defining the medical subspecialty of clinical informatics. J Am Med Inform Assoc. 2009;16(2):167-168.
  2. Lehmann CU, Shorte V, Gundlapalli AV. Clinical informatics subspecialty board certification. Pediatr Rev. 2013;34(11):525-530.
  3. Detmer DE, Munger BS, Lehmann CU. Clinical informatics board certification: history, current status, and predicted impact on the clinical informatics workforce. Appl Clin Inform. 2010;1(1):11-18.
  4. Perna G. In Growing Health IT Job Market, Clinical Background Necessary [Internet]. New York: Healthcare Informatics. 2012 [cited 2015 Jan 14]. Available from: http://www.healthcare-informatics.com/article/growing-health-it-job-market-clinical-background-necessary.
  5. Gardner RM, Overhage JM, Steen EB, et al. Core content for the subspecialty of clinical informatics. J Am Med Inform Assoc. 2009;16(2):153-157.
  6. Safran C, Shabot MM, Munger BS, et al. AMIA Board of Directors. Program requirements for fellowship education in the subspecialty of clinical informatics. J Am Med Inform Assoc. 2009;16(2):158-166.
  7. Clinical Informatics Board Certification [Internet]. Chicago: The American Board of Preventive Medicine. 2013 [cited 2015 Jan 14]. Available from: http://www.theabpm.org/abpm_clinical_informatics.pdf.
Michael C. Bond, MD, FACEP, FAAEM

Michael C. Bond, MD, FACEP, FAAEM

Associate Professor, University of Maryland School of Medicine, Baltimore, MD
Michael C. Bond, MD, FACEP, FAAEM

Latest posts by Michael C. Bond, MD, FACEP, FAAEM (see all)

Michael A. Grasso, MD, PhD, FACP

Michael A. Grasso, MD, PhD, FACP

Assistant Professor, University of Maryland School of Medicine, Baltimore, MD
Michael A. Grasso, MD, PhD, FACP

Latest posts by Michael A. Grasso, MD, PhD, FACP (see all)

Daniel L. Lemkin, MD, MS, FACEP

Daniel L. Lemkin, MD, MS, FACEP

Assistant Professor, University of Maryland School of Medicine, Baltimore, MD
Daniel L. Lemkin, MD, MS, FACEP

Latest posts by Daniel L. Lemkin, MD, MS, FACEP (see all)

Share.

Leave A Reply