It has become a tradition for this blog for my last posting of the calendar year to be a message reflecting on the past year and looking ahead to the following one. As such, this marks my fifth annual message, dating back to 2009, 2010, and 2011, and 2012. I continue to enjoy writing this blog, with it serving as a venue to discuss issues of importance to myself and the biomedical and health informatics field.
This past year of 2013 was another gratifying year, as well as a transitional one, as the work and funding under the Health Information Technology for Clinical and Economic Health (HITECH) Act, at least for myself and our program at Oregon Health & Science University (OHSU), drew to a close. Indeed, this blog has paralleled the HITECH Act since the inception of both, getting its start in early 2009 around the time of the passage of the American Recovery and Reinvestment Act (ARRA), the economic stimulus legislation passed in 2009 in the early days of the Obama Administration. HITECH itself is now transitioning, as the most of its grant funding has ended and its incentive payments for EHR adoption are tapering off.
HITECH has certainly been a career-defining era for many of us working in informatics. As with many large initiatives, especially government ones, it has had its successes and failures. It is interesting to read my postings from the early days, after the legislation was passed but prior to it being implemented, followed by the reality that not everything in HITECH, nor the Obama Administration, has gone as we might have hoped. Nonetheless, I do feel comfortable that the government and the taxpayers received their money's worth for the work that our informatics program was funded to do. We created a useful new curricular resource and trained a number of people that resulted in new informatics careers being launched. But going forward, HITECH will increasingly be seen in the rear-view mirror.
In this transitional year, a number of other new initiatives came about, which point the direction of the future for myself and our program. For myself, 2013 is ending with my becoming a "board-certified" clinical informatician. While the new subspecialty is still a work in progress, I was pleased to be part of 450 or so individuals who passed the first offering of new board exam. I was also proud that 40 of those who passed received at least part of their informatics education in our program at OHSU. It was also great to see the press postings from OHSU as well as AMIA, with the former picked up by a local business magazine and the latter described in the health IT press.
For our department, one of the most important new initiatives of the last year was the launch of the Informatics Discovery Lab (IDL). I had the opportunity to give a talk about the IDL in an interesting format of 5 minutes total with exactly 15 seconds per slide at a local forum called IgniteHealth. The IDL was also described in an interview with its leader, faculty member Dr. Aaron Cohen, in Oregon Business, a local business magazine. We also received a good deal of notice about one of the first tangible outcomes of the IDL, which is our partnership with EHR vendor Epic to use their system for research and educational purposes. This initiative too made it into the HIT press: Healthcare IT News, Healthcare Informatics, and HIT Consultant.
Despite the end of the HITECH funding and the modest decline in enrollment expected after it, we are still moving forward and innovating with our educational program. A number of new initiatives are in the works and likely to reach fruition in 2014. Recognizing the need to stay relevant, we are forging ahead in new directions where we believe the field is headed. One of these initiatives is to add coursework in data analytics, with the eventual likelihood of an entire track in this area. In the meantime, we are also developing plans for a clinical informatics fellowship that will complement our other fellowship programs. We are also pleased to be working with other programs developing clinical informatics fellowships, being able to provide coursework and related expertise to them.
Another opportunity for our department has been to become involved in the curriculum transformation process for OHSU medical students. OHSU was also one of 11 medical schools receiving grants from the American Medical Association to accelerate change in education. My role in the grant is to develop competencies and curricula for the data-driven future of medicine that will be forthcoming as care delivery models change. The new OHSU curriculum will also feature more informatics than it ever has before.
Finally, I had the opportunity to weigh in on the year in review for the California Health Care Foundation iHealthBeat year in review.
As for what lies ahead in 2014, I believe it will mainly be built on the foundation of new post-HITECH activities started in 2013. The clinical informatics subspecialty will be important, although I also hope we will see more progress in professional recognition and certification for the larger majority of non-physician (and even non-clinical) informatics professionals. There is a large and important role for all who work in informatics, not only those in clinical (healthcare) areas, but other areas of the field as well. This will be especially so, for example, as advances in clinical research informatics enable other areas, from translational bioinformatics to public health informatics, disseminate their progress into healthcare and individual health spheres. Although each subarea of informatics is distinct, I expect their work to increasingly overlap going forward. For example, as bioinformatics and genomics have more impact in health and healthcare, the underlying informatics will necessarily become more similar.
From a program standpoint, I am equally certain that initiatives such as the IDL will be drivers of our research directions. While government sources of research support will still be important and form the bedrock for advancing the science, it will be equally critical to collaborate with industry and other partners to disseminate the fruits of that research. Academia is unexcelled for making discoveries but industry is just as critical to making them available to a wide audience. The era of "home-grown" informatics systems is receding, with the need to build and study on top of commercial platforms in widespread use becoming more critical.
As for this blog, I plan to continue in the same manner as in the past, with postings only when I have something I believe is interesting to write about, and not serving as my stream of consciousness. I have nothing against the latter types of blogs, but my preferred approach (and time availability!) is the former. I hope to maintain the focus on the issues in informatics that are most core to me, but not hesitating to branch out when appropriate.