Tuesday, November 29, 2016

Kudos for the Informatics Professor - Fall 2016 Edition

The year 2016 has been a busy but fun year of personal achievements. Many of the notable accomplishments involved giving talks, both in person and online, and around the country and the world. However, I also had a number of other achievements.

A few months ago I posted about talks during the summer of 2016. The fall of 2016 was equally busy. As I noted at the end of the summer posting, I was slated to give two talks in September. The first was the opening talk at the National Library of Medicine (NLM) Georgia Biomedical Informatics Course entitled, What is Biomedical Informatics? This talk was an updated version from the previous offering in this course delivered in April, 2016. In September, I also provided an online lecture in the National Institutes of Health BD2K Guide to the Fundamentals of Data Science Series entitled, Data Indexing and Retrieval.

In October, I had the opportunity to visit the world-renowned Geisinger Health System, where I met with a number of individuals who have taken courses of mine, both my 10x10 ("ten by ten") course as well as physicians in the new Clinical Informatics Fellowship who are taking online courses in the OHSU Biomedical Informatics Graduate Program. I also presented Grand Rounds on the topic of competencies in clinical informatics required of 21st-century clinicians and informaticians.

Also in October was the 25th Anniversary Celebration of the Biomedical Information Communication Center (BICC) at OHSU. The speakers at the event  included the current and long-time former Directors of the NLM. I provided an overview talk about the OHSU Department of Medical Informatics & Clinical Epidemiology (DMICE) and presented a poster on all of the collaboration that DMICE does at OHSU.

I started November with a talk at the OHSU Informatics Research Conference on Challenge Evaluations in Biomedical Information Retrieval, which was a preparation talk for another 25th anniversary talk to be mentioned in a moment.

In mid-November I was busy at the AMIA Annual Symposium, first leading a workshop on Evidence-Based Informatics at the Clinical Informatics Fellows’ Retreat that took place at my alma mater, the University of Illinois College of Medicine. Next I provided a talk at the AMIA Annual Symposium Learning Showcase entitled, The Full Spectrum Biomedical and Health Informatics Education at Oregon Health & Science University.

My final talk of the fall was at the Celebrating 25 Years of TREC Conference at the National Institute for Standards and Technology (NIST) in Gaithersurg, MD. My talk, The TREC Bio/Medical Tracks, described the various tracks in the biomedical domain at TREC over the years. A video of the talk is in Part 3 (starting around the 50-minute mark) of the Webcast archive page for the meeting.

What other accomplishments did I have this past fall? One was teaching my introductory biomedical and health informatics course to a group of clinical and IT leaders from Bangkok Duisuit Medical Services (BDMS), a network of hospitals in Thailand and a few in nearby countries. OHSU has an ongoing collaboration with BDMS in many areas, including informatics. This offering of the course had the usual recorded lectures and discussion forums, but added other activities, including interactive videoconferences and in-person sessions in both Bangkok and Portland. One of the participants in the course, Dr. Somsak Wankijcharoen, created a video of the experience.

Saturday, November 12, 2016

ABPM Extends “Grandfathering” Period for Clinical Informatics Physician Subspecialty Through 2022

The single most-viewed entry in the history of this blog is a posting from 2013 describing eligibility for the clinical informatics subspecialty for physicians. This was partly due to my wanting to have a standard reply for the frequent emails I received at the time from individuals asking if they would be eligible to sit for the board exam during the "grandfathering" period. I would also mention to them my singular most important piece of advice, which was to try, if possible, to get certified before 2018, after which they would need to complete an Accreditation Council for Graduate Medical Education (ACGME)-accredited fellowship.

Earlier this month, however, the American Board of Preventive Medicine (ABPM) extended the period that allows physicians to be eligible for board certification in the clinical informatics subspecialty by five years, through 2022. This means that the grandfathering (and "grandmothering" for my female colleagues!) period can be used to achieve board eligibility through 2022.

One new issue is how this will impact the growing number of ACGME-accredited fellowships, such as the one we offer at Oregon Health & Science University (OHSU). I still believe those fellowships will be the gold standard for early-career physicians to receive the best training in clinical informatics. But other physicians wanting to enter the field who cannot relocate jobs or families will still be able to pursue other options, one of which is master's degree programs such as our program at OHSU.

The official eligibility statement for the subspecialty is otherwise unchanged from the beginning of the grandfathering period and is documented on the ABPM Web site. The first three eligibility requirements are:
  1. Primary certification by one of the 23 member boards of the American Board of Medical Specialties (ABMS)
  2. Graduate from a US, Canadian, or other medical school deemed acceptable by the ABPM
  3. Unrestricted license to practice medicine in the US or Canada
The fourth requirement is the "pathway" by which one is eligible during the grandfathering era. There are two pathways for eligibility, one of which must be completed to be eligible to take the certification exam under the grandfathering criteria.

The first of the two pathways is the "practice pathway." Those who have been working in informatics professionally for at least 25% time during any three of the previous five years, and can have a supervisory individual attest to it, are eligible for this pathway. "Working" in informatics not only includes "practice" (i.e., being a Chief Medical Information Officer or other clinical informatics professional or leader), but also teaching and research.

The second pathway is the "non-traditional fellowship," which is any informatics fellowship of 24 or more months duration deemed acceptable by ABPM. At a 2012 panel at the American Medical Informatics Association (AMIA) Annual Symposium, Dr. William Greaves of ABPM stated this would be composed of informatics educational programs that were listed in the proposal submitted to ABPM by AMIA in 2009. This list, which has never been made public by ABPM, included programs that were funded by training grants from the National Library of Medicine (NLM) or were members of the AMIA Academic Forum at the time the proposal was submitted by AMIA to ABMS in 2009. (I can say that OHSU was definitely on the list, since we were both NLM-funded and a member of the Academic Forum at that time and still are. both). Dr. Greaves also said that ABPM would review applicants trained in other fellowships for eligibility on a case-by-case basis.

The ABPM eligibility criteria also state that time spent in training in informatics can be applied to the practice pathway at one-half the value of practice time. In other words, someone in an educational program for at least 50% time during the previous five years would be eligible to take the certification exam. My interpretation of this is that someone in a master's degree program that involves the equivalent of one and a half years of full-time study would thus be eligible. This has indeed been the case, i.e., those completing the Master of Biomedical Informatics (MBI) Program at OHSU have been deemed eligible, presumably since it requires six academic quarters of full-time study. The OHSU Graduate Certificate Program, on the other hand, which is a subset of the MBI requiring about nine months of study if done full-time, has not on its own been enough. Some applicants have been able to mix and match to achieve eligibility, i.e., with some practice time combined with some education.

It should be noted that another option for physicians who are not eligible for board exam will be the Advanced Health Informatics Certification being developed by AMIA. This certification will be available to all clinician practitioners of informatics trained at the master's level and higher. It will also provide a pathway for physicians who are not eligible for the board certification pathway.

Overall, I am pleased with this development, although it still presents problems for physicians in the future who will want to transition their careers into informatics in the middle of their careers. But since that day of reckoning has now been put off another five years, I guess we can cross that proverbial bridge when we come to it in the early part of the next decade.