In looking over the topics I have addressed in the year and a half of this blog, I have tried to convey biomedical and health informatics as a broad field with many roles and opportunities for people from a wide variety of professional backgrounds. One group that I have not addressed explicitly is physicians.
I admittedly have a kinship for physicians in the informatics field. After all, I am a physician by training, and even though I know longer actively care for patients, my training and early career experience provide a perspective that informs my understanding of the role of physicians in informatics.
Overall, the opportunities for physicians in informatics are substantial and growing. While many early informatics roles for physicians focused on research and development, the real growth opportunities are now for those seeking to be informatics practitioners. These practitioners play a variety of roles not only in planning and implementing systems, but deriving value from the information within them.
An ever increasing number of healthcare organizations have recognized the importance of physician informatics leadership, manifested most frequently in positions that go by the name of Chief Medical Information Officer or Chief Medical Informatics Officer (both of which conveniently are represented by the acronym CMIO). While the CMIO position is probably now the most visible physician role in informatics, it is hardly the only one. Physicians also play other roles in healthcare organizations as well as other entities, such as vendor, consulting, government, and research organizations.
The OHSU biomedical informatics graduate program has always had a strong representation from physicians, who comprise about 50% of our enrollment. They are therefore not the only demographic of student in the program, as we also have students from other healthcare professionals (e.g., nurses, pharmacists, lab/radiology technicians, health information managers) as well as from outside the health professions (e.g., information technology, computer science, and even further afield from law, biology, business, and others). Furthermore, the professional diversity of our program has always, in my mind, been one of the program's assets, even though trying to teach informatics simultaneously to a physician, nurse, computer scientist, and businessperson can be a challenge!
But it nonetheless has been gratifying to see many physicians go on to assume roles and leadership in the field. The diverse roles that physicians who enter the field take exemplifies the expansion of these roles.
There are a number of issues ahead for physicians contemplating careers in informatics to ponder. One concerns training. How much should they seek? Should they get it at all? If they do, in what kinds of programs should they train? I honestly cannot give an unequivocal answer. There are many physicians who move into informatics roles without any formal training. However, I do believe over time that formal training will be a requisite for informatics jobs. If nothing else, one's competitors for those jobs will have such training.
As for how much training, that is also an uncertainty. There is a growing recognized knowledge base for the informatics field. There is also recognition of an increasing number of best practices. Physician-informaticians might not need to understand all the technical details of the systems with which they work, but they must have the big picture both of the technology and how it fits into their environment.
Another issue on the horizon for physicians is certification, in particular the proposed clinical informatics subspecialty. This subspecialty will be available to physicians in many, perhaps all, specialties (e.g., internal medicine, pediatrics, family medicine, surgery, etc.). There are still many unknowns about this process, such as how will other informatics experience and training besides formal on-site fellowship training be viewed and how physicians without board certification might be able to take part. Nonetheless, certification is important in healthcare professions, and certification in informatics will lead to more professional recognition of the field.
I believe it is safe to conclude here are tremendous opportunities for physicians to be innovators and leaders in the proper and most effective use of information technology IT) not only in healthcare, but also personal health, public health, and research.
Despite the uncertainty about some of the details, the outlook for physicians in informatics is bright, even after the initial wave of EHR adoption is complete (as addressed in a previous blog entry). The need for expertise in health IT implementation will only increase, especially as we see more coordination and quality measurement of care delivery.
Showing posts with label certification. Show all posts
Showing posts with label certification. Show all posts
Thursday, October 14, 2010
Sunday, March 29, 2009
Certification in Informatics
The current issue of Journal of the American Medical Informatics Association (JAMIA, March-April, 2009) contains several papers related to a process the American Medical Informatics Association (AMIA) is spearheading to establish a medical board sub-certification in clinical informatics (Detmer et al., 2009). I myself was involved in the training requirements paper that will be submitted (Gardner et al., 2009), along with the core curriculum (Safran et al., 2009), to the American Board of Medical Specialties. I note that the core curriculum looks a great deal like the OHSU medical informatics track curriculum of our biomedical informatics graduate program.
As AMIA is not a physician-only organization, another process is underway to establish certification for non-physician doctoral-level certification in clinical informatics. This will include doctoral-level health care professionals (e.g., those with PharmD, DNP, DPT, etc. degrees) as well as those with PhD degrees. At the same time, the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM), which certifies health information management professionals, has announced plans to establish a master's-level credential in health informatics.
What does all of this mean? First, it is important to understand the terminology. Certification applies to individuals, who obtain a credential that certifies their knowledge and skills to perform certain professional tasks, e.g., board certification of physicians, nurses, and other health care professionals as well as in other fields, such as a certified professional accountant (CPA). This is different from accreditation, which applies to educational programs and declares them capable of providing the training of individuals to attain certification. Sometimes programs are accredited without a corresponding formal certification, such as academic programs in public health and computer science.
Certification is usually applied to people in professional positions. It is not usually applied to those who are in academic or research settings. So while a Department of Medicine in a medical school may have its clinical faculty certified to practice medicine, it does not have corresponding certification for its research faculty (or for the non-practicing portion of the jobs of clinical faculty). Certification usually indicates that one has a competency to carry out a professional task, such as practicing medicine. In the case of informatics would most likely apply to those who work in operational settings, such as hospitals, clinics, health centers, and the like.
Certification would add some order to a field now where anyone can call themselves an informatician or offer an academic program. Indeed, there are a growing number of four-year colleges and even community colleges that are beginning to offer baccalaureate and associate degrees in the field. Of course, without a formal certification in informatics, there is no reason why they cannot. However, my own view is that informatics is the synergistic and unique intersection of health sciences, computer sciences, and management sciences, and as such, is difficult to impart with just a baccalaureate or associate degree. This does not mean that those individuals cannot work in health care settings, but rather that to truly do informatics professionally requires a level of training that combines expertise in multiple disciplines, and it is difficult to see how it can be imparted without some amount of graduate study.
Another challenge with certification will depend on how the training requirements are implemented. As many reading this know, I direct one of the largest academic informatics programs in the country, and its distance learning option has been extremely popular and successful. While I do believe that informatics expertise requires real-world experience, we have been able to provide that for those who have sought it in their education. Whatever on-site training requirements emerge, I do hope the educational and/or fellowship experience will allow sufficient flexibility for didactic coursework to be on-line and for hands-on training experience to be available in diverse settings and not necessarily just the sites of academic programs.
The implementation of certification and accreditation will bring a new level of maturity to our field. It will allow informatics professionals to gain the recognition of the important role they play in health and health care organizations. But hopefully it will be implemented in a way that maintains the intellectual, geographical, and other forms of diversity that exist in our field.
References
Detmer, D., Lumpkin, J., et al. (2009). Defining the medical subspecialty of clinical informatics. Journal of the American Medical Informatics Association, 16: 167-168.
Gardner, R., Overhage, J., et al. (2009). Core content for the subspecialty of clinical informatics. Journal of the American Medical Informatics Association, 16: 153-157.
Safran, C., Shabot, M., et al. (2009). ACGME program requirements for fellowship education in the subspecialty of clinical informatics. Journal of the American Medical Informatics Association, 16: 158-166.
As AMIA is not a physician-only organization, another process is underway to establish certification for non-physician doctoral-level certification in clinical informatics. This will include doctoral-level health care professionals (e.g., those with PharmD, DNP, DPT, etc. degrees) as well as those with PhD degrees. At the same time, the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM), which certifies health information management professionals, has announced plans to establish a master's-level credential in health informatics.
What does all of this mean? First, it is important to understand the terminology. Certification applies to individuals, who obtain a credential that certifies their knowledge and skills to perform certain professional tasks, e.g., board certification of physicians, nurses, and other health care professionals as well as in other fields, such as a certified professional accountant (CPA). This is different from accreditation, which applies to educational programs and declares them capable of providing the training of individuals to attain certification. Sometimes programs are accredited without a corresponding formal certification, such as academic programs in public health and computer science.
Certification is usually applied to people in professional positions. It is not usually applied to those who are in academic or research settings. So while a Department of Medicine in a medical school may have its clinical faculty certified to practice medicine, it does not have corresponding certification for its research faculty (or for the non-practicing portion of the jobs of clinical faculty). Certification usually indicates that one has a competency to carry out a professional task, such as practicing medicine. In the case of informatics would most likely apply to those who work in operational settings, such as hospitals, clinics, health centers, and the like.
Certification would add some order to a field now where anyone can call themselves an informatician or offer an academic program. Indeed, there are a growing number of four-year colleges and even community colleges that are beginning to offer baccalaureate and associate degrees in the field. Of course, without a formal certification in informatics, there is no reason why they cannot. However, my own view is that informatics is the synergistic and unique intersection of health sciences, computer sciences, and management sciences, and as such, is difficult to impart with just a baccalaureate or associate degree. This does not mean that those individuals cannot work in health care settings, but rather that to truly do informatics professionally requires a level of training that combines expertise in multiple disciplines, and it is difficult to see how it can be imparted without some amount of graduate study.
Another challenge with certification will depend on how the training requirements are implemented. As many reading this know, I direct one of the largest academic informatics programs in the country, and its distance learning option has been extremely popular and successful. While I do believe that informatics expertise requires real-world experience, we have been able to provide that for those who have sought it in their education. Whatever on-site training requirements emerge, I do hope the educational and/or fellowship experience will allow sufficient flexibility for didactic coursework to be on-line and for hands-on training experience to be available in diverse settings and not necessarily just the sites of academic programs.
The implementation of certification and accreditation will bring a new level of maturity to our field. It will allow informatics professionals to gain the recognition of the important role they play in health and health care organizations. But hopefully it will be implemented in a way that maintains the intellectual, geographical, and other forms of diversity that exist in our field.
References
Detmer, D., Lumpkin, J., et al. (2009). Defining the medical subspecialty of clinical informatics. Journal of the American Medical Informatics Association, 16: 167-168.
Gardner, R., Overhage, J., et al. (2009). Core content for the subspecialty of clinical informatics. Journal of the American Medical Informatics Association, 16: 153-157.
Safran, C., Shabot, M., et al. (2009). ACGME program requirements for fellowship education in the subspecialty of clinical informatics. Journal of the American Medical Informatics Association, 16: 158-166.
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