How can clinicians with no IT experience break into the informatics workforce and what certifications best suite a physician executive in today's healthcare market place?
Answers from Jonathan Teich
It really depends on what part of the informatics workforce we're talking about. There are different places to play a role, and some require more training and background than others. When I mentor individuals who are starting out in informatics, we discuss the various different types of work and the different work environments. Some of the informatics jobs in each that come out of a clinical background include:
- Academic – researcher/professor in informatics would generally require considerable academic training, either in fellowship programs or graduate programs; persons with quality improvement or evidence-based medicine academic backgrounds can also play a prominent role
- Provider - CMIO, CQO and related positions can branch out of your clinical and other skills, with some additional training: see below
- Industry: Medical adviser, subject-matter expert, quality expert. The leader in bringing, prioritizing and translating medical ideas into the IT environment, working alongside others with more of an IT background.
- Government – Policy worker, facilitator/leader of programs reaching out to clinicians
You can gain experience and skill by formal and experiential means – let's talk a bit about both.
Learn on the job
Let's say you're a clinician affiliated with a hospital or large group. Whatever stages of HIT implementation your organization is in, there are important places for a clinician to take leadership. Become a clinical champion within your organization. This means that you work with your HIT team frequently, represent clinical interests in meetings discussing new implementations and features, serve as an early tester who can work out the bugs in a new roll-out before they can annoy the larger mass of users, and provide a point of communication between your fellow clinicians and the HIT team. In so doing, you will steadily become expert not only in your own system but also in key principles essential for other implementations elsewhere. This set of skills can help you on a path that could eventually lead to HIT implementation careers, such as CMIO or consulting roles. You may also find that this role is providing the value you were seeking in the first place.
As a clinician, there are also unique opportunities to represent the clinical side of the HIT equation. If you have advanced skills in quality improvement, analytics, or evidence-based medicine (we have a number of clinicians who are strong in EBM and work hand-in-hand with our technologists), or expertise in specific areas such as analytics, terminology/vocabulary, or cognitive science, then your current skills are in need. I know several individuals who started out as clinical champions and quality experts, then became medical advisors to a company or to a governmental agency, and now work full-time in the latter capacity.
Get formal training
More formal training is important and can be obtained in several ways at several levels. For a CMIO, for example, formal training in practical informatics is a big leg up, hand-in-hand with deep experience as mentioned above. For academic positions and senior leadership roles in industry and government, more rigorous training is going to be an advantage both to getting a position and executing it.
The strongest position is to devote a couple of years to an informatics graduate training program or post-MD fellowship program. If you have the time and the strong motivation, this will be the strongest in the long term. The programs have different emphases – some are more oriented toward foundational research, others toward applied development. There are online versions of training programs, at least in part, coming out of places like Oregon Health & Science University and Stanford; you might start out with an online course or two from one of those organizations.
Consider "boot camps" and certification programs
At the lower-time-commitment level, groups such as AMIA and HIMSS run several-day-long "Boot Camp" programs periodically, directed toward different occupations, where you can get an immersion in the basics and foundations that will be a great help in your job. These organizations also sponsor shorter online learning modules. Incidentally, I'm revealing my limited perspective as a physician; nursing informatics training is at least as strong, if not more so, both in person and online.
Regarding certifications, there are a variety of certificates for health professionals. To me, their biggest value is that they reflect a commitment to the field and a solid background of education. I think it is not so important which certificate you have, but rather that you have convincingly demonstrated experience, training and commitment in one way or another.
None of this happens in a day -- that's because it really is a skilled field, not something you can casually pick up. But there are ways to grow into the field without completely quitting your day job.
Answers from Karen Ondo
Jonathan has done a good job outlining the various environments where medical informatics can really play out. What I would add to this discussion are the attributes that I have seen make clinicians successful in the informatics workforce.
An "Informal Leader"
The fact that you are asking this question suggests that your personal interest in computers and technology are high, and that's a good place to start. Hospitals seriously look for physicians that want to be involved and can bridge the gap in conversations between the technology and care delivery to a variety of audiences, most importantly the medical staff. Many times a clinician starts out as an ‘informal leader', one that their physician peers respect, and builds from there. Besides ones formal training it's the ability to put those learning's into practice or the practical application that really counts. Some real skills in flowing out a process and understanding the impacts to others (nursing and other care providers) go a long way to earning the respect needed to be successful.
There are examples of strong physician impact in the installation of comprehensive medical information systems, starting with activities in the 60's, so it's not exactly been an easy thing to do. Having a good read on the culture of the organization and the ability to work within that culture are important ‘technology adoption' skills. Look for opportunities to represent, publish or present on your successes involving technology, especially to peer organizations. Build your network of relationships; look for meaningful opportunities to serve on committees, editorial boards and the like. Volunteer to teach at local community colleges or certification agencies. Know that vendor application knowledge can be learned. Volunteer to go to the vendor led training sessions, the deeper the better.
Clinical disciplines and "practicing physicians"
One thing that Dr. Teich did not mention is the clinical discipline. While not required it's been my experience that internal medicine, family practice and emergency medicine seem to have a leg up when it comes to a broader understanding of workflow of their peers. It's also impressive, both from an industry and provider perspective, for a clinician to be a ‘practicing physician'. Again, while not required I would not give up that experience lightly as it seems to open more doors than it closes and gives more ‘credentials' to your suggestions or recommendations whether they are to a vendor in application design or to a provider in their design/decision making during system implementation.
Being a ‘government healthcare expert' is a job within itself. It adds politics to the equation of everything that has been said and an extreme importance and interest in strategy. The bottom line - our industry needs technology savvy clinicians. Even with meaningful use and all the new government regulations, it's a hard role to fill. Regardless, your peers will still give you a hard time, knowing what to respond to and when, as well as having ‘thick skin', are requirements.