Educational Shift in Informatics

HIMSS Clinical Informatics Insights

The last five years have seen unprecedented change in the field of clinical informatics, including its educational programs. Much of the change emanates from the Health Information Technology for Economic and Clinical Health (HITECH) Act, either directly from its programs or indirectly from derivative needs. Although there are other factors have led to change as well.

The HITECH Act brought unprecedented resources to clinical informatics. Most directly, it allocated $118 million for development of educational programs and their curricula. New programs were developed at all levels; from community colleges to universities and curricular; resources were developed and made available. Indirectly, the $24+ billion spent in the HITECH Act on EHR adoption led to a great need for expertise in clinical informatics within organizations implementing EHRs, which also drove the need for educational programs.

Post-HITECH, there have been other drivers of clinical informatics. Accountable care and other new models of healthcare delivery are requiring application of data analytics, which in turn requires better management of IT systems and, more importantly, the data within them. Others have discovered the importance of “Big Data.” The growing amount of consumer use of IT (e.g., the “quantified self”) research bodies, such as the National Institutes of Health, recognize Big Data is important to advance biomedical research, requiring not only research funding, but a well-trained “data science” workforce.

One big change has been an increasing precision in our understanding of the role of clinical informatics. This has better defined the knowledge and skills needed to succeed in clinical informatics as a career. Recent data from ONC and others show that job growth in clinical informatics has exceeded the projections many of us made as healthcare moved to more advanced use of IT. There is a clear need for informatics expertise in healthcare organizations as they pursue meaningful use incentives as well as move to newer models of care delivery. This has led a number of organizations to call on the Bureau of Labor Statistics to recognize health informatics in the Standard Occupational Classification (SOC) code system, which if approved, will lead to better quantification of those who work in informatics careers.

There has also been a refinement of specific subsets of professionals within clinical informatics. Most prominent among these is the emergence of the physician subspecialty. Last year, about 450 physicians became the first diplomates to successfully achieve clinical informatics board certification. Going forward, informatics education will change for these individuals, as training transitions to a clinical fellowship model.

Recognizing that physicians are only one part of the clinical informatics workforce, the American Medical Informatics Association (AMIA) has established a task force to develop recommendations for certification of other clinicians and non-clinicians in informatics. By the same token, Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) is now accrediting educational programs in informatics.

Concomitant with the growth of the clinical informatics profession is recognition that healthcare professionals will also need skills in clinical informatics to function effectively in the 21st century. As our medical school revamps its curriculum, we have had the opportunity to define competencies in clinical informatics and integrate them into the curriculum of future physicians. There is actually very little that is physician-specific in these competencies and they should be easily translatable to other health professions, such as nursing, pharmacy, and others.

Events of the last five years have not only led to the growth of clinical informatics and educational programs, but has set the stage for its future engagement in all aspects of personal health, healthcare, public health, and research. The optimal collection, analysis and use of data and information have become an integral part of the healthcare system and will require skills and knowledge to best leverage it. Well-educated clinical informatics professionals will lead the way in this process.

About the Contributor
Dr. Hersh is professor and chair of the Department of Medical Informatics & Clinical Epidemiology at Oregon Health & Science University and is a leader and innovator in biomedical informatics both in education and research.