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Medical Informatics: A Formal Subspecialty Whose Time Has Come

April 21, 2014
by Mark Hagland
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Hospitals like Lucile Packard Children's Hospital are creating a professional pathway around clinical informatics

Things have been moving fast around the creation of a unique new subspecialty—clinical informatics. In 2011, the American Board of Medical Specialties (ABMS) approved clinical informatics as a clinical subspecialty, uniquely designed that physicians already boarded in virtually any specialty could sit for the clinical informatics examination.

The first examination was offered in the autumn of 2013, and also uniquely, the ABMS allowed for physicians to “grandfather” into the specialty via a practice pathway based on experience, or to qualify by earning a master’s degree program in the fi eld. That means that physicians already practicing as medical informaticists have until 2018 to grandfather in through experience and exam-taking.

One CMIO who has been helping to lead movement in this area is Christopher Longhurst, M.D., CMIO at Lucile Packard Children’s Hospital at Stanford
University, in Palo Alto, Calif. Longhurst and his colleagues have established a two-year fellowship at their hospital that involves three required rotations, plus several elective rotations.

“I think that the new board specialty is important and will become recognized for hiring CMIOs,” says Longhurst. “It’s just like the development of emergency medicine in the late 1980s; by the 1990s, no one would hire an ED doctor without that certification. I think that the same thing will eventually happen with this board certification.”

Christopher Longhurst, M.D.

Longhurst continues, “People will learn through apprenticeship. We’re applying for accreditation for our apprenticeship at Stanford. The core rotations involve two months in the children’s hospital, two months in the adult hospital, and one to two months in medical school, and then an elective apprenticeship, with elective opportunities at nearby integrated health systems, as well as industry rotation opportunities at software vendor companies.” Part of this, he says, involves “giving these fellows exposure to healthcare enterprise IT departments, which is the thing that’s always hard to break into. We weren’t looking for fellows who could write code or create apps; we were looking for fellows who wanted to learn how to do clinical informatics.”