The field of informatics is changing, and no one has a better view of the transition that Doug Fridsma, M.D., Ph.D.
The president and CEO of AMIA just wrapped up the organization’s annual symposium in Washington, D.C., last week. When I asked him for his impressions from the meeting, he started out by saying that he spent a lot of his time hanging out with “newbies” to the field. “It used to be that you were a doctor and you got interested in technology and got a Ph.D. or master’s degree, and that was a mid-career shift,” Fridsma said. “Informatics is now a primary career path for folks.”
Attending the symposium were college students and clinical informatics fellows just beginning their careers. To better understand these new entrants to the field, AMIA developed a work force survey and complementary employer survey, and Fridsma presented the results at the symposium. There are approximately 1,500 diplomates board-certified in clinical informatics. But many informatics professionals exist in nursing, pharmacy and other ancillary services as well. With the survey, AMIA sought to understand what jobs they hold and what level of expertise they have. It got about 2,000 responses from non-physicians, and most were not members of AMIA.
“Informatics used to be an interesting, esoteric program of study or research. We had a lot of folks who were academics, Ph.D.s and others, doing research on this activity,” Fridmsa said. “Over the last five to 10 years as we have seen the rapid adoption of health information technology and EHRs, we have not only academicians, but also an increasing number of people who are applied in their focus. There are a lot of folks who are informatics professionals who spend most of their time in healthcare settings, and they are novice, intermediate and advanced. We are developing a career pipeline that lets people come in not just at the Ph.D. level, but at a bachelor’s or master’s level and work their way up.”
With an eventual goal of certifying other levels of competency besides the board subspecialty in clinical informatics, AMIA is doing a job task analysis. “We are trying to understand the skills and competencies people need to do their jobs. Based on that we will try to develop a way for people to get recognized for their professional expertise,” Fridsma said. “We are hoping to find some partnerships with organizations able to help us with an equivalent exam to what the clinical informatics diplomates have.” For instance, he said, the medical genetics community can provide an exam for board-certified physicians in medical genetics as well as genetic counselors with Ph.Ds.
“We also recognize that there is a broad swathe of folks at novice and intermediate levels, and we want to provide ways for them to get credentials,” he explained. The high-stakes test model of credentialing is changing, even within the medical field. “We would like to get ahead of the curve a bit,” he said. “We are exploring ways for people to be recognized for their skills and expertise that may or may not require that every-10-year high-stakes examination. We can figure out ways that someone can put together a program that says I am an expert in clinical research, data analytics and standards.”
Fridsma believes it is important for AMIA to engage these professionals as well as physicians. “We aren’t going to be successful as informatics professionals unless we can create team-based approaches, and that means engagement of the nursing, pharmacy and boots-on-the-ground folks. There is a lot of work going on to embrace all those professionals and provide professional recognition for them as well as conference offerings.”
Reflecting on his own experience of the symposium, Fridsma was impressed that so many young people were participating. “We had a whole host of high school students present their work. One had written an editorial that got published in the Annals of Internal Medicine, which was really impressive,” he said. A group of about 50 women college students from underrepresented communities around the Washington, D.C., area, attended. “This is the second year we had a leadership dinner where we raised funds to create a sustainable way to pay it forward. Those kinds of things are going to be important as well.”
During the symposium, AMIA announced a closer working relationship with the OpenNotes organization, which is pushing for health systems to routinely share provider notes with their patients. I asked Fridsma why that was important to AMIA. “As we have been developing our policy principles to define what we stand for, one thing that has risen to the top is what can the informatics community do to support patients,” he said. A lot of the informatics work early on was supporting the hospital and doctor enterprise, he added, “but increasingly we know that if we are going to improve health and not just care delivery, we have to be able to find ways to apply the expertise we have in informatics to help the patient. The goal should be to make patients first-order participants in their care so they can engage with providers, understand their responsibilities and ask good questions.”
OpenNotes is not a technology, but a cultural change, he added. “It is aligned with the importance we place on patients. Our job is to use informatics to make it easier for them to have access to their information.”