Clinical informatics specialists should refine their skills in response to industry changes, including the use of EHR data and innovative data analytics technologies, according to a report published in JAMIA.
Physicians who practice clinical informatics analyze, design, and implement information systems to improve population health outcomes, support patient care, and strengthen the patient-clinician relationship. In 2009, the American Medical Association (AMIA) developed the Core Content for the Subspecialty of Clinical Informatics (CIS Core Content), the foundation for board examination review materials and maintenance of certification requirements.
Since the publication of the Core Content, CIS practice has evolved considerably. Clinicians have increased their use of EHR data to support research and population health, and scientific advancements have led to the development of data analytic technologies. Providers also have a better understanding of how health IT impacts patient satisfaction and clinician productivity.
“Awareness of these changes prompted CIS leaders to consider how to update the CIS Core Content to reflect current CIS practice,” the association said.
“Additionally, as clinical informatics fellowship program directors gained experience in training and assessing fellows, it became clear that the knowledge outlined in the CIS Core Content was not sufficient for developing competencies on which fellows could be assessed.”
To update and expand the CIS core content, AMIA conducted a formal practice analysis survey, which would provide a direct link between what clinical informatics specialists do and how their competence is examined for certification. The organization would then develop a delineation of the practice (DoP) in terms of domains and tasks.
Survey respondents said they spend 32 percent of their clinical informatics work time improving care delivery and outcomes, and 26 percent of their time focusing on leadership and professionalism. Participants said they spend just 18 percent of their time working on enterprise information systems, and 18 percent of their time on data analytics and governance.
The survey also asked respondents to rate the tasks they perform in terms of frequency and importance. Concerning frequency, respondents said they perform just three tasks at least frequently, while they said they perform 21 tasks less than occasionally. With respect to importance, respondents rated 37 out of 42 tasks as moderately to highly important to effective clinical informatics practice.
The team found that the DoP differed from the original CIS Code Content in two key ways. The first is that the DoP reflects changes in practice since the CIS Code Content was published, mainly respondents’ focus on data governance and analytics.
The DoP also describes CIS practice in terms of tasks, in addition to identifying the knowledge needed for competent CIS practice. The tasks shed light on how a clinical informatics specialist uses their knowledge in practice.
AMIA noted that the tasks and knowledge required for clinical informatics professionals should be researched and updated regularly.
“The discipline of Clinical Informatics is evolving rapidly and predicting the future is difficult,” the association said.
“Anticipated areas of growth or decline may not come to pass so it will be important to perform periodic practice analysis studies (typically every 5-7 years) to ensure the DoP remains accurate, comprehensive, and contemporary.”
The organization also stated that it expects the DoP developed in this study to have a significant impact on the CIS in the near term by allowing the American Board of Preventive Medicine (ABPM) to align the CIS certification exam with current practice.
The DoP will also support the evolution of the Accreditation Council for Graduate Medical Education (ACGME) Clinical Informatics Fellowship Requirements and will influence CIS education and conference programming.
“In the longer term, we envision that the CIS practice analysis and DoP will impact more than AMIA educational programming, ABPM CIS examination specifications, ACGME accreditation requirements, clinical informatics fellowship curriculum development, and fellow assessments,” the team said.
“The DoP may eventually inform future job descriptions, hiring decisions, performance evaluations, and professional development choices.”
This analysis marks the first time that CIS professionals were surveyed to validate their practice. The resulting DoP will help inform the role of health informatics professionals.
“Perhaps most important, by capturing the full range of work performed by informaticians, the CIS and forthcoming health informatics DoPs will help organizations understand the unique capacity that informatics professionals possess and the value they offer to healthcare organizations,” AMIA concluded.