Interview with a Clinical Informatics Trained Physician!

informatics interview
The below questions and answers are from an interview that I conducted with a physician that recently finished up his clinical informatics fellowship at University of Illinois Chicago. I shadowed this physician for an extensive period of time as I learned more about how he integrated his use and growing knowledge of clinical informatics with everyday medical practices and processes.
1. In your clinical informatics fellowship, what was the overall gist of it? Was it meant to have physicians with a strong understanding for the healthcare technologies in general? Or was there more of a specific push into shaping physician leaders?
The overall gist of CI fellowship is to gain understanding about the subspecialty as a whole, what other people are doing with it, and how you can apply this to your own interests. Given it’s massive scope, it would be impossible to gain expertise in every area of course. Instead, our basic structure works around teaching you the fundamentals of the specialty (see Gardner’s article) and it’s use in decision making / care processes. There is also a focus around information systems (such as basic knowledge about programming principles, data structure, security, etc.) as well as the change management process.
Overall, I think it’s good to consider what you can do with informatics. I separate it as follows: academic (use data to advance our knowledge), operational (implement and upgrade tools and workflows), and innovative (design/create the tools to be implemented). You can do any variation of those three, but in the end, you will probably be doing some version of that. Examples include the adacamician who teaches CI exclusively, the researcher that focuses heavily on one aspect of clinical medicine, and the chief medical information officer who focuses heavily around EHR / tool implementations and upgrades. Compare that to people who work in the startup space and those who work for the large EHR vendors. The subspecialty is quite expansive.
2. Since this fellowship is pretty multi-disciplinary, what is the work or experience like? How much are you able to interact with your peers from different specialties? When you applied, were there specific experiences that they required? I know that criteria may have changed a little since then. I know that the UIC program is with the pathology department but there are fellows from all over the spectrum of medical care, how does that work? Is it a specific emphasis in pathology? Or was it more of just a department to sponsor the program?

Work experience will vary based on the program, but as a whole interacting with different specialties should be a given. Most CI programs plan around an 80/20 model, where 20% of your time is spent working clinically in your department (read for me: EM attending seeing patients) and 80% of your time is spent doing informatics work. Some of this was administrative, such as meetings / etc. Some of this was for me to take classes online. But the majority of the time was to allow me to work on my own projects. No specific focus on pathology was given, since the majority of my work was to help out the ED (my home specialty) and the operating room workflows (since that was a project I had interested in). As a whole, UIC was fairly flexible and worked around my interests. (As an example, I spent a lot of time at UIC’s Electronic Visualization Lab).

3. You mentioned before that clinical informatics can go into three different areas, or the people that do this fellowship are able to go into three different areas, could you reiterate on those again?

Academic, Operational, Innovative. See above. Glad you liked my distinction.

4. What specialties do you expect to mainly pursue a fellowship like this? What is the difference in a fellowship like this, say instead of pursuing a master’s in biomedical/health informatics? How about in situations of medical, clinical, biomedical, or health informatics? Are those just different names for the same area?
Because of the rigorous nature of the operating room (both the duration of surgical residencies and daily time commitment for the job), it is probably more difficult for the surgical specialties (e.g. gen surg, OB/GYN, ortho, neurosurg) to get into this field. That said, I’ve seen general surgeons and OB/GYN’s apply to CI fellowship, so by no means is that a given. Radiology and pathology have a slightly higher stake in the data side (because of whole-slide imaging and storing imaging studies), but the data side of clinical medicine is just as important. While each specialty may have a different take on how they can utilize informatics, I think all can stand to benefit. Short version: do whatever specialty you want, and the informatics parts will follow.
5. Since this is kind of an unrelated fellowship, are people likely to pursue a fellowship more related to their specialty afterwards?

I doubt it, but that decision really has to be made individually. (Exception: the vast majority of people in pathology programs will do a fellowship after residency…because that’s their culture).

6. I probably should have asked this earlier but now I don’t want to have to renumber everything. How does the structure of this fellowship work? How much of it is didactic? Or are there didactic classes? How does this fit into your current clinical practicing? You mentioned that where you are looking to work, in Tennessee (?) allows you the flexibility but how does that actually look on a day-to-day?
80% informatics, 20% clinical. It depends on the program as to whether you will be considered an attending or a resident/fellow when you are practicing clinically. I’m starting at Carolinas HealthCare System in Charlotte, NC, specifically so that I could pursue the academic / operational / innovative structure you’ve heard me talk about previously. Fingers crossed as to how things will pan out, so I can’t really give you the day-to-day just yet.

Article by Sir. Lappleton III

I'm a happy-go-lucky college student that started a blog as a way to not only document my education and my experiences, but also to share it with whoever stumbles upon my site! Hopefully I can keep you guys entertained as well as learn about a few things from IT as well as from my time and experiences as I plunge deeper and deeper into healthcare! A couple of my areas of focus is data management, system security (cyber security), as well as information technology policy.

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