Difference between revisions of "Clinical Informatics Fellowship"

Revision as of 14:36, 18 October 2015

In 2011, Clinical Informatics (CI) was recognized as a subspecialty by the American Board of Medical Specialties (ABMS). For more information on Clinical Informatics as a Medical Subspecialty, see Medical Subspecialty Board of Clinical Informatics. In 2014, the Accreditation Council for Graduate Medical Education (ACGME) published it’s official CI fellowship program requirements document.

Program Duration

CI fellowship program must be 24 months (2 years) in length and must be completed by the fellow within 48 months (4 years).

Program Administration

CI fellowship programs must be administratively integrated within one of the following ACGME residency programs:

1. Anesthesiology

2. Diagnostic Radiology

3. Emergency Medicine

4. Family Medicine

5. Internal Medicine

6. Medical Genetics and Genomics

7. Pathology

8. Pediatrics

9. Preventive Medicine

Therefore, CI fellowship programs can be reviewed by residency review committees (RRCs) from any of the above listed specialties, and do not have their own RRC.

Program Personnel

Program Director

A single program director is held accountable for the operation of the CI fellowship program and must possess the following qualifications:

1. Documented administrative, educational, and specialty expertise within clinical informatics that is acceptable to the RRC;

2. Current board-certification in Clinical Informatics, or in a subspecialty that is acceptable to the RRC;

3. Current medical licensure;

4. At least 3 years of experience working in clinical informatics; and

5. Experience in Clinical Informatics education.

Faculty

There must be at least 2 faculty members who are qualified to instruct, supervise, and support the fellows.

Physician faculty must maintain current medical licensure and be either board-certified in Clinical Informatics or have appropriate qualifications acceptable to the RRC. Two years of experience in Clinical Informatics is recommended for physician faculty but it is not a core requirement.

Nonphysician faculty must retain appropriate institutional appointments and possess the appropriate qualifications within their respective field.

The program director and faculty members should devote at least 2 full-time equivalents (FTE) towards program administration and education.

Program Coordinator

A program coordinator must provide sufficient administrative, technical, and clerical support to the fellowship program.

Fellowship Eligibility

Each fellow must have completed an ACGME accredited residency program or a Royal College of Physicians and Surgeons of Canada (RCPSC) or College of Family Physicians of Canada (CFPC) accredited residency program located in Canada.

If an applicant does not meet one of the requirements above, the RRC may grant an exception to an exceptionally qualified applicant who meets a specific criteria outlined in pages 10-11, section III.A.2b of the CI Fellowship requirements document.

Eligible applicants may apply to any ACGME accredited CI fellowship program regardless of their primary specialty.

Educational Program Outline

A Clinical Informatics fellowship program (1)must have clearly delineated competency-based goals and objectives that are made available to fellows and faculty on an annual basis and (2)must have regularly didactic sessions, which can be taught locally or through distance education programs.

The most widely used distance program is offered through Oregon Health & Science University, which offers a graduate certificate program in CI that is closely mapped to the competencies tested on the CI subspecialty board exam.

EDUCATIONAL COMPETENCIES

Based on the 6 core ACGME competencies:

1) Patient care and procedural skills - Fellows should be competent in leveraging information and communication technology across the dimensions of healthcare to improve patient care processes and outcomes.

2) Medical knowledge - Fellows must demonstrate knowledge of principles and theory of informatics as well as application of this knowledge to patient care.

3) Practice-based learning and improvement - Fellows must develop skills and habits that promote lifelong learning.

4) Interpersonal and communication skills - Fellows must demonstrate effective communication skills that allow them to serve as liaisons between healthcare providers and information technologists.

5) Professionalism - Fellows must be committed to carrying out professional responsibilities and adhering to ethical principles as well as being able to recognize and prevent security breaches while showing sensitivity to the impact of information system changes.

6) Systems-based practice - Fellows must be aware and responsive to the large context of the healthcare system by recognizing their role in care coordination, cost awareness, identification of system errors and should identify and improve the impact of systems on clinical care.

Fellow Scholarship Expectation

Fellows should participate in scholarly activity including at least one of the following:

- Peer-reviewed funding and research

- Publication of original research or review articles

- Presentations at local/regional/national professional and scientific society meetings

Fellow Clinical Responsibility

May be performed in the fellow’s primary specialty area of practice. Must be based on PGY-level, patient safety, fellow education, severity and complexity of patient illness/condition.

Fellowship Program Evaluation

Must occur at the level of the fellow, the faculty, and also the fellowship program as a whole.

- Fellows should be evaluated semi-annually by a Clinical Competency Committee of 3 program faculty

- Annual Faculty evaluations

- Ongoing evaluation of the program by 2 faculty and 1 fellow who comprise the Program Evaluation Committee

ACGME Accredited Fellowships

In July, 2014, the CI fellowship at Stanford was the first program in the nation to become ACGME accredited. See press release here.

Subsequent CI Fellowship Programs that received ACGME accreditation:

Pathology

University of Illinois at Chicago (UIC) UIC was the second CI fellowship to receive ACGME accreditation.

Emergency Medicine

Regenstrief Institute

Internal Medicine

Oregon Health & Science University

Beth Israel Deaconess Medical Center

Geisinger Health System

David Geffen School of Medicine at UCLA and UCLA Health

The University of Arizona College of Medicine – Phoenix

Pediatrics

Stanford School of Medicine

Boston Children’s Hospital

The Children’s Hospital of Philadelphia

Anesthesiology

Vanderbilt University Department of Biomedical Informatics

Fellowship Collaboration

On September 24, 2015, the UIC Clinical Informatics fellowship program hosted the first Virtual Case Conference for CI Fellows. The CI fellows from UIC presented on the topics of workflow analysis, process improvement, and patient safety. The use of Sage2 and Google Hangout allowed for a successful collaboration among the 38 participants from 13 different institutions across the nation.

Sources and Useful Resources

1. ACGME Program Requirements for Graduate Medical Education in Clinical Informatics [1]

2. Frequently Asked Questions: Clinical Informatics [2]

3. Blog post by Dr. William Hersh summarizing ACGME CI Fellowship Program Draft [3]

Submitted by Veena Goel, M.D.

Sources and Useful Resources (rev1)

1. American Medical Informatics Association (AMIA)

2. in progress...

Submitted by J Edward B. Maddela, MD