Saturday, June 30, 2012

Overview of academic health and medical informatics training

The specialty of academic medical informatics training takes place at the junction of clinical and library sciences and Information technology. It is at this intersection where prospective students and graduates learn the necessary skills to develop, manage, integrate and perform research on healthcare imaging and IT systems. Examples of these systems are hospital and radiology department information systems, typically known by the acronyms HIS for hospitals, RIS for radiology, CIS for cardiology and LIS for laboratories, as well as electronic patient record systems such as EMR and EHR, and imaging systems such as PACS systems. Graduates may also be employed by manufacturers who design and support medical devices, and academic institutions that are heavily involved with clinical trials research.
There is a large demand for professionals with these skills, especially with the US federal incentives for physicians and hospitals to (finally) start implementing EMR’s. Industry estimates of the need for professionals with these skills range from ten thousand to forty thousand annually. As usual, formal institutions and colleges are lagging behind in training and/or retraining enough professionals to serve the new and growing areas of employment. This is especially true for the healthcare IT professions as new technologies and devices are introduced at a rapid pace. As an example, when I started my own career in healthcare technology I worked on software development of second generation CT scanners, which now are in their fourth or fifth generation, while at the time MR and ultrasound were still in the laboratory. That is why the professional societies play such an important role in providing paths for continuing education.
Vendors provide a wide variety of training opportunities; however, such training is more product oriented and lack coverage of fundamentals. That is where the colleges and universities should take a role. For example, it is hard to understand the workings of a MRI without knowing some fundamentals of physics, and the same applies for knowing how a PACS system works without any knowledge of HL7 and DICOM interfaces. Similarly, one needs knowledge of coding systems for EMR support and database knowledge to manage a hospital information system.
One of the issues with medical informatics is that there is no accepted general curriculum. This type of training is typically provided by three major academic tracks, the clinical track focuses on nursing, training for physicians and public health scientists. The engineering track supports those working toward biomedical engineering or bio-informatics degrees. Finally medical information management, with its focus on coding, organizing and indexing, typically supports those on a library sciences track.
Even within this general framework there are many variations and terms used to identify this type of training. Here is a list generated from our own search:

Course/program name
Number of programs
Health Informatics
Translational Bioinformatics
Healthcare Informatics
Clinical Research Informatics
Public Health Informatics
Nursing Informatics
Health Information Management
Bioinformatics and Computational Biology
Biomedical Informatics
Medical Informatics
Clinical Informatics
Health Care Informatics
Applied Health Informatics
Bioinformatics Management
Clinical Research
Computational Biology & Bioinformatics
Health Administration
Health Systems Management
Medical Imaging Informatics
Other related programs, each with a different name

In our search we found 78 colleges and university offering a medical informatics or similar program. These programs are offered as master’s (the majority) but also doctorates, with fellowships and quite a few certificate programs, which typically require a master’s. A complete list of the institutions, with links and contact information is available. Many of these programs are available as on-line or e-learning courses.
Also, several non-profit initiatives have sprung up to address a very specific certification; one in particular is the profession of PACS administrators, which is addressed by ABII and PARCA. To-date these two have jointly awarded about 2,000 PACS administrator certificates. There are a few institutions that have geared their curricula towards a similar certificate, but most of these particular types of training and continuing education courses are dealt with by private organizations and professional societies.