Medical informatics, long in a gray area between information technology and medicine, may soon be recognized as a full-fledged medical subspecialty. If this occurs, it will arrive just as many healthcare organizations and physician practices are beginning to view health IT as an essential tool for improving the quality and lowering the cost of healthcare. Our experts explain the thinking behind this proposal.
Medical informatics, which has long fallen into a gray area between information technology and medicine, may soon be recognized as a full-fledged medical subspecialty. If this recognition occurs, it will come just as many healthcare organizations and physician practices are beginning to view health information technology as an essential tool for improving the quality and lowering the cost of healthcare.
The American Board of Preventive Medicine (ABPM) recently proposed board certification for clinical informatics to the American Board of Medical Specialties (ABMS). Their proposal was endorsed by the American Board of Internal Medicine and the American Board of Pathology.
According to Glenn Merchant, MD, executive director of ABPM, the outlook for approval of the request is “favorable,” based on the initial reaction of an ABMS committee. If that committee okays the proposal on a second reading in July, the ABMS board could approve it in September, he says.
The ABPM embarked on this course after being approached by the American Medical Informatics Association (AMIA), which has long advocated for the recognition of informatics as a branch of medicine. The preventive medicine board was especially attuned to medical informatics, Merchant explains, because some areas of preventive medicine are highly dependent on information technology.
“One of our underlying principles is population medicine, and we use informatics to look broadly at patterns and trends,” he says. “A number of preventive medicine folks in state health departments and the federal government use these [electronic] tools, and we thought it would be appropriate to have it as a subspecialty.”
That doesn’t mean, however, that a physician would have to be certified in preventive medicine to sit for the clinical informatics board. “This is open to all of the specialties,” Merchant says.
Initially, he continues, physicians will be able to become board certified in informatics “through a practice pathway. These are people who have developed knowledge and expertise by working in the field.” But if ABMS approves the creation of the subspecialty, ABPM will ask the Accreditation Council on Graduate Medical Education to accredit fellowships in clinical informatics. The new fellowships would have to meet specific requirements-probably those that AMIA has already proposed, he suggests. While these fellowships might be offered in conjunction with training programs of various specialties, such as pathology, internal medicine, or family medicine, they’d all have to follow the same guidelines, he says.
Why should clinical informatics be regarded as a medical field rather than as a technological specialty? “We need to have clinicians involved in the design and implementation and management of these medical information systems,” Merchant says. “It takes that special insight of experienced clinicians who can say, ‘These are the tools we need for decision making.’ It takes someone who is a trained clinician, who has experience in the hospital wards, clinics and ERs, to say, ‘These are the components we need.’ So it’s a blending of informatics and medical knowledge.”