Download PDF
Appl Clin Inform 2024; 15(01): 155-163
DOI: 10.1055/a-2237-8309
Research Article

Structure and Funding of Clinical Informatics Fellowships: A National Survey of Program Directors

Tushar N. Patel
1   Department of Pathology, University of Illinois Chicago, Chicago, Illinois, United States
,
Aaron J. Chaise
1   Department of Pathology, University of Illinois Chicago, Chicago, Illinois, United States
,
John J. Hanna
2   Clinical Informatics Center, University of Texas Southwestern, Dallas, Texas, United States
,
Kunal P. Patel
1   Department of Pathology, University of Illinois Chicago, Chicago, Illinois, United States
,
Karl M. Kochendorfer
1   Department of Pathology, University of Illinois Chicago, Chicago, Illinois, United States
,
Richard J. Medford
2   Clinical Informatics Center, University of Texas Southwestern, Dallas, Texas, United States
,
Dara E. Mize
3   Departments of Biomedical Informatics and Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States
,
Edward R. Melnick
4   Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, United States
5   Department of Biostatistics (Health Informatics), Yale School of Public Health, New Haven, Connecticut, United States
,
Jonathan D. Hron
6   Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United States
7   Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States
,
Kenneth Youens
8   Department of Pathology, Baylor Scott & White Health, Temple, Texas, United States
,
Deepti Pandita
9   Department of Internal Medicine, University of California, Irvine, California, United States
,
Michael G. Leu
10   Departments of Pediatrics and Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States
11   Information Technology Services, UW Medicine, Seattle, WA, United States
12   Information Technology Department, Seattle Children's Hospital, Seattle, WA, United States
,
Gregory A. Ator
13   Department of Otolaryngology-Head and Neck Surgery and Clinical Informatics, University of Kansas Medical Center, Kansas City, Kansas, United States
,
Feliciano Yu
14   Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
,
Nicholas Genes
15   Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, New York, United States
,
Carrie K. Baker
16   Department of Family Medicine, Kettering Health, Indu and Raj Soin Medical Center, Dayton, Ohio, United States
,
Douglas S. Bell
17   Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, United States
,
Joshua M. Pevnick
18   Department of Medicine, Cedars-Sinai Health System, Los Angeles, California, United States
,
Steven A. Conrad
19   Division of Clinical Informatics, Department of Medicine, LSU Health Shreveport, Shreveport, Louisiana, United States
,
Aarti R. Chandawarkar
20   Division of Clinical Informatics, Nationwide Children's Hospital and The Ohio State, Columbus, Ohio, United States
21   Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, United States
,
Kendall M. Rogers
22   Division of Hospital Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
,
David C. Kaelber
23   Center for Clinical Informatics Research and Education, The MetroHealth System, and the Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States
,
Ila R. Singh
24   Department of Pathology and Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, United States
,
Bruce P. Levy
25   Division of Informatics, Geisinger Health System, Danville, Pennsylvania, United States
,
John T. Finnell
26   Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States
,
Joseph Kannry
27   Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States
,
Natalie M. Pageler
28   Division of Clinical Informatics, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, United States
,
Vishnu Mohan
29   Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States
,
Christoph U. Lehmann
2   Clinical Informatics Center, University of Texas Southwestern, Dallas, Texas, United States
› Author Affiliations Funding This study was supported in part by the National Center for Advancing Translational Science (NCATS) under the University of California, Los Angeles Clinical and Translational Science Institute grant number UL1TR001881 and the University of Texas Southwestern Clinical and Translational Science Award grant number UL1TR003163.
› Further Information
    Permissions and Reprints

Abstract

Background In 2011, the American Board of Medical Specialties established clinical informatics (CI) as a subspecialty in medicine, jointly administered by the American Board of Pathology and the American Board of Preventive Medicine. Subsequently, many institutions created CI fellowship training programs to meet the growing need for informaticists. Although many programs share similar features, there is considerable variation in program funding and administrative structures.

Objectives The aim of our study was to characterize CI fellowship program features, including governance structures, funding sources, and expenses.

Methods We created a cross-sectional online REDCap survey with 44 items requesting information on program administration, fellows, administrative support, funding sources, and expenses. We surveyed program directors of programs accredited by the Accreditation Council for Graduate Medical Education between 2014 and 2021.

Results We invited 54 program directors, of which 41 (76%) completed the survey. The average administrative support received was $27,732/year. Most programs (85.4%) were accredited to have two or more fellows per year. Programs were administratively housed under six departments: Internal Medicine (17; 41.5%), Pediatrics (7; 17.1%), Pathology (6; 14.6%), Family Medicine (6; 14.6%), Emergency Medicine (4; 9.8%), and Anesthesiology (1; 2.4%). Funding sources for CI fellowship program directors included: hospital or health systems (28.3%), clinical departments (28.3%), graduate medical education office (13.2%), biomedical informatics department (9.4%), hospital information technology (9.4%), research and grants (7.5%), and other sources (3.8%) that included philanthropy and external entities.

Conclusion CI fellowships have been established in leading academic and community health care systems across the country. Due to their unique training requirements, these programs require significant resources for education, administration, and recruitment. There continues to be considerable heterogeneity in funding models between programs. Our survey findings reinforce the need for reformed federal funding models for informatics practice and training.

Keywords

clinical informatics - physician - workforce - ACGME - fellowships and scholarships - internships and residency - medical informatics

Supplementary Material



Publication History

Received: 26 September 2023

Accepted: 02 January 2024

Accepted Manuscript online:
03 January 2024

Article published online:
21 February 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Kannry J, Sengstack P, Thyvalikakath TP. et al. The Chief Clinical Informatics Officer (CCIO): AMIA Task Force report on CCIO knowledge, education, and skillset requirements. Appl Clin Inform 2016; 7 (01) 143-176
    Article in Thieme ConnectPubMedGoogle Scholar
  • 2 Safran C, Shabot MM, Munger BS. et al; AMIA Board of Directors. Program requirements for fellowship education in the subspecialty of clinical informatics. J Am Med Inform Assoc 2009; 16 (02) 158-166
    CrossrefPubMedGoogle Scholar
  • 3 Lehmann CU, Gundlapalli AV, Williamson JJ. et al. Five Years of Clinical Informatics Board Certification for Physicians in the United States of America. Yearb Med Inform 2018; 27 (01) 237-242
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Longhurst CA, Pageler NM, Palma JP. et al. Early experiences of accredited clinical informatics fellowships. J Am Med Inform Assoc 2016; 23 (04) 829-834
    CrossrefPubMedGoogle Scholar
  • 5 Desai S, Mostaghimi A, Nambudiri VE. Clinical informatics subspecialists: characterizing a novel evolving workforce. J Am Med Inform Assoc 2020; 27 (11) 1711-1715
    CrossrefPubMedGoogle Scholar
  • 6 Lehmann CU, Longhurst CA, Hersh W. et al. Clinical Informatics Fellowship Programs: In search of a viable financial model: an open letter to the Centers for Medicare and Medicaid Services. Appl Clin Inform 2015; 6 (02) 267-270
    Article in Thieme ConnectPubMedGoogle Scholar
  • 7 Harris PA, Taylor R, Minor BL. et al; REDCap Consortium. The REDCap consortium: building an international community of software platform partners. J Biomed Inform 2019; 95: 103208
    CrossrefPubMedGoogle Scholar
  • 8 Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)–a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 (02) 377-381
    CrossrefPubMedGoogle Scholar
  • 9 ACGME Program Requirements for Graduate Medical Education in Clinical Informatics. Accessed November 01, 2023 at: https://www.acgme.org/globalassets/pfassets/programrequirements/381_clinicalinformatics_2023.pdf
    PubMed
  • 10 Palma JP, Hron JD, Luberti AA. Early experiences with combined fellowship training in clinical informatics. J Am Med Inform Assoc 2020; 27 (05) 788-792
    CrossrefPubMedGoogle Scholar
  • 11 Bell DS, Baldwin K, Bell EJ. et al. Characteristics of the National Applicant Pool for Clinical Informatics Fellowships (2016–2017). AMIA Annu Symp Proc 2018; 2018: 225-231
    PubMedGoogle Scholar
  • 12 Kim E, Van Cain M, Hron J. Survey of clinical informatics fellows graduating 2016-2024: experiences before and during fellowship. J Am Med Inform Assoc 2023; 30 (10) 1608-1613
    CrossrefPubMedGoogle Scholar
  • 13 Kannry J, Smith J, Mohan V, Levy B, Finnell J, Lehmann CU. Clinical Informatics Program Directors Group-AMIA. Policy statement on clinical informatics fellowships and the future of informatics-driven medicine. Appl Clin Inform 2020; 11 (05) 710-713
    Article in Thieme ConnectPubMedGoogle Scholar
  • 14 Bichel-Findlay J, Koch S, Mantas J. et al. Recommendations of the international medical informatics association (IMIA) on education in biomedical and health informatics: second revision. Int J Med Inform 2023; 170: 104908
    CrossrefPubMedGoogle Scholar
  • 15 Fridsma DB. Developing the health informatics workforce of the future: academic and industry partners. J Am Med Inform Assoc 2017; 24 (03) 677-678
    CrossrefPubMedGoogle Scholar
  • 16 Turer RW, Levy BP, Hron JD. et al. An open letter arguing for closure of the practice pathway for clinical informatics medical subspecialty certification. Appl Clin Inform 2022; 13 (01) 301-303
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Johnson R. The American Board of Pathology examiner. 2016 Accessed January 25, 2024 at: https://abpath.org/wp-content/uploads/2023/11/2016_ABPExaminer.pdf/
    PubMedGoogle Scholar
  • 18 Hersh WR. The clinical informatics practice pathway should be maintained for now but transformed into an alternative to in-place fellowships. Appl Clin Inform 2022; 13 (02) 398-399
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Henricks WH, Karcher DS, Harrison Jr JH. et al. Pathology informatics essentials for residents: a flexible informatics curriculum linked to Accreditation Council for Graduate Medical Education milestones. Arch Pathol Lab Med 2017; 141 (01) 113-124
    CrossrefPubMedGoogle Scholar
  • 20 Payne TH. The value of medical informatics expertise to health care organizations. Ann Saudi Med 1995; 15 (03) 203-204
    CrossrefPubMedGoogle Scholar
  • 21 Zhao J, Forsythe R, Langerman A, Melton GB, Schneider DF, Jackson GP. The value of the surgeon informatician. J Surg Res 2020; 252: 264-271
    CrossrefPubMedGoogle Scholar
  • 22 Nundy S, Cooper LA, Mate KS. The quintuple aim for health care improvement: a new imperative to advance health equity. JAMA 2022; 327 (06) 521-522
    CrossrefPubMedGoogle Scholar