1 © 2013 Charles Safran Clinical Informatics Subspecialty Charles Safran, MD Chief, Division of Clinical Informatics, Beth Israel Deaconess Medical Center.

1© 2013 Charles Safran

Clinical Informatics Subspecialty

Charles Safran, MD

Chief, Division of Clinical Informatics, Beth Israel Deaconess Medical Center

Associate Professor of Medicine, Harvard Medical School

21 August 2013


Clinical Informatics• Clinical informatics applies concepts, methods and tools that enable

the optimal use of information and knowledge to measurably improve patient care.

• Clinical informaticians transform health care by analyzing, designing, implementing, and evaluating information and communication systems that enhance individual and population health outcomes, improve patient care, and strengthen the clinician-patient relationship.

• Clinical informaticians are at the intersection of clinical processes and business processes andcommunication & informationtechnology

• Clinical informatics is applied -- interventional

ClinicalProcesses

InformationTechnology

BusinessProcesses


Core Content for the Subspecialty of Clinical Informatics. Reed Gardner, J Marc Overahge, Elaine B Steen et al JAMIA 2009 16: 153-157

Program Requirements for Fellowship Education in the Subspecialty of Clinical Informatics Charles Safran, M Michael Shabot, Benson S Munger, et al. JAMIA 2009 16: 158-166

Guiding Documents


Gardner RM, Safran C. Chapter 10. Clinical Informatics - Curricula for a New Medical Subspecialty.

in Informatics Education in Healthcare: Lessons Learned. Ed Eta S. Berner, Ed.D. Publisher: Springer-Verlag, London, Ltd. 2013.

Lessons Learned


Building the Exam


3.5. Information System Lifecycle3.5.1. Institutional governance of clinical information systems3.5.2. Clinical information needs analysis and system selection3.5.2.1. Methods for identifying clinician information system needs3.5.2.2. Assessment of clinical process changes that will be required3.5.2.3. Elements of a system requirements specification document (e.g., technical

specifications, intellectual property, patents, copyright, licensing, contracting, confidentiality, specific organizational needs such as user training and support)

3.5.2.4. Risk analysis and mitigation3.5.2.5. The costs of health information and communications technologies3.5.3. Clinical information system implementation3.5.3.1. Elements of a system implementation plan3.5.3.2. Models of user training and support processes that can meet clinician needs3.5.3.3. Processes and mechanisms that obtain and respond to clinician feedback3.5.4. Clinical information system testing, before, during and after implementation3.5.5. Clinical information system maintenance3.5.5.1. Disaster recovery and downtime3.5.5.2. Clinical information system transitions and decommissioning of systems3.5.6. Clinical information system evaluation3.5.6.1. Outcomes relevant to the clinical goals and quality measures3.5.6.2. Qualitative and quantitative methods for evaluating clinical information systems3.5.6.3. Evaluation plan design

Breakdown of Core Content


You accept a position as CMIO at a hospital with multiple stand alone information systems. Your first task should be to: A. Develop a strategic information planB. Design a clinical data repositoryC. Build trust with the clinical leadershipD. Implement evidence-based guidelines

A Sample Question


Carter Electronic Health RecordsDegoulet Introduction to Clinical Informatics Elkin Terminology and Terminological Systems Friedman Evaluation MethodsGreenes Clinical Decision SupportKotter Leading ChangeO’Carrol Public Health InformaticsPayne Practice Guide to Clinical ComputingPantanowitz Pathology InformaticsShortliffe Biomedical InformaticsVan Bemmel Handbook of Medical InformaticsWagner Health Care Informatics Systems

References for Best Answers


Reflections

• Consensus on “best” answer often difficult• Guiding documents more important than the

experts who created the documents realized• Writing multiple choice questions seemed un-

natural to test some concepts like leadership• No one textbook covered all the “core”

content• Process of exam writing is dynamic and a

learning experience


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1 © 2013 Charles Safran Clinical Informatics Subspecialty Charles Safran, MD Chief, Division of Clinical Informatics, Beth Israel Deaconess Medical Center.

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