Clinical Informatics has grown into a science of “analyzing, designing, developing, implementing, and evaluating information and communication systems that enhance individual and population health outcomes, improve patient care, and strengthen the clinician-patient relationship”(1). “ The accelerated adoption, implementation, and optimization of EHRs made possible by Meaningful Use provided the critical mass of experts and researchers for Clinical Informatics to qualify as a new specialty(2, 3)After 2022, there will be only one path to Board eligibility: an ACGME accredited fellowship in Clinical Informatics.
The Mount Sinai fellowship is two years in length requiring the Informatics fellow to participate in both operational (i.e., service) and scholarly activities as well as being clinically active and comprised of both service and scholarly components. The clinical home is the Division of General Internal Medicine in the Samuel Bronfman Department of Medicine and the academic home is the Center for Clinical Informatics in the Department of Pathology. We accept applications from any physician who has successfully completed an accredited residency program in any clinical specialty. We accept applications from any physician who has successfully completed an accredited residency program in any clinical specialty. The EHR used in our institution is Epic (Epic Systems, Wisconsin).
Learning Objectives for Clinical Informatics Fellowship:
- Understand and define the full depth and breadth of Clinical Informatics and its place in the broader field Biomedical Informatics
- Value and Identify Career Paths in Clinical Informatics
- Utilize peer reviewed literature to answer academic and operational questions about clinical information systems
- Explain and review system lifecycle including selection, implementation, and optimization
- Utilize Clinical Workflow Analysis, Process Redesign, and Quality Improvement
- Characterize high reliability organizations
- Recognize how and why systems are either successfully adopted or not
- Appreciate how Regulatory Programs such as Meaningful Use and PQRS are shaping the use of EHRs (Electronic Health Records)
- Realize how information can be shared across institutions electronically
- Identify opportunities to use and define different types of Clinical Decision Support
- Define usability, identify useable systems, and assess system usability
- Explain the relationship between settings of care and EHR functionality and use
- Determine how the EHRs and other clinical systems can facilitate and enable clinical research
- Appreciate how innovative technologies such as Genomic Decision Support, eHealth, and apps are changing health care
- Utilize teamwork and communication skills to implement change
- Explain how strategic decision are made as it relates to clinical information systems
- Describe the techniques and value of project management
- Gain appreciation of Clinical Informatics as either an academic and/or operational career
- Provide input and participate into local decision making clinical information systems
- Identify opportunities for improvement in care settings
- Initiate continued self-learning and research project
- Build a foundation of Informatics knowledge and experience that will be useful in any care or research setting
- Inpatient, Ambulatory, Emergency Department, Clinical Decision Support, Digital Medicine, Leadership, Scientific Computing, Clinical Research Informatics, Federal Regulation of Health Information Technology, Project Management, Usability
- Rotations are centered at Mount Sinai's main campus (Upper East Side) with supervision from Icahn School of Medicine faculty. Fellows are also exposed to other locations within the health system (e.g., Upper West Side, Queens, Brooklyn)
Sample Block Schedule
- Security & Privacy, Implementation, Natural Language Processing/Artificial Intelligence, Population Health, Pathology Informatics
- Further study in: Digital Medicine Part 1, Digital Medicine Part 2, CDS, Usability, Clinical Research Informatics, Leadership, Project Management, Federal Regulation of HIT
- Fellows are enrolled in online graduate courses through Oregon Health & Science University (OHSU) to obtain a 24-credit graduate certificate
- Courses include Intro to Biomedical Informatics, Clinical Information Systems, and Organizational Behavior & Management.
- Funding provided for at least two trips to Epic Wisconsin for certification (e.g., in Building or Analytics)
Conferences and Publications:
- Support is provided for attendance of academic conferences including those hosted by AMIA
- Local presentation opportunities at MSHS available for presenting original research
The fellowship hosts an ongoing seminar series where experts are invited to discuss topics related to clinical informatics. Examples include:
- Dona Wong, MFA: Information design and data visualization
- Rosamond Rhodes, Ph.D.: Medical ethics
- Glenn Martin, MD: IRB and research review processes
Articles pertaining to core informatics literature are reviewed at weekly journal club sessions with informatics faculty. Examples include:
- Walsh, KE., Marsolo., KA, Margolis, P., et al. Accuracy of the medication list in the electronic health record—implications for care, research, and improvement. Journal of the American Medical Informatics Association. 2018;25(7):909–912.
- Kuperman GJ, Sussman A, Schneider LI, Fiskio JM, Bates DW. Towards improving the accuracy of the clinical database: allowing outpatients to review their computerized data. Proc AMIA Symp. 1998;220–224.
- Wright A, McCoy AB, Hickman TT, et al. Problem list completeness in electronic health records: A multi-site study and assessment of success factors. Int J Med Inform. 2015;84(10):784–790.
- Hanauer DA, Preib R, Zheng K, Choi SW. Patient-initiated electronic health record amendment requests. J Am Med Inform Assoc. 2014;21(6):992–1000.
Clinical Practice Requirement:
- Up to 20% clinical time will be provisioned for.
1. AMIA. Clinical Informatics Board Review Course-History: AMIA; 2014
2. Kannry J, Sengstack P, Thyvalikakath TP, Poikonen J, Middleton B, Payne T, et al. The Chief Clinical Informatics Officer (CCIO): AMIA Task Force Report on CCIO Knowledge, Education, and Skillset Requirements. Appl Clin Inform. 2016;7(1):143-76.
3. Kannry J, Fridsma D. The Chief Clinical Informatics Officer (CCIO). J Am Med Inform Assoc. 2016;23(2):435.