Clinical Informatics Wins Official Recognition

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Following a six-year effort by medical informatics advocates, the American Board of Medical Specialties (ABMS) has formally recognized clinical informatics as a medical subspecialty. That means physicians board-certified in any of the 24 primary medical specialties soon will be able to earn secondary certification as informaticians.

"This was a big milestone," Dr. Edward H. Shortliffe, president and CEO of the American Medical Informatics Association (AMIA), which has been pushing for this recognition since 2005, told InformationWeek Healthcare.

"It's essentially a professional and public statement about the acceptance of informatics," Shortliffe added. It validates the decades of work Shortliffe and his brethren have put in to build the field of biomedical informatics, he said.

The American Board of Preventive Medicine and the American Board of Pathology are cosponsoring the subspecialty with the ABMS. AMIA said other specialty groups are considering joining as cosponsors. An ABMS committee signed off on the plan in July, setting the stage for final approval this week.

According to Shortliffe, all 24 ABMS member boards have already have approved the recognition of clinical informatics as a subspeciality, making this the first subspecialty certification that is available to any physician already board-certified in any primary medical specialty. "That's why it took so long," Shortliffe said.

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According to AMIA, plans are for the first clinical informatics board exam to be administered in the fall of 2012, and the first certifications to be awarded in early 2013. AMIA expects to have preparatory courses ready by the spring. Shortliffe said the American Board of Preventive Medicine is now forming an exam committee to develop and administer the certification exam.

Indeed, the long process is far from complete. "This is, in some sense, the starting point, at least for the programs," Shortliffe said.

The next step is for the sponsoring organizations to ask the Accreditation Council for Graduate Medical Education (ACGME), a body that accredits medical residency programs, to approve fellowship program for certification in clinical informatics.

Like the ABMS recognition process, the ACGME review likely will be based on documents AMIA approved in 2008 that spell out the core content and specific training requirements for clinical informatics. AMIA developed the documents with the help of a $300,000 grant from the Robert Wood Johnson Foundation.

AMIA has called for a two-year fellowship that must be completed within a four-year span, and wants to require any accredited clinical informatics program to have full institutional support. At least 15% of the training period should include rotations, which might include shadowing a nursing team, working in a medical records room, or assisting in an IT department.

As is often the case with new subspecialties, physicians who have not had access to an accredited training program would for the first five years be allowed to substitute real-world experience for training and sit for the exam.

AMIA has said that clinical informatics sits at the nexus of clinical care, information technology, and the business processes of healthcare. According to the core content, clinical informaticians--AMIA’s preferred term, as opposed to "informaticists"--must demonstrate mastery of many disciplines, including medical knowledge, informatics, the environment of healthcare delivery systems, process re-engineering, systems implementation, clinician adoption of IT, and organizational leadership.

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