Pathology Training in Informatics: Evolving to Meet a Growing Need

Abstract

Context.-The mechanics of the practice of medicine in general and of pathology in particular is evolving rapidly with the rise in the use of electronic information systems for managing the care of individual patients, including the ordering and reporting of laboratory tests, maintaining the health of served populations, and documenting the full range of health care activities. Pathologists currently in practice and those in training need to acquire additional skills in informatics to be prepared to maintain a central role in patient care.Objective.-To summarize the evolving landscape of pathology informatics, with particular attention to the preparation of pathologists for this discipline and to the possible influence of the new subspecialty certification in clinical informatics.Data Sources.-Most of the information discussed is drawn from the authors' direct experience with informatics, resident and fellow education, and the organizations supporting these activities in pathology.Conclusions.-The increasing reliance of medical practice on electronic health records and other clinical information systems is creating a greater need for physicians skilled in the use and management of these tools. The establishment of clinical informatics as a formal subspecialty in medicine will likely help secure a role for physicians within information management structures at health care institutions. Pathologists must actively engage in informatics to assure that our specialty is appropriately recognized and represented in this growing discipline.(Arch Pathol Lab Med. 2014;138:505-511; doi: 10.5858/ arpa.2013-0328-RA) I nformatics is a term that means different things to different people. While most will accept the generic definition of ''the science of information management,'' how that definition manifests itself in different clinical settings varies significantly.1 The term pathology informatics has existed for decades, but the recent surge in implementation of electronic health record (EHR) systems and an expanding role of pathology laboratory information systems (LISs) in orchestrating the day-to-day activities in a pathology laboratory and in integrating with hospital systems has turned a new focus to this subspecialty area of pathology. With the increasing penetration of high-throughput data generating techniques such as next-generation sequencing and personalized medicine, both pathologists in practice and pathologists in training are beginning to realize that informatics is something they can no longer ignore.Even academic medical centers are changing their attitudes toward informatics. While only a decade ago, many academic centers considered informatics to be a technical activity not meeting the scholarship requirements for academic promotion, now contributions to clinical information management activities are increasingly recognized as both scholarly and crucial to the future of health care. In fact, many institutions have chief medical information officers to manage the rapidly changing electronic environment. Large...

Pathology Informatics Essentials for Residents: A Flexible Informatics Curriculum Linked to Accreditation Council for Graduate Medical Education Milestones

“…4,7,[21][22][23][24][25][26][27] In general, these proposals have focused on topics centered largely on information technology. In 2003, a comprehensive curriculum that detailed learning objectives and skill sets in informatics for pathology residents was published.…”

“…7 Computers, laboratory information systems, and data management have been familiar to pathologists for decades because they are integral to pathology as a specialty. 8 Numerous factors are driving the prominence of informatics in pathology practice, including rapid information technology changes, increased electronic health record adoption, novel laboratory methods such as molecular tests, prioritized patient safety initiatives to minimize misidentification errors, increased health information technology-related regulations, and changing business needs (Table 1).…”

“…These challenges notwithstanding, the pathology community recognizes the mandate for appropriate exposure and training in informatics to enable the advancement and transformation of the practice of pathology. 7,9,10 APPROACH The CAP, APC, and API formed a collaborative partnership in 2013 to address the need to educate pathology residents about informatics. The 3 organizations jointly convened a work group of 20 pathologists with expertise in informatics and/or in GME to help develop the PIER curriculum for residents.…”

The Challenge of Integrating Informatics Training During Residency

“…While these pioneers have advocated for the inclusion of informatics training for nearly 30 years, it is clear that significant challenges remain regarding the exact composition of competencies required by pathologist trainees in informatics and exactly how to integrate this training into the current training paradigm. 2,3 In this issue of the Journal, Rao and Gilbertson 1 identify a major impediment to the training of residents in informatics as the incongruity between the duration of dedicated time allotted (a typical residency rotation) for informatics training and the cadence by which real-world informatics projects progress to completion. They have proposed a longitudinal model of informatics educational engagement consisting of four components-foundation, immersion, refinement, and expertise (FIRE).…”

“…The pathology informatics community has made attempts to identify a comprehensive foundational curriculum for pathology residents. 2,3 Recently, the Association of Pathology Chairs, the Association for Pathology Informatics, and the College of American Pathologists have come together to develop the Pathology Informatics Essentials for Residents. 16 This resource, which details the essential informatics competencies mapped to the ACGME informatics milestone requirements, provides implementation strategies and resource options for program directors.…”