Training Faculty (and Others) in
Biomedical Informatics
William Hersh, MD
Professor and Chair
Department of Medical Informatics & Clinical Epidemiology
Oregon Health & Science University
Portland, OR, USA
Email: hersh@ohsu.edu
Web: www.billhersh.info
Blog: informaticsprofessor.blogspot.com
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Overview of talk
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Biomedical and health informatics
Why we need more faculty
What we know about the HIT workforce
How we can/should build the HIT workforce
The HITECH workforce development program
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Biomedical and health informatics
(BMHI)
• “The field that is concerned with the optimal use of
information, often aided by the use of technology, to
improve individual health, healthcare, public health,
and biomedical research” (Hersh, 2009)
– It is more about information than technology
• We pay inadequate attention to
– The growing deluge of data and information (Stead, 2010)
– The role of information in medical education and
subsequent practice (Shortliffe, 2010)
– The critical role and importance of people, including
academics, practitioners, and users (Hersh, 2010)
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Why do we need more BMHI?
• In healthcare
– Quality – not as good as it could be (McGlynn, 2003;
Schoen, 2009; NCQA, 2010)
– Safety – IOM “errors report” found up to 98,000 deaths
per year (Kohn, 2000); problem persists (Classen, 2011)
– Cost – rising costs not sustainable; US spends more but
gets less (Angrisano, 2007)
– Inaccessible information – missing information frequent in
primary care (Smith, 2005)
• In other areas
– Clinical and translational research (Bernstam, 2009)
enabling the learning healthcare system (Friedman, 2010)
– Enabling patients, consumers, etc. (Gibbons, 2009)
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Why do we need more faculty (and
others)?
• Growing use of BMHI as users
– Improving healthcare quality, safety, costeffectiveness, etc.
– Meeting meaningful use and other incentives
– Communicating with and empower patients
– Enabling research, public health, etc.
• Increasing career opportunities as
– Academics/researchers – research, teaching, and
leadership
– Professionals/practitioners – new subspecialty and
other opportunities
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How do we train more faculty (and
others)?
• Historically most BMHI education at graduate level
– Informatics is inherently interdisciplinary and there is no
single job description or career pathway
• More information on programs on AMIA web site
– http://www.amia.org/informatics-academic-trainingprograms
• Commentary at
– http://informaticsprofessor.blogspot.com
• Let’s look at
– Competencies
– Funding opportunities
– OHSU experience
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What competencies should
informaticians have? (Hersh, 2009)
Health and biological sciences:
- Medicine, nursing, etc.
- Public health
- Biology
Competencies required in
Biomedical and Health
Informatics
Management and social sciences:
- Business administration
- Human resources
- Organizational behavior
Computational and mathematical sciences:
- Computer science
- Information technology
- Statistics
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Inventory of competencies for various
groups (Hersh, 2010)
• Competencies differ by
group
– Informaticians
• Developing, implementing,
and evaluating systems
• Making optimal use of
information
– Clinicians
…
• Applying informatics in
delivery of care
– Patients
• Health information literacy
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Funding for BMHI training
• Mostly self-funded, sometimes at institutional
level
– e.g., University of Connecticut HSC “grow your own”
• Research training historically available through
NLM (NIH) training grant program
– http://www.nlm.nih.gov/ep/GrantTrainInstitute.html
• New opportunities in ONC Workforce
Development Program funded under HITECH Act
– http://healthit.hhs.gov/portal/server.pt/community/
healthit_hhs_gov__workforce_development_program
/3659
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ONC Workforce Development Program
Based on need for 51,000 professionals in 12 workforce roles
• Five universities
funded to develop
curricula for
community college
programs
• OHSU funded to
develop curricula
and to serve as
National Training &
Dissemination
Center (NTDC)
• Nine universities funded, with
emphasis on short-term
training using distance learning
• OHSU funded to enroll trainees
in existing programs
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Experience of the OHSU program
• http://www.ohsu.edu/informatics
• Graduate-level programs at Certificate, Master’s, and PhD levels
– “Building block” approach allows courses to be carried forward to
higher levels
– Train practitioners and researchers from a wide variety of backgrounds
– Mostly self-funded but some funded by NLM, ONC, and others
• Two “populations” of students
– “First-career” students more likely to be full-time, on-campus, and
from variety of backgrounds
– “Career-changing” students likely to be part-time, distance, more
likely (though not exclusively) from healthcare professions
• Many of latter group prefer “a la carte” learning
– This has led to the successful 10x10 (“ten by ten”) program that
started as OHSU-AMIA partnership (Hersh, 2007; Feldman, 2008)
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Overview of OHSU graduate programs
Masters
- Tracks:
- Clinical Informatics
- Bioinformatics
- Thesis or Capstone
Graduate Certificate
- Tracks:
- Clinical Informatics
- Health Information Management
10x10
- Or introductory course
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PhD
- Knowledge Base
- Advanced Research
Methods
- Biostatistics
- Cognate
- Advanced Topics
- Doctoral Symposium
- Mentored Teaching
- Dissertation
Challenges
• Institutions do not understand informatics
– Do not fully appreciate potential synergy with
research, clinical enterprise, and/or education
• Growing departmental “self-sufficiency” models
that discourage collaboration and encourage silos
and short-term thinking
– Exacerbated by tightening of NIH, state, and other
budgets
• Informatics departments do not fit in classical
basic-clinical divide
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For more information
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Bill Hersh
– http://www.billhersh.info
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Informatics Professor blog
– http://informaticsprofessor.blogspot.com
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OHSU Department of Medical Informatics & Clinical Epidemiology (DMICE)
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http://www.ohsu.edu/informatics
http://www.youtube.com/watch?v=T-74duDDvwU
http://www.informatics-scholarship.info
http://oninformatics.com
What is Biomedical and Health Informatics?
– http://www.billhersh.info/whatis
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Office of the National Coordinator for Health IT (ONC)
– http://healthit.hhs.gov
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American Medical Informatics Association (AMIA)
– http://www.amia.org
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National Library of Medicine (NLM)
– http://www.nlm.nih.gov
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