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A new breed of physicians – the Physician Informatician.

By Obi Igbokwe
Increasing IT adoption within healthcare organizations sees the emergence of a new role for physicians.

Healthcare IT spending in the US is expected to increase between the years of 2004 – 2006 according to industry analysts Datamonitor. Their report, based on over 100 interviews showed that over 66% of healthcare providers expected to grow their budgets by 10% over the next three years.

One of the areas in which significant investment was expected was in technologies that increased the quality of patient care and safety.

Having the right staff in place would be central to successful implementation of their future IT projects. One key member of staff that organizations would be looking to assist in the smooth implementation of projects is the physician informatician.

The physician informatician is a new role within the healthcare organization and is a specialist role for a physician with clinical informatics experience or education. Clinical informatics is the study of the application of information systems in clinical practice.

Projects that physician informaticians may be involved in include the design and implementation of Electronic Medical Records, Clinical Decision Support and Electronic Prescribing Systems. Other projects include the evaluation of the impact of information technology on the clinical process, clinical outcome, and resources of an organizations as well as carrying out audits.

Physicians usually get into the field via two routes. The first is the physician who has had formal training in the field. There are an increasing number of academic programs offering Masters and PhD degrees in health informatics for the physician interested in getting into the field.

The National Institute of Health (NIH) also sponsors a number of health informatics fellowship programs for those looking for a more hands on approach.

The second route taken by the budding physician informaticians is by diving in at the deep end. Here physicians without any formal training, but who have a strong interest in informatics usually start off by getting involved in ongoing informatics projects and acquire their skills this way. Roles they play in these projects vary depending on experience.

The physician informaticians can expect to share their non-clinical duties with clinical responsibilities. The amounts shared between the two disciplines vary.

“I am split in two, equally employed by the IS department for our organization and for the family medicine residency at our main hospital,” says Jon White, MD, Physician Informatics Coordinator at Lancaster General Hospital, Lancaster, Pennsylvania.

“My clinical duties include my own continuity patients, precepting residents in outpatient, inpatient admissions and uncomplicated obstetrics. I spend half my time equally in both worlds.”

While Jonathan Leviss, MD, a physician for Hudson River Community Health (www.hrhcare.org) and a consultant for clinical information systems at Deloitte Consulting, New York, (www.deloitte.com) says he spends about one day a week conducting his clinical duties.

White and Leviss have both been involved in projects that have required change in the methods of operation of an organization and needed high end users acceptance for successful adoption after implementation.

Both agreed that their clinical background did help during the projects as they were able to bring in not only their clinical experiences but also offer a physician’s perspective as an end user.

It is essential that someone with a medical background is involved in the informatics projects in order to convince end users; it creates credibility, Leviss said. “The leading practice is for a physician to oversee the project as he or she is really the professional who leads the health delivery process, through all of its complexity.”
Leviss believes that more physicians should get involved in clinical informatics, a call echoed by White. “If we as a society expect our healthcare system to improve through IT, we must integrate physicians, and all stakeholders really, from the earliest stages through the ongoing ends, and accept them as partners to guide the change process rather than imposing ‘solutions’ on them.“

Physician informaticians do have a role in technology adoption. Poor technology adoption in healthcare has sometimes been blamed on physician resistance to technology, which Eric Rose believes is a bit unfair.

Dr. Rose, a Clinical Assistant Professor of Biomedical and Health Informatics at the University of Washington and Physician Consultant at IDX Systems Corporation goes on to say “Physicians have a right to be concerned about the safety of their patients and other issues that might arise with clinical information systems.”

Health IT applications have a clinical dimension to them and if physicians can be convinced about the safety of the systems and those dimensions have been addressed in the design and implementation of the applications, physicians would be happy to adopt the technology, said Rose.

This is a role well suited for the physician informatician but Rose believes that they currently face a tough time within their organizations. “The role of a physician informatician is a relatively new role and most organizations do not know how to exploit the skills and knowledge of physician informaticians.”

A lot of the present physician informaticians have had to fight for their roles as they were previously not recognized under the current organizational structure. However Rose believes as more organizations move towards technology adoption, in ten years from now, the role of a physician informatician, not necessarily reserved for a physician but someone with a clinical background would be the norm.








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