Careers in Health Informatics

For a description of health informatics click here

Career Prospects

As medical knowledge continues to explode and technology advances, the healthcare industry has struggled to successfully adopt available technology to improve its services.

This, many experts believe has left the industry in terms of technology adoption about ten years behind other industries, despite reports stating that technology can improve patient safety and clinical workflow, and invariably cut down medical errors.

Several factors have been proposed for the lag in healthcare technology adoption, amongst which include huge investment requirements and end user resistance. End user resistance usually stems from poor system design resulting in highly complex or unsuitable user interfaces, lack of adequate training for the end users and lack of involvement or poor integration of input of healthcare professionals in all stages of the technology adoption.

Adoption has also been hampered by the fact that many healthcare IT projects, especially government led projects, have a high failure rate, leading to those opposed to technology adoption, pointing out that the amount of money poured into these projects could be have been well spent on improving other aspects of patient care.

However recently there has been an increased push from several governments around the world to have healthcare organisations successfully adopt current technologies. The United States government in 2003 and 2004 has been vocal to recommending the adoption of technology to reduce medical errors and made moves to make the healthcare technology standard, SNOMED CT, freely available to within the United States.

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While the British government through its National Programme for IT (NPfIT) has set aside $3.5 billion in the period of 2003 – 2008 to make availability of essential information easier to healthcare professions in order to improve the delivery of health services. Similar projects are also ongoing in Canada and Australia.

All these have increased the need for the skilled professionals who understand the both the healthcare and information technology environments. This is a role that would be well suited for the health or medical informatics professionals.

With reports suggesting that by 2006, healthcare IT spending in the US would surpass the $15 billion and healthcare is one of the two industries to show the strongest growth in IT spending in the years 2003 and 2004, the prospects for a career in health informatics is very good.

Healthcare organisations such as the National Health Service in the United Kingdom have increased their drive to employ health informatics professions and have reportedly had problems in recruiting and retaining qualified staff.

Career Opportunities

Health informatics is a broad field and covers areas such as electronic medical records, access to knowledge-based information and digital libraries, digital imaging systems, telemedicine, clinical decision support, health policy and decision making, and much more.

This provides health informatics professionals with opportunities to move between and outside various clinical settings, work closely with a variety of health professional teams and form the hub of information systems and networks within healthcare organisations. All these enable the health informatics professional to operate in a more dynamic role than those usually found with other professions the healthcare sector.

The following are some of the areas in which health informatics professionals can find opportunities:

• Hospitals and other healthcare providers: As more healthcare organisations begin to implement information and electronic medical records systems, they need professionals to help in its implementation and management, as well as analyse the information contained within the system and make it readily available using knowledge management skills.
• Pharmaceutical companies: Health informatics professionals would be needed to aid in the analysis of the information gathered from the reports on drugs use and prescribing patterns.
• Medical software companies: They usually hire people with strong programming skills and good knowledge of the healthcare sector.
• Consulting companies: Such companies usually advice and assist healthcare organisations with development and implementation of information systems and providing knowledge management solutions.
• Public health organisations: Information on populations and communities need to be collected and analysed. The design and implementation of surveillance systems and disease reporting system are so carried out by public health organisations.
• Government and Non-governmental agencies: These agencies are involved in carrying out health planning and analysis of information at several levels of government and on the international stage. In the process tons of information is analysed and stored and made readily available for retrieval when needed.
• Insurance companies: Work here would usually involve the analysis of health insurance claims and health records.
• Academia: Opportunities here would usually require candidates to have an advanced degree and some experience in teaching.

Skills Needed

Enrico Coiera, a prominent health informatics expert defined the field as “the study of how medical knowledge is created, shaped, shared and applied.” Hence the general skills that would be required in health informatics should include not only the ability to analyse medical information but be able to communicate that information as medical knowledge.

Enrico Coiera in his paper titled Medical informatics meets medical education: There's more to understanding information than technology, published in the Medical Journal of Australia in 1998, listed the following skills as the essentials skills required by any budding health informatician.

1. Understand the dynamic and uncertain nature of medical knowledge and know how to keep personal knowledge and skills up-to-date
2. Search for and assess knowledge according to the statistical basis of scientific evidence
3. Understand some of the logical and statistical models of the diagnostic process
4. Interpret uncertain clinical data and deal with artefact and error
5. Analyse and structure clinical decisions in terms of risks and benefits
6. Adapt and apply clinical knowledge to the individual circumstances of patients
7. Access, assess, select and apply a treatment guideline; adapt it to local circumstances; and communicate and record variations in treatment plan and outcome
8. Structure and record clinical data in a form appropriate for the immediate clinical task, for communication with colleagues, or for epidemiological purposes
9. Select and utilize the most appropriate communication method for a given task (eg, face-to-face conversation, telephone, e-mail, video, voice-mail, letter)
10. Structure and communicate messages in a manner most suited to the recipient, task and chosen communication medium.

The skills highlighted above for specifically for practicing clinicians considering pursuing a career in medical informatics. However health informatics has grown in the past few years and continues to grow and thus along the way has begun to encompass some areas which were not previously considered part of health informatics. For instance, the National Health Service in the UK has included all its IT services, including IT support, as being under the jurisdiction of health informatics.

It must be mentioned that there are those who wonder if people who work in the IT departments of healthcare providers should be included under the umbrella of health informatics.

One thing is clear though, the field of health informatics is now so diverse and the skills and knowledge required varies from job to job. Below of just some of the groups of skills that would be useful to have to pursue a career in health informatics:

1. Understanding of the healthcare industry: This is a strong requirement and it might be important to demonstrate knowledge of organization culture, financing and management.
2. Communication skills: This is particularly important as health informaticians tend to act as a bridge to and communicate information to colleagues, clinicians and non clinicians, patients and members of the general public.
3. Strategic planning and management skills and leadership: This is required in senior positions as health informaticians assist healthcare organizations in formulation and implementation of their healthcare IT strategies.
4. Information technology: Technical skills in the use of, implementation and maintenance of clinical information systems are very useful skills that many healthcare organisations look on favourably.
5. Information analysis and organisation: These skills are usually required for knowledge management positions.
6. Health care professional training: Some of the roles available in health informatics do require some form of healthcare professional training. These roles tend to be senior roles and roles in academia.
7. Knowledge of system infrastructure design and networking: These skills are particularly useful in top-level design of information systems.
8. Programming skills: Strong skills in programming languages such as C++, C, Java, Visual Basic, C#, HTML are particularly required for software engineering roles in medical software companies and healthcare organisations.

Getting Started

Getting started in health informatics would usually require formal training in health informatics. Those sought favourably are those from a clinical background who have had some formal health informatics training with some clinical experience. Many organisations believe that the business knowledge possessed by these set of people is more important than any technical skills as it makes the learning curve shorter.

Clinicians who have along the way of their career acquired some IT skills are also looked upon favourably but they might be called to show they can transfer those skills to a clinical setting.

For those with clinical experience and no IT expertise or those with computer sciences degrees looking to get into health informatics, some form of postgraduate training in health informatics is probably the best route to follow.

However, there are some aspects of health informatics which usually do not require postgraduate training. These areas, which include positions in medical coding and medical transcription, require a strong understanding of medical terminology. There are some various courses available for those looking to get into these areas.

There are far more academic training programs available now than they were five years ago, with more academic institutions planning to roll out their programs. Depending on educational needs and career aspirations of those looking to seek to gain a career in health information. These program can vary from short courses, such as that offered by the National Library of Medicine and Stanford University, Graduate Certificate Programs through to academic programs that offer degrees at masters and doctorate level. A list of academic programs can be viewed here

Job Profiles

Jobs titles to look out for searching for a job in health informatics vary greatly, meaning that there are a lot on hidden opportunities out there, so one would have to actively seek them out.

These programs have been set up as a result of the increasing demand for professionals who have completed a health informatics program, and some of the career paths opportunities that are possible after a program completion can be viewed here.