Sounding Board: Career Makeover: Medicine Moves to IT

Published: Thursday, Feb 14, 2008
Most physicians choose clinical medicine because they want to make a positive impact on patients’ health. Tom Wessel, MD, is no exception. And that’s the reason he left the bedside.

"I saw that through information technology (IT), I could improve clinical care for more patients than I could through one-on-one practice,” says Wessel, who left his family medicine practice four years ago to become Medical Information Officer at Spartanburg Regional Healthcare System in Spartanburg, SC. Wessel joined an increasing number of physicians who straddle the clinical information technology divide as clinical informaticians (or “informaticists”). The demand for physicians with expertise in informatics is being fueled by the widespread adoption of electronic medical records (EMRs) and the recognition of the critical role of IT in patient safety. The result has been new career possibilities for informaticssavvy clinicians. “Virtually every hospital, clinic, physician office, or other healthcare provider organization will in some way utilize [IT] solutions in the coming years and will need healthcare professionals versed in informatics to assist with the implementation, use, and success of these systems,” said American Medical Informatics Association (AMIA) President and CEO Don Detmer, MD, in an article in the December 2006 ACP Observer.

Physician leadership is a critical factor in the successful implementation of healthcare IT projects, which ensures that physicians like Wessel will remain at the forefront of clinical IT design and adoption. For this reason, the chief medical information officer (CMIO) has become a key executive in many healthcare organizations. The CMIO has been aptly described as the person “at the nexus of executive, medical, and technology leadership,” according to the November 2006 issue of Radiology Today.

Simply the Best

A study published in 2006 in the Journal of the American Medical Informatics Association, identified the ideal CMIO as someone who is: “credible as a good clinician and not viewed as a ‘techie doctor’ who is only knowledgeable about computers; an effective communicator across services and disciplines; an effective consensus builder; and knowledgeable of hospital operations.” Of the five prominent CMIOs interviewed for this study, four continue to provide part-time patient care. All had been involved in a clinical IT project prior to assuming their current roles, and every one of them possesses executive leadership skills and experience. Only one, however, had completed a full-time medical informatics training program.

Although the CMIO may be an organization’s most visible informatician, there are many other opportunities available to physicians with interest and expertise in informatics. “I think there’s a range of opportunity. There’s definitely an emerging role for clinicians who want to make it their primary career activity, who really want to transition,” says William Hersh, MD, Professor and Chair, Department of Medical Informatics and Clinical Epidemiology at Oregon Health and Science University (OHSU).

But Hersh foresees a wider range of potential involvements: “Everything from the clinician who essentially is going to change his or her career so that informatics is their primary job responsibility to more intermediate liaison positions... where they’re still predominantly a practitioner but they have enough informatics skills that they can serve as liaison” between the clinical and IT departments.

Wessel agrees that a good introductory position for physicians interested in informatics is as a part-time liaison between clinicians and IT staff . He suggests that physicians who have extensive clinical experience will likely bring the most to such a position, since these clinicians are often best qualifi ed to communicate their colleagues’ needs to IT leaders and developers. The tradeoff , he cautions, is the need to balance clinicians’ expectations with what is actually available.

David Hall, MD, began in such a part-time IT liaison role, but soon found a transition to full-time informatics irresistible. Hall, an internist-pediatrician, left his practice to become Physician Informatics Specialist for OSF Healthcare in Peoria, IL. He saw informatics as a field that, although still in its infancy, would ultimately change the way that healthcare is practiced. Says Hall, “To be part of this opportunity was something I couldn’t pass up. I knew I would regret it if I did.”

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