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The Need for Training in Health Informatics

April 16, 2009

The NY Times recently published an excellent article on the importance of people trained in dealing with the growing amount of health information.

Given the Obama Administration’s push to implement electronic medical records systems nationwide, people who are able to bridge the gap between clinicians and information systems will be in high demand.  Although this article details that point very well, it misses out on a bigger problem.  We will need people in the very near future who can use the power of aggregated medical data to investigate some of our most vexing medical conditions.  I currently work with a database that aggregates data from dozens of hospitals.  By combining the data from many different institutions, we can explore large national trends in diseases and therapies as well as investigate rare conditions.  Both aspects are critically important.

Following trends in disease and therapies across dozens (or hundreds or thousands) of medical institutions can allow us to find areas of improvement that can impact thousands of patients.  Suboptimal treatments can be identified and quantified across the institutions.  Solutions, such as clinical practice guidelines, can then be disseminated to all member institutions.  This leverages the economy of scale you get when aggregating data across hospitals and clinics.  Although investigations into suboptimal therapies at a single institution are generally not economical–this is setting aside the fact that usually single institutions don’t produce enough data to even do adequate statistical analysis in such situations–multi-center studies provide enough data and spread the benefits across a wide enough target population to make these quality improvement projects useful.

Conversely, aggregated data allows investigators to take on rare conditions.  Frequently, diseases causing significant morbidity don’t occur often enough in a single institution to provide enough data for useful clinical research.  Maybe a condition only occurs in 20 or 30 patients in a ten year period.  By combining data from multiple institutions, those cases now provide enough data to make meaningful observations.

People trained to use the power of information created by widespread implementation of electronic health records are vital to taking full advantage of such technologies.  As the NY Times article notes, few programs in biomedical informatics exist.  More programs are needed.  More importantly, such training needs to be incorporated into both public health and medical schools.  Both epidemiologists and physician researchers currently conduct such research largely without the benefits (and ease) health information technology promises to bring.  Training these groups in how to leverage the enormous amounts of data that will be generated is of equal importance to training specialists in health informatics.

Now, the biggest challenge–how to incorporate this into already crammed curriculums.

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