Clinical Informatics Fellowship Programs: In Search of a Viable Financial Model

Summary

In the US, the new subspecialty of Clinical Informatics focuses on systems-level improvements in care delivery through the use of health information technology (HIT), data analytics, clinical decision support, data visualization and related tools. Clinical informatics is one of the first subspecial-ties in medicine open to physicians trained in any primary specialty. Clinical Informatics benefits patients and payers such as Medicare and Medicaid through its potential to reduce errors, increase safety, reduce costs, and improve care coordination and efficiency.

Even though Clinical Informatics benefits patients and payers, because GME funding from the Centers for Medicare and Medicaid Services (CMS) has not grown at the same rate as training programs, the majority of the cost of training new Clinical Informaticians is currently paid by academic health science centers, which is unsustainable. To maintain the value of HIT investments by the government and health care organizations, we must train sufficient leaders in Clinical Informatics. In the best interest of patients, payers, and the US society, it is therefore critical to find viable financial models for Clinical Informatics fellowship programs. To support the development of adequate training programs in Clinical Informatics, we request that the Centers for Medicare and Medicaid Services (CMS) issue clarifying guidance that would allow accredited ACGME institutions to bill for clinical services delivered by fellows at the fellowship program site within their primary specialty.

Citation: McCoy AB, Wright A, Krousel-Wood M, Thomas EJ, McCoy JA, Sittig DF. Validation of a crowdsourcing methodology for developing a knowledge base of related problem-medication pairs. Appl Clin Inf 2015; 6: 334–344

http://dx.doi.org/10.4338/ACI-2015-01-RA-0010

Keywords

Clinical Informatics - Education - Graduate Medical Education - Centers for Medicare and Medicaid Services - Health Information Technology

 

• References

• 1 Lehmann CU, Shorte V, Gundlapalli AV. Clinical Informatics Sub-Specialty Board Certification. Pediatrics in Review 2013; 34. 11: 525-530.
• 2 Centers for Medicare and Medicaid Services.. Direct Graduate Medical Education (DGME). Available online at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/dgme.html
• 3 Centers for Medicare and Medicaid Services.. Medicare General Information, Eligibility, and Entitlement. . Available online at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/ge101c05.pdf
• 4 Association of American Medical Colleges.. Medicare Direct Graduate Medical Education (DGME) Payments. Available online at https://www.aamc.org/advocacy/gme/71152/gme_gme0001.html
• 5 Jones SS, Rudin RS, Perry T, Shekelle PG. Health information technology: an updated systematic review with a focus on meaningful use. Ann Intern Med 2014; 160 (01) 48-54. doi: 10.7326/M13–1531.
• 6 Sick AC, Lehmann CU, Tamma PD, Lee CK, Agwu AL. Sustained savings from a longitudinal cost analysis of an internet-based preapproval antimicrobial stewardship program. Infect Control Hosp Epidemiol 2013; 34 (06) 573-580.
• 7 Kim GR, Chen AR, Arceci RJ, Mitchell SH, Kokoszka KM, Daniel D, Lehmann CU. Error reduction in pediatric chemotherapy: computerized order entry and failure modes and effects analysis. Arch Pediatr Adolesc Med 2006; 160 (05) 495-498.
• 8 Blumenthal D, Tavenner M. The ,,meaningful use“ regulation for electronic health records. N Engl J Med 2010; 363 (06) 501-504. doi: 10.1056/NEJMp1006114. Epub 2010 Jul 13. PubMed PMID: 20647183.
• 9 Burwell SM. Setting Value-Based Payment Goals –HHS Efforts to Improve U. S. Health Care. N Engl J Med. 2015 Jan 26.
• 10 Accreditation Council for Graduate Medical Education.. ACGME Program Requirements for Graduate Medical Education in Clinical Informatics. Available online at http://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/381_clinical_informatics_2016.pdf