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Appl Clin Inform 2024; 15(04): 689-691
DOI: 10.1055/a-2340-7142
Special Topic on Teaching and Training Future Health Informaticians
Editorial

The Need for Expanded Educational Opportunities in Clinical Informatics for Pediatric Trainees

Adam P. Yan
1   Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
2   Department of Pediatrics, The University of Toronto, Toronto, Ontario, Canada
,
Julia Yarahuan
3   Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States
4   Division of Hospital Medicine, Children's Healthcare of Atlanta, Atlanta, Georgia, United States
,
Jonathan D. Hron
5   Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States
6   Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United States
› Author Affiliations Funding None.
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Pediatric Clinical Informatics

Clinical informaticians use their skills to design, implement, and evaluate clinical information systems and tools.[1] Whether the initiative is transformational or incremental, focus on improving health information systems and tools has been shown to improve patient safety and clinical effectiveness; we expect health information technology (IT) will continue to play a vital role in improving patient safety and quality improvement in the future.[2] [3] [4] [5] [6] [7] [8] As with many things in pediatrics, there are special requirements for pediatric health information systems compared with those used in adult medicine.[9] As recently as 2015, the majority of pediatric providers used an electronic health record (EHR) that lacked important pediatric-specific capabilities, such as: (1) immunization management including immunization decision support, (2) growth tracking including specialized growth curves utilized in neonatology and specialty clinics such as those that care for children with Down syndrome and Noonan syndrome as an example, (3) medication dosing including clinical decision support to assist with dosing by weight and age, (4) laboratory and vital sign interpretation which changes with patient age, and (5) privacy and confidentiality concerns.[10] [11] Privacy and confidentiality considerations for adolescent and young adult patients have become increasingly complex with the uptake of patient portals, the need for institutions to navigate proxy access, and the release of sensitive information.[12] [13] [14] [15] [16] [17] While many of the large commercial EHR vendors have products that address these issues, often the vendor-provided content needs extensive modifications and customization to fit local culture and regulation requiring the expertise of a pediatric clinical informaticist.[18] The absence of these pediatric-specific capabilities may also contribute to physician burnout and frustration.[19]

A robust community of pediatric-focused informaticians is required to support the material complexity associated with pediatric-specific EHR management.[9] [20] [21] However, evidence suggests that there are not enough pediatricians equipped to drive the informatics work required to deliver optimal patient care.[22] [23] As of 2018, only 320 of 1,851 total clinical informaticians are board-certified pediatricians.[22] [23] This number may underestimate the total number of pediatricians practicing as clinical informaticians as some providers may not have opted to become board-certified or may list an alternative specialty in the database. The number of pediatric informaticists is unlikely to increase in the coming years as only 31 individuals who completed clinical informaticist fellowships between 2016 and 2024 listed pediatrics as their primary specialty.[22] This concern is amplified when considering the geographic distribution of clinical informaticians. Eighteen states had 10 or fewer clinical informaticians and 33 states had 2 or fewer practicing informaticians per 1,000 active physicians.[23] Given that pediatricians make up less than 20% of clinical informaticians overall, it is a reasonable assumption that at least several states in the United States do not have a single pediatrician who is board-certified in Clinical Informatics (CI). Without board-certified clinical informaticists, pediatricians and pediatric sub-specialists are less likely to have EHR tools that meet their needs, potentially leading to EHR fatigue and burnout.[24]



Publication History

Received: 14 May 2024

Accepted: 06 June 2024

Accepted Manuscript online:
07 June 2024

Article published online:
21 August 2024

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