Structure and Funding of Clinical Informatics Fellowships: A National Survey of Program Directors

Tushar N. Patel; Aaron J. Chaise; John J. Hanna; Kunal P. Patel; Karl M. Kochendorfer; Richard J. Medford; Dara E. Mize; Edward R. Melnick; Jonathan D. Hron; Kenneth Youens; Deepti Pandita; Michael G. Leu; Gregory A. Ator; Feliciano Yu; Nicholas Genes; Carrie K. Baker; Douglas S. Bell; Joshua M. Pevnick; Steven A. Conrad; Aarti R. Chandawarkar; Kendall M. Rogers; David C. Kaelber; Ila R. Singh; Bruce P. Levy; John T. Finnell; Joseph Kannry; Natalie M. Pageler; Vishnu Mohan; Christoph U. Lehmann

doi:10.1055/a-2237-8309

Applied Clinical Informatics, Table of Contents

Appl Clin Inform 2024; 15(01): 155-163
DOI: 10.1055/a-2237-8309

Research Article

Structure and Funding of Clinical Informatics Fellowships: A National Survey of Program Directors

Tushar N. Patel

¹Department of Pathology, University of Illinois Chicago, Chicago, Illinois, United States

,

Aaron J. Chaise

¹Department of Pathology, University of Illinois Chicago, Chicago, Illinois, United States

,

John J. Hanna

²Clinical Informatics Center, University of Texas Southwestern, Dallas, Texas, United States

,

Kunal P. Patel

¹Department of Pathology, University of Illinois Chicago, Chicago, Illinois, United States

,

Karl M. Kochendorfer

¹Department of Pathology, University of Illinois Chicago, Chicago, Illinois, United States

,

Richard J. Medford

²Clinical Informatics Center, University of Texas Southwestern, Dallas, Texas, United States

,

Dara E. Mize

³Departments of Biomedical Informatics and Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, United States

,

Edward R. Melnick

⁴Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, United States

⁵Department of Biostatistics (Health Informatics), Yale School of Public Health, New Haven, Connecticut, United States

,

Jonathan D. Hron

⁶Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts, United States

⁷Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, United States

,

Kenneth Youens

⁸Department of Pathology, Baylor Scott & White Health, Temple, Texas, United States

,

Deepti Pandita

⁹Department of Internal Medicine, University of California, Irvine, California, United States

,

Michael G. Leu

¹⁰Departments of Pediatrics and Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, United States

¹¹Information Technology Services, UW Medicine, Seattle, WA, United States

¹²Information Technology Department, Seattle Children's Hospital, Seattle, WA, United States

,

Gregory A. Ator

¹³Department of Otolaryngology-Head and Neck Surgery and Clinical Informatics, University of Kansas Medical Center, Kansas City, Kansas, United States

,

Feliciano Yu

¹⁴Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

,

Nicholas Genes

¹⁵Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, New York, United States

,

Carrie K. Baker

¹⁶Department of Family Medicine, Kettering Health, Indu and Raj Soin Medical Center, Dayton, Ohio, United States

,

Douglas S. Bell

¹⁷Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California, United States

,

Joshua M. Pevnick

¹⁸Department of Medicine, Cedars-Sinai Health System, Los Angeles, California, United States

,

Steven A. Conrad

¹⁹Division of Clinical Informatics, Department of Medicine, LSU Health Shreveport, Shreveport, Louisiana, United States

,

Aarti R. Chandawarkar

²⁰Division of Clinical Informatics, Nationwide Children's Hospital and The Ohio State, Columbus, Ohio, United States

²¹Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, United States

,

Kendall M. Rogers

²²Division of Hospital Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States

,

David C. Kaelber

²³Center for Clinical Informatics Research and Education, The MetroHealth System, and the Departments of Internal Medicine, Pediatrics, and Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, United States

,

Ila R. Singh

²⁴Department of Pathology and Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, United States

,

Bruce P. Levy

²⁵Division of Informatics, Geisinger Health System, Danville, Pennsylvania, United States

,

John T. Finnell

²⁶Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, United States

,

Joseph Kannry

²⁷Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, United States

,

Natalie M. Pageler

²⁸Division of Clinical Informatics, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, United States

,

Vishnu Mohan

²⁹Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, United States

,

Christoph U. Lehmann

²Clinical Informatics Center, University of Texas Southwestern, Dallas, Texas, United States

› Author Affiliations

Abstract

Background In 2011, the American Board of Medical Specialties established clinical informatics (CI) as a subspecialty in medicine, jointly administered by the American Board of Pathology and the American Board of Preventive Medicine. Subsequently, many institutions created CI fellowship training programs to meet the growing need for informaticists. Although many programs share similar features, there is considerable variation in program funding and administrative structures.

Objectives The aim of our study was to characterize CI fellowship program features, including governance structures, funding sources, and expenses.

Methods We created a cross-sectional online REDCap survey with 44 items requesting information on program administration, fellows, administrative support, funding sources, and expenses. We surveyed program directors of programs accredited by the Accreditation Council for Graduate Medical Education between 2014 and 2021.

Results We invited 54 program directors, of which 41 (76%) completed the survey. The average administrative support received was $27,732/year. Most programs (85.4%) were accredited to have two or more fellows per year. Programs were administratively housed under six departments: Internal Medicine (17; 41.5%), Pediatrics (7; 17.1%), Pathology (6; 14.6%), Family Medicine (6; 14.6%), Emergency Medicine (4; 9.8%), and Anesthesiology (1; 2.4%). Funding sources for CI fellowship program directors included: hospital or health systems (28.3%), clinical departments (28.3%), graduate medical education office (13.2%), biomedical informatics department (9.4%), hospital information technology (9.4%), research and grants (7.5%), and other sources (3.8%) that included philanthropy and external entities.

Conclusion CI fellowships have been established in leading academic and community health care systems across the country. Due to their unique training requirements, these programs require significant resources for education, administration, and recruitment. There continues to be considerable heterogeneity in funding models between programs. Our survey findings reinforce the need for reformed federal funding models for informatics practice and training.

Keywords

clinical informatics - physician - workforce - ACGME - fellowships and scholarships - internships and residency - medical informatics

Full Text

References

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Supplementary Material

Supplementary Material