Understanding the Clinical Informatics Core Content

The Clinical Informatics Core Content is the material every physician seeking a board subspecialty certification in clinical informatics must know and understand to pass the certification exam.

Who Wrote the Core Content?

There were two MDs, three PhDs, and two Masters degree recipients that developed the core content for the clinical informatics subspecialty board. Three of them are directly affiliated with AMIA, while the rest are retired and acting as consultants or teaching at universities. Below are the authors of the core content:

• Reed M. Gardner, PhD – Fellow of the American College of Medical Informatics, Past President and Board Member of AMIA
• J. Marc Overhage, PhD, MD – Fellow of the American College of Medical Informatics, Adjunct Associate Professor at IUPUI
• Elain B. Steen, MA – Senior Education Consultant with AMIA
• Benson S. Munger, PhD -Former Executive Director of the American Board of Emergency Medicine, ABMS Member Board Consultant
• John H. Holmes, PhD -Interim Director, Penn Institute for Biomedical Informatics
• Jeffrey Williamson, M.Ed -Vice President of Education and Academic Affairs of AMIA
• Don E. Detmer, M.D., M.A. – Professor Emeritus and Professor of Medical Education at the University of Virginia and Visiting Professor at CHIME, University College of London

 What Is the Basic Clinical Informatics Core Content?

The Clinical Informatics Core Content covers four topic areas: Fundamentals, CDM/Care Process Improvement, HIS, and Leading and Managing Change.

Some of the topics include “hard” topics such as understanding HL7, what a method is versus a class, and bayesian versus classical statistics. Some “soft” topics include communication, change management, and defining and controlling expectations.

There are expanded versions of the following outline available –we decided to condense it for readability’s sake. If you’d like to check out the expanded outline, there are two versions located in the “Additional Resources” section at the end of the article.

1. Fundamentals
   1. Clinical Informatics
   2. The Health System
2. Clinical Decision Making and Care Process Improvement
   1. Clinical Decision Making
   2. Evidence Based Medicine
   3. Clinical Workflow Analysis, Re-design, & Quality Improvement
3. Health Information Systems
   1. IT Systems
   2. Human Factors Engineering
   3. Health Information Systems
   4. Clinical Data Standards
   5. Information System Lifecycle
4. Leading and Managing Change
   1. Leadership Models, Practices, and Processes
   2. Effective Interdisciplinary Teams
   3. Effective Communications
   4. Project Management
   5. Strategic and Financial Planning for Clinical Information Systems
   6. Change Management

What Will You Learn From This Content?

Clinical Informaticists will often find themselves in difficult management situations, especially when clinicians and technical staff do not agree. The Leading and Managing Change core content prepares them for these scenarios. Leading and Managing Change covers ideas such as:

• Understanding you don’t have to have VP or Director in your title to be a leader (Leadership Models, Practices, and Processes)
• Why meetings should contain 5 or 7 individuals (Effective Interdisciplinary Teams)
• Why group presentations should always be practiced (Effective Interdisciplinary Teams)
• How to manage a project to stay on scope, on budget, and on time (Project Management)
• The strategic plan is the most important document in your organization (Strategic and Financial Planning for CIS)
• Communication is one of the best change management strategies (Change Management)

Understanding Health Information Systems and some of their nuances such as nomenclatures, taxonomies, programming, networks, security, and their management are needed for cross-communication between IT and clinical systems. Understanding the difference between SQL and SNOMED is important for clinicians to be able to “speak” IT while ensuring that they understand what they’re getting when purchasing or implementing multi-million dollar clinical IT systems. From HIS, clinicians will learn:

• The basics of “hard” IT (networking, security, programming, SDLC, etc.)
• What makes a systems usable (Human-Computer Interaction)
• How systems are able to talk to one another (Clinical Data Standards)
• What you need to know before you implement another clinical information system (Information System Lifecycle)

Clinical Decision Making and Care Process Improvement gives providers the tools and knowledge they need to improve their existing clinical workflows and processes. This core topic covers workflow re-engineering, evidence based medicine, and clinical decision making processes. Clinicians will learn:

• How to define and improve upon existing workflows in the clinical environment
• How to understand what clinical information systems are capable of achieving as well as what their current limitations are
• How to bring IT and clinicians together to make better decisions using objective and subjective measures

And finally, Fundamentals covers what clinical informatics is and how the health system works.

As you may have noticed, these once-defined boundaries between clinical and IT are becoming blurred. Understanding the topics in the core content will help you and your organization reconcile the differences between the two and create a collaborative environment where your organization can reach its strategic vision and goals.

Additional Resources

Here are two official versions of the core content if you’re looking for it in PDF form

AMIA Board White Paper (PDF)

The ABPM Study Guide (PDF)