In the era of electronic health records (EHRs), physicians have access to more data than ever. Alone, each data set is a simple drop in the bucket. Cumulatively, those drops become an ocean of information.
“It’s one of the great ironies of our time that the availability of information about individual patients, groups and populations has never been higher,” said Titus Schleyer, DMD, PhD, a professor of biomedical informatics at Indiana University School of Medicine (IUSM). “When you look at the volume of information that is stored in electronic health records and other systems, 10 or 20 years ago, that was on paper. For practical purposes, you couldn’t analyze it. You couldn’t access it. You couldn’t do anything with it.”
The influx of electronic data presents a new problem: People working in health care, on both the clinical and system levels, are not properly trained to interpret it. This problem is being addressed by a collaboration between the Regenstrief Institute, IUSM and IU’s Richard M. Fairbanks School of Public Health at Indiana University-Purdue University Indianapolis.
Their program aims to address the need by preparing graduate students and post-doctoral fellows, including physicians, to make sense of that data while working in a broad spectrum of entities across the health care industry.
Supported by a five-year, $2.5 million award from the National Library of Medicine, the Indiana Training Program in Public and Population Health Informatics launched in July 2017. The funding will support up to eight fellows annually.
The program’s focus areas are in line with a larger trend in health care, as evidenced by the growing list of clinical informatics fellowship programs listed by the American Medical Informatics Association. Generations of physicians and health professionals have tended to treat each patient on a case-by-case basis without using data from similar episodes. A population health approach calls for using all available information to make informed decisions that will improve outcomes for groups of patients.
“Quite a bit of activity in medical schools is pointed in this direction,” said Regenstrief Institute investigator Brian E. Dixon, PhD, an associate professor of epidemiology in the Fairbanks School of Public Health who co-directs the program with Dr. Schleyer. “For a long time, people in public health have sat on the sidelines and grumbled about the fact that this hasn’t happened. Now it’s happening, and it’s very exciting.”
While trainees may come from various health professional disciplines, Dr. Schleyer believes that physicians—who bring an in-depth knowledge of the operational parameters and constraints of a clinical environment—can make a unique contribution.
“A physician practice spends quite a bit of its resources on putting data into the electronic health record and other systems,” he said. “But what we haven’t stood up as a profession and said very loudly and clearly is that it’s time [to] make those data relevant and useful to physicians. Don’t just let me enter the data all day long and then somewhere somebody derives some benefit from it. Help me leverage what I produce.”
Post-doctoral fellowships are expected to take between two and three years while pre-doctoral fellowships are expected to take closer to five years to complete. At the end of training, program leaders are hoping to create change agents at the highest levels.
“We hope they take away the skills and knowledge they need to be successful in practice, that they will learn about informatics and how it can be applied in systems and public health, and that they use those skills to become the future innovators and scientists in this space’” Dixon said.
In addition to the informatics program, the Regenstrief EHR Clinical Learning Platform also represents a new frontier in medical education. The platform features more than 11,000 records with misidentified data—real patient information that has been altered so privacy is preserved—providing educators with realistic patient presentations and giving medical students insights into true-to-life clinical scenarios.
IUSM received a 2013 grant from the AMA’s Accelerating Change in Medical Education initiative to develop the Regenstrief EHR Clinical Learning Platform with the Regenstrief Institute. IUSM was one of the original 11 members of the Accelerating Change in Medical Education Consortium. There are about 3,000 licensed users on the platform, which is being used at seven health professional education programs throughout the country.