Active Participation and Engagement of Residents in Clinical Informatics
Authors: F. Quirós; Analía Baum; Antonio Lira
Year: 2019

In “A Model for Clinical Informatics Education for Residents: Addressing an Unmet Need” Mai et al describe an interesting model for residents to participate and engage in Clinical Informatics Education at the Children’s Hospital of Philadelphia, through rotations organized by the Department of Health Informatics (DHI), with hands-on project experience, led by faculty mentors.1Not only did the program lead to the improvement of information systems in the organization, but also to the emergence of new champions and educators, which eventually motivated several physicians in residency to pursue a subspecialty in clinical informatics. Latin America boasts three health resident informaticist programs, i.e., Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) (1988–1997) in Brazil, and two in the city Buenos Aires, Argentina—Hospital Italiano de Buenos Aires (HIBA) (2001 to date) and Ministry of Health (2017 todate), basedon thehands-on trainingdesignof HIBA. Founded in 1853, HIBA has been a university teaching hospital since 2000, accredited as an academic medical center hospital by the Joint Commission International in 2015. HIBA residency programs date back to 1962, there currently beingmore than 400 residents across 41 specialties and 120 subspecialties. When the Clinical Informatics Residency2 was launched in 2001, the applicants to this training program were physicians participating in the development of HIBÁs proprietary health information system (HIS). HIS was developed as the specialty progressed. Nurses were gradually incorporated and in the end the program became an interdisciplinary residency, annually enrolling five health care physicians and social sciences professionals, on the understanding that information systems pose challenges that only a multiskilled team3 can address. Applicants to the 3-year training program are now required to have at least 1-year practice and clinical experience inhealth care organizations. The HIBA DHI (with 160 information technology [IT] practitioners among faculty members) is responsible for the academic development of trainees. Residents gain exposure and training in the fields of clinical informatics4 (IT project management and organizational change), HIS (electronic health records [EHR], interoperability, standards, clinical decision support systems, safety, and privacy), and software development (software engineering, usability, databases, and programming logic). All teaching contents follow the recommendations laid down by the American Medical Informatics Association (AMIA) and the International Medical Informatics Association (IMIA). Each resident manages an HIS portfolio under the mentorship of one of the 10 certified clinical informaticists of the DHI, harnessing theory and practice to advance HIS development and implementation. On onehand, residents bridge the gap between the different players in the HIBA health care system and HIS developers by defining information needs, use cases, information flows, and adequate data for different professionals. They also develop customized interfaces to meet HIBA needs, follow-up on the data cycle across thewhole organization (quality and efficiency management, assistance, education, andresearch).Ontheother hand, trainees contribute to the integration of projects and initiatives into a comprehensive standard-based information system, and also facilitate the interaction between the IT implementation teams and care professionals. Last but not least, residents engage in research projects and impact on the assessment of DHI innovations which are communicated in regional and international fora and in numerous clinical informatics trainingactivitiesatundergraduateandgraduatelevels.5 Since the inception of the program more than 15 years ago, 41 residents have graduated—10 of them are currently clinical informaticians at HIBA, another 10 are devoted to EHR development and implementation at ministries of health under federal, provincial (province of Buenos Aires), and local governments (city of Buenos Aires). Four graduates have pursued careers in this discipline in provincial health organizations. Thirteen work at private hospitals in the city of Buenos Aires. Further, four of them are talented