SNOMED CT and its place in health information management practice.(Reports)(Systematized Nomenclature of Medicine-Clinical Terminology) - Health Information Management Journal

The Systematized Nomenclature of Medicine-Clinical Terminology (SNOMED CT[R]) has been endorsed as an international standard reference terminology to facilitate e-health initiatives. SNOMED CT is developed and supported in an international collaborative effort through the International Health Terminology Standards Development Organization (IHTSDO) and the member countries (approximately15) function as partnered National Release Centres (1). Australia, through our National E-Health Transition Authority (NEHTA) is a charter member, joining this international community early and dedicating resources to development and adoption strategies. (2) There is an eagerness to drive the uptake of SNOMED CT in order to facilitate electronic health records (EHRs) and exchange of health information, to ensure patient safety and quality care delivery, to provide decision support functionality and to achieve health system efficiencies through interoperability.

SNOMED CT and ICD-10-AM/ACHI are very different; they have different purposes, and are intended for different system deployments and for different users:

* SNOMED CT is a clinical terminology. It describes and defines clinical entities such as diseases, procedures, substances, organisms. It is designed to facilitate clinician recording of clinical information in an electronic health record. Essentially, it facilitates input.

* ICD-10-AM and ACHI are statistical classifications. They also describe clinical entities but in a much more aggregated way. They are designed for statistical analysis--the output.

Because SNOMED CT and ICD-10-AM/ACHI are used for different purposes and at different stages of information collection, they are both necessary and are complementary.

Below are two examples showing how SNOMED CT and ICD-10-AM/ACHI represent the same 'thing' differently.

There is a view that building 'maps' between SNOMED CT concepts and ICD-10-AM/ACHI concepts will make the journey from clinical reporting to statistical data collection more accurate and somewhat 'seamless'. It is acknowledged internationally that this 'map' cannot be fully automated due to the complex differences between the two systems. Health Information Managers (HIMs) and clinical coders know that assigning an ICD-10-AM/ACHI code requires a great deal more abstraction, analysis, judgment and compliance with rules and conventions than just 'picking the right word'. The mapping exercise currently underway at the IHTSDO has involved many experts over the past five years or more. Maps are not yet available or endorsed.

When Australia has widely implemented EHR systems, it is expected that these will be structured and deployed with SNOMED CT content as the national standard clinical terminology. Like clinical records now, these EHRs will be completed by clinicians, and with SNOMED CT content supporting the EHR the clinician will be routinely selecting and entering SNOMED CT terms (where appropriate). In this way, we can regard SNOMED CT as the scheme for clinical information input.

This will have an impact upon the health information management and coder workforce because there will be a significant change in the uniformity and predictability of the clinical records they work with and rely upon. Clinical records will contain unambiguous, formal, standard terms describing clinically important information, all will be legible and spelt correctly--drawn directly from SNOMED CT. These features alone should contribute to increased coded data reliability, adding clarity and consistency to documentation and coding practices and reducing miscommunication. Electronic completion, transmission and delivery of clinical records to the health information management and coder workforce could also achieve further efficiencies (through-put and timeliness). At least for the next five years or so, health information management and coding practice using ICD-10-AM/ACHI for data collection and reporting purposes will probably proceed much as it does now, producing coded data outputs (but the process will be easier and the results better, we all hope).

Nationally and internationally we see significant concerns that the health information workforce needs to be fostered and expanded to help with the transition to e-health and interoperability. The USA has taken some proactive steps, attempting an ambitious program to train 10,000 health informatics workers by 2010 (American Medical Informatics Association n.d.). The AHIMA is likewise encouraging its members and workforce to undertake career development and diversification training, particularly focusing on SNOMED CT and EHR topics (American Health Information Management Association n.d. a,b).

[FIGURE 1a OMITTED]

[FIGURE 2a OMITTED]

Recent reviews in both Canada and Australia (Health Informatics Society of Australia 2009) have also identified an alarming shortage of skilled workers in the health information arena. National health information professional associations (HISA, HIMAA) were successful in urging the National Health and Hospital Reform Commission (NHHRC) to highlight workforce capacity building as a key component of the reform agenda.

Figure 1b: Extract from ICD-10-AMAcute appendicitisK35.0 Acute appendicitis with generalized peritonitis        *   appendicitis (acute) with:        *   perforation        *   peritonitis (generalized) (localized) following            rupture or perforation        *   ruptureK35.1 Acute appendicitis with peritoneal abscess        Abscess of appendixK35.9 Acute appendicitis, unspecified        Acute appendicitis with peritonitis, localized or NOS        Acute appendicitis without:        *   generalized peritonitis        *   perforation        *   peritoneal abscess        *   ruptureFigure 2b: Extract from ACHIAppendicectomyAPPENDIXEXCISION926       Appendicectomy30572-00  Laparoscopic appendicectomy30571-00  AppendicectomyIncidental appendectomy

There is recognition that the health information management and clinical coder workforce comprises the indispensable intellectual capital needed to achieve e-health initiatives. The Australian health information management and clinical coder workforce is well trained and supported in traditional roles. We note the HIMAA submission to NHHRC emphasises the opportunities for this workforce to support health information initiatives in primary and non-acute health care settings.

New opportunities are emerging, and new roles and responsibilities will evolve. Recent recruits and new graduates beginning a career in health information are likely to encounter a range of tasks and duties not previously performed in health information management or coding roles. We speculate that the future will demand that this workforce be able to understand and use clinical data captured in SNOMED CT (not just ICD/ACHI statistical data). Data extraction and analysis skills, health outcomes research and service performance monitoring are already becoming prominent demands. Our more experienced HIMs and clinical coders have a wealth of knowledge; their comprehensive understanding of medical terms and clinician use of vocabulary and documentation practice is priceless. We imagine that this workforce sector could make significant contributions to specifying EHR content, selecting and testing relevant SNOMED CT content suited for particular clinical specialties, and for expert assistance and support of adoption and implementation strategies.

References

American Health Information Management Association (n.d.a). Building the workforce for health information transformation Available at: http://www.ahima.org/emerging_issues/ Workforce_web.pdf (accessed 8 Feb 2010).

American Health Information Management Association (n.d.b). Campus Courses. Available at: http://campus.ahima.org/ Campus/course_info/CTS/CTS_info.htm (accessed 8 Feb 2010).

American Medical Informatics Association (n.d.). AMIA 10 x 10 Program. Available at: https://www.amia.org/10x10 (accessed 8 Feb 2010).

Health Informatics Society of Australia (2009). Australian Health Information Workforce Review. [Online] Available at: http:// imianews.wordpress.com/2009/12/10/australian-healthinformatics -workforce-review/ (accessed 8 Feb 2010).

Health Informatics Society of Australia (n.d.). Australian Health Information Workforce Review. http://www.hisa.org.au/ (accessed 8 Feb 2010).

ICTC (2009). Health Informatics and Health Information Management Human Resources Report. Available at: http://www.ictc-ctic.ca/ uploadedFiles/Labour_Market _Intelligence/E-Health/HIHIM_ report_E_web.pdf (accessed 8 Feb 2010).

Donna Truran

Research Fellow (ACCTI Project Manager)

Australian Centre for Clinical Terminology and Information (ACCTI)

University of Wollongong

Wollongong NSW 2522

AUSTRALIA

Patricia Saad

Research Fellow (ACCTI Content Manager)

Australian Centre for Clinical Terminology and Information (ACCTI)

University of Wollongong

Wollongong NSW 2522

AUSTRALIA

Ming Zhang

Research Fellow (ACCTI Systems Manager)

Australian Centre for Clinical Terminology and Information (ACCTI)

University of Wollongong

Wollongong NSW 2522

AUSTRALIA

(1) See International Health Terminology Standards Development Organisation website: http://www.ihtsdo.org/

(2) National E-Health Transition Authority website: http://www.nehta.gov.au/

Corresponding author:

Kerry Innes

Senior Research Fellow (ACCTI Manager)

Australian Centre for Clinical Terminology and Information (ACCTI)

University of Wollongong

Wollongong NSW 2522

AUSTRALIA

ROGUE COMMUNITY COLLEGE PROGRAMS PREPARE STUDENTS FOR NEW HEALTHCARE CAREERS - US Fed News Service, Including US State News

Rogue Community College issued the following news release:

Rogue Community College is working with regional healthcare providers and Oregon Institute of Technology to prepare students for new technologies in healthcare settings.

RCC has joined forces with Asante Health System to establish the nation's first training for a new healthcare informatics assistants (IA) career. The objective is to train 23 current staff member to understand clinical practices and gain advanced computer skills.

In addition to the Asante project, RCC is utilizing SIM Lab, a new computer-based healthcare information system developed by Oregon Institute of Technology.

This groundbreaking system uses virtual patient data and actual healthcare information technology applications and systems to provide simulated educational, training, and research opportunities.

Juliet Long, RCC Computer Science instructor, is working with Asante's Three Rivers Community Hospital employees studying the flow of patient data - from registration to the lab to the doctor's office.

Long said medical informatics, which is the intersection of information science, computer science and health care, is increasingly important nationwide. New computer technology, combined with huge volumes of healthcare-related data, is opening a wide range of highpaying, high-demand job opportunities.

To meet that demand, RCC has developed a one-year Health Care Informatics Assistant certificate and an Associate of Science degree articulated with the Information Technology/Health Informatics option at OIT.

Lori Kainer and Jennifer Monteith work with RCC instructor Juliet Long, who is teaching Three Rivers Hospital employees how to use new healthcare-related computer technology.

'It's part of a national push to streamline the flow of medical information,' Long said. 'The integration of paper and electronic documents will be more efficient, cut costs, and reduce the cumbersome paper trail. Patients would also have access online to some records.'

Asante and RCC received a $433,000 Jobs to Careers grant to jointly develop the new Healthcare IA training and offer college-level instruction. The first group of students began coursework fall term, with an emphasis on workplace-based learning. Included in that group are Three Rivers employees Jennifer Monteith, who works in the hospital lab, and Lori Kainer, who works in patient registration. Taking two classes per term over a two-year period, they each will earn a one-year certificate.

They train using the SIM Lab, which includes the types of applications and systems employed in a variety of health care delivery and support settings, such as hospitals, outpatient clinics, laboratories, and imaging centers. SIM Lab uses real patient profiles but removes any confidential or identifying information.

'This training makes us more well-rounded employees,' said Kainer, an auditor/trainer who is sharing her new skills with other employees. 'There's an exciting sense of being on the ground floor of new technology.'

She has suggested several ideas for her training that would have a patient bypassing registration and entering information from home, the doctor ordering tests, and the patient going straight to the lab.

Monteith, a lab assistant and data analyst, is working with Kainer to evaluate how that process ties in with posting lab results online, making it easier for doctors and patients to access information, and avoid unnecessary office visits.

'There's a need for this and not a lot of people going into a new field that has great potential,' Monteith said.

'The goal is to create an entire patient profile and input it into SIM lab, schedule tests and get results - all without using any paper,' Long added. Because it eliminates paperwork, the new system is likely to save money and improve patient service, she observed.

Contact: Margaret Bradford, 541/956-7304, 541/471-354, mbradford@roguecc.edu.

UNIVERSITY OF SOUTH CAROLINA UPSTATE'S HEALTH INFORMATION MANAGEMENT PROGRAM RECEIVES ACCREDITATION - US Fed News Service, Including US State News

SPARTANBURG, S.C., March 23 -- The University of South Carolina Upstate Campus issued the following news release:

The Health Information Management (HIM) program at the University of South Carolina Upstate recently received accreditation by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM), making it the only accredited four-year program of its kind in the state of South Carolina and one of about 50 such programs in the entire United States.

Fulbright'A four-year degree and certification is necessary for career advancement in this field and South Carolina has been hemorrhaging qualified graduates from the state's accredited two-year programs for a number of years,' said Dr. Ron Fulbright, chair of the Department of Informatics at USC Upstate. 'The state's healthcare industry has been hiring people from other parts of the country over and above our own residents because we have lacked the capability to produce our own certified professionals. This accreditation is a large step forward for South Carolina.'

The HIM program prepares graduates for careers in the records management field, particularly in the areas of insurance coding and health informatics. Graduates of the program receive the Bachelor of Arts in Information Management & Systems and are eligible to take the exam for the Registered Health Information Administrator (RHIA), which is an important professional certification in the field. The HIM program offered at USC Upstate is a 'completion program,' which means that students who enter the program must have graduated from an accredited two-year program and must have achieved the Registered Health Information Technician (RHIT) certification or be able to acquire the RHIT soon after being accepted into the program.

The accredited HIM program is part of the Information Management & Systems (IM&S) program at USC Upstate. IM&S is a four-year undergraduate multidisciplinary information technology program focusing on the production of new knowledge gained from the gathering and analysis of information and the utilization of information processing technology.

'We offer a unique combination of coursework in computer technology, business, communication, and sociology resulting in a Bachelor of Arts in IM&S,' said Fulbright. 'Almost every office job today is dependent on the use of a computer or some other information technology and this program prepares professionals to be 'information workers.' Our graduates find employment in almost every department of a company including, but not limited to: IT support, customer service, sales, marketing, human resources, public relations, logistics, shipping, and manufacturing.'

DEPUTY NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY NAMED - US Fed News Service, Including US State News

The U.S. Department of Health & Human Services issued the following press release:

HHS' Office of the National Coordinator for Health Information Technology (IT) today announced the appointment of Charles P. Friedman, Ph.D., as deputy national coordinator for Health IT in the Office of the National Coordinator for Health IT (ONC). Dr. Friedman had recently been serving as senior advisor to the National Coordinator for Health IT Robert M. Kolodner, M.D.

'Chuck's recent experience in assisting me in matters related to program planning, development, and evaluation has prepared him well to assume the deputy role,' said Dr. Kolodner. 'As he carries out his new role, Dr. Friedman will continue to contribute scientific and managerial expertise and leadership to initiatives under way in the office's four directorates.'

Prior to joining ONC, Dr. Friedman was institute associate director for research informatics and information technology at the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH). Friedman joined NIH in 2003 as a senior scholar at the National Library of Medicine. Previously, Dr. Friedman was professor and associate vice chancellor for biomedical informatics at the University of Pittsburgh, where he established a health sciences-wide Center for Biomedical Informatics.

Over a 26-year academic career, Dr. Friedman's research focused on how to build information technology resources to support health care, research, and education and how to evaluate the impact of these resources. He is the author of several textbooks and has authored or co-authored over 150 articles in scientific journals. He is an elected fellow and past president of the American College of Medical Informatics.

As deputy national coordinator, Dr. Friedman will serve as operations officer for ONC's health IT initiatives to develop, maintain, and direct the implementation of the strategic plan to guide nationwide adoption of interoperable health IT to reduce medical errors, improve quality, and produce greater value in health care.

ICA Promotes Health Information Technology Expert, John Tempesco, to Vice President of Client Services. - Health & Medicine Week

Informatics Corporation of America (ICA; www.icainformatics.com), providing clinicians with a single technology solution for accessing, evaluating, and acting upon patient information across disparate systems, recently appointed John Tempesco to vice president of Client Services, effective December 8, 2008. The move expands TempescoEs responsibilities involving the implementation and support of the ICA solution as former director of client services to include marketing functions u from overall branding and positioning within the market space to Web content and sales support (see also Informatics Corporation of America).

oJohn brings 34 years of healthcare experience, including 18 years of experience in health information technology in both the civilian and government sectors,o says Gary Zegiestowsky, CEO of ICA. oPrior to his impressive civilian career as a pioneer in HIT implementation, he completed a career in the United States Navy as a healthcare administrator, where he was instrumental in the development and implementation of the Department of DefenseEs Tricare program.o

Before joining ICA in February of 2008, Tempesco served as vice president of operations for the Practice Management, Electronic Medical Records, and Revenue Cycle Management product lines of HealthPort. Previously, he was national director of Support Services for Companion Technologies and vice president of Marketing and Sales for Companion Information Management Resource.

oI feel privileged to work with a company like ICA because, as an HIT leader, it offers the kind of cutting-edge technology that brings seamless access to clinical data and allows smoother clinical workflow,o Tempesco says. oAt this crucial time in our nationEs history, the adoption of the ICA solution could bring positive and sustainable change to our ailing health care system.o

In addition to his exceptional marketing expertise, TempescoEs responsibilities will encompass overall implementation of new clients, including the transition from sales to the operational implementation process, expectation setting, goal setting, and project management, as well as scheduling, integration planning, and training of clients for the ogo-liveo process.

Tempesco holds a Bachelor of Science in Business from Lock Haven University and a MasterEs in Health Administration from Baylor University. He is a Fellow in the Life Management Institute, a certified managed care executive, and a diplomat in the American College of Health Care Executives. About Informatics Corporation of America (ICA) Informatics Corporation of America (ICA) was created with nationally renowned Vanderbilt Medical Center to take innovative technology developed by Vanderbilt physicians to the broader healthcare market. ICA builds on existing IT systems to offer a single technology solution for accessing, evaluating and acting upon patient information across all treatment settings. Visit www.icainformatics.com.

Keywords: Informatics Corporation of America.

Recognition given for ground-breaking advancements in digitalizing health data and information. - Biotech Week

'The Signature Award recipients have made significant contributions to informatics, and in the process, have helped streamline the way data and information can be applied to patients,' said AMIA Chairwoman Nancy M. Lorenzi, PhD, Assistant Vice Chancellor for Health Affairs, Vanderbilt University Medical Center. 'This group of Signature Award recipients joins an impressive cohort of pioneers in health who are leading the way to more robust biomedical research, a more responsive public health sector, advancements moving more quickly and efficiently from bench to bedside, and more incisive clinical practice-all of which are made possible through the science of informatics,' she added.

The Signature Awards and recipients are:

Recognizes an individual who has made a significant contribution over the course of a career in health policy, conducted in accordance with the philosophy that all citizens and populations deserve a state-of-the-art health system that provides safe, effective, patient-centered, timely, efficient, and equitable health care services. The recipient exemplifies visionary leadership in the health policy realm, action-oriented advocacy work producing a regional, national or global result, advancement in thought leadership, and generating a sustainable contribution to the health system.

David Bates, MD, MSc, is chief of the Division of General Medicine at the Brigham and Women's Hospital, Boston; medical director of Clinical and Quality Analysis, IS; and a professor at both Harvard's Medical School and its School of Public Health. Dr. Bates has done extensive work evaluating the incidence and prevention of adverse drug events, and in improving efficiency and quality of diagnostic testing using information systems. He is currently evaluating the impact of guidelines on the delivery of quality of care, using electronic medical records. His work focuses on how to help clinicians make better decisions to produce more efficient, higher quality, and safer care, using information technology (see also Public Health).

Donald A.B. Lindberg Award for Innovation in Informatics

Recognizes an individual for a specific technological, research, or educational contribution that advances biomedical informatics. The recipient's work will have been conducted in a nonprofit setting, and the adoption of the particular advance will be on a national or international level.

Carol Friedman, PhD, is a professor of Biomedical Informatics at Columbia University. Her work has demonstrated that a general natural language processing system could be used to improve clinical care and to advance understanding of medicine. Dr. Friedman developed a comprehensive natural language extraction and encoding system for the clinical domain called MedLEE, which has been in use at New York-Presbyterian Hospital, and which has been shown not only to behave similarly to medical experts but also to improve actual patient care. In collaboration, she adapted MedLEE into a natural language processing system called GENIES, which extracts biomolecular relations from journal articles to obtain data on molecular pathways. From there, she went on to co-develop the BioMedLEE system, another adaptation of MedLEE, which extracts a broad range of genotypic-phenotypic relations from the literature, and maps the extracted information to an ontology appropriate for biology. Dr. Friedman is currently working on research in the area of patient safety, using data from clinical narrative notes to detect novel adverse drug events.

Keywords: American Medical Informatics Association, Emerging Technologies, Hospital, Information Technology, Information and Data Systems, Machine Learning, Natural Language Processing, Public Health.

Technology jobs for physician leaders.(Health Care IT) - Physician Executive

The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, is designed to promote the adoption and meaningful use of health information technology. Discussions around HITECH and meaningful use have generated a growing interest in nonclinical careers in the health information technology industry.

Health TT jobs are opening up all over the country for positions ranging from medical director of informatics to chief medical information officer (CMIO). These positions are available within the public and private sectors as hospitals and corporations seek talented physician executives to join their staffs.

Hospitals are recognizing their need to meet meaningful use requirements and they are seeking talented physicians who understand the health IT needs of hospital-based clinicians. Companies like McKesson, Allscripts, Cerner, Siemens, Epic, HP, Dell, Microsoft, and Verizon are hiring physicians to help them develop, improve, and sell health IT solutions that can improve health care delivery.

Language of health IT

Because of the HITECH Act, there is a growing number of career opportunities for physicians who have a strong understanding of health information technology and the evolving world of medical informatics.

You don't need to have a formal degree in medical or health care informatics to find a job in the IT industry. However, you need to understand the language of health IT, because this industry is full of strange acronyms and terminology that may be foreign to you. Here are several examples of common health IT acronyms:

* CDS = Clinical Decision Support

* CPOE = Computerized Physician Order Entry

* HIE = Health Information Exchange

* PHR = Personal Health Record

* PHI = Personal Health Information

* RHIO = Regional Health Information Organization

* CCHIT = Certification Commission for Health Information Technology

* ONCHIT or ONC = Office of the National Coordinator for Health IT

* HITRC = Health Information Technology Research Center

* ONC-ATCB = Office of the National Coordinator for Health IT Authorized Testing and Certification Bodies

Here are some technical acronyms that often come up in the health IT industry:

* API = Application Programming Interface

* ASP = Application Service Provider

* SaaS = Software as a Service

It is also important for physicians to gain familiarity with information technology terms like interoperability, data exchanges, client-based solutions, ASP models, and more. Physicians need to know how to communicate with the IT staff so they can describe their evolving needs and collaborate to build effective systems.

Getting started

If you're interested in pursuing a career in health IT, how should you get started? Here are a few suggestions:

1. Get involved with national health IT organizations.

There are a number of health IT organizations that provide educational resources and networking opportunities for physicians who are interested in health IT. Each of these organizations holds national conferences and several of them also have local and regional chapters. Here are several examples of major health IT organizations:

* AHIMA = American Health Information Management Association

* AMIA = American Medical Informatics Association

* AMDIS = Association of Medical Directors of Information Systems

* HIMSS = Healthcare Information and Management Systems Society

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This year, the HIMSS annual meeting had over 30,000 attendees and the American College of Physician Executives teamed up for the first time to get more physician executives to attend HIMSS. All ACPE members were offered complimentary registration for the convention so they could participate in HIMSS' first-ever physician executive forum. About 100 ACPE members took advantage of the offer.

The conference was full of energy and attendees were clearly excited about the growing opportunities to improve health care delivery through the use of information technology. There are other national conferences that are more focused around specific issues like mobile health, telemedicine, participatory medicine, and social media. Here are a few examples:

* Health 2.0

* ATA (American Telemedicine Association)

* mHealth Summit

* Connected Health Symposium by the Center for Connected Health

* iHT2 Health IT Summit by the Institute for Health Technology Transformation

By attending major conferences, you will have the opportunity to meet other physicians who are currently working in health IT. You'll also get the chance to walk through the exhibit halls and speak directly with companies and organizations that may be interested in employing you.

2. Volunteer in health IT committees and task forces.

Make time to get involved by volunteering with a health IT committee in your local hospital or medical center. If you spend a significant amount of time in a hospital, get involved in different committees that are looking at ways to leverage health IT resources to improve patient care. Some groups may be focused on finding ways to improve care quality or patient satisfaction. There may be opportunities to identify gaps in care and opportunities for clinical workflow improvement.

Other hospital committees may be trying to identify ways to reduce medical errors by using CPOE and CDS in the ICU. As an experienced physician, you have the opportunity to volunteer in these committees and to interact with nurses, pharmacists, and other members of the care team to develop strategies, protocols, and policies that may improve workflow efficiencies, patient care, and clinical outcomes.

Getting involved with hospital committees may also provide you with greater knowledge about health IT implementation challenges and opportunities within the inpatient setting. Companies that sell EHR solutions are often looking for physicians who have experience and insight around improving EHR clinical workflow and overcoming common implementation challenges.

If you mainly work in an outpatient setting, you can still find opportunities to volunteer in health IT committees by exploring these opportunities at local hospitals. Or, you may create a workgroup within your group practice to identify ways to improve efficiencies or to enhance your existing EHR systems.

Perhaps you can lead a committee involved in identifying the best EHR for your office-based practice as you prepare to transition from paper records to EHRs. By collaborating with surrounding hospitals or group practices, you may identify best practices surrounding health IT selection and adoption.

3. Try writing and publishing.

Another way to transition into the health IT industry is to establish yourself as a subject matter expert by publishing articles related to the use of health IT to improve clinical outcomes or workflow efficiencies. You can submit articles to the Journal of Health Informatics or the Journal of Healthcare Information Management.

Collaborate with nurses and pharmacists so that you can also describe the importance of interdepartmental collaboration as clinicians adopt health IT. You can also create a blog or submit an article to an established blog by writing about health IT security, patient privacy, or clinical workflow challenges.

If you demonstrate your working knowledge of current health IT issues, potential employers may find you and approach you to seek your expertise.

4. Look into mobile health (mHealth), teleHealth and electronic health (eHealth).

Health IT isn't only about hospitals and group practices. Organizations are looking at ways to leverage mobile technology such as smartphones and slate tablets like the iPad in the health care setting. We are in the midst of a mobile health or mHealth revolution, and there are a number of organizations investing resources to grow their mHealth capabilities.

As communication technology advances, the world of telehealth is converging with mHealth. There are still many rural sites that rely on video conferencing and other communication technologies to provide care remotely. However, as mobile devices get equipped with cameras and video capabilities, the future of telehealth may largely reside in the mHealth domain.

Today, mHealth is gaining tremendous momentum in developing countries because the mobile infrastructure provides an affordable way for health care delivery. If you have a strong interest in public health and international medicine, the mHealth industry could be a good fit for you.

The world of eHealth continues to evolve as patients become empowered by finding resources on the Internet. A number of organizations may be looking for medical directors to provide clinical oversight as they develop electronic health solutions through their websites.

Many of these companies focus on providing PHR services, so it is important to become fully knowledgeable about the latest HIPAA guidelines and regulations that relate to personal health information and digital communication technologies.

5. Investigate online learning and social networking

There are a growing number of opportunities to use the Internet to learn and to network with other professionals working in the health IT industry. ACPE offers networking resources on its website and it has an active LinkedIn group where you will find physicians discussing health IT issues. There are other LinkedIn groups such as HIMSS, AMIA, and AMDIS where you can join discussions and contribute your insights surrounding health IT.

By becoming more visible within these online communities, you may get recognized by a potential employer who may eventually approach you about a possible job opportunity.

Other opportunities

Here are some other places where you may find career opportunities related to health IT:

* State medical societies: Your local state medical society may have a group dedicated to providing resources around health IT. Some organizations have developed a separate consulting organization to provide health IT support and guidance for local physicians and hospitals.

* Professional specialty societies or associations: Perhaps you belong to the A AFP, ACP, or other specialty societies like AAP or ASCO. Are you plugged into the health IT workgroups or committees within your specialty societies?

* Consulting organizations: Many management consulting firms are expanding their capabilities to provide health IT services to hospitals and medical group practices. Consulting may require a considerable amount of work-related travel, but you may find it enjoyable to solve complex problems and help medical groups improve organizational efficiencies.

* Startup companies: These days, there are many new startup companies that are trying to ride the huge health IT wave that has been generated by the HITECH Act. You can find these startup companies by engaging local entrepreneur-ship clubs like the MIT Enterprise Forum or Entrepreneurs' Organization. You may also identify startup companies by visiting local business schools that hold startup competitions.

The time to jump into health IT is now. The HITECH Act continues to provide momentum in this field as hospitals and group practices adopt health IT solutions within their organizations. Many health organizations are still operating without clear guidance on the most effective ways to utilize health IT.

There is a lack of formal clinical practice guidelines on health IT implementation, improving clinical workflow processes, transitioning from paper records to EHRs. Make sure to stay current about ongoing health IT issues by reading blogs, journal articles and health IT news websites. Also, participate in health IT webinars so that you can learn what other institutions are doing to effectively leverage health IT solutions.

The health IT industry is rapidly expanding and there is still plenty of room for growth within many organizations. Prove your value as a physician leader so that you become an indispensable member of the care team.

Resource

Do your IT skills need improving?

ACPE is offering a new Health Care IT certificate, aimed at helping physician leaders learn the fundamentals of IT. The 40-hour program is offered entirely on-line and features faculty from Carnegie Mellon, AMIA, CHIME, among others.

Read more at acpe.org/HIT.

Joseph Kim, MD, MPH, is founder of NonClinicaljobs.com.

jkim@nonclinicaljobs.com