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Levy BP. Training Aspects of Laboratory-Based Decision Support. Clin Lab Med 2019; 39:303-17. [PMID: 31036283 DOI: 10.1016/j.cll.2019.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Pathology has a large role to play in the proper development, implementation, and optimization of clinical decision support (CDS). CDS training must be supported by an educational foundation in clinical and pathology informatics. Educational opportunities are currently limited, but expanding, in the pathology residency space with Pathology Informatics Essentials for Residents. The use of an educational version of electronic clinical systems is an important educational tool to support the needed outcomes-driven and exercise-based informatics and CDS training. With the multidisciplinary nature of informatics, it is advantageous to include laboratory professionals in the training exercises as appropriate.
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Rudolf JW, Garcia CA, Hanna MG, Williams CL, Balis UG, Pantanowitz L, Tuthill JM, Gilbertson JR. Career Paths of Pathology Informatics Fellowship Alumni. J Pathol Inform 2018; 9:14. [PMID: 29721362 PMCID: PMC5907454 DOI: 10.4103/jpi.jpi_66_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/03/2018] [Indexed: 11/15/2022] Open
Abstract
Background: The alumni of today's Pathology Informatics and Clinical Informatics fellowships fill diverse roles in academia, large health systems, and industry. The evolving training tracks and curriculum of Pathology Informatics fellowships have been well documented. However, less attention has been given to the posttraining experiences of graduates from informatics training programs. Here, we examine the career paths of subspecialty fellowship-trained pathology informaticians. Methods: Alumni from four Pathology Informatics fellowship training programs were contacted for their voluntary participation in the study. We analyzed various components of training, and the subsequent career paths of Pathology Informatics fellowship alumni using data extracted from alumni provided curriculum vitae. Results: Twenty-three out of twenty-seven alumni contacted contributed to the study. A majority had completed undergraduate study in science, technology, engineering, and math fields and combined track training in anatomic and clinical pathology. Approximately 30% (7/23) completed residency in a program with an in-house Pathology Informatics fellowship. Most completed additional fellowships (15/23) and many also completed advanced degrees (10/23). Common primary posttraining appointments included chief medical informatics officer (3/23), director of Pathology Informatics (10/23), informatics program director (2/23), and various roles in industry (3/23). Many alumni also provide clinical care in addition to their informatics roles (14/23). Pathology Informatics alumni serve on a variety of institutional committees, participate in national informatics organizations, contribute widely to scientific literature, and more than half (13/23) have obtained subspecialty certification in Clinical Informatics to date. Conclusions: Our analysis highlights several interesting phenomena related to the training and career trajectory of Pathology Informatics fellowship alumni. We note the long training track alumni complete in preparation for their careers. We believe flexible training pathways combining informatics and clinical training may help to alleviate the burden. We highlight the importance of in-house Pathology Informatics fellowships in promoting interest in informatics among residents. We also observe the many important leadership roles in academia, large community health systems, and industry available to early career alumni and believe this reflects a strong market for formally trained informaticians. We hope this analysis will be useful as we continue to develop the informatics fellowships to meet the future needs of our trainees and discipline.
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Affiliation(s)
- Joseph W Rudolf
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN, USA
| | | | - Matthew G Hanna
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Christopher L Williams
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Ulysses G Balis
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Liron Pantanowitz
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - J Mark Tuthill
- Department of Pathology and Laboratory Medicine, Henry Ford Health System, Detroit, MI, USA
| | - John R Gilbertson
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
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Walker A, Garcia C, Baron JM, Gudewicz TM, Gilbertson JR, Henricks WH, Lee RE. Perceptions of pathology informatics by non-informaticist pathologists and trainees. J Pathol Inform 2016; 7:14. [PMID: 27141320 PMCID: PMC4837799 DOI: 10.4103/2153-3539.179904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Accepted: 02/17/2016] [Indexed: 11/25/2022] Open
Abstract
Background: Although pathology informatics (PI) is essential to modern pathology practice, the field is often poorly understood. Pathologists who have received little to no exposure to informatics, either in training or in practice, may not recognize the roles that informatics serves in pathology. The purpose of this study was to characterize perceptions of PI by noninformatics-oriented pathologists and to do so at two large centers with differing informatics environments. Methods: Pathology trainees and staff at Cleveland Clinic (CC) and Massachusetts General Hospital (MGH) were surveyed. At MGH, pathology department leadership has promoted a pervasive informatics presence through practice, training, and research. At CC, PI efforts focus on production systems that serve a multi-site integrated health system and a reference laboratory, and on the development of applications oriented to department operations. The survey assessed perceived definition of PI, interest in PI, and perceived utility of PI. Results: The survey was completed by 107 noninformatics-oriented pathologists and trainees. A majority viewed informatics positively. Except among MGH trainees, confusion of PI with information technology (IT) and help desk services was prominent, even in those who indicated they understood informatics. Attendings and trainees indicated desire to learn more about PI. While most acknowledged that having some level of PI knowledge would be professionally useful and advantageous, only a minority plan to utilize it. Conclusions: Informatics is viewed positively by the majority of noninformatics pathologists at two large centers with differing informatics orientations. Differences in departmental informatics culture can be attributed to the varying perceptions of PI by different individuals. Incorrect perceptions exist, such as conflating PI with IT and help desk services, even among those who claim to understand PI. Further efforts by the PI community could address such misperceptions, which could help enable a better understanding of what PI is and is not, and potentially lead to increased acceptance by non-informaticist pathologists.
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Affiliation(s)
- Addie Walker
- Cleveland Clinic, Robert J. Tomisch Institute of Pathology and Laboratory Medicine, Cleveland, OH 44120, USA
| | - Christopher Garcia
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jason M Baron
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Thomas M Gudewicz
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - John R Gilbertson
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Walter H Henricks
- Cleveland Clinic, Robert J. Tomisch Institute of Pathology and Laboratory Medicine, Cleveland, OH 44120, USA
| | - Roy E Lee
- Cleveland Clinic, Robert J. Tomisch Institute of Pathology and Laboratory Medicine, Cleveland, OH 44120, USA
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Idoate MA, García-Rojo M. Clinical Neuropathology Views - 2/2016: Digital networking in European neuropathology: An initiative to facilitate truly interactive consultations. Clin Neuropathol 2016; 35:53-7. [PMID: 26833552 DOI: 10.5414/NP300899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2016] [Indexed: 11/18/2022] Open
Abstract
Digital technology is progressively changing our vision of the practice of neuropathology. There are a number of facts that support the introduction of digital neuropathology. With the development of whole-slide imaging (WSI) systems the difficulties involved in implementing a neuropathology network have been solved. A relevant difficulty has been image standardization, but an open digital image communication protocol defined by the Digital Imaging and Communications in Medicine (DICOM) standard is already a reality. The neuropathology network should be established in Europe because it is the expected geographic context for relationships among European neuropathologists. There are several limitations in the implementation of a digital neuropathology consultancy network such as financial support, operational costs, legal issues, and technical assistance of clients. All of these items have been considered and should be solved before implementing the proposal. Finally, the authors conclude that a European digital neuropathology network should be created for patients’ benefit.
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Garcia CA, Baron JM, Beckwith BA, Brodsky V, Dighe AS, Gudewicz TM, Kim JY, Klepeis VE, Lane WJ, Lee RE, Levy BP, Mahowald MA, Mandelker D, McClintock DS, Quinn AM, Rao LK, Riedlinger GM, Rudolf J, Gilbertson JR. Environmental components and methods for engaging pathology residents in informatics training. J Pathol Inform 2015; 6:42. [PMID: 26167386 PMCID: PMC4498313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 11/04/2022] Open
Affiliation(s)
- Christopher A. Garcia
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA,Corresponding author
| | - Jason M. Baron
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Bruce A. Beckwith
- Department of Pathology, North Shore Medical Center, Salem, Massachusetts, USA
| | - Victor Brodsky
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, NY, USA
| | - Anand S. Dighe
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Thomas M. Gudewicz
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ji Yeon Kim
- Clinical Chemistry and Laboratory Informatics, Southern California Permanente Medical Group Regional Reference Laboratories, North Hollywood, California, USA
| | - Veronica E. Klepeis
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - William J. Lane
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Roy E. Lee
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Bruce P. Levy
- Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Michael A. Mahowald
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Diana Mandelker
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Andrew M. Quinn
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Luigi K. Rao
- Department of Pathology and Laboratory Services, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Gregory M. Riedlinger
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Joseph Rudolf
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - John R. Gilbertson
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Garcia CA, Baron JM, Beckwith BA, Brodsky V, Dighe AS, Gudewicz TM, Kim JY, Klepeis VE, Lane WJ, Lee RE, Levy BP, Mahowald MA, Mandelker D, Mcclintock DS, Quinn AM, Rao LK, Riedlinger GM, Rudolf J, Gilbertson JR. Environmental components and methods for engaging pathology residents in informatics training. J Pathol Inform 2015; 6:42. [DOI: 10.1016/s2153-3539(22)00497-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Abstract
OBJECTIVES The intersecting of pathology training and practice and the utilization of information technology has become an increasingly common occurrence, and the most effective means of teaching residents informatics during these invaluable years has yet to be firmly established. METHODS In offering the idea of longitudinal engagement that stresses early and extended trainee involvement, we attempt to provide a different manner of helping address some of the leading time-limited issues surrounding education in informatics. RESULTS The proposed model is intended to allow building off a base of fundamentals reached through introductory didactics, exposure to and active participation in departmental and hospital-wide administrative bodies, refining of initial skills gained through frequent mentoring and coaching, and combining these cumulative knowledge and experiential underpinnings with graduated responsibility in a particular area of expertise. CONCLUSIONS In transforming the ways in which pathology residencies teach their trainees informatics, the prospects of realizing its potential utility are heightened.
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Affiliation(s)
- Luigi K. F. Rao
- Massachusetts General Hospital, James Homer Wright Pathology Laboratories, Boston
| | - John R. Gilbertson
- Massachusetts General Hospital, James Homer Wright Pathology Laboratories, Boston
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Quinn AM, Klepeis VE, Mandelker DL, Platt MY, Rao LKF, Riedlinger G, Baron JM, Brodsky V, Kim JY, Lane W, Lee RE, Levy BP, McClintock DS, Beckwith BA, Kuo FC, Gilbertson JR. The ongoing evolution of the core curriculum of a clinical fellowship in pathology informatics. J Pathol Inform 2014; 5:22. [PMID: 25191621 PMCID: PMC4141423 DOI: 10.4103/2153-3539.137717] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Accepted: 05/13/2014] [Indexed: 12/05/2022] Open
Abstract
The Partners HealthCare system's Clinical Fellowship in Pathology Informatics (Boston, MA, USA) faces ongoing challenges to the delivery of its core curriculum in the forms of: (1) New classes of fellows annually with new and varying educational needs and increasingly fractured, enterprise-wide commitments; (2) taxing electronic health record (EHR) and laboratory information system (LIS) implementations; and (3) increasing interest in the subspecialty at the academic medical centers (AMCs) in what is a large health care network. In response to these challenges, the fellowship has modified its existing didactic sessions and piloted both a network-wide pathology informatics lecture series and regular “learning laboratories”. Didactic sessions, which had previously included more formal discussions of the four divisions of the core curriculum: Information fundamentals, information systems, workflow and process, and governance and management, now focus on group discussions concerning the fellows’ ongoing projects, updates on the enterprise-wide EHR and LIS implementations, and directed questions about weekly readings. Lectures are given by the informatics faculty, guest informatics faculty, current and former fellows, and information systems members in the network, and are open to all professional members of the pathology departments at the AMCs. Learning laboratories consist of small-group exercises geared toward a variety of learning styles, and are driven by both the fellows and a member of the informatics faculty. The learning laboratories have created a forum for discussing real-time and real-world pathology informatics matters, and for incorporating awareness of and timely discussions about the latest pathology informatics literature. These changes have diversified the delivery of the fellowship's core curriculum, increased exposure of faculty, fellows and trainees to one another, and more equitably distributed teaching responsibilities among the entirety of the pathology informatics asset in the network. Though the above approach has been in place less than a year, we are presenting it now as a technical note to allow for further discussion of evolving educational opportunities in pathology informatics and clinical informatics in general, and to highlight the importance of having a flexible fellowship with active participation from its fellows.
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Affiliation(s)
- Andrew M Quinn
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Veronica E Klepeis
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Diana L Mandelker
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Mia Y Platt
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Luigi K F Rao
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Gregory Riedlinger
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jason M Baron
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Victor Brodsky
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY 10065, USA
| | - Ji Yeon Kim
- Regional Reference Laboratories, Southern California Permanente Medical Group, North Hollywood, CA 91605, USA
| | - William Lane
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Roy E Lee
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic Main Campus, Cleveland, OH 44195, USA
| | - Bruce P Levy
- Department of Pathology, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - David S McClintock
- Department of Pathology, The University of Chicago Medicine, Chicago, IL 60637, USA
| | - Bruce A Beckwith
- Department of Pathology, North Shore Medical Center, Salem, MA 01970, USA
| | - Frank C Kuo
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - John R Gilbertson
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
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Mandelker D, Lee RE, Platt MY, Riedlinger G, Quinn A, Rao LKF, Klepeis VE, Mahowald M, Lane WJ, Beckwith BA, Baron JM, McClintock DS, Kuo FC, Lebo MS, Gilbertson JR. Pathology informatics fellowship training: Focus on molecular pathology. J Pathol Inform 2014; 5:11. [PMID: 24843823 PMCID: PMC4023031 DOI: 10.4103/2153-3539.129444] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 02/15/2014] [Indexed: 11/17/2022] Open
Abstract
Background: Pathology informatics is both emerging as a distinct subspecialty and simultaneously becoming deeply integrated within the breadth of pathology practice. As specialists, pathology informaticians need a broad skill set, including aptitude with information fundamentals, information systems, workflow and process, and governance and management. Currently, many of those seeking training in pathology informatics additionally choose training in a second subspecialty. Combining pathology informatics training with molecular pathology is a natural extension, as molecular pathology is a subspecialty with high potential for application of modern biomedical informatics techniques. Methods and Results: Pathology informatics and molecular pathology fellows and faculty evaluated the current fellowship program's core curriculum topics and subtopics for relevance to molecular pathology. By focusing on the overlap between the two disciplines, a structured curriculum consisting of didactics, operational rotations, and research projects was developed for those fellows interested in both pathology informatics and molecular pathology. Conclusions: The scope of molecular diagnostics is expanding dramatically as technology advances and our understanding of disease extends to the genetic level. Here, we highlight many of the informatics challenges facing molecular pathology today, and outline specific informatics principles necessary for the training of future molecular pathologists.
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Affiliation(s)
- Diana Mandelker
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Roy E Lee
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Mia Y Platt
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Gregory Riedlinger
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Andrew Quinn
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Luigi K F Rao
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Veronica E Klepeis
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Michael Mahowald
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - William J Lane
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Bruce A Beckwith
- Department of Pathology, North Shore Medical Center Salem Hospital, Salem, MA 01970, USA
| | - Jason M Baron
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - David S McClintock
- Department of Pathology, University of Chicago Medicine, Chicago, IL 60637, USA
| | - Frank C Kuo
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Matthew S Lebo
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - John R Gilbertson
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114, USA
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