title: Clinical Informatics Fellowship Programs: In Search of a Viable Financial Model: An open letter to the Centers for Medicare and Medicaid Services.
abstract: In the US, the new subspecialty of Clinical Informatics focuses on systems-level improvements in care delivery through the use of health information technology (HIT), data analytics, clinical decision support, data visualization and related tools. Clinical informatics is one of the first subspecialties in medicine open to physicians trained in any primary specialty. Clinical Informatics benefits patients and payers such as Medicare and Medicaid through its potential to reduce errors, increase safety, reduce costs, and improve care coordination and efficiency. Even though Clinical Informatics benefits patients and payers, because GME funding from the Centers for Medicare and Medicaid Services (CMS) has not grown at the same rate as training programs, the majority of the cost of training new Clinical Informaticians is currently paid by academic health science centers, which is unsustainable. To maintain the value of HIT investments by the government and health care organizations, we must train sufficient leaders in Clinical Informatics. In the best interest of patients, payers, and the US society, it is therefore critical to find viable financial models for Clinical Informatics fellowship programs. To support the development of adequate training programs in Clinical Informatics, we request that the Centers for Medicare and Medicaid Services (CMS) issue clarifying guidance that would allow accredited ACGME institutions to bill for clinical services delivered by fellows at the fellowship program site within their primary specialty.
authors.affiliation: Departments of Pediatrics and Biomedical Informatics, Vanderbilt University , Nashville, TN.
authors.forename: C U
authors.initials: CU
authors.lastname: Lehmann
authors.affiliation: Departments of Pediatrics and Medicine, Stanford University , Palo Alto, CA.
authors.forename: C A
authors.initials: CA
authors.lastname: Longhurst
authors.affiliation: Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University , Portland, OR.
authors.forename: W
authors.initials: W
authors.lastname: Hersh
authors.affiliation: Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University , Portland, OR.
authors.forename: V
authors.initials: V
authors.lastname: Mohan
authors.affiliation: Departments of Pathology and Biomedical and Health Information Sciences, University of Illinois at Chicago , Chicago, IL.
authors.forename: B P
authors.initials: BP
authors.lastname: Levy
authors.affiliation: Departments of Biomedical Informatics and Internal Medicine, The Ohio State University , Columbus, OH.
authors.forename: P J
authors.initials: PJ
authors.lastname: Embi
authors.affiliation: Department of Emergency Medicine and Regenstrief Institute, Indiana University , Indianapolis, IN.
authors.forename: J T
authors.initials: JT
authors.lastname: Finnell
authors.affiliation: Departments of Biomedical Informatics and Medical Education, University of Washington , Seattle, WA.
authors.forename: A M
authors.initials: AM
authors.lastname: Turner
authors.affiliation: American Medical Informatics Association , Bethesda, MD.
authors.forename: R
authors.initials: R
authors.lastname: Martin
authors.affiliation: American Medical Informatics Association , Bethesda, MD.
authors.forename: J
authors.initials: J
authors.lastname: Williamson
authors.affiliation: Executive Director (Ret.), American Board of Emergency Medicine.
authors.forename: B
authors.initials: B
authors.lastname: Munger
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D005257:Fellowships and Scholarships; D008490:Medical Informatics / Q000191:economics* / Q000193:education; D014481:United States
keywords: Centers for Medicare and Medicaid Services; Clinical Informatics; Education; Graduate Medical Education; Health Information Technology