Pediatric Informatics: Computer Applications in Child Health (Health ...

2 Informatics and Pediatric Health Care 11
and entrepreneurs eager to partner with health care providers. The pediatric portion
of the market place is small, but important, which is driven by advocacy for
pediatric-specific applications. As applications and their use become standard,
legislation and regulation of health IT adoption and use (as a sign of quality) is
becoming more prevalent, in the forms of increased reporting requirements by practices
and pay-for-performance 23 driven by sentinel events and pressures from stakeholders.
This is met by resistance to change without incentives, since the burden
and risk of health IT adoption belongs to practices while the go not only to patients,
but to health insurance payors, information technology vendors and regulatory
commissions (who benefit from increased knowledge from reporting). Therefore,
it is in pediatricians’ interest to lead in the technical, organizational, political, and
the economic aspects of pediatric health IT adoption.
2.5 Pediatricians’ Training in Informatics
The training required by pediatricians to perform these functions varies, depending
on the location and nature of practice (inpatient setting, pediatric hospital, academic
medical center, ambulatory practice of varying sizes, rural or urban, etc.). To
remain competitive, practitioners will need to understand how to leverage information
technology as a part of business. In addition to using electronic health records
(Chapters 15, 18), and electronic prescribing (Chapter 19) for health maintenance
and disease management, 22–26 practices will integrate pediatric disease-based
clinical practice guidelines into standard workflows. In addition, adoption of new
information tools such as the Internet by families as an adjunct source of health
information stimulates health discussions with their providers. 27
Health IT has been embraced by new pediatric graduates within their training
(as a part of systems-based practice 28 and patient safety 29 ), with appreciation of
the functionality that health IT plays in reporting quality metrics to governmental
and regulatory agencies. Beyond general knowledge and awareness of health
IT use, practitioners will likely participate in additional learning of information
technology and informatics for advanced learning. Programs vary in length of time,
financial investment and the depth of knowledge. Short programs are offered by the
American Medical Informatics Association (AMIA 10 × 10 program 30 ), Stanford
University 31 and the National Library of Medicine, 32 with longer programs offered
by universities funded by the National Library of Medicine, 33 up to and including
doctoral and postdoctoral programs.
Curricula vary according to local expertize. Beyond the United States, the
International Medical Informatics Association (IMIA) supports a “world-wide systems
approach to health care…that is supported by informatics-based information
and communication systems and technologies.” A scientific map of the breadth and
the depth of informatics knowledge in the context of clinical science is shown in
Table 2.3 serves to guide the development of formal training programs.