This Week Health

March 29: Today on TownHall Jake Lancaster, Chief Medical Information Officer at Baptist Memorial Health Care interviews Dr Ellen Kim, Clinical Informatics Fellow & Radiation Oncologist at Mass General Brigham. What is the structure of a clinical informatics fellowship? What sort of rotations do they do? Who do they interact with the most? Do they work with the CMIO? Doing a fellowship has huge benefits. Not only helping to maintain clinical skills but also being able to feel the pain points personally, see where the big needs are and see opportunities for improvement for clinical informatics within your specialty. 

Transcript

Today on This Week Health.

A lot of fellowship programs do include a master's degree or a certificate or some sort of structured coursework or curriculum on the side. And I think that's important to build a solid broad-based foundation. And one of the things that's really special about fellowship is that it gives you time to get that structured educational component.

Welcome to This Week Health Community. This is TownHall a show hosted by leaders on the front lines with ???? interviews of people making things happen in healthcare with technology. My name is Bill Russell, the creator of This Week Health, a set of channels designed to amplify great thinking to propel healthcare forward. We want to thank our show sponsors Olive, Rubrik, Trellix, Hillrom, Medigate and F5 in partnership with Sirius Healthcare for investing in our mission to develop the next generation of health leaders. Now onto our show.

Hello I'm Jake Lancaster, an internal medicine physician and the chief medical information officer for the Baptist Memorial healthcare system based out of Memphis, Tennessee. And today I'm with Dr. Ellen Kim, a second year clinical informatics fellow and a radon practitioner out of Mass General in Brigham. Ellen, welcome to the program.

Can you for the audience just give us a little bit of your background and tell us, tell us what you do.

Sure. I guess very briefly chronologically, I found my way to clinical informatics majoring in computer science before I became pre med and did a lot of retrospective database studies got frustrated and bored with the same old, same old data sets and started looking for alternative data sources during residency. And that kind of led me to discover clinical informatics as a clinical subspecialty. And now I'm in my second year of clinical informatics fellowship at Mass General Brigham.

Thank you so much for coming on and joining us today. One of the things that I've been trying to highlight with some of the guests that I brought on, since I'm a former informatics fellow, I've been bringing on a lot of informatics fellows, both current and former and just trying to introduce the wider audience to the informatics fellowship. And so you're a little bit different in that your primary specialty is radiation oncology whereas a lot of fellows maybe have internal medicine or pediatrics or emergency medicine. Can you tell us just a little bit about your fellow experience and, and how you've been able to weave radiation oncology into it?

Yeah, I think one of the really special things about clinical informatics as a clinical subspecialty and as a fellowship is that we do have very diverse clinical backgrounds. So I'm a radiation oncologist. You mentioned a lot of internal medicine, but also general surgeons and medical oncology fellows.

And the fellowship itself has been around, around 10 years as a formal fellowship with some older programs that were a little less structured, but it's usually two years of clinical informatics fellowship. Majority of that time is dedicated to informatics but there's also a component that's reserved for continuing to practice clinically and whatever your background is. And I think that's really important. So if you're, if you're not in clinic, want to maintain your clinical skills for those two years but also to see where the big needs are and to feel the pain points personally. So you can see the opportunities for improvement for clinical informatics within your specialty.

And it's great that we all bring such diverse. So you can bring different perspectives. But usually two year programs sometimes you can combine it into one year if it's combined with pathology or certain other fellowships, and you're able to utilize some, some time, if you have a lot of research months sometimes we use it for both fellowships to kind of shave off a little time that way.

Yeah, I know a lot of programs are experimenting with the combined fellowship tracks where you could do GI or something like that along with informatics fellowship at the same time and extend it a little bit more. Can you tell us just a little bit about how is your fellowship structured? What sort of rotatations do you do and who do you interact with the most? Do you work with the CMIO? Who do you work with on your projects?

You know, I feel really lucky that through Mass General, Brigham for two years, part of my curriculum and part of the program includes a master's degree in biomedical informatics at Harvard Medical School's department of biomedical informatics.

And And I know nationally speaking a lot of fellowship programs do include a master's degree or a certificate or some sort of structured coursework or curriculum on the side. And I think that's important to build a solid broad-based foundation. And what's one of the things that's really special about fellowship is that it gives you time to get that structured educational component. And even if you're in a smaller program that doesn't have those kinds of resources or university affiliations the national clinical informatics program directors have started lecture series and there's a lot of national resources through the fellowship and through the fellowship community to help support those for structured dedactics

the rest of the time is really free for whatever projects I'm interested in. Very fortunate to have strong mentorship, very regular meetings, personal one-on-one guidance from our program directors who happened to be a CMIO and CIO of Brigham and women's hospital.

So very, very personalized some people are interested in working with industry groups and startup companies and being in those projects, I've been a little more focused in oncology, radiation, oncology, patient reported outcomes, and looking at combining different data sources and workflow and operations to make that more seamless and bring that back into the clinic. But very open-ended in terms of project opportunities.

Yeah, I definitely think that's one of the great things about the fellowships is you really do get to work on a very wide variety of projects across the informatics space and wherever your interests lie, you can kind of gravitate towards what interests you the most. But one other thing about you is that you are the president of ACIF. Can you tell us a little bit about what ACIF is?

Sure. ACIF is a fantastic organization. And I remember meeting you through that when I was at Vanderbilt as a resident before I, when I was first discovering CAI fellowship.

But the ACIF is AMIA clinical informatics fellows. So we are affiliated with AMIA, the primary American Medical Informatics Association. Really tight group, nationally speaking, of current fellows and alumni, we have a very active Slack group where it's really great to have opportunities and resources and kind of support.

If you say I have a question about implementing this type of tool within this type of EHR it's great to see other alumni and other fellows quickly chime in and offer support or collaborate on, on research projects. So a really great community and a lot of kind of structured and unstructured opportunities like lecture series, or we have a virtual case conference series nationally every month where you get to hear what other fellows and other programs they're working on.

We have monthly newsletter. We have gatherings at national informatics conferences. Just a lot of community and network support, especially if a lot of programs are small and you may be the only fellow in your program or the only fellow for your year. It's nice to have a community of current fellows and alumni to reach out to you easily.

Yeah no that that's a great introduction. So when I was coming through fellowship we started it when there was, there's only about 11 or 12 informatics fellowships out there. And so we got together at one of the conferences at AMIA kind of created this Slack channel and it's grown since then. And it's a small closely knit community. It feels like, I mean, it's, it's grown bigger. I mean, there's over a hundred, I think fellows that are part of the Slack channel as current fellows or former fellows. But we still reach out to each other and still see each other at all the national conferences and communicate regularly.

And that's how I've gotten most of my guests to come on this program is to guilt them through the Slack channel. So I really appreciate that. Some of the other things that they do that they have their podcast series as well. The go live podcasts that we started a long time ago, which is still seems pretty popular.

And now it's just been a great resource for current and former fellows, I think. And so, as tell us a little bit about the work that the president of, of ACF, we do who do you interact with? My understanding is there's a board associated with ACF now there's all sorts of other elected positions within that, that body, that kind of advocate for fellows within AMIA, I believe. Is that correct?

Yeah, exactly. So primarily in terms of routine structured engagements we have monthly executive board meetings with other fellows across the country. So that's about a dozen of us. And it's great to hear their ideas. And part of the meeting is obviously structured and talking about current and future initiatives and topics of interest for fellows nationally speaking.

And then part of the time is really just kind of support and networking and talking to each other about job searches and challenges within our fellowship programs and finding common threads and support and potential solutions to some of these issues. And part of it is also as president interacting with AMIA who are our primary sponsors and Kind of thinking big picture, where to go next.

And I think we set the bar low and our goal every year is to not let ACF die. And I think now it's, it's grown to such a way that I don't think we're going to die and I think we can be a little more ambitious about where to go next.

I think you've done great work since taking it over from muscle a long time ago. And the job board that you you mentioned is, is certainly a highlight of the slack channel. That gets a lot of, a lot of posts from former fellows and current fellows just highlighting opportunities for the fellowship cause that in the beginning of the fellowship, that was one of the areas of struggle.

And it still is a little bit of a struggle now is that a lot of organizations don't know about these fellowship programs and they don't know about the capabilities and skills of fellows coming out. And so those job opportunities don't necessarily arrive at the fellows as maybe as they should. And so that's part of the reason why I wanted to, to bring a bunch of fellows on this podcast series, is highlight what they're doing. And put that out there. And so along with those sorts of activities that you mentioned, I know you all write journal articles and opinion pieces. There's been a few that have come out recently. I think it's a great way to get a close knit informatics group around the country together and share ideas.

So kudos to you for continuing that. So I know we just have a couple of minutes left, but can you tell us just a little bit about what you plan on doing in the future? Where do you go from here?

Yes, I am lucky and very happy to be saying that I'm staying at Brigham and Women's. I'll be continuing clinically. Obviously and part of my time will also be as Director of Clinical Informatics of Radiation Oncology at Brigham and Women's.

Well, that is great. Thank you again so much for coming on the program. Hope to see you soon at some of these national conferences. Talk to you ???? soon.

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