Career in Health Informatics

by Andrea Pitkus, CLS(NCA), MT(ASCP)

Introduction

This report outlines how I moved from the clinical laboratory to a career in health informatics. Health Informatics plays an important role in all aspects of health care and can be defined as the science underlying the acquisition, maintenance, retrieval, and application of biomedical information to improve patient care, medical education, and health sciences research. Since health informatics is interdisciplinary, combining computer science, medicine, biology, and health care, it is a natural fit for someone trained in clinical laboratory science.

Early Career

My medical technology training began in 1991 at Winona State University in Minnesota and clinical training continued at Duke University Medical Center in Durham, North Carolina. Upon graduating in1995, I was offered a position as a bench technologist at Duke in the Carl Clinical Laboratory, which at that time was the main laboratory, performing ~50% of the clinical laboratory testing at Duke University Medical Center. As a new graduate I was eager to gain experience as a generalist in toxicology, hematology and chemistry.

Moving Towards Computers

Besides training on 14 of the 16 bench areas of the lab, I also gained knowledge about the Laboratory Information System (LIS). Computers and related courses have always been a hobby and interest. While doing my clinical training, I began surfing the internet for information. Later a supervisor became aware of my computer skills and I assisted her with the yearly validation process for the LIS, writing the LIS training manual for new employees, creating a laboratory website, and other applications of computers in the clinical laboratory.

This led to becoming a point specialist to assist coworkers with basic LIS problems. I would occasionally meet with other point people in the other labs and pathology informatics analysts, who would update us on any changes. As well, I learned to set up programs such as inventory and calibration review spreadsheets for others to use. Before entering graduate school and being interested in informatics, I spent one of my days off shadowing an employee of the Pathology Informatics group. It was a valuable learning opportunity.

Masters in Clinical Laboratory Science

Deciding that further education was right for my interests, I applied to the University of Minnesota and was accepted into their Master Degree program in Clinical Laboratory Science. I received a research assistantship with a 25% appointment that included such benefits as health insurance, a stipend, and tuition waivers. I furthered my education in hematology but took electives in health informatics.

To maintain my laboratory skills, I also applied with a temporary agency (Interim at Park Nicollet) to work when they needed coverage at Methodist Hospital and Park Nicollet clinic sites. Although studying hematology, I worked primarily in chemistry. Working with a temp agency worked well with my ever-changing class schedule.

Focusing on Health Informatics

I enjoyed health informatics electives, learning about the basics of health information, standards, and databases. The course format allowed us to share experiences and learn with project applications of our own choosing. For example, our group project and paper involved applying what we had learned to solve a problem in our professional area. I was interested in developing an automated inventory system so we wouldn't run out of reagents, calibrators or controls in the lab. We didn't really need to construct an operational system since some of it was theoretical, such as automated purchase orders or contracts so the computer could automatically order stock when it sensed it was low. However, we needed to create a sample database and screen shots to show what the program would do.

Other informatics courses were structured differently including having different speakers teach us each week, and field trips to different areas of the hospital as well as the bioinformatics laboratory on campus to learn about their information systems. For this course, our project was on home monitoring of blood pressure to avoid white coat hypertension in the office in applying what we learned in class.

PhD in Health Informatics

In 2000 as I was finishing my Master’s research related to sickle cell anemia, I was asked if I was interested in the PhD program in health informatics. I met with the Director of Graduate studies to discuss the PhD program and serving as a teaching assistant for the first year informatics courses I had taken. I began to take informatics courses towards the PhD in Health Informatics in the fall of 2000. I found that I liked the courses on medical decision support techniques to aid health personnel in decision making and patient care. For the class project and paper, I decided to research the Decision Support System (DSS) integrated in the LIS used at work in the clinical lab. Fortunately, there were several people knowledgeable about this product as this health care system had been a beta test site for the DSS. These resources were most helpful as I researched my class project.

Other informatics courses I’ve taken include operations management and quality, computers in healthcare, and cognitive science from the Carlson School of Management, Computer Science classes in Java programming, Databases, Artificial Intelligence I and II, and Intelligent Agents, Biostatistics from Public Health, a web-based Medical Ethics course in the Nursing Department and two teaching courses.

NLM Fellowship in Health Informatics

After serving as a teaching assistant for two years, I applied for a National Library of Medicine Fellowship (NLM) in Health Informatics. There are 18 institutions across the US that offer NLM training fellowships for medical professionals interested in furthering their education in medical informatics. This has allowed me to continue my education, learn more about informatics research, and also make professional connections.

The University of Minnesota also participates in the International Partnership for Health Informatics Education Master Class that is hosted by one of the partner institutions at the University of Heidelberg/ Heilbronn in Germany, University of Innsbruck in Austria, University of Utah in Salt Lake City, University of Minnesota in Minneapolis, and the University of Amsterdam in The Netherlands. Each summer, select students and faculty from each partner school participate in a week long Master Class to explore topics in health informatics in depth. Students and faculty may also participate in an exchange program with the partner universities.

I recently returned from a six-month study abroad at the University of Heidelberg. It was not only a wonderful learning experience in medical informatics, laboratory medicine and hematology, but also about various aspects of European culture such as the language, people, food, politics, sports, etc. This summer, a colleague in transfusion medicine plans to further studies in informatics applications in blood banking for a year in Heidelberg as well.

My research interest involves bone marrow diagnostic reporting and its impact on clinician decision making and patient care. I plan to finish my PhD in a few years and practice as an informatician in decision support aiding health care professionals in providing quality patient care. This career path has taken me from Winona State University in Minnesota to the University of Heidelberg, Germany and who knows where next. I highly recommend health informatics as an option for clinical laboratory scientists with an interest in computers.

Additional information about the University of Minnesota health informatics program is at www.hinf.umn.edu and an explanation of medical informatics is at www.amia.org/history/what.html

Andrea Pitkus, CLS(NCA), MT(ASCP)
National Library of Medicine Fellow in Health Informatics
University of Minnesota, Minneapolis