API Overview and Informatics Training and Education J. Mark Tuthill, M. D., Henry Ford Health System. API Overview:

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API Overview and Informatics Training and Education J. Mark Tuthill, M. D., Henry Ford Health System API Overview: The Association for Pathology Informatics is the only organization dedicated to Pathology Informatics at a national level. Historically, the Association for Pathology Informatics was founded in 2000 by a group of pathologist with interest in defining pathology informatics as a clinical sub-specialty of pathology by way of education. The API continues to support this educational mission by sponsoring national education meetings, both standalone and in conjunction with other national organizations such as the USCAP, ASCP, and the CAP. We have been working to develop and educate members about standards for reporting, transferring, storing and merging pathology related information. Very recently, the Association for Pathology Informatics launched a journal, The Journal of Pathology Informatics, which has been published since March of 2010. We continue to promote education of residents and practicing pathologists in informatics and technology that enhance the field of laboratory medicine. Thus, the mission of the API is to promote the field of pathology informatics as an academic in clinical subspecialty of pathology. Our specific aims are to focus on the data sets that include clinical laboratory testing and to support the advances of the field of pathology informatics through research, education, scientific meetings, electronic and printed communications. The association will develop standards and has been working to develop standards with other organizations and will also play an active role in legal, ethical, social, and regulatory as well as governmental issues that are related to pathology informatics. Pathology Informatics involves examining, reporting and storing large data sets that come from tests performed in clinical laboratories, anatomic laboratories or research laboratories in order to improve patient care. Pathology Informaticists also seek to continually improve existing laboratory information technology and enhance the value of laboratory test data writing developing computational algorithms and models aimed at deriving clinical value from new data sources. As previously mentioned, the API is the only national organization dedicated exclusively to the field of pathology informatics. API sponsors informatics meetings at the national level in conjunction with other groups, and sponsors pathology residents and fellows to attend our major national meeting, encouraging greater interest in pathology informatics among residents and fellows. Last year API funded over 40 resident and fellow travel awardees. The API has also published a comprehensive set of learning objectives and skill sets for training in pathology informatics. This was published in Archives of Pathology and Laboratory Medicine in 2003. API has also initiated an annual lifetime achievement award recognizing the contributions made by many of the early leaders in pathology Informatics. The award is presented at the Pathology Informatics national meeting. The most recent recipient was Franklin Elevitch who may be know to many of you. The API has an active listserv that allows for discussion around pathology

informatics issues as well as allowing for members to share breaking news in the industry. The website for the API has recently been redesigned and provides additional information around the organization as well as links to other pathology and bioinformatics resources. The API provides a leadership role in the promotion of data standards relating to both pathology research and service pathology. Recently the Association for Pathology Informatics sponsored a strategic summit to examine the future of pathology informatics in the laboratory information systems. Informatics Training and Education: An important component in pathology informatics is our efforts in training in education and there have been significant developments here. The API website lists key fellowship training programs currently listed. The API website also contains links to all of the past meeting s presentations online so that fellows and residents can review active pathology informatics content. It was also already mentioned that the API published guidelines for pathology informatics training in 2003. Recently, several API members contributed to the first comprehensive textbook on Pathology Informatics (ASCP Press 2012). While not a formal API initiative, the vast majority of the authors were API members and officers. Recently several API members have been engaged by the American Board of Pathology (ABP) to work with the American board of Preventive Medicine (ABPM) to develop a clinical informatics board exam cosponsored by the ABP and ABPM. This examination will lead to the first formal certification in clinical informatics. While again, not a formal API activity, API s recognition likely helped selection of participants to the exam committee as well as validating the concept of pathology informatics viable practice area. Information about the clinical informatics board exam can be found both at the ABPM s website ( http://www.theabpm.org/abpm_clinical_informatics.pdf ) as well as the website of the American Medical Information Informatics Association (AMIIA) (http://www.amia.org/faqclinical-informatics-medical-subspecialty ). The first examination date will be October 7-18, 2013, and will consist of a one day multiple choice examinations taken in person at that training location. In order to sit for the examination, eligibility will require certification by at least one of the member boards of the American Board of Medical Specialties. Those certified by the American Board of Pathology must apply through the American Board of Pathology. Graduation from a medical school in either the United States or an approved medical school outside the United States is required as is an unrestricted, currently valid, medical license. In order to sit for the exam, two pathways will be allowed: either the practice pathway; or the fellowship pathway. In the practice pathway, it is required that individuals have at least 3 years of practice of at least 25% full time. Practice time need not be continuous; however, all practice time must have occurred in the five year interval immediately preceding the examination. Practice is defined as consisting of broad based professional activity with significant clinical informatics responsibility. Documentation of research and teaching activities may also be submitted for review.

Verification is also required to prove that an equivalent of at least 3 years of an individual s professional time has been devoted to the practice of clinical informatics during the five years prior to application. Individuals who have successfully participated in a 24 month, acceptable, informatics fellowship program may also sit for the exam through the fellowship training pathway. These nonaccredited fellowships training curricula must be described and the actual training must be submitted for the board s consideration. Training in a non-accredited fellowship program of less than 24 months may be applied toward the practice program assuming that they have additional evidence of practice to satisfy the additional practice pathway requirements. It is expected that beginning in 2018, only programs accredited by the Accreditation Council for Graduate Medical Education will be accepted.

API Overview Informatics Training and Education USCAP 2013 Baltimore, MD J. Mark Tuthill, MD Division Head, Pathology Informatics Department of Pathology & Laboratory Medicine Henry Ford Hospital Detroit, MI MTUTHIL1@hfhs.org 313-916-2524

No Disclosures In the past 12 months, I have not had a significant financial interest or other relationship with the manufacturer(s) of the product(s) or provider(s) of the service(s) that will be discussed in my presentation. This presentation will (not) include discussion of pharmaceuticals or devices that have not been approved by the FDA or unapproved or "off-label" uses of pharmaceuticals or devices.

Goals and Objectives Describe the history and mission of the API Present recent accomplishments Understand the education focus of the API Describe the upcoming clinical informatics certification exam, and eligibility requirements

http://www.pathologyinformatics.org/

What is the API? The Mission of the Association for Pathology Informatics is to promote the field of pathology informatics as an academic and a clinical subspecialty of pathology

What is the API? Brief History The Association for Pathology Informatics (API) was founded in 2000 by a group of pathologists interested in defining pathology informatics as a clinical subspecialty within pathology by way of education. API continues to support this educational mission by: Sponsoring a national educational meeting Providing educational content to other Pathology meetings (e.g. United States & Canadian Academy of Pathology annual meeting), Developing and educating members about standards for reporting, transferring, storing and merging pathology related information, Developing an independent, not-for-profit, open access peer-reviewed electronic academic journal, Journal of Pathology Informatics (JPI), which published the first quarterly edition in March, 2010. JPI is available for viewing at http://jpathinformatics.org. JPI is indexed in PubMed. Promoting education of residents and practicing pathologists in informatics and technology that enhances the field of laboratory medicine.

What is the API? Specific Aims: The data sets used in pathology informatics include clinical tests, anatomic pathology reports, image files, telepathology data, and large scale experiments including gene, proteomic and tissue array studies. The Association will support advances in the field of Pathology Informatics through research, education, scientific meetings, and through electronic and printed communications. The Association will develop standards for reporting, transferring, storing, and merging confidential and other pathology-related information. The Association will play an active role in legal, ethical, social, regulatory, and governmental issues related to pathology informatics, and this will also seek to develop relationships with other professional societies and industry partners that share similar interests and goals.

What is the API? What We Do: Pathology Informatics involves collecting, examining, reporting, and storing large complex sets of data derived from tests performed in clinical laboratories, anatomic pathology laboratories, or research laboratories in order to improve patient care and enhance our understanding of disease-related processes. Pathology Informaticists seek to continuously improve existing laboratory information technology and enhance the value of existing laboratory test data, and develop computational algorithms and models aimed at deriving clinical value from new data sources.

What is the API? API is the only national organization dedicated exclusively to the field of service/research pathology informatics and supports a set of wide-ranging educational efforts in the discipline API sponsors the Pathology Informatics national meeting and is actively involved in events with the CAP, ASCP, and USCAP and other national organizations API sponsors pathology resident and fellow travel awards to the Pathology Informatics national meeting and encourages greater interest in Pathology Informatics among pathology residents and fellows

What is the API? API has published a comprehensive set of learning objectives and skill sets for training in Pathology Informatics for pathology residents to encourage the integration of a high quality informatics experience within pathology residency programs (Henricks et al, Arch Pathol Lab Med 2003; 127: 1009-1018) API has initiated an annual Lifetime Achievement Award to recognize the contributions made by the thought leaders in Pathology Informatics; the award is presented at the Pathology Informatics national meeting The API listserv provides a forum for spirited discussion about informatics topics and allows members access to breaking news in the industry

What is the API? The recently redesigned API Web site provides information about the organization and also links to other pathology and bioinformatics resources API provides a leadership role in the promotion of data standards relating to both pathology research and service pathology to encourage effecting reporting and integration of pathology data Recently sponsored a strategic summit to examine The Future of Pathology Informatics and the LIS http://www.pathologyinformatics.org/content/api-strategicsummit-future-pathology-informatics-and-lis

Informatics Training and Education Resident and fellowship training is a key focus for the API The API website lists key fellowship training program in pathology informatics (5 sites currently) API members have recently been engaged by the American Board of Pathology (ABP) to work with the American Board of Preventive Medicine (ABPM) to develop a clinical informatics board exam that is cosponsored by ABP and ABPM This examination will lead to the first formal certification of clinical informaticists

Informatics Training and Education Clinical informatics board examination Information can be found at the ABPM s website as well as the American Medical Informatics Association s (AMIA) http://www.theabpm.org/abpm_clinical_informatics.pdf http://www.amia.org/faq-clinical-informatics-medicalsubspecialty The first examination date will be from October 7-18, 2013 One day, multiple choice examination

Informatics Training and Education Clinical Informatics Certification Eligibility, license and training: Current certification by at least one of the Member Boards Those certified by ABP must apply through ABP Graduation is required from a medical school in the United States which at the time of the applicant s graduation was accredited by the Liaison Committee on Medical Education, a school of osteopathic medicine approved by the American Osteopathic Association, an accredited medical school in Canada, or a medical school located outside the United States and Canada that is deemed satisfactory to the Board Unrestricted and currently valid license(s) to practice medicine

Informatics Training and Education Clinical Informatics Certification Eligibility, practice pathway: Three years of practice in Clinical Informatics is required. Practice time must be at least 25% of a Full-Time Equivalent (FTE) to be considered. Practice time need not be continuous, however, all practice time must have occurred in the five-year interval immediately preceding application for certification Practice must consist of broad-based professional activity with significant Clinical Informatics responsibility. Documentation of Clinical Informatics research and teaching activities may also be submitted for review Verification is required that the equivalent of at least 3 years of an individual's professional time has been devoted to the practice of clinical informatics during the five years prior to application for the examination. A person or persons who are knowledgeable about the applicant s practice, such as the chief of staff, the applicable department chair, the director of a related Clinical Informatics training program, or the director of the clinical informatics program in the related institution must complete the verification. Completion of the verification by a partner or practice associate is not acceptable. The verification form will be available at the time of application

Informatics Training and Education Clinical Informatics Certification Eligibility, fellowship training pathway: Completion of a fellowship program of at least 24 months in duration that is acceptable to the ABPM is required. The non-accredited fellowship training curriculum as well as a description of the actual training must be submitted. Training in a non-accredited fellowship program of less than 24 months in duration may be applied toward the practice pathway (see Practice Pathway above). Starting in 2018, only programs that are accredited by the Accreditation Council for Graduate Medical Education (ACGME) will be accepted.

Informatics Training and Education Clinical Informatics Certification Elilgibility, fellowship training pathway: For those who completed non-accredited fellowship training of less than 24 months, the fellowship training curriculum as well as a description of the actual training must also be submitted. The applicant must submit evidence of additional practice to satisfy any additional Practice Pathway requirements.

Questions? J. Mark Tuthill, MD Division Head, Pathology Informatics Department of Pathology & Laboratory Medicine Henry Ford Hospital Detroit, MI MTUTHIL1@hfhs.org 313-916-2524