Clinical Informatics

Informatics is unique due to its opportunity to collaborate and work closely with a wide variety of clinical and operational groups across the health care system. This interdisciplinary nature is essential in ensuring that all stakeholders are aligned, and allows for a more integrated and holistic approach to health care.

The focus of this specialty is leading and supervising the selection, installation, configuration, management, and use of information systems that support pathology practice. Some fellowships may concentrate on the R&D of new software; others may focus on the collection, storage, analysis, and reporting of large, complex sets of data from pathology laboratories. Regardless, the goal is to support patient care, improve laboratory workflow, and enhance the experience of pathologists and our clinical colleagues.

Pathology informaticians often supervise the technical teams that support laboratory information systems (LIS) and other essential operations systems. They may establish and review lab IT procedures, help manage IT problems, review and accept testing results for new systems, and even lead the new system evaluation and deployment.

In a broader sense, pathology informaticians seek to implement, effectively maintain, and improve LIS that enhance pathologists’ diagnostic capabilities and the value of laboratory reports and test results.

There is actually a shortage of informatics specialists, simultaneous to a growing demand for their services. Not only is there more work available than there are applicants, but qualified individuals may have more bargaining power in terms of salaries and benefits. While most pathology programs support only one senior informatics specialist, there is an excellent opportunity to work across specialties with informaticists in other disciplines.

The standard is two years for an ACGME-accredited fellowship, with the opportunity to combine clinical informatics with another fellowship.

To put it bluntly, informatics is always on call; however, many urgent issues can be addressed remotely.

As a general rule, informatics is not case-based work.

Informatics interacts with all specialties across the health care system, including surgical, inpatient, ambulatory, acute care, and more. It collaborates with professionals from various fields to optimize the use of technology and data in patient care, from developing electronic health record systems to improving communication and information exchange between different departments. Because pathology data is used by all specialties, pathologist informaticists have the potential to take advantage of all these relationships and work with all specialties.

Yes. The Digital Pathology Association (DPA), American Medical Informatics Association (AMIA), the Association for Pathology Informatics (API), and the Association for Molecular Pathology (AMP). Additionally, in 2022, the CAP launched the Council of Informatics and Pathology Innovation, providing guidance on medical information science, data science, and computational technologies that could impact the practice of pathology. 

Informatics issues are encountered in all pathology subspecialties. Informatics fellowships have most frequently been paired with molecular pathology, but there are opportunities to combine pathology informatics with any AP or CP specialty, from microbiology to forensic pathology. Given the rising importance of digital pathology, pairing informatics with surgical pathology fellowships will likely become more common to meet the increasing interest and need for overlapping expertise in these domains.

No, it is highly unusual for pathologist informaticists to interact directly with patients. However, it is important to remember that informaticists act as patient advocates in information system design, report design, and data regulations—especially when creating reports and online screens for patient use, and in helping design and manage patient data release and security policies.