Pathology Informatics Training
Informatics is defined as the science of information management. As the amount of medical information that needs to be accessible and assimilated has grown, manual management of this information has become impossible. Therefore, familiarity and proficiency with computers has become an essential component of informatics. The pathologist of the future (and of today), in order to effectively serve his/her role as a diagnostic consultant, must become comfortable with the use of computers to access and manage information. Therefore, training in informatics is an essential part of any modern pathology residency training program. However, unlike many of the subspecialty areas of pathology which have segregated from the mainstream, ALL pathologists must be able to use computers. Therefore, informatics exposure and training at Yale is fully integrated into each and every rotation.
All day-to-day operations in both anatomic and clinical pathology are managed by laboratory information systems (LIS). Each department maintains its own LIS. The anatomic pathology services use CoPath Plus from Cerner/DHT. Yale Pathology is unique among all CoPath users. Extensive in-house expertise and special arrangements with the vendor allow us to customize our system to meet departmental needs. This is managed by the Pathology Informatics Program's Operations Unit. The clinical pathology laboratories have recently installed a new LIS from SCC Soft Computer which is maintained by Laboratory Medicine's Instrumentation and Data Processing Unit. Each resident interacts with these systems on a daily basis, managing their cases, entering histology information, ordering tests, looking up test results, and printing reports. The systems can also be searched to identify cases for teaching or research purposes. Virtual Private Networking software and accounts allows the residents to access the laboratory information systems from off-site locations, such as home, when on call.
Residents also have electronic access to other hospital information systems, including the radiology PAC system (which allows residents to view not only the reports but the actual images for all plain films, CT, and MRI studies) and the inpatient and outpatient electronic medical record systems.
Residents are also exposed to many other informatics tools. All residents are given electronic mail accounts. All resident computers, as well as most workstations throughout both departments, give the residents access to the internet and the world wide web for literature searches and access to other information resources and on-line databases. Departmental conferences and vacation schedules are maintained by the residents in on-line calendars. All residents learn to acquire and use both gross and microscopic digital images. Digital cameras, both copy stand-mounted and microscope-mounted, are available to all residents 24 hours a day. Residents use digital images and presentation software (PowerPoint) in preparing formal conferences which are delivered in conference rooms equipped with digital projection equipment, available in both departments. The also use image editing, word processing, and spreadsheet software.
Finally, residents receive a formal education in informatics through a series of didactic lectures, delivered by faculty in both departments with a special interest in informatics. Topics include desktop computer hardware and software, networking and the internet, databases, interfaces, laboratory information systems, and diagnosis coding.
Opportunities are available for the residents to get involved in system customizations, interface design and deployment, and web page development. Elective time may be spent working on special informatics projects, under the instruction and supervision of faculty.
Additional Goals and Objectives for Informatics Training
- Demonstrating proficiency in the use of the departments' clinical information systems and understanding their role in the delivery of patient care
- Demonstrating an ability to access hospital patient information systems to obtain clinical information on patients who have material being evaluated in pathology or laboratory medicine
- Understanding basic computer hardware components
- Understanding software architecture, including operating systems, object code, and the differences between high-level and low-level programming languages
- Understanding basic networking logic and the functioning of the internet
- Understanding basic database theory, the advantages of relational databases, and the utility of database management systems
- Demonstrating proficiency in acquisition of digital images
- Demonstrating basic understanding of image editing techniques
- Demonstrating proficiency in the use of word processing, spreadsheet, and presentation software
Practice-based Learning and Improvement:
- Using on-line literature searching resources to identify recent advances in our understanding of disease processes
Interpersonal and Communication Skills:
- Being able to communicate to Information Technology staff when a desktop machine or the central information system is not functioning properly
- Understanding that information systems are a tool to assist in the provision of medical care, are imperfect, and are limited in their abilities by the lowest common denominator between the builders and the user
- Demonstrating an understanding of the importance of preserving patient privacy and confidentiality in the performance of their duties
- Promoting the practice of evidence based health care delivery, drawing upon literature and other investigative work
- Demonstrating an appreciation of the importance of accurate data entry into the department's Clinical Information System (eg Part Type) which will allow appropriate retrieval of cases for approved research or educational purposes