Strategic Initiatives

In 2010 the AMIA Board of Directors decided to re-evaluate AMIA’s strategic plan and overall objectives. This report summarizes the realignment, including: Process, Mission, Planning Assumptions, Domains, and Pillars with goals and objectives.

Process Overview

Prior to beginning the strategic realignment process, it was important to listen to AMIA members. A request was submitted to members, committees, and working groups to participate and provide input. We collected comments and asked participants at the 2009 Annual Symposium which issues AMIA needed to address and what we needed for the future. The call for information resulted in more than 30 pages of raw-data. The data were turned into key concept areas. (See Pillars below.)

With data in hand, the board held two retreats. The executive committee met in September 2010 and reviewed components of the strategic realignment supported by the AMIA staff. Many iterations of this material were shared with the board for comment and refinement. We are excited to share this report, which contains the organizational goals and selected objectives, with AMIA members.

Mission

AMIA and its members aim to transform healthcare through trusted science, education, and practice in biomedical and health informatics.

Assumptions For Planning

In order to make progress toward an envisioned future, we anticipated strategic factors likely to affect our ability to succeed. The outcome-oriented goals that formed the basis of this plan are based on the following assumptions:

Informatics

• Informatics will continue to be a rapidly evolving scientific field.
• Informatics is an important discipline and a supporting technology to other aspects of biomedicine.
• Informatics is an interdisciplinary, inclusive, and collaborative discipline.
• The need for informatics will continue to grow.
• There is a huge opportunity from increasing complexity in the health sector. Some of this complexity comes from an increasing volume of information, increasing networks, - increasing information channels, increasing velocity of data, etc.

Climate

• Federal dollars have changed the academic research enterprise and informatics is in demand.
• The amount of money spent on health care will increase.
• More money will be spent on drugs and devices.
• Interest in knowledge management in health care will increase with an increased focus on the way knowledge can increase efficiency and/or quality.
• Informatics-related revenue opportunities will continue to be available in the areas of grants, research, and development.
• There is an ever changing market that will exhibit an increasing appetite for basic and advanced informatics capabilities.

Science, Technology and Research

• There will be increasing research revolving around personalized medicine leading to more personalized care.
• There will continue to be significant technological advances in health care, especially in devices and pharmaceuticals.
• Low resource environments will create innovations that have relevance broadly.
• There is a critical need to gather evidence in a scientific and computable manner.
• There is a need for continued discovery.
• There is a continuing need to evaluate the impact/role of informatics-based systems on wellness, and the cost and quality of care.

Informatics Education

• The profession of Informatics is continually evolving. New and new types of educational programs will be needed.
• The informatics workforce will continue to grow and most of the growth will not be in the academic area.
• There are multiple emerging informatics roles as various levels of education are defined that should be aligned to provide value.
• There will be an advanced certificate in nursing informatics.
• There will be a board certification process for clinical informatics.
• More training programs will be needed to prepare for certification.
• Informatics as a field (academic discipline) needs to mature with its methods and scientific foundation.
• There is a significant opportunity for informatics as a discipline resulting from increasing healthcare complexity, increasing information flow, and increasing challenges to decision-making in the health sector.
• Informatics is increasingly seen as an essential basic science in the curricula of professional schools, i.e. medical, nursing, pharmacy, dental, allied health, etc.
• There will be educational needs about informatics for non-professionals.
• AMIA is the leading organization to move informatics education forward and to make informatics a recognized profession.

Health Care

• There are a lot of dollars in health care, and informatics can help us to use those dollars more effectively.
• The "medical home concept" will become an important approach to increasing the efficiency and quality of care.
• Health care teams will provide care using data and tools that support the coordination of care. The focus on population health will continue.
• Genetic research will continue to change treatment options, thereby affecting how health care is delivered.
• Informatics will capture, analyze, and present data in easy to understand ways and support better decision making by health care practitioners.
• Personalized medicine and PHRs will evolve.
• Care capabilities will move from hospitals toward ambulatory care and home settings.

Consumers

• The health care system is changing to a consumer-driven or consumer-centric system in which consumers play a more active role.
• There is a continuing need to evaluate the impact/role of informatics-based systems on wellness, and the cost and quality of care.
• There will be an increasing need to educate the consumer on the value and use of personal health records.
• Personal health records will become routinely integrated into practice workflows.
• Consumer health will involve more telehealth and alternative ways to interact with clinicians.

Policy, Legislation and Regulations

• Engagement based on trusted and unbiased knowledge will be needed.
• There will be increased regulations and standards influencing the field.
• Significant national policy issues, such as the current meaningful use policy, will cast a long shadow over the next 5 years and will set the stage for the subsequent era.
• There will be pressures to "bend the curve" of health care costs.
• Electronic health record adoption will create changing environmental conditions leading to new challenges for informatics.

Industry Development and Competition

• Competition from a variety of external sources will heighten.
• Policy initiatives and extraordinary funding will dramatically stimulate and reshape the industry, through consolidation, disruption, and technologic evolution.
• AMIA should recognize and meet the needs of policy makers and industry in identifying cost-effective strategies that support implementation of industry-wide standards, tools, and services that advance policy goals. AMIA will assume the dual role of trusted source and leader for such information.
• Now that clinical information systems have matured, industry will play an increasingly important role in HIT and informatics directions.

AMIA’s Role

• AMIA can contribute to the existing continuum of education needs.
• AMIA is a source of needed education.
• AMIA is the home of informatics- and boundary-spanning informaticians, offering a place where they can interact at the individual level and within groups.
• AMIA is the trusted source for unbiased policy advice.
• AMIA will continue to support its corporate members and partners with specialized education, training and networking programs as they create cultures of informatics within their own organizations.
• Health information technology will be disseminated widely. Much of it will be done well, but there will be problems. AMIA should be the organization that assures that lessons of the next 5 years are captured and applied to new generations of clinical information systems.
• AMIA should advocate for continued biomedical informatics research funding.

Domains

AMIA recognizes that the discipline of biomedical informatics is inherently motivated by problems encountered in a set of applied domains in biomedicine. The first category historically has been clinical informatics, with its emphasis on patients and clinical care. The second early domain of activity has been imaging informatics (and the set of issues developed around both radiology and other image-management and image-analysis domains such as pathology, dermatology,hematology, and molecular visualization). In the 1990s we saw the emergence of bioinformatics, which at the molecular and cellular level is offering challenges that draw on many of the same informatics methods. More recently we have seen rapid growth in the field of public health informatics, in which similar methods are generalized for application to populations of patients rather than to single individuals.

AMIA actively supports five domains across a continuum from the research areas through to clinical practices to the consumer and public health areas and has defined them as such. Knowledge and collaboration range throughout each of the domains and is essential for the field.

Translational Bioinformatics is the development of storage, analytic, and interpretive methods to optimize the transformation of increasingly voluminous biomedical data, and genomic data, into proactive, predictive, preventive, and participatory health. Translational bioinformatics includes research on the development of novel techniques for the integration of biological and clinical data and the evolution of clinical informatics methodology to encompass biological observations.

Clinical Research Informatics involves the use of informatics in the discovery and management of new knowledge relating to health and disease. It includes management of information related to clinical trials and also involves informatics related to secondary research use of clinical data. Clinical research informatics and translational bioinformatics are the primary domains related to informatics activities to support translational research.

Clinical Informatics is the application of informatics and information technology to deliver healthcare services. At times, this has also been referred to as applied clinical informatics. Despite some acknowledged variations, AMIA considers informatics when used for healthcare delivery to be essentially the same regardless of the health professional group involved (whether dentist, pharmacist, physician, nurse, or other health professional). Clinical Informatics is concerned with information used in health care by clinicians. Clinical informatics includes a wide range of topics ranging from clinical decision support to visual images (e.g. radiological, pathological, dermatological, ophthalmological, etc); from clinical documentation to provider order entry systems; and from system design to system implementation and adoption issues.

Consumer Health Informatics is the field devoted to informatics from multiple consumer or patient views. These include patient-focused informatics, health literacy and consumer education. The focus is on information structures and processes that empower consumers to manage their own health--for example health information literacy, consumer-friendly language, personal health records, and Internet-based strategies and resources. The shift in this view of informatics analyses consumers' needs for information; studies and implements methods for making information accessible to consumers; and models and integrates consumers' preferences into health information systems.

Public Health Informatics is the application of informatics in areas of public health, including surveillance, reporting, and health promotion. Public health informatics, and its corollary, population informatics, are concerned with groups rather than individuals. Public health is extremely broad and might even reflect an interest in information technology with regard to ecology, architecture, climate, agriculture, and such.

The AMIA Pillars

Based on data collected from AMIA members, Board retreats, and planning assumptions, four pillars emerged as supporting AMIA as an Association.

• Informatics Leadership. In this area the strategic goal is that AMIA will be the first stop for trusted knowledge for transforming health care through biomedical informatics.
• Serving AMIA’s Members. AMIA members are the core component of trusted knowledge. Therefore AMIA’s will continue to build and support its membership, organization, and programs.
• Sharing AMIA’s Knowledge. AMIA will strive to have the best vehicles for academic communication in the field of informatics.
• Effective and Sustained AMIA. Goals are to develop a plan to sustain AMIA through times of positive and negative economics and to update AMIA’s organizational infrastructure and governance to enable rapid response and nimbleness to emerging issues.

Objectives underpinning the first Pillar, Informatics Leadership:

• AMIA will appoint a group to develop a process for prioritizing, discussing, and implementing new ideas into AMIA’s suite of programmatic offerings. This group will focus efforts on the objectives noted in this strategic realignment document to bring more information, ideas, and concepts forward as soon as possible.
• AMIA will support global connections and partnerships by supporting the Global Health Informatics Partnership (GHIP) and other non-profit organizations that seek to develop and promote global biomedical and health informatics, extending to the International Medical Informatics Association.
• AMIA will continue to develop clinical informatics as a medical subspecialty and will support the integration of clinical informatics into other disciplines to serve other member populations.
• AMIA will develop and articulate communication messages for all our members about the realigned AMIA mission and goals.
• AMIA will support the rebranding initiative to expand the familiarity and influence of the organization within the health care, scientific, and educational communities.
• AMIA will better communicate AMIA’s value and mission to potential members, policy makers, opinion makers, journalists and the general public.

Objectives underpinning Pillar 2, Serving AMIA members:

• AMIA will develop a pipeline of new members from all sectors of the industry to support our individual member growth.
• AMIA will update its corporate membership program to address the changing needs of our industry partners.

AMIA will establish a non-profit membership program to address the needs of our non-profit partners.

• AMIA will significantly improve the renewal retention rate of our current members.
• AMIA will evaluate and enhance the working group program.
• AMIA will engage the American College of Medical Informatics (ACMI) in strategic planning to align ACMI and AMIA goals.

Objectives underpinning Pillar 3, Sharing AMIA’s Knowledge:

• AMIA will determine the best way to establish its goal on sharing knowledge.
• AMIA will conduct a detailed analysis ("environmental scan") to be sure that new educational offerings do not cannibalize existing offerings.
• AMIA will develop a blueprint for future programs that will align member domains across a matrix for education, publications, and policy.
• AMIA will undertake an analysis of its educational offerings and develop a list of enhancements that can serve the new HIT workforce.
• AMIA will develop a biomedical informatics career ladder for our community.
• AMIA will develop education to support clinical informatics certification.

Objectives underpinning Pillar 4, Effective and Sustained AMIA:

• AMIA will reconfigure its bylaws and standard operating procedure to support a more streamlined operation and nimble organization.
• AMIA will appoint a task force to recommend changes to our committee structure based on the realigned strategic plan.

Note from the AMIA Board

It is our plan as AMIA leaders to use this strategic realignment to measure ourselves, our leadership, and our direction. We ask that you join us. There are multiple opportunities for member participation within AMIA and if you see something in this plan in which you are particularly interested, please let us know. amiabod@amia.org