Q: “What advice would you have for students that are looking into getting into the informatics part of pathology”
A: “I would find a mentor – have conversations, talk to people, get involved locally with a project.  Connect with someone nearby who can help expose you to everything in informatics and pathology.”

“We’ve all been watching digital path for a long time and there are advantages for multiple hospital systems like ours. But, what’s really going to push this all forward is AI and machine learning, which will allow us to do things like quantifiable histo-chemistry and will provide much more accurate results than the human eye is capable of assessing. Whatever the disease might be, we’ll have a lot of opportunities for multi-disciplinary work and the need to understand what predictive models are built upon.”

Q: “Is formal training necessary or is self-training sufficient?”
A: “Many senior pathology informaticists are self-trained because there was no formal training. For example, one can take physician builder courses if there is no formal program available at your own institution. Formal training is helpful, but may not be needed if this is a secondary part of your job. However, if your goal is to be a CMIO or Director of Pathology Informatics, then doing a formal training is critical, however.”

Q: What do you wish you had known early in your career?
A: "That it is critically important to get networking through organizations like API and to look for potential mentors. For places where mentoring isn’t as strong, speak up with your residency directors. If you can’t get to CI training first, then get to quality improvement. From there, you can learn to assess data, understand a system, how to change it, develop root-cause analysis, and learn all areas of quality assurance. Then, go to places like API and look for potential mentors to identify things you’re interested in and start meeting those people."

Q: How do you keep yourself current?
A: "Partly surround yourself with people with different skill sets. There are also organizations such as API that provide a lot of training and educational materials, as well as opportunities to connect with others. As much as I have tried to supplement my learning with books, I really prefer example-based learning." 

Q: What is your rule-of-thumb approach to triage/identify medical versus informatics questions? 
A: "We developed a clinical lab steering committee with Subject Matter Experts (SME) from all areas and meet on a regular basis to discuss 'grey zone' issues like these with the goal to determine how to address the problems.... If someone asks me a microbiology question related to orders and results - I understand the system but not the test. So, that steering committee can provide the expertise in the different fields and provide the information necessary to carve a pathway to solve the problem."

Q: How do you prove your worth in your institution?
A: "We have a ticket system. We quickly realized, if we were going to keep track of a system, we needed something like that - so, we generated a homegrown system within the department.... Because Clinical Informatics is not a fee-for-service, it is more difficult to demonstrate or document the value that we provide. For both our department and our health care system as a whole - the ticketing system is a good way to show it. For example, I can look back and say, 'Remember all of the C-Diff orders? We spent this much time and helped fix that for you!'"

"Informatics is a part of enabling pathology to move forward.  Pathology informatics is pathology – some of the best informaticists I know don’t consider themselves informaticists but pathologists. There are wonderful courses and mentors out there.  You need to ask yourself, what do I really want to focus on?"

"A lot of work cannot be published in industry vs. in academics. It’s nice to be invited to this mentoring event because it makes me feel part of the community."

"Every industry is different and while I work for a very large company there are many different sizes of companies that focus on a variety of areas and you will see people float in and out between academia and industry."

"What skills do you need as a resident?  Find projects that you are passionate about or that will keep your interest to develop the skills that you need – project-based learning is key."

"Ask yourself: What is your focus?  Do you want to be a CMIO? – then, take on operational aspects. Digital pathology or bioinformatics? - then, take on projects related to those aspects which will set you up as a good match for various programs.  That’s how you find your niche in informatics."

“Rather than pursue a particular skill set in Pathology Informatics, I encourage you to find a question that you are curious about, or a problem that you have come across in healthcare, and consider learning skills that might help you solve that problem. You want to learn how to learn – that is what you want to master – and not worry too much about a particular skillset.”

“I wouldn’t say that coding or knowledge of coding is integral to the practice of PI. Instead, an informaticist plays the important role of understanding how data is collected, shaped, and interpreted. It is our role to take leadership in acquiring and presenting data in a way that is accurate and impactful.”

“Find a project that you are passionate about – something that is important to you and work on it -  even if you aren’t the lead informaticist at your institution.”