Announced in March as the new president of AMIA (formerly the American Medical Informatics Association), he is taking over a post usually held by a high-level academic researcher. While Fickensher has done his share of that sort of thing, his career has been unusually diverse, including long tenures in family practice, health system administration, and consulting.
Starting in health care at 16, as an orderly in a nursing home, he drove an ambulance to help pay for college and medical school. He fell under the informatics spell while creating a rural health program in North Dakota and exploring the potential for telemedicine to improve care there. He believes informatics is "the issue of the next decade" and informaticists will play a central role in the battle to reduce cost while improving quality and access.
On the role of informatics
We have a tremendous number of problems in the health care industry, and we can't continue to take 20 percent of GDP. It's not sustainable. We need to create knowledge out of information. The investments we've made through HITECH are a good first step, but now we need to take that information and help the health care industry drive better quality, reduce costs, and enhance service. The industry needs informaticists to do that.
On the role of informaticists
Historically a lot of informaticists have done clinical studies, and that's all well and good and should continue, but there's a difference between doing research and applying it. They can look at the infrastructure and the systems and how they work together. They understand both technology and the clinical side, so they can build bridges. Here's an example I heard recently. It's easy to say everyone should get their (hemoglobin) a1c tested, but an informaticist might look at the data on where people get their health information and tell us to educate barbers in the black community, so that when someone is sitting in their chair, they can talk to that person about getting tested.
On the untapped potential of informatics
The top 10 problems of health care consume at least half the dollars, if not more. The incentive of the system is to wait and do things to people. That's starting to change with the idea of accountable care. For instance, congestive heart failure takes a huge percentage of the dollars. We know that CHF patients start going into failure 24 to 48 hours before they show up in the emergency room. Why not help them 48 hours earlier? Informatics will help us identify what we should be doing.