Core Competency Framework for Clinical Informaticians

Uses clinical, social, biomedical (including genomics) terminology, language and abbreviations appropriately when contributing to informatics projects and programmes to be able to facilitate accurate and appropriate communication across clinical informatics projects and/or teams

1. Understands the main components (including clinical audit, clinical risk management, quality assurance, clinical effectiveness and staff development) of the clinical governance framework
2. Understands how informatics can assist in the monitoring and implementation of healthcare services and standards
3. Be able to use data and information effectively in clinical audit to identify service improvements

1. Demonstrates an understanding of the UK care delivery models, organisations and governance involved across the care pathway and their inter-relationships (e.g., GP practices, hospitals, ambulance services, care homes, community services) and how they influence the delivery of informatics projects/programmes
2. Can identify and address the challenges related to using information systems in the health and social care sector for health care and/or research
3. Is aware of the latest initiatives, drivers and constraints affecting health and social care planning and service delivery to make sure that informatics plans are shaped accordingly  

1. Demonstrates knowledge of how resources, information flow and quality metrics are used through the UK Health System structure, administration and services (e.g., healthcare planning, service commissioning, delivery of health, social care and pharmacy)
2. Demonstrates knowledge about the social determinants of health (e.g., environment, socio-economic, genetics), and their influence on the delivery of healthcare and informatics services and work
3. Recognise how UK and international health policies can change and how they impact on system and organisational informatics delivery, strategies and plans
4. Shows knowledge of clinical and business processes, indicators and reported outcomes for healthcare delivery and systems management and their role in the quality assurance of healthcare

1. Has knowledge of the UK and international informatics strategy landscape including which organisations develop and deliver them, their similarities and differences and the stakeholders involved in influencing and/or funding them, and how they influence your informatics priorities, strategies and work

1. Has awareness of the role of health informatics and information systems in the health and social care systems, and understands lessons learned from previous programmes to prevent replicating mistakes, promote best practice and ensure improvement of future informatics project implementations for healthcare practice and/or research

1. Is able to perform searches and critically appraise literature to support evidence based decision making
2. Knows about hierarchies of evidence and appropriately applies them to evaluate informatics interventions
3. Defends methodologies and approach for a defined clinical informatics proposal and/or project
4. Understands research governance frameworks and guidance to ensure that informatics research projects/programmes are conducted to the appropriate standards including safeguarding of safety, wellbeing and rights

1. Analyse key information technology components including hardware and software, and how they can be used in health and social care settings
2. Is able to demonstrate knowledge of computer science principles and terminology including modelling data and systems using appropriate representations (e.g., UML, BLMN, MDA)
3. Discusses the range of health information systems and technologies available and how they can be or are used in the delivery of health and social care and research (e.g., medicines management, telehealth, imaging, test requests and reports, electronic patient records, mobile-health)  
4. Understands the qualities of a system/technology and the trade-off between them when developing/deploying them (e.g., maintainability, scalability, performance, recovery)  
5. Discusses systems and technologies in relation to current and future thinking around health systems, especially with technology providers to drive innovation to address health and care delivery
6. Can identify an appropriate technology to resolve healthcare problems and contribute to the  development of good practice to do this
7. Applies knowledge of health data, information and workflow models to design and deliver information technology solutions
8. Understands each stage and associated processes of the lifecycle of how an information system is developed including the planning creating, testing and deploying stages, and when clinical engagement is key to a successful informatics project outcome
9. Awareness of the benefits and risks of different project methodologies (e.g., agile, waterfall) when used for software development and is able to employ the appropriate strategies to meet the needs of the project

1. Has a good working knowledge of technical and clinical terminology and can demonstrate how the effective use of both can lead to a common understanding of an informatics project/programme
2. Is able to manage expectations of stakeholders and guide prioritisation toward incremental development that is both clinically useful and/or technically possible within the available resources
3. Awareness of the phenomenon that some problems cannot be solved by conventional requirements gathering and classical product design, and if they are applied will actively make things worse
4. Is able to clearly and effectively communicate clinical and business requirements to technology suppliers, specialists, helping them understand how to align their solutions to health and social care practices and objectives
5. Considers patient safety, usability and cost when specifying requirements for informatics projects and is able to discuss the trade-off between them
6. Be able to highlight and communicate about problems with information systems to technical groups and provide feedback and information for healthcare professionals

1. Demonstrates knowledge of the procurement framework including teams involved in contract negotiation and management, costs and how to identify return on investment
2. Is able to contribute to the selection and utilization of appropriate information systems and/or technologies to meet clinical and operational requirements through the evaluation of tender responses
3. Is able to identify informatics solutions that guarantee data privacy, patient and user confidentiality, security and integrity following current excepted standards

1. Recognise that interoperability is an unresolved problem and the issues surrounding this (e.g., lack of adherence to informatics standards, different processes surrounding informatics system) impact on the delivery of integrated care
2. Demonstrates knowledge of the range of technology for transmitting information (e.g., messaging between systems) and clinical standards (e.g., standards for structuring clinical information) for information needed to support the creation of interoperable systems, and promotes their importance to drive an integrated delivery care model
3. Demonstrates knowledge of the basis, application and limitations of clinical coding systems, terminologies and classifications and understands their purpose in delivering safer health care
4. Is able to discuss the appropriate health informatics standards systems including coding systems, data structures, data security and privacy, and system-to-system messaging to enable system interoperability and procurement/design of future systems

1. Assesses clinical models and is able to interpret mapping of data relationships and dependencies of health information system architecture (e.g., electronic health records, decision support systems, prescribing systems)
2. Applies information technology best practices (e.g., quality management systems, testing, service level agreements, business continuity and incident management) throughout the system life cycle  

1. Demonstrates knowledge of the security and governance of  data, systems, devices and networks (e.g., Data Security and Protection Toolkit), and is able to use this to contribute to the development of solutions required to manage data
2. Appreciates the international and national standards and regulatory frameworks for quality management, software deployment, medical devices, clinical safety (e.g., DCB0129, DCB0160) and interoperable systems (e.g., ISO9001, ISO80001 family)
3. Understands what informatics solutions (e.g., current GP systems and/or clinical decision support that includes Artificial Intelligence or any coded algorithms) constitute as a medical device and must adhere to the Medical Device Regulations
4. Understands the trends in cybersecurity risk in healthcare (e.g., cloud computing, medical physical systems, data confidentiality, malware, app security, insider threats)
5. Knows about cybersecurity capability, countermeasures and risk mitigation strategies (e.g., technological solutions, risk assessment frameworks, regulatory and legislation, healthcare/team education to embed digital security practices, encryption) so as to develop secure systems and team/local policy and protocols to protect patient safety
6. Understands the procedures to report any cyber or data security incident

1. Is able to work with other system developers and healthcare professionals to consider the key qualities of a system (e.g., scalability, maintainability, performance, structure, availability) when designing and developing  information systems (e.g., electronic health records), and apply current best practice to these
2. Is able to develop processes and methods with other colleagues to continuously assess the safety and efficacy of information systems

1. Can use knowledge of key aspects of information systems (e.g., usability, performance, cost effectiveness) to develop evaluation criteria to assess and evaluate digital solutions and information systems in practice settings to make sure they are useful and/or successfully adopted
2. Demonstrates awareness of evidence and regulatory frameworks used to assess digital technologies (e.g., NICE) in order to contribute to discussions of the development of digital health interventions

1. Is able to use basic descriptive statistics and explain the concepts of probability, predictive modelling and machine learning techniques to discover patterns and knowledge in recorded data, and know when to use them to solve health and social care,  clinical practice and research problems
2. Understands what clinical questions can be addressed with different data sources, and working with data custodians and others can understand what data is required and the data analytical methods to be used to address the problem and derive insights
3. Is able to demonstrate how data quality effects analysis, and resulting clinical and healthcare insights, and how important it is to improve to derive maximum potential from its utilisation
4. Understands how technologies (e.g., R, Python, Jupyter notebooks) facilitate the analysis, display of results, and reproducibility of analyses to be able to re-run protocols to verify results and modify for other purposes
5. Is aware of the latest techniques (e.g., AI) and their application to healthcare (e.g., imaging and genomics interpretation, clinical diagnostic evaluations, prediction of readmission risk, extracting semantic information from text) and the challenges in deployment and usage of these in health and clinical settings (e.g., population data and algorithmic bias, explainability of results, robust regulation and quality control, metrics vs clinical applicability, ethics and unintended negative consequences)

1. Demonstrates an understanding of the key attributes of data and information including quality, integrity, accuracy, timeliness and appropriateness and can discuss their limitations within the context of intended use
2. Understands the variety of data streams and sources that contribute to health decision making including those not necessarily primarily collected for health (e.g., mobile, sensors, phenome)
3. Discusses the opportunities and challenges with using real-world health data for analysis and to drive decision-making

1. Applies current best health informatics standards for the recording of health data (e.g., classifications, vocabularies) to increase data quality and utilisation for improving  healthcare and clinical practice and research
2. Understands the importance of data linkage, record linkage methods, and the relevant strengths and limitations, to be able to conduct or review linked data analysis

1. Demonstrates an understanding of the data inter-relationships and dependencies among the various health information systems (e.g., decision support systems, electronic health records, order entry, registries, etc.)
2. Has awareness of the different approaches used to store health data and the pros and cons of using these approaches, and how these effect data accessibility and analyses

1. Explains the ethical, legal and regulatory guidelines to determine the appropriate access, use, disclosure and protection of data to protect patient information and ensure confidentiality, and applies them when processing patient data at all times
2. Demonstrates an understanding of processes, guidelines, and governance structures needed to achieve trustworthy use of methodologies such as Artificial Intelligence, and is able to assess these with others to address health care problems
3. Has some awareness of privacy enhancing technologies (e.g., K-anonymity, homomorphic encryption), and how and what they might be used for

1. Demonstrates an understanding of a range of visualisations used to present data analyses and information so as to be able guide others in their usage
2. Contributes to quality analysis by organizing and transforming data into reliable and meaningful information to support decision making
3. Presents information in a way that is effective for users’ decision making, and that takes into account the variability in the user capability to assess methods and draw appropriate conclusions

1. Applies quality improvement and process engineering to facilitate business and clinical transformation, measuring and analysing appropriate outcomes
2. Appraises patient safety risk in the design and development of information systems and technologies and ensures that all risk is assessed and managed appropriately to minimise or avoid harm

1. Can use change management tools and techniques in the implementation of new processes or informatics systems within clinical practice and/or research and is able to communicate the change effectively to a range of stakeholders
2. Engages with identifying ‘best practice’ in informatics enabled change across settings and look at translation to a local setting

1. Understands the organisational and human factor challenges to effective use of health information systems and technologies and can apply appropriate methods to address these and ensure maximum user engagement and widespread adoption

1. Appreciates the methods and techniques for requirements gathering, design, and user-centred evaluation and testing for health systems and technologies, understanding their strengths and limitations, and applies these to clinical informatics projects
2. Demonstrates an understanding of the clinical input, knowledge, workflow and impact when proposing informatics solutions and interventions
3. Analyses situations critically to address usability and accessibility issues, design problems and use of digital health technologies
4. Assess the demand for evolving services in your organisation &/or system, and appropriately present results to various stakeholders

1. Appreciates the range of patient resources providing information on healthcare interventions, public health and engaging with the patient and technology used to deliver it (including the quality of information, type and assessment) to inform patients’ decision-making
2. Discusses the value of technologies that enable co-production of health (e.g., mobile applications, social media, sensors) to improve health and promote citizen (patient) engagement
3. Demonstrates understanding of the latest developments in patient access to health records and the implications this has on the nature of relationship between healthcare professionals and patient
4. Discusses the impact of digital interventions (including data sharing and usage) on governance frameworks and public trust
5. Is able to support patients when accessing and viewing their health data (e.g., access guidance and processes, correction of factual inaccuracies) and other health data sources to empower them to make decisions about self-care and share in the decision-making
6. Uses appropriate communication strategies and language to effectively present and impart knowledge and explain concepts to non-expert and expert audiences through involving patients in projects, speaking at meetings/conferences, publishing articles etc.

Is able to contribute to the evaluation of the design, implementation and functionality of systems so that they can evolve to support best practice in clinical care

1. Understand the definition, key components and the rationale of evidence-based practice and the application of informatics
2. Develops and assesses evidence-based search strategies and guidelines to support clinical management and decision making
3. Demonstrates an understanding of the different types of clinical knowledge  and their sources from across the health system and how they can be applied to make clinical and operational decisions
4. Promote evidence based practice, use of guidelines and care pathways across different healthcare settings and contribute (where appropriate) to the development and use of guidelines

1. Demonstrates understanding of models for effective knowledge acquisition, storage and dissemination, including strengths and limitations
2. Understands how knowledge can be transformed from generation to modelling into a computable form

Understands the nature of clinical decision making and defines the processes of clinical decision making and diagnostic strategies

Demonstrates knowledge of the types of clinical decision support tools (e.g., computer interpretable guidelines), including their strengths and weaknesses

Demonstrates understanding of best practice and approaches (including how information is accessed, sources of information, integration into systems) used to construct and translate clinical pathways and guidelines into decision support tools

Discusses best practice in the development and application of clinical decision support tools to individuals and/or populations

Is able to lead discussions about risk assessment and mitigation, and validation of a decision support system

Knows the core concepts to be able to evaluate impact of implementation on behaviour, workflow and decision-making such that these can be understood and used to inform next iteration or usage

Applies theories, concepts and practices of management to informatics projects (including: setting clear goals and objectives, developing effective internal and external project communications using clear and unambiguous language to ensure progress is easily understood; financial and budget management; setting up  governance structures to ensure clear accountability and management/ownership of risk; building procurement and vendor relationships; recognising the differences in organisational culture, and adopt approaches to manages these whilst being clear of your own values and principles) to develop clear strategies and plans for delivery of clinical informatics projects/programmes

1. Creates a professional culture & facilitates continuous individual, team and organisational learning and development to ensure thinking is kept up-do-date and relevant for the future delivery of services
2. Defines the needs for good quality training in informatics and knows how informatics can facilitate research and improve digital literacy to be able to embed and increase the knowledge across healthcare professionals and other informaticians

1. Promotes open, transparent information sharing and multi-disciplinary team working to solve clinical informatics challenges through effective communication, development of a supportive network and the recognition of individual and team achievements to increase visibility of individuals and required skills for completion of informatics projects
2. Has awareness of different roles of people working in informatics and the knowledge and skills they should have and is able to identify how they can contribute to the successful delivery of an informatics project/programme through collaborative working  

1. Has awareness of project management and change management methodologies, tools and techniques considering factors (e.g., team-working and governance, resources, project planning , business cases, monitoring  and reporting) and is able to  apply them to informatics projects/programmes
2. Is able to contribute to project planning, implementation, monitoring and evaluation of informatics projects, ensuring that programme/project goals remain aligned to clinical and operational objectives where appropriate, to increase project/programme success
3. Is able to recognise when an informatics project/programme is not going according to plan, and can appraise benefits, risks for continuation, change of direction or stopping, and can communicate these through appropriate governance structures
4. Adapt an appropriate communication style to be able to distil information to deliver key messages to address a range of audiences and stakeholders (e.g., organisational boards, project teams, other healthcare professionals) 

1. Have awareness of stakeholders influencing development and funding of clinical informatics projects and/or programmes at local or national level
2. Understand and evaluate local and national health informatics policies and strategies and their key elements of technology, process, clinical engagement and governance
3. Discusses the components for successful innovation and its adoption and/or scalability into other healthcare contexts/organisations

1. Creates and assesses strategic, implementation and financial plans for clinical and health information systems to ensure increase chances of a successful deployment
2. Justifies allocation of resources to informatics for service redesign to improve delivery of health and social care and patient safety