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Emerging Specialty Computes as New Niche

Tech consultant needs to expand clientele. His background suggests a switch to up-and-coming medical informatics field.


Stan Lieberson, 53, isn't your typical client-juggling computer consultant. For the last 16 years, he has depended on a single East Coast-based firm for his $75,000-a-year earnings.

But a few months ago, Lieberson, of Los Angeles, received bad news: That bread-and-butter account is going to cut back his billable hours, due to financial constraints.

"The situation with my client is now shaky at best," Lieberson said. "It's clearly apparent the client will not be able to retain me at the same level of work anymore."

Lieberson knows he'll have to dredge up new customers. But he has some concerns. As a programmer, he's largely self-taught, so he may need more database training to be marketable. Additionally, he's uncertain about his next career move. Could he find a programming niche that might prove challenging and stimulating?

For advice, Lieberson contacted Jo-Ann Ruffolo, a Caltech career counselor.

Lieberson admitted to Ruffolo that, as yet, he hadn't explored many alternative career opportunities. He realizes he's not without options, however, for he's well-versed in the programming language Pascal (specifically Turbo Pascal and Pascal-based Delphi) and holds a doctorate in clinical psychology.

"Changes like this can either energize or immobilize people," Ruffolo said. "It may sound strange to you, but you may go through a grieving process after this client is gone."

Ruffolo encouraged Lieberson, a UCLA alumnus, to visit the school's career center to do some preliminary exploring of vocational alternatives. She also asked him to think of ways he might merge his two interests--computer science and behavioral science--into one fulfilling career.

Ruffolo and Lieberson eventually arrived upon a vocational niche that Lieberson might enjoy: medical informatics, or the use of computer technology to improve health-care delivery in such areas as electronic medical records, Internet-based drug prescriptions and teleconsults between physicians.

Here are some tips for Lieberson, should he decide to pursue a career in this rapidly emerging field.

First, Lieberson should learn all that he can about it. Medical informatics is revolutionizing health-care delivery and improving physicians' ability to care for patients.

Using electronic medical records, physicians can reduce medication errors, be alerted to patient allergies and potentially harmful drug interactions, order lab tests and prescriptions over a secured Internet connection and much more.

"It's dramatically changing the way we do business," said David Artz, medical director of information services at Northwestern Memorial Hospital in Chicago.

Paul Tang, chief medical information officer at Palo Alto Medical Foundation, agrees. In a study he conducted at Stanford University he found that, in 81% of cases, physicians, relying only on written records and verbal histories from medical residents, lacked sufficient information to make proper decisions about patient care at the time of their visits.

Tang believes that medical informatics will greatly enhance patient care. "Once you've practiced with [electronic medical records], it's almost unethical not to," Tang said. "I consider it indispensable to the practice of medicine."

Medical informatics also is being used to train physicians-to-be and to augment the skills of experienced physicians. At Stanford University, one of the nation's leaders in medical informatics research and education, computers are employed by personnel to simulate surgery, microsurgery and critical patient-care situations.

A growing number of companies are jumping into medical informatics and turning out clinical software products and Internet solutions that can be utilized in inpatient, outpatient and ambulatory settings.

Companies such as BAI Clinical Software (, IMedica(, Pocketscript ( and EPhysician ( offer electronic medical record applications that give physicians rapid, easy access to patient histories, drug data and clinical research.

LabDat ( offers physicians a secure interactive Web site where they can order lab tests and review results online.

Some firms, such as CliniComp International in San Diego (, which has 32 hospital clients, specializes in inpatient electronic records--the automating of patients' bedside charting for nurses and physicians. Others, such as Global Telemedix (, are becoming application service providers, or ASPs, which contract with health-care organizations to deploy, host, manage and lease access to medical software applications.

Through their service, such companies host secure "teleconsults" in which physicians can exchange clinical information and engage in real-time collaborations using diagnostic images, video clips and test results, such as ultrasound.

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