As a follow-up to the earlier insights blog post “How Female Leaders are Shaping the Adoption of Technology in The Public Sector”, this post speaks with two female informaticians serving in leadership positions at RTI International. Dr. Melissa McPheeters is an epidemiologist and informatician with expertise in identifying, assessing, and synthesizing data for public health and health care. Dr. Laura Marcial is a senior health informaticist and specializes in the design, development, implementation, and evaluation of health IT tools including clinical decision support. I spoke with Dr. McPheeters and Dr. Marcial to gain insight on their experience as women in informatics, to learn what they think the future holds for informatics, and the evolution of their continued work in the field.
Can you describe your current role at RTI International?
Dr. Marcial: I currently lead a program focused on the use of data and evidence generation to support care coordination and health care decision making. My program also specializes in the development of implementation tools, applications to support care delivery, and evidence generation that evaluates the impact of those tools.
Dr. McPheeters: I focus on informatics in public health, specifically the use and flow of data between health care and public health. I support RTI’s presence in that space, working with the federal government and states to improve their public health informatics capacity.
How did you launch your career in informatics?
Dr. Marcial: My early work was in development of hardware for gaming and serving in a staff role at the UNC Gillings School of Public Health. I then transitioned to developing clinical decision support solutions at Johns Hopkins. After several years at Johns Hopkins, I went back to school at UNC’s School of Information and Library Science to harmonize my interests in health IT, implementation projects, and research. When I completed my PhD, I joined RTI to continue building the field of health informatics research.
Dr. McPheeters: I was originally trained as an epidemiologist. I then spent several years as faculty at Vanderbilt, which is a hub for biomedical informatics. I was working as an epidemiologist in an environment that was also immersed in informatics. After my time at Vanderbilt, I joined the Tennessee Department of Health to build their program in informatics and analytics. In this role, I worked to organize how informatics and data visualization happened across the department. For example, we built a program around a data driven response to the opioid epidemic that would be translatable to other public health challenges. This is where I learned the most about informatics on the ground, especially seeing firsthand how public health initiatives were reliant on data from health systems across the state. I gained a new appreciation for the complexity and challenges in getting the data, integrating the data, and providing that data back to the community to mount a response to the public health issue at hand.
What do you love about working in the field of informatics?
Dr. Marcial: This field has an incredible community with great problem solvers. The problem-solving component is vital when looking for ways to make data more moveable, accessible, and useable. Another great aspect of RTI’s work, we get to problem solve some of the most challenging issues with the goal of improving the human condition. This has become more heighted during the pandemic, but we are working to address issues that will change people’s lives.
Dr. McPheeters: Almost everything we do is touched by a need for data to move from one place to another. You can’t change what you can’t see, and we do that with data. You need to measure things to know you’re making a difference. This is reliant on data. If I can be a small part of providing data to a community to address an intractable problem (e.g., maternal mortality, the opioid epidemic, or COVID-19) then I’m contributing to a small part of improving the human condition.
Dr. Marcial: We’re also translators. We work in teams as people who work to understand the language for nearly any side of a system. We’re always looking for the people in the room, metaphorically speaking, who are willing and able to step back and re-say something in a different way or step forward and provide direction on how to move to the next phase of the work.
Dr. McPheeters: Every piece of data represents a person or story. If we can make that real by ensuring the data is reliable, is accessible, and that the story makes sense then it is more likely to lead to real action. It’s exciting to be a part of that work.
What challenges have you faced in your informatics careers?
Dr. Marcial: First, I tend to start in the middle of things. Specifically, I come to a problem assuming everyone has a basic understanding of the issue. Where to begin with a complex problem? How many people are coming at the problem from a different perspective? You need to strike a balance when bringing folks up to speed to ensure everyone is on the same page. Second, there is a language that informaticians speak. I know the term “Clinical Decision Support”, but this is less clear to those outside the field. You need to be conscientious of your language and how you approach different audiences.
Dr. McPheeters: A big challenge is deciding what to focus on. Within the field of informatics, there are sub-fields that are distinct (e.g., biomedical informatics, public health informatics, nursing informatics). Figuring out where you fit in the field of informatics is challenging and can be intimidating. I also agree there is a jargon to informatics, and it is rapidly changing because the field is continuing to grow. Finally, communicating what we do. We aren’t the IT people, and we aren’t the clinical people. How do we define where we fit in that space?
What advice do you have for other women interested in informatics?
Dr. Marcial: Have domain interests. These interests can be great drivers for working in a specific space. That being said, don’t worry about choosing a domain and sticking with it. All the hours you put into a domain will be used throughout other areas of informatics. Multiple informatics domains are applicable to a wide range of problems. Don’t be intimidated by the number of domains in informatics. Allow yourself to become a specialist in multiple areas throughout your career.
Dr. McPheeters: Women who are interested in informatics should reach out to other women in informatics. Women in the field are really excited to welcome more women in the field, which is still likely dominated by men. What’s fascinating about informatics is the range of pathways people have taken to get there. Informatics is an incredibly flexible field and that makes it a great fit for those with multiple interests.
Dr. Marcial: I strongly encourage women in the informatics field to put themselves out there. Be willing to make mistakes and be assertive, pushing in the direction you think things should go. I agree that women still represent the minority of voices in informatics, especially on the technical side.
Dr. McPheeters: You can be a technical informatics expert, but that’s not everything. That should not intimidate anyone. There are lots of informaticians who evaluate workflows and look at social use of technology. Informatics is a team sport. That teamwork plays well to a lot of different people with varying interests and specialties.
Where do you see the field of informatics going in the future?
Dr. McPheeters: I think about informatics from a public health perspective, but it is important in almost every field. During the COVID-19 pandemic, there was a desperate need for better health data systems as well as people who know how to use and improve them. The need to connect data across sectors to ensure we are sharing and using data well will be an incredible area of growth. The idea of integration will be extraordinarily important to break down barriers and use data to keep populations healthy. People with lots of different perspectives in informatics will need to come together to make that happen.
Dr. Marcial: We need to knit together multiple informatics disciplines to solve those truly complex population-based challenges (e.g., COVID-19). Informatics will play a key role in bridging the gap between clinical care and public health. I also think the issue of health equity and the impact of a person’s zip code is only solvable with teams of informaticians looking across problem areas and identifying potential solutions.
Dr. McPheeters: The other piece is data, not just as a commodity but as a public good and how informaticians ensure those who need the data have access to it and can use it in ways that are productive. This means data must be provided in usable ways. In addition, as data gets bigger and more public, we get into more privacy issues.
Dr. Marcial: We see the explosion of data flows and we’ve worked hard on improving the transmission and integration of the data. Another growing problem is the signal to noise ratio, making sense of the data to provide real information that can be transformed into knowledge.
Anything you want to share about the field of informatics that we haven’t covered already?
Dr. Marcial: There’s the last mile problem. Communication to the patient, the primary end user. We don’t effectively communicate what we do, why we do it, and why it matters to the end user. How do we do a better job talking about why clinical decision support matters? These are opportunities to extend our reach and make the work real for the people that matter the most.
Dr. McPheeters: We talk a lot about technology and data, but informatics is all about technology, data, and people. It’s the people part that drives everything. These three components are what makes it informatics and we need to always keep them in mind.