Future Careers and the Future of Healthcare: Dr. Spiegelman’s Journey into the Field of Clinical Informatics

By Jamie Lenihan, UCI School of Medicine

If you had asked Dr. Spiegelman 10 years ago where she saw herself in the future, she certainly wouldn’t have told you she would be an emergency medicine (EM) physician and the department’s lead clinical informaticist. Yet, these are just some of the many roles she currently holds.

When Dr. Spiegelman left her Palo Alto home in Northern California to study at USC, she was planning on a career in Psychology. During her time as a neuroscience major, she realized she was drawn to medicine as a career path that combined both the sciences and her people skills. Though when Dr. Spiegelman started her medical education here at UCI School of Medicine, EM wasn’t on her radar, and her experiences volunteering to hold newborn infants at Children’s Hospital LA made a field like pediatrics seem much more likely to her.

After shadowing in the ER during her second year of medical school, Dr. Spiegelman began to consider that EM might be for her. She loved the pace, and the way that patients presented to her with acute issues that she could use her problem-solving skills to manage. Through her EM sub-internship, Dr. Spiegelman found excellent mentors at UCI and felt that the environment of the UCI EM residency program would allow her to flourish.

Even as she began residency, Dr. Spiegelman had no intention of pursuing clinical informatics. The idea arose slowly through the mentorship she received from program director Dr. Scott Rudkin. Working with Dr. Rudkin, Dr. Spiegelman saw that clinical informatics provided a powerful tool to address efficiency in the clinical setting and she found that she had “so much fun” with project management and thinking about healthcare in this unique way.

Dr. Spiegelman notes that she is “not that techy” and certainly felt a level of imposter syndrome when beginning the clinical informatics fellowship without a strong tech background. However, she quickly found her niche in what she describes as the “people and problem-solving” aspects of clinical informatics. While for some, clinical informatics becomes an avenue for data science or research, for Dr. Spiegelman, the focus was understanding and leveraging the technology for real-world applications.

When the COVID-19 pandemic emerged during Dr. Spiegelman's fellowship year, her focus on implementing technology to solve clinical problems proved to be especially well-timed. Before the pandemic, Dr. Spiegelman had begun to work on a small project to introduce telehealth technology in UCI’s ambulatory clinics. She remembers feeling as though one of the largest challenges would be convincing physicians to integrate telehealth into their practices and noticed a sentiment that clinics were “never going to use this technology”. When COVID-19 put a sudden halt to all in-person visits, this need certainly changed. Serendipitously, Dr. Spiegelman already had a plan in place and was able to work quickly to establish capacity for telehealth visits. What had started as a small project became a crucial element for maintaining clinic flow across UCI.

While it’s not every day that your project is perfectly timed to solve the problems that arise from a pandemic, it becomes clear after talking with Dr. Spiegelman that the skills and tools she acquired through her fellowship have a critical place in healthcare delivery that is only likely to increase in the coming years. As Dr. Spiegelman puts it, “technology is everywhere” and there is an increasing requirement for clinicians to interact with it. When we spoke, Dr. Spiegelman was working with her fellows on a project to assist EM physicians in adapting to new billing requirements going into effect. She explained that they were hard at work designing a new template and appropriate prompts to help adapt to these changes. This is a modern solution that aims to save time and produce better outcomes than simply teaching the requirements and expecting physicians to learn and fulfill them.

As the need for clinical informatics continues to grow, Dr. Spiegelman is working to ensure that UCI’s clinical informatics fellowship is optimized for training its fellows and meeting these needs. After becoming faculty at UCI in July of 2021, she began working closely with Associate Program Director Dr. O’Connell to completely redesign the fellowship curriculum. The curriculum moved from an online program to an in-person curriculum that eliminates busy-work and emphasizes project-based learning. Dr. Spiegelman currently acts as the head educator for two of the curricular blocks, providing teaching and mentorship alongside other faculty with diverse experience in the field.

Dr. Spiegelman’s advice for anyone interested in learning more about clinical informatics is to seek out people in the field and learn more about what they do, as the applications of clinical informatics are broad. More importantly, she encourages anyone interested in this field, or another, not to shy away from pursuing an opportunity just because they hadn’t previously considered it. After all, 10 years ago she never would have guessed her career would look like this now.