A Profession of I.T.'s Own:

The Rise of Health Information Professionals in American HealthCare

ABSTRACT: As clinical information technology (IT) grows in prevalence and power, medical professionals will increasingly interact with patients through digital media, make care decisions in light of computerized data, and perform medical procedures by electronic control, sometimes over great distances and across multiple legal jurisdictions. As great and often wrenching as these transformations may be, however, we must also consider the possibility that IT may exert its greatest impact on medical professionalism not directly, by changing what practitioners do, but indirectly, by changing with whom they collaborate in doing it. As the sociologist Andrew Abbott has famously observed, professional occupations form a “system,” in which the fates of different professions (and hence professionalisms) are linked, sometimes competitively, sometimes cooperatively. Nowhere is this more true than in health care, a field where the practitioners of multiple clinical and, increasingly, administrative professions work in close proximity and in tight coordination to provide crucial time-sensitive care. Thus, to understand medical professionalism in the information age, one must look beyond the absorption of IT into medicine itself, to consider how the introduction of IT may restructure the larger “system of professions” that constitutes the health care enterprise as a whole.

One likely consequence of the rising prominence of health information, health information technology, and health information technology governance will be a concomitant rise in the prominence of new health-information professions. This chapter lays out some preliminary thoughts—and some tentative evidence—on what these new professions will be, who will be their members, and how those members will conceptualize their work, their workplaces, and their own “medical professionalism.”

We begin by enunciating a sociological account of professionalism, not as an idealistic aspiration but as a distinctive type of occupational structure. We then assess the state of today’s health information occupations against this archetype, to determine where and to what degree new health information professions may be emerging. Finally, we consider possible futures for professionalism and professionalization in the health information field, and we briefly speculate on how these futures might shape the impact of information technology on the professionalism of the health care sector’s more longstanding and familiar occupational groups.

Cite as: Suchman, Mark C. and Matthew D. Dimick (2010), “A Profession of IT's Own: The Rise of Health Information Professionals in American Healthcare,” p. 132-173 in D. Rothman & D. Blumenthal, eds., Medical Professionalism in the New Information Age. East Rutherford, NJ: Rutgers University Press.