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Journal of the American Medical Informatics Association: JAMIA logoLink to Journal of the American Medical Informatics Association: JAMIA
. 2024 Oct 11;32(1):3–8. doi: 10.1093/jamia/ocae258

The journey to building a diverse, equitable, and inclusive American Medical Informatics Association

Tiffani J Bright 1, Oliver J Bear Don’t Walk IV 2, Carl Erwin Johnson 3, Carolyn Petersen 4, Patricia C Dykes 5, Krista G Martin 6, Kevin B Johnson 7, Lois Walters-Threat 8, Catherine K Craven 9, Robert J Lucero 10,11, Gretchen P Jackson 12,13,14,15, Rubina F Rizvi 16,17,✉
PMCID: PMC11648708  PMID: 39394736

Abstract

Objective

The American Medical Informatics Association (AMIA) Task Force on Diversity, Equity, and Inclusion (DEI) was established to address systemic racism and health disparities in biomedical and health informatics, aligning with AMIA’s mission to transform healthcare. AMIA’s DEI initiatives were spurred by member voices responding to police brutality and COVID-19’s impact on Black/African American communities.

Materials and Methods

The Task Force, consisting of 20 members across 3 groups aligned with AMIA’s 2020-2025 Strategic Plan, met biweekly to develop DEI recommendations with the help of 16 additional volunteers. These recommendations were reviewed, prioritized, and presented to the AMIA Board of Directors for approval.

Results

In 9 months, the Task Force (1) created a logic model to support workforce diversity and raise AMIA’s DEI awareness, (2) conducted an environmental scan of other associations’ DEI activities, (3) developed a DEI framework for AMIA meetings, (4) gathered member feedback, (5) cultivated DEI educational resources, (6) created a Board nominations and diversity session, (7) reviewed the Board’s Strategic Planning for DEI alignment, (8) led a program to increase diversity at the 2020 AMIA Virtual Annual Symposium, and (9) standardized socially-assigned race and ethnicity data collection.

Discussion

The Task Force proposed actionable recommendations that focused on AMIA’s role in addressing systemic racism and health equity, helping the organization understand its member diversity.

Conclusion

This work supported marginalized groups, broadened the research agenda, and positioned AMIA as a DEI leader while reinforcing the need for ongoing transformation within informatics.

Keywords: diverse, equitable, and inclusive (DEI), biomedical and health informatics, systemic racism and health disparities, workforce development

Introduction

The American Medical Informatics Association (AMIA) Board of Directors (BOD) established the Task Force on Diversity, Equity, and Inclusion (DEI) in response to the national dialogue on systemic racism sparked by the tragic and unjust killings of George Floyd, Breonna Taylor, Ahmaud Arbery, Daniel Prude and many more unnamed victims. The Task Force aimed to leverage biomedical and health informatics member expertise to address health disparities and promote health equity across 5 domains: translational bioinformatics, clinical research, consumer, clinical, and public health informatics. The AMIA BOD charged the Task Force to provide specific and actionable recommendations that advance racial DEI in informatics science and practice. The charge from the BOD stated: “The purpose of the DEI Task Force is to guide and execute strategic goals and objectives related to diversity, equity, and inclusion through recommendations to the AMIA BOD.” The Task Force directed specific attention to AMIA’s mission and its intersection with systemic racism and health equity. AMIA needed to improve its DEI efforts because it lacked: (1) a clear vision and commitment from the AMIA Board on DEI; (2) a governance framework to implement DEI; (3) an understanding of the diversity of its members; (4) integration of DEI and health equity content in meetings; and (5) sustained pathway programs to attract, develop, and retain diverse leadership. AMIA’s leadership and membership should be representative of the diverse users of our healthcare system to ensure that all individuals benefit from its science and innovation. To achieve this, AMIA needs a sustained pathway to attract, develop, and retain diverse leaders and members, ensuring ongoing progress. This paper presents the Task Force’s contributions to AMIA’s DEI initiatives, while a separate paper will cover the accomplishments of the DEI Committee.

Materials and Methods

Organizational structure

The Task Force, consisting of 20 members aligned with AMIA’s 2020-2025 Strategic Plan, worked across 3 groups. Task Force members were identified and selected through a systematic process: the DEI Task Force leader curated a list of potential members based on their years of informatics experience, AMIA membership duration, subject matter expertise, demographics, and career sector. This list was then presented to the AMIA BOD for approval. Additionally, 16 volunteers were recruited through an online call for participation sent to AMIA members. The Task Force met biweekly from August 2020 through May 2021, alternating between full Task Force meetings and subgroup sessions. Figure 1 illustrates the Task Force’s organizational structure, including the subcommittees formed to address diversity, inclusivity, and sustainability within AMIA.

Figure 1.

Figure 1 illustrates the organizational structure of AMIA’s DEI Task Force initiatives from 2020 to 2025. It highlights key elements, including the formation of Diversity and Inclusivity Subcommittees in January 2021 with 16 additional member volunteers. The diagram outlines major recommendations aimed at advancing DEI objectives. Acronyms: AMIA (American Medical Informatics Association); DEI (Diversity, Equity, and Inclusion).

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Task Force organizational structure for AMIA’s DEI initiatives (2020-2025). In January 2021, 16 additional AMIA member volunteers joined the Diversity and Inclusivity Subcommittees to help achieve Task Force objectives. The Task Force identified major recommendations for AMIA’s DEI initiatives from 2020 to 2025. AMIA = American Medical Informatics Association; DEI = Diversity, Equity, and Inclusion.

Process

The process used to move from the initial charge to the final DEI Major Recommendations presented to the AMIA BOD is outlined in Figure 2. This flow diagram illustrates the sequential steps taken by the Sustainability Subcommittee, including the review of the AMIA Strategic Visioning Final Report, compilation and mapping of recommendations, communication of learnings, prioritization through an online survey, and final presentation to the BOD. The detailed process and activities under each charge area are outlined in the Results section. Following the procedural steps outlined in the flow diagram (Figure 2), the timeline below (Figure 3) outlines the key milestones from the formation of the Task Force in August 2020 to the final presentation of DEI Major Recommendations to the BOD in May 2021. This timeline captures the progression of activities, including the formation of subcommittees, data collection and analysis, and the finalization of recommendations. Final recommendations were presented to the BOD in May 2021, indicating the work described occurred nearly 4 years ago. To clarify, the recommendations were designed to address immediate needs in response to national unrest, particularly in 2020 and 2021, during a period of heightened focus on DEI within AMIA. This manuscript’s focus chronicles and illustrates the process by which a professional association’s membership can organize and create recommendations and outcomes for its leadership in the heat of socially charged events. As a result of these initial efforts, additional developments have occurred since then.

Figure 2.

Figure 2 shows the process from AMIA’s initial charge to the final recommendations presented to the Board of Directors (BOD). The figure outlines key stages in the development of recommendations, from the formation of the task force to the final presentation. Acronyms: AMIA (American Medical Informatics Association); BOD (Board of Directors).

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From AMIA charge to recommendations. This figure illustrates the process from the initial charge to the final recommendations presented to the AMIA BOD. AMIA = American Medical Informatics Association; BOD = Board of Directors.

Figure 3.

Figure 3 presents a chronological overview of the major stages of the Task Force’s work, starting with its formation in August 2020 and culminating with the presentation of final recommendations to the AMIA Board of Directors (BOD) in May 2021. The figure highlights key milestones throughout the process. Acronyms: AMIA (American Medical Informatics Association); BOD (Board of Directors).

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Major stages of task force work. This figure provides a chronological overview of the key stages in the Task Force’s work, from its formation in August 2020 to the final presentation of recommendations to the AMIA BOD in May 2021. AMIA = American Medical Informatics Association; BOD = Board of Directors.

The process used to develop the DEI Major Recommendations presented to the BOD was systematic and involved these steps:

  1. Formation of the Task Force: The DEI Task Force was formed in August 2020, consisting of 3 subcommittees, each dedicated to one of the following areas: diversity, inclusivity, and sustainability.

  2. Environmental Scan: The Inclusivity Subcommittee conducted an environmental scan of DEI activities in similar associations and societies to gather insights and establish a knowledge base for AMIA’s strategic planning. This included reviewing DEI-related policies and activities from 30 organizations for healthcare and health Information Technology (IT) professionals.

  3. Stakeholder Engagement: Listening sessions were organized for marginalized groups, including Black/African American, Hispanic/Latinx, Asian American and Pacific Islander communities, and Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, Asexual, and others (LGBTQIA+) communities.. Feedback from these sessions informed the Task Force’s recommendations.

  4. Data Collection and Analysis: The Task Force collected data from various sources, including a review of DEI initiatives from other professional associations. This data was mapped against AMIA’s goals and used to develop targeted recommendations.

  5. Development of DEI Framework: Using the Centers for Disease Control and Prevention (CDC) logic model, the Task Force developed a framework to support workforce diversity, exposure to informatics, and AMIA awareness.

  6. Final Presentation to the BOD: The Task Force compiled their findings, prioritized recommendations through an online survey, and presented the final DEI Major Recommendations to the BOD in May 2021.

This structured process, detailed in Figures 2 and 3, ensured that the Task Force’s work was comprehensive, data-driven, and aligned with AMIA’s strategic objectives.

Results

Major recommendations

The final DEI Major Recommendations were presented to the BOD for approval in May 2021, marking the culmination of the Task Force’s work. Since the submission of these recommendations, AMIA leadership and committees have been responsible for prioritizing the implementation and ongoing progress of these initiatives. The specific action recommendations to the AMIA BOD are listed in bold print.

Major recommendation #1—diverse AMIA recommendation: fortify existing outreach programs with broader scopes and partnerships

To reach more historically marginalized students, the Task Force recommended extending the engagement of AMIA outreach programs to high schools, community colleges, Historically Black Colleges and Universities (HBCUs), Tribal Colleges and Universities (TCUs), and Hispanic Serving Institutions (HSIs). These new partnerships would aim to attract and support a broader pipeline of students into informatics by providing education, resources, and mentoring. The Task Force also suggested participating in conferences focused on historically marginalized students in science, technology, engineering, and mathematics (STEM) fields and supporting AMIA members who represented the organization at these events. AMIA should develop outreach programs in collaboration with organizations that serve historically marginalized communities in ways that are respectful and beneficial.

Major recommendation #2—inclusive AMIA recommendation: build a multifaceted DEI communication strategy to promote, attract, and advance diversity and diverse research

AMIA leadership had the responsibility to relay information consistently and transparently regarding its DEI and health equity initiatives and actions using various mediums such as its website, emails, and publications. AMIA should present, and regularly update information on the diversity of its membership and leadership and communicate changes in governance and policies related to DEI. Their commitment to effective communication strategies promoted a DEI network spanning all educational levels, from early education to career advancement. These practices aided AMIA in achieving other DEI objectives, such as attracting, retaining, and advancing diverse members and research.

Major recommendation #3—sustainable AMIA recommendation: design a leadership training and mentorship program

The global and national response to the dual crises of police brutality and COVID-19 faced by Black and/or African American people was a call for AMIA to advance DEI. To sustain DEI efforts, leaders needed training and mentoring skills. Given AMIA’s diverse membership with varying skills, expertise, and experiences, DEI leadership and mentoring development extended across the entire membership spectrum. The AMIA BOD should require that any AMIA member in a leadership position participate in AMIA’s DEI Leadership Training and Mentoring Program to ensure they can maintain DEI efforts within their AMIA group. As a concrete outcome of this training, the Task Force recommended that each leader set yearly DEI goals and be accountable for achieving them as part of their ongoing leadership role. DEI efforts should be embedded throughout AMIA, not just within the DEI Committee. AMIA can find its leaders within its existing structure of committees, working groups, discussion forums, and projects. The AMIA BOD is at the top, while there is also 1 student-member community within AMIA that encourages student-members to take on leadership roles by managing projects and programs. Between these embodiments of experience, influence, and skill are many AMIA-supported committees and member-formed working groups and discussion forums, each with its own leaders. The AMIA BOD should recruit and select leaders from this broad range to strategically target leadership training and mentoring programs to equip its current leaders and leadership pipeline to be effective in the sustainability of DEI efforts and planned projects.

Outcomes from full charge

In addition to the major recommendations to the AMIA BOD, the Task Force achieved other significant outcomes:

  1. DEI Framework

    • Development of a DEI Framework: A comprehensive framework was developed to guide AMIA’s efforts in workforce diversity, informatics exposure, and organizational awareness. This framework includes strategies and actions to enhance recruitment and retention efforts.

  2. Environmental Scan

    • Comprehensive Environmental Scan: The Task Force conducted an environmental scan of DEI activities across 30 healthcare-related organizations, identifying common strategies and policies that informed AMIA’s DEI initiatives.

  3. Member Engagement Initiatives

    • Listening Sessions: The Task Force organized listening sessions with members from marginalized groups, gathering valuable feedback that directly shaped the DEI recommendations.

  4. Educational Resources and Training

    • Curated Educational Resources: A list of recommended DEI-related readings and tools was created and made available to AMIA members through the AMIA Connect platform.

  5. Governance and Policy Recommendations

    • Changes to the Nomination Process: Recommendations were made to enhance diversity and inclusion in the nomination and selection process across all AMIA leadership positions and organizational structures.

    • Bylaw Revisions: Proposed changes to AMIA’s bylaws to ensure diverse representation within the BOD and other leadership roles.

  6. Strategic and Tactical Actions

    • Free Access to Virtual Symposium: Implemented a program offering free access to the 2020 AMIA Virtual Annual Symposium for individuals from backgrounds not well represented within AMIA, expanding participation and engagement.

    • Standardized Data Collection: Improved the race, ethnicity, and gender data collection process within AMIA’s membership profiles, enabling better tracking of diversity and language that better represented membership identities.

  7. Proposals for Long-Term Structural Change

    • Establishment of a Permanent DEI Committee: Recommended the creation of a standing DEI Committee within AMIA to provide ongoing guidance and support for DEI initiatives.

    • Integration of DEI into Strategic Planning: Advocated for the inclusion of DEI considerations in all aspects of AMIA’s strategic planning processes to ensure long-term sustainability.

  8. DEI content and health equity presence at AMIA events

    • Development of DEI Content at AMIA Events: The Task Force successfully established a presence for DEI-focused content at key AMIA events, including the Annual Symposium, Informatics Summit, and Clinical Informatics Conference. Some of these events have received AMIA Symposium corporate partner sponsorship for member gatherings, panels, and dedicated sessions that highlighted the importance of DEI within informatics.

    • Promotion of Health Equity through Informatics: The Task Force also emphasized the role of informatics in promoting health equity. This was reflected in the content presented at AMIA meetings, which focused on systemic racism, health inequities, and the application of informatics to address these critical issues. By integrating DEI and health equity content into AMIA’s major events, the Task Force positioned AMIA as a thought leader in these areas, driving the conversation forward within the informatics community.

Discussion

The collaborative, multi-experiential, and multi-background Task Force developed a comprehensive approach to enhance DEI within AMIA and the broader informatics field. Our approach describes how a professional society can organize its members and leadership to address systemic inequalities in the wake of national racial crises and recommend actionable and measurable benefits. By implementing the Task Force’s recommendations, AMIA can achieve several key objectives: (1) broaden its outreach to historically marginalized groups often excluded from informatics, (2) diversify the research agenda to incorporate a wider array of perspectives, (3) increase representation within the informatics workforce, and (4) position AMIA as a leader in DEI within both the informatics field and other professional societies. Furthermore, the insights and implications drawn from AMIA’s DEI efforts are valuable not only to AMIA but also other organizations striving to enhance their own DEI initiatives. The potential consequences of failing to act on DEI recommendations are particularly pressing in the current climate in which anti-DEI movements threaten to undermine progress. Organizations that neglect these initiatives risk perpetuating systemic racism, losing critical talent, and missing out on the innovation that comes from a diverse and inclusive environment. The ongoing pushback against DEI efforts through legislative and policy changes such as Texas Senate Bill 17 (June 2023),1 Florida Senate Bill 266 (July 2023),2 and the University of North Carolina System Board of Governors repeal of their DEI policy for its 17 institutions (May 2024)3 has already had harmful effects in academia. Faculty members at institutions such as UNC-Chapel Hill, where these policies have been revoked, have expressed concerns about being excluded from key information, signaling a growing sense of exclusion and uncertainty that extends beyond marginalized faculty.4 A recent study found that 46% of Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+) faculty surveyed were living in states that had passed anti-DEI legislation or policies related to higher education. Additionally, 74% of the LGBTQ+ faculty felt that the current environment had negativelyimpacted their mental health and 48% had explored relocating to another state.5 The destabilizing effect of these laws on higher education institutions and the broader academic community not only hampers the well-being of faculty but also threatens the future of inclusive education and research.6,7 In this context, it is more important than ever for AMIA to remain steadfast in its DEI commitment. By doing so, AMIA not only strengthens its own community but also sets a powerful example for other professional organizations on the importance of resilience and dedication to equity during times of social and political adversity.

The Task Force’s recommendations emphasize that only through perspectives inclusive of and driven by marginalized communities can sustainable solutions for health equity be initiated and developed within biomedical informatics. The integration of DEI across all levels of AMIA, from leadership to membership engagement, is essential for creating a robust and equitable informatics field. While AMIA has made significant progress in its DEI journey, there remains a critical need to address intersectional inequalities in the field to produce high-quality informatics science, with equitable participation.8 Despite challenges, it is imperative for organizations like AMIA to remain resilient and committed to DEI, ensuring that the momentum gained is not lost but rather leveraged to foster long-term structural change.9

Conclusion

The Task Force strongly urged the AMIA BOD to maintain an unwavering commitment to DEI initiatives. Delaying or neglecting this commitment risks exacerbating the existing disparities perpetuated by structural racism but also allowing informatics research and technologies to perpetuate systemic oppression. This could lead to biased algorithms, inequitable healthcare innovations, and the reinforcement of health disparities, ultimately undermining the goal of equitable healthcare for all.

AMIA has a pivotal opportunity to lead the way in diversifying the informatics workforce and ensuring inclusivity across all levels of the profession. For AMIA to effectively serve the diverse users of the healthcare system, its leadership and membership must be representative of this diversity. To achieve this, a sustained pathway is needed to attract, develop, and retain diverse leaders and members, ensuring ongoing progress in DEI efforts. Failure to do so may not only result in the loss of invaluable talent, expertise, and resources to other professional organizations actively investing in DEI but also perpetuate systemic inequities within informatics research and technology. This would compound the very health disparities DEI efforts we aim to resolve.

It is essential for AMIA and its members to recognize that a diverse society necessitates a more inclusive research agenda in biomedical informatics research and healthcare. Without the adoption of DEI principles and equity-centered models of scholarship, the potential impact and innovation that AMIA can contribute to healthcare will be significantly diminished. The Task Force’s recommendations are not just reactive measures but proactive strategies designed to position AMIA as a leader within and beyond the informatics field. By leveraging the diverse knowledge, experience, and expertise of its members, AMIA can drive equity-centered, informatics-driven initiatives that lead to a more equitable healthcare ecosystem and more equitable health outcomes.

Acknowledgments

The DEI Committee would like to acknowledge and gratefully thank the Task Force Steering Committee Members and Task Force Member Volunteers who gave generously of their time to support the activities for this paper. Task Force Members: Casey Overby Taylor; Clair Kronk; David Butler; Harriett Burns; Hongfang Liu; Hope G. Gray; Jennifer Eaton; Jyotishman Pathak; Karen Wang; Kenrick D. Cato; Kevin Wiley, Jr; Leyla Warsame; Marcy Antonio; Martin C. Were; Mina Ostovari; Paul Fu, Jr; Rakhal M. Reddy; Rebecca L. Rivera; Rosemary Ventura; Shilpa Patel-Teague; Suzanne Bakken; Vignesh Subbian; Wanda Pratt; and William Brown.

We also want to acknowledge the AMIA BOD for their approval of the DEI Task Force as a permanent DEI Committee on June 1, 2021, and the AMIA staff for their unwavering support. Last but not least, we are most appreciative to the AMIA membership for their willingness to embark on this transformative journey with the organization; to be curious, reflective, and proactive as we seek to continue leading in the field of informatics.

Furthermore, we extend our gratitude to all those who have contributed to the discussions and provided valuable insights that have shaped the direction and outcomes of our work. Their commitment to DEI has been instrumental in our progress.

Finally, we dedicate this paper to all those who strive for a more equitable and inclusive world. Your efforts are not unnoticed and are making a difference in the lives of many. Together, we continue the journey toward a more diverse, equitable, and inclusive AMIA.

Contributor Information

Tiffani J Bright, Department of Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, CA 90069, United States.

Oliver J Bear Don’t Walk IV, Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA 98195, United States.

Carl Erwin Johnson, Merck & Co., Inc., Merck Research Laboratories, Rahway, NJ 07065, United States.

Carolyn Petersen, Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN 55905, United States.

Patricia C Dykes, Center for Patient Safety, Research, and Practice, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, United States.

Krista G Martin, American Medical Informatics Association, Washington, DC 20011, United States.

Kevin B Johnson, Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, United States.

Lois Walters-Threat, Division of Professional Programs, Health Information Technology, University of Maryland, Baltimore County, Baltimore, MD 21250, United States.

Catherine K Craven, Department of Biomedical Informatics, Biostatistics, and Medical Epidemiology, School of Medicine, University of Missouri, MO 65201, United States.

Robert J Lucero, School of Nursing, University of California, Los Angeles, CA 90095, United States; College of Nursing, University of Florida, Gainesville, FL 32603, United States.

Gretchen P Jackson, Intuitive Surgical (Digital), Sunnyvale, CA 94086, United States; Department of Surgery, Vanderbilt University Medical Center, Nashville, TN 37064, United States; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37204, United States; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN 37203, United States.

Rubina F Rizvi, Division of Computational Health Sciences, Department of Surgery, University of Minnesota, MN 55455, United States; Center for Learning Health Systems, University of Minnesota, MN 55455, United States.

Author contributions

Tiffani J. Bright led the DEI Task Force, conducted the primary analysis, and took the lead in writing the manuscript. Patricia C. Dykes and Krista G. Martin, as Task Force members, provided valuable input during the project’s conceptualization and the development of the Task Force, and they also contributed to the review and editing of the manuscript. Oliver J. Bear Don’t Walk IV chaired a Task Force subcommittee, developed the DEI framework, and provided feedback on multiple drafts. Carl Erwin Johnson and Kevin B. Johnson led Task Force subcommittees, contributed critical feedback, shaped the research design and analysis, and provided feedback on the manuscript. Carolyn Petersen was a Task Force member, offering valuable feedback and contributing to the research design, analysis, and manuscript development. Lois Walters-Threat, a Task Force volunteer, contributed to the DEI framework and provided feedback on subsequent drafts. Catherine K. Craven, a Task Force volunteer, assisted with reviewing and editing the manuscript. Gretchen P. Jackson and Robert J. Lucero reviewed and edited the manuscript. Rubina F. Rizvi chaired a Task Force subcommittee, provided substantial feedback during the writing process, and played an instrumental role in refining the manuscript.

Funding

We received internal funding from the American Medical Informatics Association (AMIA) to support DEI Task Force activities. AMIA had no role in the design, data collection, analysis, or preparation.

Conflicts of interest

K.G.M. is an AMIA employee.

Data availability

The data underlying this article are available in Dryad Digital Repository, at https://doi.org/10.5061/dryad.3r2280grt.

References

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Data Availability Statement

The data underlying this article are available in Dryad Digital Repository, at https://doi.org/10.5061/dryad.3r2280grt.

Articles from Journal of the American Medical Informatics Association : JAMIA are provided here courtesy of Oxford University Press

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