Table 7.

Specific changes proposed to competencies (NB: competencies from second iteration of the framework)

Competency	Suggested change
2.1 (a) Demonstrates knowledge of key information technology components including hardware and software, and how they can be used in health and social care settings.	2.1 (a) Should be at the level of ‘Analysing’ rather than ‘Knowledge’ for core competencies.
5.2 (a) Demonstrates understanding of models for effective knowledge acquisition and storage, including strengths and limitations.	5.2 (a) Needs to include something on dissemination.
5.2 (b) Understands the transformation of knowledge (from generation to modelling) into clinical decision tools.	5.2 (b) Do you want to talk about computable knowledge?
4.1 (a) Applies quality improvement and process engineering to facilitate business and clinical transformation, measuring and analysing appropriate outcomes.	4.1.(a) Please emphasise that Clinical Safety covers the deployment and use of health information technology systems, not just their manufacture.
4.3 (a) Understands the organisational and human factor challenges to effective use of health information systems and technologies and can apply appropriate methods to address these and ensure maximum user engagement and widespread adoption.	4.3. (a) One bullet point for behavioural change is not really enough!
3.1 Methodologies and applications.	Domain 1 and competencies therein, need to include a global perspective as a second bullet point. 3.1 needs to mention databases, data access/storage options. The database (or other) also fundamentally affects the ability to create the analyses. Only mentioning R/Python is akin to saying you need a steering wheel to drive without mentioning the car’s engine.
2.2 Working with project stakeholders.	2.2 …I think the inclusion of human factors and user-centred design at this stage might be useful (It is referred to in the change section 4).
2.1 (d) Can identify appropriate technology to resolve healthcare problems and contribute to the development of good practice to do this.	2.1 (d) Can identify appropriate technology to resolve healthcare problems and contribute to the development of good practice to do this—what do we mean by this and particularly resolving healthcare problems?
2.4 (a) Demonstrates knowledge of the range of technology for transmitting information (eg, messaging between systems) and clinical standards (eg, standards for structuring clinical information) for information needed to support the creation of interoperable systems, and promotes their importance to drive an integrated delivery care model.	2.4 (a) ‘Clinical standards’ should read ‘clinical information standards’ as without context clinical standards could mean something different.
3.1 (a) Is able to explain the methodological concepts of basic descriptive statistics, probability, predictive modelling and artificial intelligence (AI) and know when and how to use them to solve health and social care, and clinical practice and research problems. 3.1 (b) Is able to demonstrate how data quality effects analysis, and resulting clinical and healthcare insights, and how important it is to improve to derive maximum potential from its utilisation. 3.1 (c) Understands how technologies (eg, R, Python, Github) facilitate the analysis, display of results and reproducibility of analyses.	3.1 (a–c) I would be very thoughtful about exactly how much you would expect basic, core clinical informaticians to be able to explain about methodological concepts of modelling and AI. Or indeed expect a robust understanding of R, Python, Github.