Vanderbilt University Medical Center
How I describe my work to those outside the profession
In basic terms, biomedical informatics is an interdisciplinary science pursuing effective use of information in healthcare and biomedical research. For example, biomedical informatics provides methods to structure information so that a very simple system can make complex relationships clear.
My focus is on putting people, process and technology together differently to break common perceptions of what is possible. That has been a common thread of the work we are doing at Vanderbilt.
Years of experience
Forty-two years ago: In 1968, as a work study student while an undergraduate at Duke University.
I grew up on the Duke campus and was a Duke undergrad. Duke did not have computer science courses, so my introduction to algorithms was through a mathematics course. I was addicted by the fact that I could represent a solution to a problem as an algorithm with a computer – once programmed, the computer could tell me which of two solutions is best. I had never been able to test competing approaches to solve a problem, and the ability to work that way attracted me to the computer.
My father was chairman of medicine at Duke at the time. When the first minicomputer came into Duke as part of an NIH-funded myocardial infarction research unit, I joined that team as a student and Frank Starmer showed me how to work with clinical data. I then started medical school, a bit backwards, starting with the first three months of my third year the summer before my first year doing research with Ed Hammond in what we now would call a biomedical informatics lab.
What is your legacy? At the end of your career, what do you hope others remember?
During my time at Duke, I began writing programs to support tasks such as taking a medical history directly from a patient. I then learned how to separate the metadata and knowledge from the applications. In the process, I began to understand the distinction between the science of biomedical informatics and the underpinning information technology infrastructure. When I came to Vanderbilt 19 years ago, we decided to focus on linking information into workflow to help people make better decisions. We decided to develop biomedical informatics as a scholarly discipline and to allow the faculty and fellows to use the operation and decision support infrastructure of the medical center as an applied laboratory to work through the real-world approaches that it takes to be successful – I was a constant change agent.
Informatics is now in the water at Vanderbilt. Biomedical Informatics is the fifth-largest department in the school of medicine, with 68 faculty members: People will remember that we created biomedical informatics at the scale needed to change how the place does its work.
In 2009 I was appointed the chief strategy officer for the medical center. I am now facilitating a set of 10 innovation “proof-of-concept” projects that we believe can show how to provide twice the health to twice the people at half the cost. If we are able to demonstrate that we can provide systems-based care that does what we need it to do each time yet be individualized to the patient, we will be viewed as helping to change the nature of health and health care. I will be remembered for having been part of the team that figured it out.
Who or what are your “key sources” in the informatics field?
Since I have grown up with the field of biomedical informatics, I learn less from individuals within the field than from people working in the disciplines that biomedical informatics builds on.
In particular, the computer science, systems engineering, applied mathematics, cognitive science and business worlds. In 2008, I had the privilege of chairing a National Research Council committee that took a team of computer scientists into hospitals to see what was deployed and ask whether today’s technology would be adequate to provide the information foundation for the IOM’s vision of quality health care. Our report was issued two days prior to President Obama’s $50 billion commitment to health care IT; it said if we just accelerate the current approach to health care IT, we won’t fix the healthcare problem and may make it worse. In the process of the study, I learned a great deal from computer scientists and systems engineers who live outside what we think of as biomedical informatics.
Articles that spotlight my research interests:
W.W. Stead, et al. Biomedical Informatics: Changing What Physicians Need to Know and How They Learn. Academic Medicine, Vol. 86 / 2011.
W.W. Stead. Electronic health records. Information Knowledge Systems Management 8 (2009) 119–143
Stead, W.W., Hammond W.E. Computer based Medical Records: The Centerpiece of TMR. MD Computing 5(5): 48 62, 1988.
AMIA is important to me because …
AMIA is the only place where biomedical informatics is being discovered and applied. For those trying to figure out how to use computation and informatics in ways that improve health care, there is nowhere else to go but AMIA. You have to go to AMIA to understand what research is being done, to actually understand what it takes for people to get improvement and to get breakthroughs when what we do today is not adequate.
Most people confuse health care information technology and biomedical informatics – they think they are the same thing, but they are not. Information technology centers on automation and transaction processing. Biomedical informatics centers on how we present information so people can understand it, and how we use computer algorithms to create information that people can use.
I am involved with AMIA …
… and have been since its inception. I was president of one of the three associations that merged to form AMIA, and also was the founding editor of JAMIA. I also served as program chair of the 11th Annual Symposium. Today I teach tutorials and participate in panels.
For young professionals, to be able to control your destiny in the face of rapid change in health care and in information technology, you need AMIA to know what is easy and hard; where the research frontier is; where the application frontier is; and what it takes – how careers evolve – in this very interdisciplinary area. The Collen Award presentations center on this, to show people how careers evolve.
It may surprise people to know …
…that I have an Innovation Center with 17,000 net square feet of rolling white boards – we do all of our cross-disciplinary design work here. I have an addiction to laying things out where I can see how they fit together.
...that to relax I go to a completely communication-free zone, 100 acres of an old farm near Nashville on a lake where I can cook over an open wood fire, climb rocky trails, cut wood and plant trees.