Current affiliation: Department of Biomedical Informatics, Vanderbilt University
Education: BS, Dickinson College, Pennsylvania; MS, Stanford University, MD, Johns Hopkins University School of Medicine
How I describe my work to those outside the field …
My particular area of interest has been thinking about medication management and ways that we can improve the safety of medication delivery in our patients, especially in children.
Years of experience …
About 25 years.
Why Informatics? ...
Since the first time I thought about being a physician, I was aware of the challenge physicians had managing all the information they needed to do a good job. I was lucky enough to run across a professor when I was in college who gave us a chance to do independent study and I chose to think about information management in medicine. I had learned about a couple of very interesting artificial intelligence projects and then was able to meet up with somebody doing research in this field when I first got to Hopkins as a medical student. I really caught the bug then and decided that this was going to be a part of my career, regardless of my clinical specialty.
What are your ambitions? At the end of your career, what do you hope to have accomplished?
I think it’s going to be very important for our field to have a new generation of leaders who are going to be able to continue to evolve health care using information technology and using decision making, now that people realize that that’s important. So I think that the legacy I’m anticipating is to have influenced a large group of people who are going to continue to transform health care.
In terms of my own research, I’ve been really fortunate to be a part of some of the policy making and the recommendations that have led to meaningful use and I’m pretty excited about that particular legacy. I imagine that the other thing that I’m going to continue to work on is getting patients involved in their own health care and health decision making, especially with regard to medication management, but also in general, just giving patients an opportunity to practice safe care delivery in the home.
Who or what are your key sources in the informatics field?
Clearly AMIA is my medical informatics professional home. And its members, its philosophy and its meetings are all a source of inspiration for me. They help to channel ideas that I have and help translate those into something that’s more than just a dream. For that reason, I would say that AMIA is my number one source of inspiration and colleagues.
I would also say that since I’ve been here, Vanderbilt has been a terrific source of information for me professionally as well as personally. I’ve had a chance to work with faculty from a bunch of different departments and to hear about information management challenges in disciplines outside of healthcare that can apply very much to the same issues we have in healthcare.
My mentor in life is a guy named Dr. Richard (Dick) Johannes. Dick is a gastroenterologist, a really close friend, and a person I talk with about anything that I think needs to have validation. Dick has been there to help me with every key inflection point in my career since the 80s.
Articles that spotlight my research interests …
There’s an article that I wrote in Pediatrics, called Discharging Patients with Prescriptions Instead of Medications.1 The reason I refer to this article is because it was one of the first projects that I was involved with that pointed to that juxtaposition between what we as clinicians think we are doing to help our patients and what actually happens after we’re done.
The other paper that I would spotlight was a very big study that we did about using a computer program called Clic Tate, which was a documentation system that was in use at Hopkins in pediatrics for at least 10 years. That particular paper is also in Pediatrics. It’s a paper that describes the parent physician computer interaction and how the computer impacts that interaction. It was a complex study that we did using audio and video and the goal was to refute the concern that computers were somehow going to be to the detriment of the patient encounter. It is called Computer Based Documentation: Effect on Parent Provider Communication During Pediatric Health Maintenance Encounters.2
This was a difficult study to do. It took us years to analyze all of the results to understand what they meant in a way that we could publish them and be comfortable with the paper. It taught me a lot about how to work with a team, how to do larger projects, what some of the challenges associated with data management are, so I spotlight that because personally it helped me to become a stronger researcher. And it actually helped me in the last 5 years to do a few projects that were much harder and to do them much more easily.
AMIA is important to me because …
It is the epicenter of my professional life, and it has provided me with a source of colleagues who have become friends, ideas that have turned into projects, and leadership opportunities that have turned into leadership skills.
I am involved with AMIA …
Right now, I’m on the executive committee for ACMI (The American College of Medical Informatics), and I’ve been working very closely with our new president on a new iHealth conference. I’ve just completed being on the Board, running the Meetings Committee, and participating on a task force to look at our meetings. I was the Program Chair for the spring meeting a couple of years ago, and I’m enjoying a little break while I take on my new role of Chair of Biomedical Informatics here at Vanderbilt.
It may surprise people to know …
That I have become progressively lower tech as I’ve gotten older. I started out my career with speech recognition technology and was very involved with the development of the Apple Newton and the Palm PDA, and over the last 10 years have been thinking more about the processes of managing information than about the vehicle for disseminating information. While we do text messaging interventions now, I do them because the problem we are trying to solve was most easily addressed using text messaging technology.
The other surprise is that although I love to write software and have written games I rarely if ever play them. Instead, I like to do things like mess around with our home landscape, get outside and either go for long walks or ride my bike or read. I am a facebook junkie as well—dragged into that technology by my daughter!
1Discharging Patients With Prescriptions Instead of Medications: Sequelae in a Teaching Hospital
Pediatrics 1996; 97:4 481-485
2Computer-Based Documentation: Effects on Parent-Provider Communication During Pediatric Health Maintenance Encounters
Pediatrics September 2008; 122:3 590-598