Reflections on Christmas Eve

As I sit in an old Morris chair, sipping a Lamarca Proseco and watching the glow of the Christmas tree, I'm beginning to  unwind and reflect on the tumultuous 2010 that's drawing to a close.

It was a year of thousands of pages of new Federal HIT regulations, of debate and consensus on standards, of new privacy requirements, of ever-increasing demand for increasing complex IT services, and escalating expectations for speed/reliability/efficiency in everything that we do.

It was a year of recovery from the economic doldrums of 2009, with a gradual increase in new jobs and budgets, but still a bit of uncertainty.

The stress, the pace, and global competitiveness were unsettling to many, leading to a lack of civility and patience.

Whether you think 2010 was a year of innovation, chaos, or anxiety, there is one thing we can all agree upon - 2010 was a year of incredible change.

As I tell my staff and all my colleagues, it's impossible to evaluate a year based on the events of any given day.   Don't consider your position today, consider your trajectory over the past year.

My family is all on track.   My parents are fully recovered from their November hospitalizations and are healthy and happy.   My daughter was admitted to Tufts University.  My wife is running the NK Gallery in Boston's South End and she's creating new art.   I'm balancing my home life, work life, and personal life in a way that is satisfying and invigorating.    I'll be 50 next year and I do have 3 grey hairs but otherwise I'm medication free and my body mass index is still 20.

Nationally, we've implemented regulations for content, vocabulary and security standards.   We have a consensus approach to transport standards using SMTP/SMIME through NHIN Direct.    EHR adoption is climbing steadily.   Boards throughout the country are talking about the interoperability, business intelligence, and decision support that are needed to support the healthcare future described in the Affordable Care Act/Healthcare reform.

In Massachusetts, we've agreed upon a short term and long term HIE governance model. We're procuring workgroup facilitation and a program management office to oversee our statewide "entity level" provider directory, certificate management, and standards/conformance/certification.

At Harvard Medical School, we've created one of the top 100 supercomputers in the world, deployed a petabyte of storage, automated numerous administrative, educational, and research workflows, and established governance committees for all our stakeholders.  

At BIDMC, we're on the home stretch of our community EHR rollout, our massive lab project, our major replacement of our extranet and intranet, and our disaster recovery efforts.   We've kept our infrastructure stable, reliable and secure.   We enhanced our  enterprise clinical, fiscal, administrative, digital library, and media applications in a way that kept most users satisfied.   Every compliance, regulatory, and e-discovery need was met.

In many ways, this Christmas is a milestone.   My daughter leaves for college next Summer, so we'll have an empty nest.   2010 was an especially stressful year due to ARRA funded projects, Meaningful Use, Harvard's LCME reaccreditation planning, BIDMC's Joint Commission reaccreditation, and more policy/technology change in a single year than any year before.

The details of the good and bad, the joys and sorrows, the triumphs and defeats are fading in importance because the trajectory is uniformly good.

Based on my definition of the Good Life, getting the basics right and ensuring every member of your family feels good about themselves, all is calm, all is bright.

So hug your family members, pat yourself on the back, and toast with your favorite beverage.   2010 has been a year of great change, but we did all we needed to do and the world is a better place because of it.

May 2011 be a year of satisfying work, a little less anxiety, and a boost to your own sense of self worth.

Cheers!