I think about the next week, the next month, and the next year. Hopefully, I'll be able to skate where the puck will be.
As I approach 50, I've become particularly introspective about the challenges in healthcare and medicine that lay ahead.
I believe that Accountable Care Organizations, Patient Centered Medical Homes, and the Partnership for Patients/CMS Center for Innovation will create exponential growth in healthcare IT requirements.
My senior leadership at BIDMC knows that we'll need novel approaches to healthcare information exchange for care coordination and population health management. They know we'll need new analytics which include cost, quality, and outcomes. They want new tools to make these analytics available to every stakeholder, both outside and inside the EHR.
Furthermore, state infrastructure to support "push" and "pull" data exchanges will need to be built. The need for Federal standards and policies will accelerate.
At the same time, the science of medicine at Harvard Medical School (HMS) is becoming more computationally intensive.
The next generation of whole genome analysis requires tools like BFAST that require new approaches to processing and storage infrastructure.
Image analysis also requires new tools such as OMERO for visualization, management and analysis of biological microscope images.
These and other research tools need to run on petabytes of data maintained on high performance storage, backed by thousands of processors, numerous specialized graphics processing units and high speed infiniband connections.
How does this relate to me?
As the CIO of hospitals, the innovation required to support healthcare reform will require increasing amounts of my time.
As the part time (50%) CIO of Harvard Medical School, the tools and technology required to support new scientific approaches will require increasing amounts of my time.
How do I ensure the exponentially increasing needs of the customers I serve are best met?
The answer requires a tough decision.
I believe that Harvard Medical School requires a full time dedicated CIO with a skill set in highly scalable infrastructure and the tools needed to support emerging science.
Thus, I think it best that I pass the baton at HMS to a new IT leader. I will continue to serve the Dean of HMS as an advisor on strategic projects, especially those which require cross-affiliate and clinical coordination. In collaboration with the IT stakeholders of HMS, I will work to find my replacement.
Once my successor is found, I will take on additional challenges implementing the next stages of meaningful use, healthcare reform, and new healthcare information exchange initiatives at BIDMC, in Massachusetts, and Nationwide.
Wish me luck!