Thursday, July 21, 2011

Preparing for the Future of IT at HMS

Every day I examine my life and think about the roles I serve.   I consider all the unresolved issues in my professional and personal life, then ponder the processes needed to address them.

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!


Michael Craige said...

Hi John,
I am doing a review of existing clinical decision support systems/expert systems (e.g., Internist-I, Mycin, Oncocin, QMR and/or Dxplain). However, I am having a hard time finding the most current information on DSS and Expert Systems currently in use. Any information/research on current performance review, on their applications and use (clinical, research, training) is of utmost importance. Please send me any source (links, papers, web...etc) you have.

Michael Craige

Medical Quack said...

Best of luck and thanks for posting and keeping us updated, and please keep this blog going even if you decide to change the name:)

What you are saying there as far as time, having a life and the growing Health IT concerns today is so very relevant. It does take a lot of time and planning as our systems become more complex today and extensive with what we can do too.

I understand completely to where you do have to be able to have at least a "postage stamp" side of a personal life too. I say that because it seems that's about the best I am doing these days myself and should probably look into a better fix myself to at least a grow to a couple postage stamps if not more:)

With all the mergers and acquisitions occurring today and combining and working with new and different data sets all the time, it takes time to plan for a good end result and I get that completely and it overwhelms what one human can handle at times as you always say it's teamwork and collaborating today and one person can't consistently be spread too thin. I'm always amazed at the number of topics where you contribute and post, and more so on all the committees where you serve.

Perhaps the new person selected to fill your shoes will also decide to blog and share the wealth too. I can always count on information here that is credible with "hands on" and real life experiences, which is getting harder to find today.

Peter Charland said...

I hope you continue sharing your perspectives on healthcare IT as you transition - I've enjoyed them greatly, and also put your garden construction ideas to good use as well! All the best during these changes.

Riccardo Susigan said...

Good luck and thank you for sharing with us the reasons behind this change.

James said...

Best of luck with your transition. May the benefits and discoveries you participated in at HMS become 10 fold in your future endeavors. Thanks for being a guiding light and an example of transparency.

GreenLeaves said...

I look forward to your writings on running a hospital IT and continuing to develop much needed standards for HIT.

That and family would be more than enough to fill my plate. I'm sure there will be much to share from your perspective.

Martin Kappeyne

annamarie said...

All the best in your emerging adventures. What Harvard may be losing in your CIO role, the rest of us hopefully stand to gain with your continued efforts in federal Health IT standards and adoption. Thanks for all you do! Annamarie

Tom Mariner said...

John, just reading your listing of current vocations leaves one breathless and wondering how your time machine managed to stretch the 24 hours normal mortals are allotted. Your decision to excise CIO seems logical, but not a lot of fun for those you serve.

Being a medical device exec with an innovative head, your futures statement certainly says that your community / state / nation (and bigger) will get more use out of you as we accelerate into the use of exchanged bits to keep us healthy. I know through HITSP that your leadship helped us get the HiTech part of HR1 / 111'th, and that term stolen from there "meaningful use" will take some defending and "agile" changing. I'm dying to hear what you think is next. I know that HIE and other means of helping our medical professionals keep us alive is a huge part of that and you seem to concentrating in that direction.

And yes, please, if the Single Malt episode doesn't sour you on the deal, keep the "Life as ..." blog. Whenever folks ask me about IT in healthcare, I give them the 60 second tour of personal opinion, then say: "If you really want to know, there's this blog ..." Required reading.

I'm staying tuned to see if I can be dissuaded from my belief that my Long Island and New York State are the best place for healthcare technology. Your position in national healthcare exchange may help convince me.

Ellie said...

John: As a medical librarian, I've been sharing your blog entries and insights with my colleagues. Your comments keep us informed about medical IT issues. I, too, hope you keep posting to your blog. Best of luck to you in your next adventure. Ellie Bushhousen

Girish Pathria said...


Best wishes. Thanks for sharing your health care IT insights through this blog. Whenever I confront a new challenge, I recall your statement on using process to resolve it.

Girish Pathria

Daniel said...

Hi John,

I read your post and it was very informative. Your insightful knowledge as a CIO inspired me to work very hard to become a CIO of an healthcare organizaiton.

Daniel Addison