Every year since the inception of this blog, my last posting of the year has been a reflection looking back over the year that is ending. This year’s reflection marks the completion of eight years of this blog, and writing this year’s posting feels different. This is no doubt because this blog has been very much tied into the key events of informatics over the last decade, in particular the Health Information Technology for Economic and Clinical Health (HITECH) Act and other actions emanating from the Presidency of Barack Obama. This has been a period of activist government with respect to our field, and now the US electorate (at least according to the rules of the Electoral College) has chosen a different path going forward.
Fortunately, the need for informatics is not going away. Even if the Affordable Care Act is repealed, the underlying problems in healthcare that led to its passage are still a challenge. Healthcare in the US is still the most fragmented, expensive, and inefficient of any country in the world. This does not mean I would want to get seriously ill anywhere else in the world, but I still believe there is also an ethical imperative to provide basic healthcare to all citizens in the least costly manner. Medicine is supposed to be a calling for physicians, and not just a job. Although I no longer care for patients directly, I view my work as a physician-informatician to support the delivery of more universal and efficient care by supporting the data, information, and knowledge needs of healthcare delivery and patients.
Informatics also supports other aspects of health that will also continue to be important even if reform of the US healthcare delivery system takes different directions. Informatics should support the health of the population through public health. It can support expansion of our knowledge and best practices by enhancing basic, clinical, and translational research. It can extend the reach of healthcare through telehealth and telemedicine. And because the US is still a prosperous nation to whom many still look for leadership, we can share our knowledge and tools for better health and healthcare with our fellow planetary citizens around the world, especially clinical and informatics professionals.
As for the blog itself, it continues to thrive. I am always gratified when people tell me they find it a valuable source of information, especially for key topics in the application of informatics as well as for issues for people seeking to start or advance careers in the field. The number of page views continues to increase, and in this last month, the total barreled through the 400,000 mark for the (including this) 267 posts I have made over the eight years. I have no plans to change anything with my approach to the blog any time soon.
There is no question that for people who work in academia, in research, and in health IT that there is uncertainty as to the future. Nonetheless, I am grateful that I have a loving family, wonderful colleagues, and a great many other friends who bring happiness and stability to my life.