As longtime readers of this blog know, I always end each year with an annual reflection on the year past. I did this in the first year of the blog of 2009, and have done it every year since.
The life of this blog has seen a remarkable transformation of the biomedical and health informatics field, especially for those of us who had been working in it for a long time. In my case, I entered the field in 1987 when I started my NLM postdoctoral fellowship at Brigham & Women’s Hospital in Boston, MA. After spending three years in Boston, I arrived at Oregon Health & Science University (OHSU) as a newly minted Assistant Professor. I have climbed the ranks to full Professor and am the inaugural (and still only ever) Chair of the School of Medicine’s Department of Medical Informatics & Clinical Epidemiology.
During my career, I have witnessed a great deal of other change and growth in information technology. I witnessed the birth of the World Wide Web in the early 1990s (with skepticism it could really work since the bandwidth of the Internet was so slow back then). I was doing information retrieval (search) before the emergence of Google (why didn’t I come up with the idea of ranking Web page output by number of links to each page?). And I watched the rest of healthcare, especially the policy folks, “discover” the potential benefits of the electronic health record (EHR).
It could be argued that EHRs were not quite ready for prime time when new President Barack Obama unveiled the Health Information Technology for Clinical & Economic Health (HITECH) Act, with the American Recovery & Reinvestment Act (ARRA). HITECH can certainly be criticized in hindsight that the “meaningful use” program had too much emphasis on process measures and not enough on information exchange or standards and interoperability. But, as those of us glass-half-full types would note, we do have a wired healthcare system now, and the next challenge is to meet the needs of patients and their providers.
I always remember students who asked, in the early days of HITECH, whether there would be jobs once we were “done” implementing. Of course, not only is implementation of large and complex software systems never truly “done,” there is so much more to do to obtain value.
As for me personally, I still remain gratified by my career choice at the intersection of medicine and computers. My interactions with my colleagues and my students, helping and mentoring them in different ways, gives me that nice human touch that I abandoned through making the decision in 2001 to stop seeing patients.
My department at OHSU continues to thrive under my leadership and, more importantly, the dedication of faculty, staff, and students. Our research programs are still being impactful and well-funded, and the enrollment in our various educational programs remains strong.
My family also adds a critical dimension to my life, with the academic and career successes of my wife and two daughters as gratifying as my own. I did suffer a couple unfortunate losses this year, with the passing of both my mother and father. Fortunately both lived long relatively healthy lives, although my mother’s last years were compromised by dementia. I do miss them both, and am sad that they will not see the rest of my family and I going forward in life.
And of course this blog is doing well. Last year I touted reaching 400,000 page views. This past month I barreled through the half-million page views milestone, and was able to make the 500,000th view myself, as seen in the picture below.
There are still challenges ahead, both for myself and the field. But this year, and likely next year, I receive comfort not only from family, friends, and colleagues, but also the satisfaction of my work.