Why am I here?

So I never I thought I would blog. I routinely read other people's blogs with interest but didn't think I'd have the time or inclination to blog myself. Until recently. Now I think "hey maybe I do have something to say." 

I'm a physician (Neurologist by training) who throughout the course of my career accidentally found myself working in medical informatics. I say "accidentally" because it was never planned. In medical school, I didn't know what medical informatics was. I never knew it existed. When I tell people what I do, they ask "what is that?" Then I explain as best I could. Medical Informatics (for me) is all about finding new and better ways to use information technology (hardware, software, networks) to make better medical decisions and improve people's lives. 

It's only natural for me that I wind up in this field. I've always been a frustrated "techie." As a senior at Princeton many years ago, I was one of the few who used a word processor on the university's main frame computer to write my thesis. Almost everyone else was using a typewriter. I eagerly bought a Commodore 64, and then an Amiga (who remembers that?) and spent hours in front of those screens. As a chemistry major, I learned to program in APL to digitally probe the three-dimensional structure of proteins, looking for empty spaces where water molecules could possibly hide. As a neurology resident, I wrote a program using BASIC to generate call schedules automatically, taking into account individual residents' desire for vacation days or other time off. I became a Neurologist to study how the brain, our incredibly complex biologic computer works. 

In 1983, I did my internship at Letterman Army Medical Center in San Francisco. I remember working on the Oncology ward, taking care of extremely sick cancer patients. Every day, we'd collect blood samples in the morning. Every day, at 3pm, I'd park myself outside the hematology lab waiting for the paper lab slips that would contain the complete blood counts so we could decide who needed a blood transfusion, a six pack of platelets, or who needed their chemotherapy modified. I remember thinking...there's gotta be a better way to access these results!

I also remember sleepless nights on call, where we would admit patients to the ward, and then spend hours at 2, 3, 4 in the morning flipping through pages and pages of outpatient records, (most in unintelligible handwriting) trying to decipher the important clues about a patient's medical history that might shed light on what was going on or what we needed to do. I remember thinking then, there's gotta be a better way to document a patient's medical record.
Not long ago, my elderly mother went to the emergency department at her local clinic. There they did an abdominal CT scan that came back "acute colitis." She was severely dehydrated and had a low serum sodium and was transferred to the local community hospital about a mile away. Two days later, the hospital physician still couldn't get a hold of the original CT scan. So what did he do? He ordered another one. What a waste. What if that original CT had been available over the internet? She's on medicare so you and I paid for that second, unnecessary CT scan. Here again I wonder "there's gotta be a better way."

I now work in Medical Informatics because I passionately believe that better use of information technology will transform medicine in the 21st century, and will also help make it cheaper to deliver higher quality medicine. I want to be part of that transformation. My goal with this blog is to document that journey and share my thoughts on how well I think we're doing, solely from one little perspective in cyberspace. Thanks for reading. 

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