"Connecting Payers, Providers and Patients" is the title I give to many of my lectures around the world. The last decade of my life has been dedicated to the technology and policy that enables information exchange among clinical, educational and administrative stakeholders. This has given me the opportunity to teach extraordinarily diverse audiences, ranging from medical students to international policy makers. My clinical background and my multiple roles as a teacher have enabled me to implement innovative technologies in local, regional, national, and international settings.

As the CIO of CareGroup, my work has leveraged the web to exchange medical records securely among the 5 hospitals of CareGroup. Today, the clinicians of CareGroup deliver personalized care to each patient using web applications such as webOMR and Provider Order Entry. Patients use PatientSite 40,000 times a month to lookup their results and interact with their providers. Patientsite is the testbed for new personal health record innovations from Microsoft and Google. CareGroup has been recognized as national leader in healthcare IT and our innovations have been widely adopted throughout the country.

As the CIO of Harvard Medical School, my work has focused on using the web to build communities throughout the Quad and NRB via data sharing, collaborative applications, and high performance computing. We launched Mycourses in 2001 as the HMS platform for multimedia courseware, simulation, and course administration. In 2008, the Harvard Catalyst team and my IT team implemented the next generation of web applications to support the Clinical and Translational Science Awards. These systems, called Profiles and SHRINE, bring access to people, expertise, and clinical data from all HMS affiliates, ensuring that every researcher can leverage the resources of the community. We have open sourced this software and it is now widely implemented throughout the country.

As Chair of the New England Healthcare Exchange Network, my early work focused on connecting the payers and providers of the state to reduce administrative costs. Today, 100 million transactions are exchanged among 42 organizations each year. NEHEN has expanded to encompass 90% of the healthcare transactions in Massachusetts, has been extended to other states, and is the foundation of the regional data exchange efforts funded by the American Recovery and Reinvestment Act (ARRA).

As the CIO of Harvard Clinical Research, my early work focused on building a clinical trials platform that could support all the data management needs of a Harvard-wide clinical research organization. Today, HRCI is profitable and conducting numerous clinical trials on a highly reliable infrastructure.

As CEO of MA-Share, my work has focused on creating clinical gateways for secure data exchange among providers in the state. For the past 3 years, Massachusetts has been the leading e=Prescriber in the country, using the MA-Share RxGateway to connect clinicians and pharmacies electronically. MA-Share has connected the clinical systems of BIDMC, Children's, and Atrius to ensure continuity of care as patients leave the hospital or emergency department and seek follow-up with their primary care giver. In 2009, MA-Share merged with NEHEN to form a single healthcare information exchange for the state of Massachusetts.

As Chair of the Healthcare Information Technology Standards Panel, my work has focused on harmonizing the electronic data standards for personal health records, electronic health records, public health reporting, biosurveillance, and medication management. In 2008, Secretary Leavitt officially recognized HITSP Harmonized standards as required for Federal procurement. HITSP’s work served as the foundation for the data standards required in ARRA.

With a change in administration Washington, a new Federal Advisory Committee was created to guide electronic health record standards and security efforts, the HIT Standards Committee. I serve as co-Chair. The efforts of HITSP and the HIT Standards Committee became the criteria for allocating $27 Billion in ARRA stimulus incentives for healthcare IT.

2011 will be the most pivotal year for healthcare IT in the history of the US, with acceleration of electronic health records, data exchange, decision support, clinical research, and informatics innovations. I look forward to leveraging my local, regional, national, and international experiences to lead many aspects of this transformation.