My research focuses on the interface of education and information technology to improve the care that physicians deliver and to facilitate the health care system’s engagement of individuals in their own care. This research has centered on evaluation of problems in the quality and safety of primary care, particularly in the domains of medication use and laboratory testing, with an emphasis on the clinical topics of diabetes and cardiovascular conditions, especially in the elderly. I have active research programs in computerized decision support to improve clinicians’ diagnosis and treatment of common conditions in primary care, including the monitoring of medications, management of hypertension and hyperlipidemia, and diagnosis of pediatric obesity. Over the past five years, I have expanded my investigations to include “patient-facing” e-Health, ranging from automated telephone outreach interventions that use interactive voice recognition to web-based portals and personal health records that can engage patients in their care, remind them and educate them about recommended screening and treatment, and facilitate their transitions between primary care and other settings. These current research programs build on a strong foundation of work as a principal investigator or co-investigator on multiple collaborative studies that have enabled me to develop expertise in the design, implementation, and evaluation of interventions using technology and education to improve and transform the delivery of primary care.
My educational activities have evolved considerably over the past several years. I spent the first decade of my faculty career emphasizing undergraduate (medical student) education. I had the privilege of leading Clinical Epidemiology, the required course for first-year Harvard medical students, and participating in curricular reform efforts. More recently, my educational activities have emphasized hands-on research mentorship of medical students, residents, fellows, and faculty members. Moreover, in my transition to VA Boston, I have had the fortunate opportunity to teach residents in the primary care setting as well as on the inpatient service. As Chief of the Section of General Internal Medicine at VA Boston, I have been gratified by the opportunities to provide career guidance to a wide range clinician-investigators, clinician-investigators, and full-time primary care clinicians. I recognize that the growth and success of the GIM Section at VA Boston will hinge on the cultivation of the considerable talent and energy of existing primary care staff as well as the nurturing of students and trainees. The expansion and development of the GIM Section involves not only the recruitment and retention of outstanding faculty members but also the fostering of collaborative relationships with research and clinical partners within and beyond VA Boston.
My practice of primary care general internal medicine gives me the opportunity to continue the fulfillment of caring for patients with complex medical and psychosocial problems. My clinical work, which comprises about 20% of my actual time, is a natural linkage to my research with their mutual goals of improving the delivery of primary care in addition to the health of populations. Serving as inpatient attending at the West Roxbury VA affords me the opportunity to care for patients with complex and acute medical problems and to teach medical students and housestaff in this high-intensity setting.