About me

Work experience

Chief Health Information Officer, UnitedHealthcare Clinical Services, UnitedHealth Care (August 2018-present)

Provide physician input into payment innovations to address population health and value-based care

  • Developing a scalable model to monitor patients and deliver care virtually in the ambulatory, inpatient and post-acute arenas
  • Crafting provider facing decision-support using patient-reported outcomes and claims histories from similar patients as possible inputs

Vice President, Clinical Information (Inpatient Chief Medical Information Officer), Advocate Health Care, Downers Grove, Illinois (March 2013-August 2018)

Optimize the clinical information systems supporting the inpatient independent ordering provider community including chart review, order entry, documentation, decision support and transitions of care for 5000 owned and affiliated providers across eight hospitals (academic and community-based).

  • Reduced transcription costs by 50% (~$4 million) in 2015 by
    • Obtaining senior leadership support to drive physician behavior toward voice-to-text technologies including desktop speech recognition and Cerner’s mobile app use
    • Influencing site clinical informatics teams and hospital physician leadership councils to encourage providers to use voice-to-text and other technologies
    • Developed site-specific performance scorecards with physician-level detail to identify candidates who might benefit from using voice-to-text technologies
  • Developed decision support to help physicians and nurses meet publicly-reported metrics for sepsis detection and early treatment that
    • Allowed role-specific alerts to tailor diagnostic and treatment recommendations based on clinical consensus and each user’s scope of practice
    • Included a lactate reflex order to support tracking blood level changes over time without any keystrokes from an end-user
  • Targeted computerized physician order entry (CPOE) improvement tactics based on
    • Creating actionable reports at the physician level using R to process over a million orders a month
    • Engaging hospital leadership to drive improvements in hospitalist CPOE rates
    • Developing workflows for nurses to update orders without generating new phone or verbal orders for physicians to co-sign
    • Developing protocols and order sets to manage common clinical conditions

Associate Medical Director, University of California, San Diego Medical Center (December 2007-March 2013)

San Diego Beacon Collaborative (Co-Principal Investigator)

$15.3 million collaborative agreement from the Office of the National Coordinator of Health Information Technology to test approaches to improve health care across a metropolitan area using health information technology

  • Translated the clinical community’s expectations into a series of customized applications:
    • Gathered stakeholder information,
    • Helped draft request for proposals,
    • Negotiated the contracts with the vendor and the University of California, San Diego’s legal team including defining specific acceptance criteria for payment
    • Worked with project programmers and technology vendors to develop working prototypes, and
    • Validated the application with prospective end-users
  • Major contributor to helping select health information exchange vendor to interface with electronic medical records across the San Diego metropolitan area including federal health systems, private integrated delivery systems and stand-alone electronic medical record systems
  • Lead contact for establishing DIRECT (secure email) accounts to share patient health information with providers and health plans when a patient has registered to be seen in an emergency room, admitted to an inpatient facility or discharged from an inpatient facility
  • Developed the Collaborative’s privacy and security practices through deliberations with local site privacy officers with a vision that a patient’s demographic information would be the only data shared among competitors within the metropolitan area, but clinicians could query sites for patient-specific data on-demand
  • Drafted the project’s business plan to move the project from a federally funded project to an independent entity supported by multiple medical centers, health care providers and payors
  • Directed the activities of two project managers and two programmers to accommodate the project’s evolution

Ambulatory Electronic Medical Record (Epic) optimization

Led initiatives for the outpatient provider communities working with programmers, database analysts, medical center leadership and providers to achieve quality goals and safety initiatives using the electronic medical record

  • Physician lead for hospital and 222 providers to qualify for Stage 1 Meaningful Use in 2011 (approximately $10 million)
  • Leveraged the electronic medical record’s decision support technology to improve the medical group’s pay-for-performance quality scores to achieve statewide recognition for excellent performance each year for the past three years
    • Helped analytics team refine feedback reports to providers including metrics for ordered tests, resulted tests and tests within control
    • Developed nurse and provider task reminders within the context of an office visit for appropriate test ordering resulting in a 20% increase in appropriate test ordering for diabetes monitoring, breast cancer screening and immunizations
    • Formulated a strategy to have nurses reach out to patients between office visits for appropriate testing using the electronic medical record
  • Physician lead for patient portal cited by patients as one of the primary reasons they continue to receive care at the University of California San Diego Health System

Professional Activities

  • DirectTrust.org Board Member (2018-present), Board Chair (2020-present)
  • American College of Physicians Journal Club, Associate Editor (2014-2019)
  • National Baldrige Performance Excellence Program Examiner (2014-2016)

Education and Training

Presentations

2020 posts