I am Chief of the Division of General Medicine at Brigham and Women's Hospital, which now includes approximately 150 physicians. I am directly responsible for the research activities of this group, and oversee its teaching and clinical activities.
I am also Medical Director of Clinical and Quality Analysis for Partner's Healthcare Systems. My main responsibility in this role is to evaluate the impact of information systems across the Partners network.
Regarding education, I have been active in education of fellows, residents and medical students, as well as in CME. I have mentored many fellows personally (usually several at a time), and teach regularly in several courses at the School of Public Health. I’m also a co-Director of the Clinical Effectiveness Program, which now has more than 175 enrollees annually. I teach a course in Medical Informatics which began in 2000. Regarding residency education, I developed and continue to coordinate the Clinical Epidemiology lecture series, which has been given to primary care residents since 1990, and is now being given to all medicine residents. Together with Bill Branch, I developed the Humanistic Curriculum in 1991, and I precepted in it annually until 2000. I developed the Evidence-based Medicine series in 1995, and it has been expanded; I continue to teach in it regularly. I attend on the wards 2-4 weeks per year. Regarding medical student education, I have taught in the history/physical examination course, Patient-Doctor III, and the Ambulatory clerkship. I have served as a Primary Care Mentor since 1994. Regarding CME, I give many lectures annually around the country and overseas, and was the co-Director of the Radiology Utilization Course, and was the co-Director of the Division of General of General Medicine’s Primary Care course.
I also have a large and active research group; my main interest has been the use of computer systems to improve patient care. I have done extensive work on evaluating the incidence and preventability of adverse drug events, or injuries due to drugs. We have focused primarily on improving the systems by which drugs are given, and our group has demonstrated that computerizing medication ordering has resulted in a major decrease in serious medication errors. This work has been cited by the Health Care Financing Administration in its regulations, and in the Medicare Patient Advisory Commission’s 1999 Report to Congress, as well as by the Leapfrog Group. We have also improved the efficiency of drug use through decision support. We have also done many studies on improving efficiency and quality of laboratory and radiology testing using information systems. I have also published on predicting bacteremia and evaluation of patients with suspected sepsis.
On the national level, I served as one of two Science Advisors to the SCRIPT project which was charged with developing medication indicators. I have testified on multiple occasions to the Institute of Medicine and Congress, and serve as an advisor to the Leapfrog Group, and am the editor of the Journal of Clinical Outcomes Management.