Healthcare and Science thomsonreuters.com

I've been practising medicine for about 26 years. I spent the first eight years of that in private practice and doing general surgery in Georgia and Alabama.  I enjoyed that, but my desire to 'be all I can be' led to me wanting to care for the sickest of the sick. I went back and did two years of fellowship trauma and critical care because I wanted to become more of an expert in taking care of the most severely injured patients.

Around ten years ago I was just practising medicine here as a trauma surgeon and the IT department upgraded their computers systems from an older version to a more advanced product. Following the upgrade, I had a patient that came in with serious injuries from a severe car crash and I needed blood products to save this patient's life. The hospital was very busy that day and there were no ICU beds available, we were holding patients in the recovery room. For some unknown reason the patient was not correctly registered on the new computer system, and he was, quite literally, bleeding to death because I could not get any blood or blood products for him.

In this country there are very strict regulations about blood and blood products so I couldn't do anything until the patient was registered. So I implored everyone to pull together, as we had a level one trauma patient dying in front of our eyes.
Eventually, we did get the blood products, and the patient did okay, but for about 45 minutes we were pretty helpless. At that point, I raised a lot of Cain - it just seemed unbelievable that a patient almost bled to death because of a faulty computer system somewhere. We just couldn't tolerate this in a modern American hospital. Because I made so much noise, people in IT asked me, "since you are obviously passionate about this, do you want to become part of the solution?"

It was then that I took on the role of Chief Informatics Officer here. Getting the right information to the physician and to the patient is obviously critical and the biggest challenge is trying to make sure that we can co-ordinate healthcare for every patient. Today, 85% of healthcare in this country is delivered outside the four walls of the hospital, yet we don't have very robust information systems out there. Right now less that 20% of physicians offices in the USA have computers.

Because of lack of standards and because physicians are busy doing what they do best - practising medicine - very few of them get involved with medical informatics.

We often have to make life threatening decisions based on a limited data set. We have to work with what we have got. The patient may be on blood thinners, but unless they are awake and alert, for the first 10 to 15 minutes we won't know that. Unfortunately, a lot of my patients come in on breathing machines, and they cannot talk.

Luckily technology has improved, and hopefully I have been able to make an impact here. Today, we have a much more robust system in the hospital, something called the Physicians Portal, which takes a complete look at any inpatients. We also have a mobile product called Clinical Xpert Navigator from Thomson Reuters, that also helps us to care for patients on the fly by having information directly at our fingertips. So I can go to any desk computer and find the information, or if I'm in between patients in the ICU, I can use my portable device and I am able to look at the information there and then. I can then hopefully make an informed decision.

My goal is for healthcare to be integrated in the same way as the ATM card. I would like the kind of standardization where it should not matter where you go, your treating physician will still have the full picture.

One thing that makes Clinical Xpert Navigator so good is that it is a very simple interface, and it works very well, speeding up the workflow rather than slowing it down.