Overcoming barriers to the adoption and implementation of predictive modeling and machine learning in clinical care: what can we learn from US academic medical centers?

I currently serve as the Chief Health Information Officer for Duke Medicine. I also practice primary care internal medicine at the Durham Medical Center as part of Duke Primary Care. In my capacity as CHIO, I am responsible for the visioning and strategic planning of clinical and analytic information systems that impact patient care, research and education.  I work with the Duke Medicine leadership to ensure technology solutions are well aligned with our overall organizational objectives. I oversee the optimization of the Maestro Care (Epic) electronic health record, and partner with physicians, patients and operational leaders to effectively leverage innovative IT in support of the Duke mission.  I also have a keen interest in IT innovation, and work with investigators across Duke to pursue new and innovative ways to efficiently deliver high quality care to our patients.

My research interests have revolved around the use of health information technology to improve the quality of care and patient safety in both the ambulatory and hospital settings.  My work in the ambulatory setting has focused on the efficient delivery of decision support to clinicians to prevent errors of omission and commission during diagnostic test ordering and review of test results. I have also worked to use information technology, including secure on-line patient portals, to improve the communication between clinicians and patients around health maintenance and the follow-up of abnormal test results.  In the inpatient setting, I have conducted several studies to delineate the barriers to and facilitators of the wide-spread diffusion of computerized physician order entry and have led many studies evaluating the safety, financial and socio-technical impact of barcode technology in the hospital pharmacy and nursing units.