Assistant Professor, Acute and Chronic Care, The Johns Hopkins University School of Nursing, Baltimore, MD, USA



I did not begin my career as an informatician.  In fact, informatics as a specialty did not exist at that point in time – desk top computing in the workplace rarely existed then.  I was not a nurse but a field epidemiologist in the 1970’s and was responsible for Vital Statistics Maternal Child Health data.  Everything was batch processed then and went from mailed in paper forms, to key punch operators, to main frame processes, and then to the statisticians who manually calculated rates. By the time we knew we had a public health issue, it was long over.  I was asked to project manage the development of the first electronic birth and death certificates for the United States in the State of Maryland.  I was young, energetic, and naïve regarding computer science, but I natively understood the power of information.  I had to take myself back to class post Masters to learn this new science and then determine how we were going to collect the required data, develop databases for the hospitals and other care settings, and then transfer that data to the State Health Department for analysis.  We had to do this all prior to standards, interoperability, and modems.  We did it, however, and I saw the efficiencies, workflow redesign, and patient/provider impacts this unleashed.  I then was asked to oversee the development of a connected information system for the local health departments which would serves the providers and clients of the Supplemental Food Program for Women, Infants, and Children (WIC).  This program needed to store client centered demographic and nutrition information, provide some rudimentary decision support in terms of food and diet, and then produce the customized food vouchers for clients to take to the grocery stores.  I led this development and deployment in the early 80’s. I was then asked to oversee the development of community-based data collection and information development systems for jurisdictions serving at risk youth and the Birth Defects Reporting System for Maryland.  These were foundational systems for the rest of the nation.

At this point, I had become a second degree nurse.  I had experienced the power of patient care.  I wanted to take my skill set into the acute care setting and merge my two interests.  In the early 1990’s, I became an analyst, a project leader, then ultimately a manager overseeing the development and deployment of Electronic Health Records, Nutrition, Order Entry, Operating Room Management, Anesthesia, Nursing Documentation, and Scheduling Systems.

Currently, I am a consultant and faculty member.  I have a keen interest in HIT policy and evaluation.  I still maintain grounding with operations through the many interesting doctoral and masters projects that my students undertake.  I also participate in and lead policy boards, think tanks, and interest groups that impact health information technology and the point of care and beyond.

My career has been always fascinating and has allowed me to understand the importance of the interdisciplinary team.