Profiles

In 1987 as a Brown University undergraduate concentrating in cognitive science, I undertook an elective honors thesis in artificial intelligence entitled, “Character Recognition using Neural Networks, Polar Coordinates, and Line Orientation”. This included designing, authoring, testing, and refining computer software that successfully interacted with a digital input tablet, to recognize handwritten letters and transform them into structured text. Since then, my research has included additional work pertaining to artificial intelligence in healthcare. Two studies examined the role of natural language processing in understanding clinical conditions that are difficult to identify in medical records without such techniques: hypoglycemia, and chronic cough.

Today, my clinical and health systems research focuses on measuring and improving the quality, coordination, safety, and delivery of health services. I study the effects of health information and information technology on clinicians' practices and patients' outcomes. I have conducted studies of specialty referral, telehealth, telecommunication to improve health care, and care for adult autism. I published the first U.S. report of secure, Internet-based, mobile videoconferencing for assessing acute medical problems in a nursing facility; and one of the first comparisons of quality indicators between medical records and Medicare claims data. My study methods have included cohort studies, clinical trials, surveys, interviews, direct observation, and focus groups. Current research includes the development, implementation, and study of information systems to promote clinical handoffs, management of medications, patient-centered care, health information exchange, clinical decision support, and telecommunication in health care. I co-led the project, “Coordinating hub to promote research optimizing Veteran-centric EHR” (SDR 20-197), funded by the U.S. Department of Veterans Affairs. This nationwide initiative supported, promoted, and enhanced health systems research related to the modernization of the VA’s electronic health record; delivered timely and actionable research findings to decision-makers to improve implementation of the electronic health record; and conducted pilot projects on this topic. I was the lead guest editor for a special Journal of General Internal Medicine supplement that published, in October 2023, 18 articles about electronic health record transitions. My research has included investigation of continuous glucose monitoring, including attention to statistical modeling, usability, clinical decision support, and outcomes. I led a report about accuracy, thoroughness, and quality of medical documentation--critical areas for artificial intelligence.

I have provided primary care to older Veterans since 2010. I led the VA Health Services Research & Development Center for Health Information and Communication from 2013 to 2023. I continue to serve as a scientist, advisor, and mentor. I have mentored more than 30 trainees, fellows, and faculty, several of whom have succeeded with career development awards and became faculty-level scientists.