How long have you worked at IMO, what is your role, and what does it entail?
I started to work with IMO toward the end of 2013 as a consultant. I came to IMO from McKesson, where I was a VP of Medical Affairs. While at McKesson, I had hired Dr. David Trace into my physician group. Dr. Trace (along with Frank Naeymi-Rad) founded IMO. So when I left McKesson, Dave asked me to come work for IMO. My current role is that of Physician Informaticist, reporting to Dr. Steve Rube. In general, our group serves as the clinical liaison between what we create at IMO and how we iterate that into the clinical world. In particular, I am most closely associated with what Frank labeled our “Intelligent Problem List” or IPL. Once a stand-alone product, IPL is now part of our overall problem list management solution within IMO Core. It’s used to organize our terminology so that the information contained within the medical problem list is easily processed by clinicians into an effective clinical picture.
How does your job at IMO add value to our clients?
IMO’s problem terminology library gives a clinician about a million text strings, or “problem descriptions,” so that they can accurately enter exactly what they want to say into the EHR. In the modern healthcare world, multiple clinicians within multiple care settings all contribute to a single patient’s list of problems. This can make it very difficult to take care of a patient because the aggregated list is not organized in such a way that a clinician can easily focus on an immediate problem, or put the immediate problem into context within the overall set of conditions. IMO clients have given us feedback that, although having many terms is critically important, it is equally important to have those terms visually displayed in such a way that a clinician can process the information. I often use the analogy of an airplane cockpit. Thousands of points of data are available, but that information needs to be structured for presentation so that a pilot can immediately focus on a particular issue but still be able to get an overall sense of the situation at hand.
The complexity of solving this problem has given me access and interaction with some of the most brilliant minds at IMO.
How has working at IMO changed your perspective as a patient, an employee, a manager, or otherwise?
I came to IMO with a very broad background — a 25-year clinical career; a couple of board certifications; and multiple positions within leadership at both a large healthcare organization and at McKesson. Now at IMO I get to work with the foundational building blocks of terminology that underpin all those higher-level entities. I have learned that focusing on detail is far more interesting than I ever thought it would be, and that creating a product from scratch is incredibly rewarding as long as you have a tough enough skin to weather the vicissitudes of going from concept to marketable solution.
What has been your favorite project to work on at IMO, and why?
IPL (as mentioned above) is my baby. It tries to solve a problem that every EHR vendor and every healthcare organization (including advanced academic centers) has been unable to solve: How do you display a million terms to clinicians in a way that lets them efficiently and safely take care of a patient?
For me, the joy of bringing this from an inchoate idea into a deliverable solution is not any personal success I have had. Instead, it is that the complexity of solving this problem has given me access and interaction with some of the most brilliant minds at IMO. David Arco turned IPL into a marketable product. Chip Masarie patiently coded the IPL Editor against every little request I made for the sorting algorithm. Andy Kanter suffered through my harangues about various clinical approaches and nudged me back to what was viable. Mike Decaro — IPL’s unsung hero — analyzed millions of real-world entries that I used for the underlying schema. Jonathan Gold, Deepak Pillai, and Steve Rube pitched in when I was stuck and gave me three extra superb clinical minds. Shelly Jude answered every ICD-10-CM complaint I ever had. Prasad Unni mastered how the IPL Editor works and now has become an equal partner maintaining the highly complex ongoing maintenance of content. The list goes on and on, in a remarkable testimony to what IMO can accomplish as a team effort. Being a part of that brings me great satisfaction. Last month I was in my ophthalmologist’s office and I asked him to pull up my problem list, displayed with IMO’s IPL problem list management categories. There it was (and properly sorted, LOL). Now that’s a reason to show up at work every day.
