The Delaware Health Information Network (DHIN) is a rapidly growing non-profit organization on the forefront of health information exchange (HIE). DHIN is the nation’s first statewide HIE established in 1997 to facilitate the electronic movement of health-related data among health care entities to improve the quality and efficiency of health care services for patients in Delaware. Reporting to the DHIN Board of Directors, the CEO provides strategic leadership and day-to-day management of the organization's programs, operations and policy development. • 40% or better year-over-year improvement in all major business metrics in first year alone• In four years, more than tripled the number of organizations sending data through the HIE• Increased number of EMRs able to connect to the HIE from two to 22• Took DHIN from Stage 5 to Stage 7 (highest) on HIE Maturity Model in three years• More than doubled provider enrollment in HIE in four years; currently nearly 100%• Attracted new members from across the continuum of care; 100% of skilled nursing facilities, 87% of assisted living facilities, 53% of home health agencies, 81% of walk-in clinics, 95% of imaging centers• Established interstate data exchange with Maryland’s HIE (CRISP)• Introduced new forms of data exchange, to include Direct secure messaging, exchange of care summaries from the ambulatory setting, image sharing (including motion studies), medication history, immunization update and query• Frequently sought speaker at professional conferences (domestic and overseas) and quoted in numerous print and on-line publications

After two years with NextGen Healthcare, I was promoted to a VP position in which I oversee a department of 45 employees responsible for design and development of clinical content of the NextGen electronic health record.Fostered an environment of critical self-evaluation and continuous improvement which led to 94% improvement in resource estimates per release, 76% reduction in scope creep, 45% reduction in QA reject rate, and 66% reduction in reported post-release defects.Received accolades from users for responsiveness to their needs and numerous ease-of-use improvementsInstituted a patch process to address post-release defectsRepresented NextGen on two national level collaboratives in health ITFrequently sought as speaker at local and regional user group meetings

Upon retirement from the Air Force, I accepted a consultant position with NextGen Healthcare Information Systems, Inc. working with the Electronic Health Record product line. Duties included a mix of implementation support, sales support, and content development.Averaged one client visit a month to reenergize a stalled EMR implementationPerformed root cause analysis Communicated identified problems frankly but tactfully Recommended way forward to professional staff and organizational leadershipCustomer satisfaction ratings averaged 10 on a 10 point scaleDeveloped demo scenarios representing "a day in the life" of multiple clinical specialtiesResearched current clinical practice guidelines and generated specs for clinically relevant data entry templates across multiple medical specialty areasCreated > 100 standard database queries in support of clinical quality measurement setsCollaborated on development of eLearning courses; taught end-users in a variety of settings, from classroom to over-the-shoulder coaching to web based demonstrationsIdentified by Chief Medical Officer of NextGen as "our best motivational speaker"

Due to my performance leading the Air Force electronic health record deployment, my retiring boss recommended I replace him as CIO. I was the first physician to hold this post. With the CIOs of Army and Navy medical services, I steered management of a $3.2B IT portfolio supporting 130K Department of Defense (DoD) healthcare employees and 9.1M beneficiaries worldwide in an integrated delivery system with nine regional support offices, 75 hospitals and medical centers, 461 ambulatory medical facilities, 417 dental clinics, an air-evacuation system, hospital ships, and battlefield/theater healthcare. Collaborated with senior operational and technical leadership in the AF Medical Service and its strategic partners to ensure integrated, interoperable, consistent IT policies and practices across numerous organizational boundaries.Spearheaded design/development of standard IT architecture linking Air Force medical facilities with base service delivery point; untold savings in engineering rework.Led AF Medical Service through various stages of development and deployment of 12 major business, clinical, decision support IT programs. Championed automated medical coding tool for capture of $21.8M in third party collections.Consulted by members of the US State Department, academia, and IT industry leaders for insights in realizing President's national health IT and electronic health record (EHR) goals. Recognized by Air Force CIO as the best of nine HQ functional CIOs.

Hand picked for position requiring a senior physician executive skilled in change management and collaboration across varied constituencies. Directly responsible to USAF Surgeon General (CEO equivalent) and Air Force Medical CIO for planning, policy development, integration, deployment, and change management in Air Force adoption of CHCS II, DoD's $4.3B electronic health record, supporting 8M beneficiaries, 40K Air Force medical personnel, and 75 Air Force medical facilities worldwide. Oversaw a budget of $270K (exclusive of labor costs). Recruited and supervised a multidisciplinary staff of 36 with backgrounds in IT, clinical practice, and training. Collaborated with Army, Navy, DoD, industry, and acquisition representatives in development, testing, and implementation.Researched civilian experience in EHR implementations; crafted and "sold' to AF medical operations senior leaders an aggressive but achievable training plan balancing learning curve with productivity imperatives. Catalyst for $15M in infrastructure upgrades at 74 AF medical facilities to support data exchange at the rate, volume, and reliability required by an EHR. Synchronized 24 enterprise IT project timelines with CHCS II deployment. Drove migration of ~900K patient encounters from a legacy system into CHCS II. This established the process for migrating encounters from other local or "homegrown" systems so all historic electronic encounter data for our highly mobile DoD beneficiaries will be accessible within one system worldwide from all DoD locations.On the day CHCS II was approved for worldwide deployment, the DoD medical CIO told me we would never have reached that milestone without my leadership. Industry partners also referred to me as a thought leader within the DoD EHR community.

Managed a staff of 140 responsible for outpatient and inpatient medical, pediatric, OB/GYN, and surgical care, mental health services, and physical therapy serving an enrolled population of 13K. Operating budget of $730K (exclusive of labor costs). Oversaw maintenance and management of 35K medical records. Responsible for organizational human resource development. As a member of the executive team, I participated in governance and strategic planning.Reversed abysmal unit morale by multiple measures on externally conducted assessment. Overhauled patient appointment process; slashed unused appointments by 76%. Boosted primary care productivity by 20-40% per year for three successive years, despite downsizing of staff. Initiated aggressive case management program that cut visits by "high utilizers" 24%. A solid disease management program saved 57% on treatment of Attention Deficit Hyperactivity Disorder, improved diabetic annual eye exam completion by 10%. Our preventive health program was cited as best seen by regional headquarters.Inspired voice-recognition software use, cutting transcription costs by 75% and provider time spent on dictation and proof reading by 50%. Achieved JCAHO "accreditation with commendation." Over half of the areas assessed fell directly under my scope of command. Named "Delaware Woman of Courage and Vision," presented by the state governor in 2001.

Directed staff education programs for 1,600 medical center personnel. Ensured three graduate medical education programs met accreditation requirements. Coordinated training affiliation agreements with 50 universities and hospitals. Oversaw Education and Training staff of 23. Responsible for administration of Department of Family Practice, with staff of 70 physicians and support personnel and an equipment account worth $352K. Department logged 50K outpatient visits per year and trained 40 medical students and 30 residents. Provided medical support for congressional delegation trips abroad. Expert reviewer of Air Force medical malpractice claims. Member of numerous medical center and regional managed care committees. Reversed morale crisis of section plagued by frequent leadership turnovers. No-nonsense leadership resolved problem of employee with multi-year history of 30-50% absenteeism.Expanded enrollment to Family Practice by 22%. Reduced wait time for routine appointments by 56%. Clinic achieved 66% higher throughput than civilian HMO benchmark. Captured previously overlooked $188K/year in third party collections