As I've said in my blog about "The Number 5" I tend to organize my life and my projects in groups of 5. My 2009 Review has five segments - Harvard Medical School, State projects, and Federal projects which I presented yesterday plus Beth Israel Deaconess and my personal life which I'll present today.

BIDMC

Beth Israel Deaconess had a turbocharged 2009 which included a new alliance with Atrius Health, numerous new applications, and significant infrastructure improvements.

Community EHR - the first step toward care coordination among all providers associated with BIDMC is to ensure all PCPs, specialists, and referring clinicians have electronic health records. In 2009 we built a data center filled with virtual servers, clustered databases, and software as a service EHR applications fully integrated into our statewide data exchange for administrative transactions, e-prescribing and clinical data sharing. It's a huge change management project as well as a technical one.

Infrastructure - Just as with Harvard, BIDMC experienced explosive growth in the need for storage, especially of medical images. We developed a tiered storage system of SAN, NAS, and Cloud Storage using EMC products. The end result is the right storage platform for the business requirements of the data. We continued to virtualize our servers, cluster our databases, build redundant electrical systems, and ensure business continuance through geographically separated data centers. We elected to move our mainframe to an external hosting facility/vendor - a major transition for us. We enhanced our security capabilities significantly, revised our network architecture for robustness, and upgraded to Exchange 2007, expanding email box size tenfold.

Clinical - We completed our ICU automation efforts, implementing Metavision through all critical care areas including fully electronic documentation and device interfacing. We completed the programming for provider order entry in the NICU and Emergency Department, our last remaining areas with paper orders (both go live in 2010). We implemented electronic Emergency Department documentation, an electronic ED Dashboard at BID-Needham, automated inpatient Oncology management that is fully integrated with our existing outpatient system, pharmacy initiated renewals as part of e-prescribing, results sign off, scanning of the inpatient record, and created a plan for enterprise image management of all modalities over the next year. We enhanced our extranet, redesigned our intranet (goes live in mid 2010), created web-based radiology workflow tools, increased our business intelligence capabilities, and brought new focus to our laboratory information systems project. Interoperability projects linking BIDMC, community providers, patients, government and payers via the NEHEN gateway accelerated and will continue to flourish in 2010 with our Boston Public Health and Community Quality Data Warehouse projects.

Financial - We built numerous additions to our revenue cycle systems preparing for the 5010 and ICD10 conversions ahead. We upgraded all our Peoplesoft platforms to the latest versions, ensuring our customers in HRMS/Payroll, Research, General Financials, and Supply Chain are served with the most modern software available. We enhanced our integration engine capabilities and investigated new platforms to ensure we can provide the connectivity required for meaningful use data exchanges.

These are just a sampling of the hundreds of projects we completed on time and on budget while maintaining 99.9% uptime. I'm very proud of my teams.

Personal

In yesterday's blog, I called 2009 the year of changing everything. In my personal life, it was the year of moving everything.

Last Christmas, I committed to move my parents from the 1970's house where I grew up to a one story, easy to maintain, more modern home. We all accumulate things in our lives and moving requires us to rethink what we own. This year, my parents and my family worked together to streamline the contents of the old house, find a new house, move everything, upgrade the old house, and sell it. A heroic effort by all.

My wife is an artist and she recently expanded her South End (the artsy side of Boston) studio and created the NK Gallery at 460 Harrison, which will open March 1, 2010. This meant that all art, furniture, and supplies had to be moved from our house to the studio and gallery.

My daughter is in the marathon of the High School junior year, getting her life ready for college applications. We'll begin college visits in April. Children grow up fast. She also became an expert archer, averaging over 200 points per round (that's a lot of bull's-eyes from 50 yards away)

This was the year that I maintained every aspect of our 80 year old house - painting the exterior, repairing all screens/storm windows/porch, planing every door, repairing every worn bit of electrical/plumbing/hardware. In addition to being a CIO, I fix toilets!

My federal and state responsibilities, especially ARRA, reduced my free time and I did little rock/ice climbing in 2009. However, I was able to hike in New Hampshire, Japan, and the Eastern Sierra, as well as my usual kayaking, biking, and nordic skiing, so I've stayed in reasonable shape.

During 2009 I was able to maintain my daily writing for my blog, my Computerworld columns, and several journal articles. I practiced the Japanese Flute every weekend to clear my mind.

As I end 2009, BIDMC projects are on track and there are governance processes in place to ensure our resources are well aligned with customer needs. My family, my home, my outdoor activities, my writing, and my flute playing seem in good shape.

I look forward to everything 2010 will bring - the final regulations for meaningful use and certification, the HIE/RHITEC/Beacon Communities grants, and acceleration of healthcare IT in every practice setting. Hard work is fine as long as it's predictable. I'm hopeful that 2010 will be more consistent than 2009. Then again, I'm the eternal optimist!