Ninth and Jefferson Building  (Directions)

908 Jefferson Room 832

Seattle Washington 98104

tpayne at u.washington.edu

Box 359968

325 Ninth Ave

Seattle WA 98104-2499

My major professional interest is the use and evaluation of clinical computing systems, especially computer-based medical record systems in patient care, clinical research, and quality improvement.  Most of my work since completing my fellowship has involved development, selection installation and operation of computer-based record systems (also known as electronic medical record systems).  Since coming to the UW in 2000 I’ve been involved installation and improvements to our electronic medical record systems,  and serving as Medical Director for the IT group serving UW Medicine.   Before that, from 1997-2000 at VA Puget Sound, I served as the leader of the team that piloted the VA computer-based medical record system (CPRS).  We served as the 3rd and largest test site for CPRS that has subsequently been installed in all VA facilities and is widely regarded as successful.  In the early 1990s I worked at Group Health Cooperative of Puget Sound in a similar role.  I’ve remained clinically active throughout my career.   

Research interests

Electronic documentation.  Much of what physicians and other health professionals document about their patients is in the form of notes:  clinic notes, discharge summaries, progress notes, admission notes, and others.  We know little about how these are created, how long it takes, what constitutes a “good note,” and what information they contain.  Seven years ago Jan Hirschmann, Susan Helbig and I published a short paper titled “The Elements of Electronic Note Style” which has been a frequently cited (and copied) source of recommendations on how to write electronic notes.  At 2010 AMIA we presented a paper on The Physical Attractiveness of Electronic Physician Notes.

Natural language processing. Most clinical notes and reports electronic medical records are in narrative text form (“No text is free--somebody pays for it” [attributed to Octo Barnett]). To unlock contents of notes, we need natural language processing.  I’m a student of this field because I believe there is enormous potential to understand care quality, patterns of illness, and to more easily manage the necessities of clinical care including professional fee billing.

Operating clinical computing systems.  After clinical computing systems have been installed, they have to be kept running.  This requires supporting users, planning maintenance, recovering from downtime, and myriad other tasks that are less appreciated and understood than installation.  This is the reason we organized our seminar series and wrote our book.  I also plan to write more on this topic, including vulnerabilities of the clinical computing infrastructure that underlies EMRs and other clinical computing systems

Other professional interests

I’m on the faculty of the AMIA Clinical Informatics Board Review Course.  With Bill Hersh, Diane Montella, Bimal Desai, Ben Munger, Elaine Steen, Jeff Williamson and others, we are holding Board Review courses around the nation to help colleagues prepare for the first Board Certification exam under the auspices of the American Board of Preventive Medicine.  It is a great deal of work, but worth it, to review the core content for this specialty (see the Gartner article in JAMIA) and use it to review in preparation for a formal board exam.  Many of us will take it together for the first time in October, 2013.

I am on the Board of AMIA and am active in the American Medical Informatics Association.  I was program chair for the 2011 ACMI Winter Symposium and we are preparing a paper based on that meeting.

Click here for Medline search for my publications or click here for my CV.

Click here for a blog of my travels in 2011, and recent travel photos.

Click here for my personal website.

Last updated 5/19/13