I  began my career in the 70's as a community psychiatrist. I was part of a team out in the field working to engage people with Serious and Persistent Mental Illness. The work was challenging and creative. It demanded a wide scope of thought and action. I loved it. In the late 90's in what seemed a sudden shift, I found myself confined to an office and the managed care driven 20-30 minute med check. I wrote the prescriptions, while others were gifted with out-reach and the therapeutic relationship. I felt cut-off, suffocated. As a community psychiatrist I was a dinosaur, an unhappy one.

Then our CEO suggested that I take on the leadership role in the implementation of the newly purchased electronic medical record (EMR). My response: a startled "Me?!" "Yes, you," he said. "Think about it." As a clinician I focused on the human rather than the technical dimension. Why would I join the dark side of the business managers and number crunchers? I was a novice computer user, how could I lead a computer software implementation? The "Why?" answer is short and simple. I'll tell it now. The "How" answer has many, detailed parts and has to wait for later blogs.

So OK, why? I knew enough of trends in the larger world to be totally convinced that computers in clinical care were inevitable. It followed immediately from this realization, that the urgent call was to make the computer serve the work. Another question emerged: "Who better than a senior clinician to try to make this happen?" I pondered this new question. I acknowledged the importance of the goal. Then before my mind’s eye, the question flipped to "Why not me?" I saw the timeliness of the opportunity. The challenge energized me. Yes, indeed, why not me. It became clear that I must try. I accepted the job. My personal buy-in was complete.