I was born in Boston MA and grew up outside of Washington DC in Rockville MD. I attend Duke University for my undergraduate education in Electrical and Biomedical Engineering. Then I moved to Case Western Reserve University (CWRU) where I created my own MD-PhD program in Biomedical Engineering. I finished my MS and PhD in the Department of Biomedical Engineering in 1994 and 1999 respectively, working on a project in eletrocardiography. I completed a residency and Chief residency year in Internal Medicine and Pediatrics (known at Med-Peds) at Case Western Reserve University (CWRU), MetroHealth Medical Center in 2004.
After residency and was the Med-Peds Chief Resident for a year and then was a staff physician in Internal Medicine and Pediatrics at Case Western Reserve University, MetroHealth Medical Center for one year while my wife, Kristin Kaelber, completed her Med-Peds residency. During that year, my responsibilities also include being an Assistant Residency Program Director in the Department of Internal Medicine and Pediatrics and Co-Director of the Pediatric Nutrition, Exercise, and Wellness (NEW) Lifestyles clinic in the Department of Pediatrics. I also had a variety of other inpatient and outpatient duties in the Department of Pediatrics and the Department of Medicine. I was (and am still) on faculty at the School of Medicine at Case Western Reserve University and am involved in a number of teaching roles with medical students and residents within the School of Medicine.
Currently and am in Boston pursing a fellowship in Medical
Informatics at the Center for Information
Technology Leadership (CITL) at Partners
Healthcare, Harvard University. This fellowship involved non-clinical (~80%) and
clinical (~20%) work. My current areas
of interest in medical informatics involve telehealth/telemedicine,
personal/patient health records, electronic medical records, clinical decision
support, and the role of medical informatics in medical education. I have some outpatient and inpatient clinical
responsibilities through my staff physician appointments at Brigham and Women’s Hospital,
Boston Children’s Hospital,
and Massachusetts General Hospital. I am also an Assistant Program Director in
the Harvard Associated Med-Peds
Programs and have continued my connections with
Additional specific information about my background and credentials can be found by looking at my Curriculum vitae.
Over the years I have been involved in many research efforts
and have many research interests. My MS and PhD research is described below.
MS and PhD
My MS and PhD research involved electrocardiographic
imaging (ECGI). My research bridges the gap between engineering and medicine
and was conducted in the Cardiac
Bioelectricity Research and Training Center in the Department of Biomedical Engineering at Case Western Rerserve
University (CWRU). With the help of my research advisor, Yoram Rudy,
PhD, as well as many cardiologists, especially Albert Waldo, MD, Jerome Liebman, MD and Lee Biblo, MD,
radiologists, and research assistants, I developed a non-invasive in vivo
technique to map the electrical activity of the heart. The technique
involves coupling a 224 lead EKG, called a body surface potential map (BSPM),
with measurements of the internal anatomy of the chest to reconstruct cardiac
electrical activity. Given the BSPM measurements, information about the
geometry and conductivity of the internal anatomy of the chest allowed us to
work backwards from the body surface potentials to determine cardiac electrical
activity. Although much previous research has utilized theoretical and
experimental in vitro models, I was one of the first investigators to apply
this technique in vivo. This approach allows detailed cardiac
electrical activity with geometric specificity to be obtained, which is
impossible to ascertain from the traditional EKG or the more complicated vectorcardiogram.
My MS work in biomedical engineering focused on the basic scientific and engineering development of this new imaging tool. My project entailed developing the technical tools to attempt inverse problem reconstructions (reconstructing cardiac electrical activity from body surface measurements) in vivo. This in turn involved creating, refining, and evaluating techniques to obtain body surface and epicardial geometries, as well as the BSPMs needed to reconstruct epicardial voltage activity. I built a 224 lead BSPM vest, examined various approaches using computed tomography (CT), fluoroscopy, magnetic resonance imaging (MRI), mechanical and optical digitizing systems, adapted these imaging techniques to in vivo studies, and wrote the computer software for data processing and inverse problem computations.
For my PhD in biomedical engineering, I began examining the medical aspects of this new imaging tool. I completed two basic sets of initial clinical trials reconstructing epicardial potentials, electrograms, and isochrones (activation times). The first trial concerned the technique’s ability to reconstruct cardiac activation during single ectopic pacing in cardiac patients with epicardial lead intracardiac defibrillators (ICDs). Patients with ICDs were paced while BSPM and geometrical recordings were made. The location of the actual pacing site was compared to the reconstructed pacing site. These tests indicated the spatial, temporal, and voltage resolution of this in vivo technique to be:
Once the validity and imaging characteristics of this
technique were tested, I undertook a second clinical trial to study its
application to more sophisticated cardiac activation sequences. This
second phase concentrated on patients with normal sinus rhythm, as well as left
and right bundle branch block. During this second clinical trial, we
qualitatively compared ventricular activation through these physiological
activation sequences, reconstructing overall activation and repolarization
sequences. In addition, we examined details of activation and repolarization such as left and right ventricular
breakthrough points. We clearly demonstrated in vivo septal activation, right ventricular activation, left
ventricular activation, right ventricular repolarization,
and right ventricular repolarization with geometrical
detail never before seen using a noninvasive cardiac imaging technique.
Possible applications of this in vivo noninvasive cardiac imaging
modality include:
Currently, further studies investigating the technique's clinical potentials continue.
I also have many extracurricular interests generally
involving community service, various computer initiatives, and professional
organizations.
Community Service
I am and/or have been very involved in the activities of Habitat for Humanity International (HFHI),
through Greater Cleveland Habitat for Humanity
(GCHFH) and Case Western Reserve
University Habitat for Humanity (CWRU HFH), as well as Alpha Phi Omega
(National Co-educational Service Fraternity) through the Theta Upsilon Chapter of Alpha Phi Omega at Case Western Reserve University and the Lambda Nu Chapter at Duke University.
Computer Initiatives
I am and/or have helped in the creating and/or maintenance of many
different web site, including the following:
The Cardiac Exam
Case Western Reserve
University Faculty Senate
Case Western Reserve University Habitat
for Humanity (CWRU HFH)
Case Western
Reserve University School of Medicine Primary Care Track
National Med-Peds Residents' Association
(NMPRA)
United Protestant Campus
Ministries (UPCaM)
I was involved in the internet start-up company Web
Hosting Headquarters for several years.
Professional Organizations
Professional organization involvement has included the following:
American Academy of Pediatrics (Resident Section
and Med-Peds Section)
American College of Physicians (ACP)
American
Medical Informatics Association
MetroHealth
System House Officers' Association
National Med-Peds Residents' Association
(NMPRA)
(09/18/2006)