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Robert A. Greenes is a pioneer in the field of Biomedical informatics (BMI). His work has focused on knowledge representation, decision support, and human-computer interaction for health and healthcare. He was co-developer of the MUMPS System and Language in the 1960s, which continues to be used as a basis for healthcare information systems. As the first person with doctoral-level training integrating both medicine and computer science, he has been a leader and proponent for specialized education and training in biomedical informatics, for the development of the field as an academic discipline, and for recognition of it as a healthcare institutional priority.

Early life and education
Growing up in Cleveland, Ohio, Greenes received a B.A. degree from the University of Michigan in 1962, and an M.D. from Harvard Medical School (HMS) in 1966. Following his M.D. degree, he obtained an individual postdoctoral fellowship from the National Institutes of Health, to pursue a Ph.D. in applied mathematics and computer science from Harvard, which he received in 1970. Following these degrees, and after an interlude as President of a MUMPS-based startup, Automated Health Systems, Inc., (1970-1974) and a year as a faculty member at Stanford University (1974-1975), he returned to Boston to do an internship and residency (1975-1978) in diagnostic radiology, at Massachusetts General Hospital (MGH).

Career
Greenes’ early professional career during the 1960s overlapped with his medical school and doctoral training. While a medical student, he developed software and carried out statistical computing, for researchers at MGH, and neuroelectric signal analysis for scientists studying the visual system in monkeys. He also built one of the first geographic visualization systems for health services research.

Greenes joined the Laboratory of Computer Science (LCS) at MGH in 1965. The LCS was directed by G. Octo Barnett, M.D., established under a subcontract to MGH from the Hospital Computer Project, a National Institutes of Health-supported grant to Bolt Beranek & Newman, Inc..

In 1966, for a research honors thesis for his M.D. degree, Greenes developed a software platform for interactive discourse design. Further pursuing the interest in facilitating the human-computer interface, Greenes then worked with Neil Pappalardo and Curt Marble, two engineers in the LCS, along with Barnett, to develop a prototype of a minicomputer-based time-sharing system called MUMPS, for healthcare applications that included an interactive, interpretive programming language.

Greenes used MUMPS as a platform for his Ph.D. thesis on computer-based interactive capture of progress notes by clinicians. This work, carried out using a home-grown touchscreen computer, led to further investigation into the physician-computer interface for both progress notes and radiology reports, and to work on capture and generation of ultrasound reports in the 1980s-90s, and later to modeling of cognitive processes, to anticipate physician-patient interaction, provider workflow, decision-making needs, and potential clinical actions.

Following a 1970-78 interlude in the commercial world, a year at Stanford, and radiology residency at MGH, Greenes joined the Department of Radiology at Brigham and Women’s Hospital (BWH) as a practicing radiologist in 1978. Shortly thereafter, he established the Decision Systems Group as a BMI research and development laboratory, which he directed for 27 years and which, at its peak, consisted of over 30 faculty, staff, and doctoral and postdoctoral fellows. Greenes was professor of radiology and of health sciences and technology (HST), at Harvard Medical School, where HST was a joint division of Harvard and MIT. He was also professor of health policy and management at Harvard School of Public Health. In 2005 he became the Distinguished Chair in Biomedical Informatics at BWH.

From 1985 to 2007, Greenes directed the Harvard-based Biomedical Informatics Research Training (BIRT) program, with support from the National Library of Medicine and other sources. By 2007, under his leadership, this program had grown to include participation by 10 hospital and university-based informatics groups throughout the Boston area.

After 40 years at Harvard and its affiliate hospitals, Greenes moved to Phoenix, AZ in 2007 to lead a new Department of Biomedical Informatics at Arizona State University (ASU), where he became the Ira A. Fulton Chair and Professor of Biomedical Informatics. He was also professor of biomedical informatics at Mayo Clinic. During the period at ASU (2007-2020), he continued his work on knowledge-enhanced care, directing collaboration initiatives on a platform for deploying interoperable healthcare apps.

In August 2020, he became Emeritus Professor, and is now living in San Diego, where he is a Visiting Scholar, at the University of California San Diego Health System and continues to engage in various projects.

Key accomplishments
After his early work on health information system development (MUMPS) and human-computer interaction (progress note and radiology report capture), Greenes became engaged in computer-based clinical decision support, in  terms of models and approaches for decision making, the knowledge representation underlying it, and its clinical application and validation.

He has also been active in the promulgation of standards and fostering of group collaborative work, particularly in knowledge management. His book Clinical Decision Support and Beyond: Progress and Opportunities in Knowledge-Enhanced Health and Healthcare, Elsevier, 2023, is in its third edition (this edition co-edited by Guilherme del Fiol).

Greenes also focused his research activity on workflow optimization, particularly with respect to the use of clinical information systems by providers and patients, improved capture of clinical data, and the incorporation of individualized, context-specific decision support, data analyses, and visualizations at the point of need.

Greenes contributed to the recognition and growth of BMI. Besides leading a large training program in BMI, running a research and development laboratory, and subsequently chairing a Department of BMI, he wrote and spoke frequently on the academic discipline of BMI, the needs and approaches to training for this field, and the opportunities available.

Awards and honors
Greenes won the Borden Research Prize from Harvard for his medical school thesis on computer-based interactive discourse design. Greenes is a member of the National Academy of Medicine, and inaugural member of the International Academy of Health Sciences Informatics, Distinguished Fellow and 2008 Morris F. Collen Award Recipient in the American College of Medical Informatics, and Fellow of the American College of Radiology and Society of Imaging Informatics in Medicine. The Distinguished Robert Greenes Chair of Biomedical Informatics was established at Brigham and Women’s Hospital in 2005 in his honor. The current incumbent is CF Westin.