This week, I participated in another HIMSS Analytics Acute Care EMRAM Stage 7 review team as the CIO reviewer. During the opening presentations by the organization’s leadership, I leaned over to the
full-time HIMSS reviewer to say, “They are hitting it out of the ballpark”. By the end of the day, our three-person review team had indeed reached that conclusion. The full-time reviewer said, “Some organizations barely clear the bar but this one far exceeded it.”
Only 6.1% of hospitals have achieved Stage 7. What does it take?
On review day, the review team is presented with information that includes a system overview, including governance, clinical and business intelligence, health information exchange, and plans for disaster recovery and business continuity.
The review team has been given a 17-page document that includes checklists for each major clinical area.
Several case studies are presented that demonstrate how the organization has used the system to improve clinical care.
The organization prepares for this visit for months, developing the case studies and verifying they have met every specific criterion. The full-time reviewer spends time on the phone reviewing their readiness.
Achieving Stage 7 takes teamwork throughout the organization to fully leverage all aspects of the vendor’s product. It takes engagement and passion from executives and clinicians.
The organization we were reviewing implemented their EMR according to these guiding principles: Continue reading
I woke up Monday morning after a sleepless night with a text from my daughter, Ann, “do you have power?”. Only 10 miles from our house, her neighborhood had lost power and Internet access due to the storm while we were up-and-running. Ann works from home as Communications Manager for a national company, and was not interested in wasting a sick day sitting in the dark. So after dropping my granddaughters off at daycare, she set up shop in our dining room.
Except for being limited to just her laptop and not the two large extension monitors in her home office, she was ready for a productive day. A year ago, I would have thought she was crazy for needing two monitors, but she convinced me to get a second. There’s nothing like it for multi-tasking and having multiple windows open when you are working on a project.
We respected each other’s space and work. We had minimal conversation when I went to the kitchen for coffee. But in our two brief morning interactions, we casually discussed the common challenges of remote workers – one being the isolation. And I got some new ideas from her.
Half the dining room table was covered in my receipts as I was working on expense reports. I used to just hand the task over to my executive assistant, but in my new life, I do them myself. I dislike the task so much that I get way behind. Monday was the day to catch up. Continue reading
A year ago, I was asked by a University CIO to participate in an External Advisory Committee on Information Technology. At that point, I was just finishing up the interim CIO engagement at University Hospitals and launching a new HIT advisory firm, StarBridge Advisors. I asked the CIO “why me” and considered the time commitment. I said yes.
This week I attended the second half day in-person meeting of the committee. The first was a few days before I started the interim CIO engagement at Stony Brook Medicine in March.
These commitments to other organizations take time: time to review extensive materials in advance, travel and connecting flights, and in-person meetings.
But they are a win-win.
I learn and they learn. I am impressed with this CIO and his IT leadership team as I have gotten to know them. I am impressed with the support and engagement they have been able to garner from the Chancellor and Provost. I am impressed with my colleagues on the committee – a mix of university CIOs and IT business leaders. And I’m impressed with the ambitious, multi-year roadmap to replace their financial, HR and student administration systems with a new, integrated solution.
While my IT experience is in healthcare, I have worked in academic medical centers and collaborated with university IT teams. Financial and HR systems are universal across industries. But I have not gone this deep, before, into the unique systems of the higher education sector. I’m learning that student administration systems have some of the same complexities and challenges that electronic health records have in my world.
Of course, IT implementations regardless of industry and domain have many common components. Addressing a current state that is fragmented, self-developed, and highly customized with proven, integrated vendor solutions is not new to me. The many decisions involved in data conversions and archive strategies, the establishment of robust data governance, the inclusion of change management throughout the project – these are all components that we in IT know are fundamental to success. Continue reading
For the first birthdays of my four grandkids, there have been party hats and “smash” cakes. But what does a small team of entrepreneurs do on the first anniversary of founding their firm? They take stock and plan for year two.
David Muntz, Russ Rudish and I launched StarBridge Advisors in October of 2016. So how does a health IT advisory firm measure success after year one?
Number of clients – We have already assisted 12 healthcare provider organizations with some repeat engagements and have national reach.
Revenue – Any first-year projections can be a crapshoot but you need to start somewhere. We may have been overly optimistic but we are well on our way with our client base and pipeline.
Size of our team – In addition to our three principals, we now have almost 20 advisors on our team available for interim management, leadership support and consulting. Their IT leadership experience includes serving as CIO, CTO, CISO, CMIO or CNIO in healthcare organizations.
Channel partners – We work closely with several larger consulting firms who offer services that we don’t. We partner with Healthcare IT Leaders, a leading staffing firm and Rudish Executive Search, which specializes in healthcare. And we are working with a few start-up technology vendors who are bringing to market new and novel solutions for healthcare providers.
Referrals – Our principals combined have over 90 years of experience in the healthcare industry. Our relationships are a key component of growing a new business and getting known in the market.
Name and brand recognition – A year ago we had decided on a name and incorporated, but had yet to figure out our branding. That was some fun work at first; by January we launched our website and social media presence. Continue reading
“My spouse won’t move.” You may have heard this if you have ever hired someone who would need to relocate their family. You may have even heard it after you extended the offer. If it happens that late in the process, it may be just an easy excuse because they weren’t going to accept the position anyway.
Whether your spouse and family are willing to relocate to a particular city is something that should be discussed and agreed on together very early in the process. Why waste everyone’s time if it’s not going to work.
Relocating is a big decision. I’ve done it several times. And each time, my husband and I discussed it early on. Was this a part of the country we were willing to live in? Was this city one that we’d be happy in? What did the housing market look like? These are just some of the considerations.
If you are early in your career, you probably want to figure out what kind of future opportunities are in that area, is it family friendly, are there good schools, and can you afford to buy a house. If you are later in your career, you may think of your next move in terms of where you might want to eventually retire or living closer to your grandkids.
Regardless of where you are in your career, there are some common considerations. Assuming it’s a job you really want and an organization you really want to work for, here is my advice on what to consider when relocating: Continue reading
You have priority work scheduled on your calendar. You have carved out time when not in meetings to get some work done. Yet urgent issues keep finding their way to your office. Sound familiar?
That’s the life of anyone in management, especially in large complex organizations. And it’s a challenge these days as our new Stony Brook Medicine CIO and I try to get through a three-week transition period. The outline of what I need to cover with her is four pages long. And I keep adding more items.
We are ending week two. By next week, I should be in far fewer meetings as she handles them without me. I should be able to finish my tasks as part of the transition and organize my paper and electronic files to turn over to her. I know she doesn’t like paper, so I’ll be ruthless as I purge and give her only the most important paper files.
We’ve done our best to block out some chunks of time together to get through everything.
But when we sit down together to go over the next block of information, we often end up first dealing with the latest requests and issues. What started as a focused two-hours is suddenly half gone.
What have I learned? Continue reading
I recently had the opportunity to do a talk as part of a Women in Leadership lecture series. The title of the talk was “Yes We Can – Developing Next Generation Leaders”. I covered leadership lessons from my many years of experience, the challenges for women in STEM, and general career advice. The group had a lot of great questions and comments from their experience, so it was a lively and interactive session.
Regardless of gender, if you are a leader or future leader, these tips may be useful to you.
Find a mentor – You can’t do it yourself. Find someone you consider a role model and who is willing to invest some time and energy in helping you develop.
Let go and be willing to delegate – If you try to do it all yourself, you won’t develop others nor have time to do the work that allows you to grow.
Give up on perfectionism – It is the enemy of good. It wastes time and keeps you from doing other work.
Ask for feedback – Take off the blinders and ask for honest feedback from your staff, your boss, your peers, and your customers. What should you start doing, stop doing and continue doing.
Consider everything a learning opportunity – Remember that you can learn from every experience. Whether it is a new skill, knowledge or lesson on how to improve for next time. Continue reading
If you live in a large metropolitan area, chances are you have been either a patient or a visitor in an academic medical center that has 500 to 1000 beds. If you live in a rural area, you are probably more familiar with a small local community hospital with less than 100 beds.
Because of healthcare mergers and acquisitions, these two different kinds of hospitals are likely to be part of one integrated health system. While different in size and scale, they both deliver healthcare to their community 24×7.
Small, independent hospitals are often very agile, extremely customer service oriented and supported by a loyal community. In IT, the staff are often generalists and less specialized. They may have a single integrated system from one vendor with basic functionality and limited integration points with other applications.
In contrast, large academic medical centers can be slow to make changes and appear more bureaucratic. They provide advanced medicine with subspecialists and clinical services not found elsewhere. They have to work harder to create a culture of customer service. Their community is broader and they attract patients from greater distances, including international patients. And their IT teams are larger with many specialized roles. In addition to their core electronic health record, they have many specialized departmental applications, many interfaces. Overall, it’s a far more complex environment.
So how do these different profiles mesh at merger time? Continue reading
It’s that time again. Time to close out my current interim CIO engagement and transition to the new CIO. I’m delighted to share the news that Stony Brook Medicine has hired Kathy Ross as their next CIO. She starts July 24th and we will have a few weeks together to complete the transition.
Kathy brings extensive healthcare CIO experience having served for many years as a CIO within Ascension Health. She is no stranger to Cerner, our core EMR vendor. But walking into a new environment with all its complexities and uniqueness is a challenge for the most seasoned leader.
We can only have one CIO at a time so day one, it will be Kathy. I will work out of a temporary space nearby. My focus and role will be to support her and provide as much background information as I can to ensure she gets up to speed quickly.
While I have only been serving as interim CIO since early March, my plan for what I need to fill her in on is long and growing. It includes a review of where we’re at on my focus areas during this interim. We’ll block time to review together key background information and issues needing attention. And we’ll do meetings together with everyone on the IT leadership team as part of the handoff.
I learned at my last interim to block out chunks of time to review everything on the transition outline and not let the usual day to day meetings fill all available time. Continue reading
Telehealth or connected health as some call it, takes different forms depending on the provider organization and their strategy. The primary driver may be extending geographic reach by providing telehealth services to rural areas. Or it may be largely a focus on consumer engagement.
Regardless, there are common themes for successful initiatives. Based on my experience in several healthcare systems in recent years, I offer these tips for success:
Strategy is key – The organization must first determine what the key drivers are for the initiative. Is it to extend reach or provide an easier patient experience or a combination?
Tactics and specific programs will follow – Once the strategy is clear, which specific clinical services and offerings are needed the most will become clear.
Physician leadership is needed – If the focus is on extending reach of certain clinical services, physicians are at the center and must provide overall direction. For consumer-focused services, ambulatory services or strategic planning leadership may play a more central role.
Operational issues and decisions must be considered early on – There are legal and billing factors along with workflow issues for clinicians and staff to work out before any implementation. Continue reading