I had the opportunity to talk about lessons learned from EHR implementations as part of the faculty for the “Leadership Strategies for Information Technology in Health Care” course at the Harvard School of Public Health (HSPH) last week. And yes, I was fortunate to make it in and out of Boston between snowstorms for the one day I was there.
The course is part of Executive and Continuing Professional Education at HSPH. It is a two week course with 4 modules. The first week covers Module 1 on IT Strategy and Governance and Module 2 on the EHR.
The faculty lineup for the first week is impressive. John Glaser, CEO Health Services at Siemens Healthcare and former CIO at Partners HealthCare System, lectured on “IT Strategy Considerations.” John Halamka, CIO at Beth Israel Deaconess Medical Center in Boston covered “The National Perspective and IT in the Era of Health Care Reform.” Vi Shaffer, Research Vice President and Global Industry Services Director at Gartner, provided an “Overview of the IT Industry.” Meg Aranow, Senior Research Director and Health Care IT Advisor at The Advisory Board Company, discussed analytics. New care models including telehealth, retail clinics, and accountable care organizations were also covered by various faculty members. Mary Finlay, Professor Simmons School of Management and former Deputy CIO at Partners, discussed IT Governance. Mary is the program director for the course and does a terrific job.
Students come from various roles in health care. The course has also become well known internationally at this point – with about 30% from other countries. For this session some students came from as far away as Australia and India.
I was happy to be part of the faculty and get a chance to hear a few other lectures that day as well as interact with the students over lunch. Here are some of the EHR implementation lessons I shared in my talk:
- The CIO and executive leadership in health care organizations have many priority initiatives at any given time. The EHR implementation will become a primary focus, especially as it gets closer to the go live date. As the CIO, you need to know where and when to be deeply involved vs. maintaining an overall awareness of the project’s progress, being ready to address issues as they are escalated.
- Engaged executive sponsors are needed throughout the life of the project. If the CIO is the only one worrying about the project, there’s something wrong. At the same time, the CIO should avoid saying “it is not an IT project”. To be successful, it has to be a true partnership between clinicians, operations, and IT.
- An EHR implementation has a significant impact on your entire organization and all staff members. A robust change management program is critical given the multi-disciplinary effort that EHRs require.
- Many decisions get made through the life of the project. Establish early on very clear decision rights. Know which group makes what decisions and define the escalation path when issues can’t get resolved at lower levels of the project governance structure.
- Your plan should include a “Go Live Readiness Assessment” at 120, 90, 60 and 30 days prior to go live. All teams are expected to report out their progress and open issues in detail. Project leadership then creates a readiness scorecard. This allows leadership to focus on the areas that are behind schedule and address issues to ensure an on-time, successful go live.
- Contingency planning needs to be part of the overall plan. Any major system implementation needs a back-out plan if something goes wrong. But you also need to account for the operational impact. You can’t stop the flow of patients into the emergency room but do you reduce your surgical or clinic schedules? Each organization has to determine what’s right for them. And then there’s the unrelated and unanticipated crisis that you have no control over – it could be a major facility issue like a power outage, a weather incident like the snowstorms we’ve seen the past few weeks, or a mass casualty incident in your area. Be sure to include your organization’s emergency management team in your activation and contingency planning.
- At go live, it’s all hands on deck in the command center and throughout the organization. Everyone has their specific roles. Leaders need to be present. The CIO may not be running the project but maintains a very visible presence in and around the command center. It’s a 24/7 operation for the first few weeks after go live. And be sure to round – find out how things are going for front-line staff and thank them for their work.
- Once the system is up and running, you have to recognize that optimization is ongoing. Don’t minimize the requests. Listen carefully to your users. At the same time, manage expectations about how much will get done and by when. Help shape the message. Multiple communications channels are important. Structured processes for intake of requests and a formal prioritization process with agreed upon criteria are critical. While optimization for your organization and the unique workflows is needed, don’t get stuck there. Learn from others how they have leveraged the product. Reach out to your colleagues and learn from them. Many have gone before you at this point.
And when you’re ready, be sure to share your own lessons with others.
Harvard School of Public Health’s Executive and Continuing Professional Education program, “Leadership Strategies for Information Technology in Health Care”
Three Days and Counting. . .
Values in action. . .
MiChart summer interns – a win-win!
If you live in the north, you know about snow days. Your kids feel cheated if there aren’t a few each winter. Parents juggle to find backup plans when school closings are announced. If your employer is quick to close when there is a major storm or tells you to work from home you may breathe a sigh of relief. You’re just glad that you don’t have to get up at the crack of dawn to shovel out your driveway and try to get down your unplowed street.
But hospitals never close, nor can they or should they. The everyday heroes I want to recognize are everywhere at the University of Michigan Health System. The nurses who pulled a double shift because their colleagues couldn’t make it in to relieve them. The support staff throughout the hospital who ensure patients are cared for, in a safe, clean environment. The diligent teams who ensure there are meals for patients and staff. There are too many to mention but just think about all the hospital staff you see on a normal day – they all keep the hospital operating like nothing happened. Continue reading
We’ve all had those bad customer experiences: rudeness, “not my problem” attitude, bounced from person to person, being left on hold too long, not hearing back from someone as promised. You know what I’m talking about.
And we’ve all had those excellent customer service experiences: think about the difference. Was it the smile, the caring attitude, the problem solving focus, the level of ownership, the offer to help before you could even ask for help? These are just some of the attributes of good customer service.
If you provide a product or service to anyone in the work you do, it’s a good idea to look at your own customer service and how you stack up. And,who doesn’t provide some kind of product or service to others? You may have both internal or external customers.
When I started this position in late 2012, I laid out my core principles and values to my staff. Customer Service was one of them – as I said then, “while we don’t touch patients directly, we are all part of the extended care team; clinicians and caregivers rely on the systems we provide and support to care for patients in a safe manner. Excellent customer service in all our interactions is critical.” Continue reading
When we encourage staff to speak up, we, as leaders, must be ready to listen. I’ve heard it said we have two ears and one mouth so we can listen more than we speak.
I encourage my staff to “make their voice heard” and have written about this. Yesterday, I participated in the University of Michigan VOICES of the Staff Town Hall Meeting. It was the third such session in the last ten years and focused on the Future of Work. Over 100 staff from across the university and health system were brought together to help define and shape changes needed in our working environment. The goal of the meeting was to determine the most pressing challenges for all UM staff to develop VOICES work team themes for 2015.
Prior to the town hall, 600 staff were surveyed for ideas. 100 staff members who were willing to give a half day to the town hall were to turn those ideas into concrete proposals. At the end of their working session, each of the 12 groups gave a 30 second “elevator speech” pitch to our new University President, Dr. Mark Schlissel. Continue reading
Monday, January 19th, is Martin Luther King, Jr. Day, celebrated as a national holiday since the mid-80’s. I’ve worked for organizations who considered it a formal holiday and those that did not. But whether you are working or not on Monday, there are many opportunities in the coming days to celebrate the life of the great civil rights leader. There are educational forums, community breakfasts, and musical events. I have attended many events over the years and always come away with a renewed commitment to do my part to end the injustices in our society.
I saw the film “Selma” last weekend and highly recommend it. Why did thousands of people march from Selma to Montgomery in 1965 – to ensure that African Americans could exercise their basic legal right to vote. The movie may be hard to watch in certain scenes, but we have to recognize it as part of our collective history. The violence against black people really happened as depicted. But that was a different time in our history – it was 50 years ago. Continue reading
How often have you heard that leaders have to “walk the talk”? But how often has a leader you admire disappointed you with either their comments or behavior? We ask ourselves “what were they thinking”?
Being a positive role model and leading by example is something I take very seriously – in both my professional and personal life.
I am deeply touched by the congratulatory notes and kind words I’ve received this week after it was announced that CHIME and HIMSS selected me to receive the John E. Gall, Jr. CIO of the Year Award.
Awards like this don’t happen for CIOs without great teams. I’m extremely grateful for all the talented and dedicated IT teams I’ve worked with over the years. Special thanks to my MCIT team at Michigan for the excellent work they do every day!
This award is named in honor of John E. Gall, Jr. who Continue reading
Everywhere you turn technology makes our lives easier. Yet we take it for granted – until it’s not there.
I spent the holiday week in Boston with family. I observed every day, commonplace technology in my travels, our hotel stay, shopping, eating out, and more. We booked our airline tickets online. We check-in online or at an airport kiosk. We pass through security and find our current gate info on large screens conveniently located. Barely any human contact except when the flight attendant checks our seat belts and offers us pretzels and a drink. The safety information is a video and when we arrive we find the right baggage carrousel on another large screen. Continue reading
I had the chance to deliver the opening keynote talk at the NG HealthCare US Summit two weeks ago. I was to fit a 20 minute talk between the salad and the entree at a dinner. The summit organizers said I could talk about whatever topic I wanted; I just had to be inspiring.
I titled my talk: “Our Future Workforce – Unlocking the Potential”. As I posed the problem in a recent post “Technology, where are all the women?,” I talked about the fact that not enough women are going into STEM (science, technology, engineering, and math) fields. I have been particularly concerned with the drop in women entering computer related fields.
Why does this problem exist, what are some of the programs that are helping address it, and what can IT leaders do about it?
The IT leadership conference where I was speaking was about 75-80% men, so I thought there might be a risk with this angle on the future workforce. I am happy to say the talk was very well received.
Afterwards, men talked to me about their daughters – whether they are in college studying in a STEM field or in grade school interested in computers and robots. Women told me about their own Continue reading
It’s been 18 days since the Ferguson grand jury decision and 9 days since the NYC grand jury decision. We have all seen the news and protests in cities around the country. Black lives matter.
Yesterday, another group demonstrated their support. Students at 70 medical schools around the country organized a national white coat die in. They lay down for fifteen and a half minutes. Eleven minutes to represent the number of times that Eric Garner said “I can’t breathe” as he was in a choke hold by police in New York City and four and a half minutes to represent the four and a half hours that Michael Brown’s body lay in the street after being shot by a police officer.
Medical students with the support of deans and faculty at prestigious schools such as Harvard, Yale, UCLA and Johns Hopkins said that racial bias is a public health issue. Physicians are trained to do no harm. They are trained to heal. They are trained to save lives. Yes, this is a public health issue. Continue reading
It’s a game-changer if it has the potential to change the outcomes. We often see how new technology creates a big shift in the market.
Uber car service has been taking hold in large cities over the past few years. It’s even come to Ann Arbor. Is it a game-changer in local transportation? Looks like it. I know there is plenty of controversy right now about Uber and their business practices but you have to admit they have figured out how to leverage GPS technology and mobile devices in new ways. I experienced this first hand recently when I used an Uber to get to the airport. No question it was easy and convenient.
And that’s what consumers look for in the products and services they buy: easy, reliable, convenient, and low cost. We all love that one-click purchasing on Amazon: buy a book and it immediately downloads to our Kindle readers – a game-changer in the book business!
We, health care IT leaders, are sometimes criticized for Continue reading