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
Communicate, communicate, communicate. How often have you heard it said that you can’t communicate enough?
A best practice for CIOs is to have “all staff” meetings at least quarterly or semi-annually. Regardless of the size of the IT department and the logistical challenges of getting people in one place, these meetings have value. Depending on the geographic spread of the IT team and availability of meeting space, you can always leverage technology to allow staff to dial in from their workspace.
Connecting with colleagues that they only hear on conference calls or “see” via email has value. If you are able within your budget to provide food, all the better to encourage social time before or after the actual meeting.
Such meetings allow you or guest speakers to provide the big picture on your organization’s strategy and priorities so everyone understands how their work fits in. You can communicate key updates and information on major projects and new processes that impact all or most of the staff. You can use it as a forum to provide education on key topics that all IT staff need to understand such as cybersecurity or bring in a motivational speaker.
At one organization where I served as CIO, shortly after I started, one of my direct reports was quick to tell me the exact number of years, months, and days since their last all staff meeting. How do you really feel about that was what I wanted to ask him. But I quickly understood he was representing staff who missed those meetings and wanted them re-introduced. I did ask why they were discontinued. The story I got was that the previous leader was asked a difficult question by a staff member, felt on the spot and didn’t want that to happen again.
As a leader, I welcome questions, even if I can’t answer them. Continue reading
I am regularly reminded how much young working couples with children need family support systems. Even with the new more flexible work arrangements and the ability to work from home occasionally or on a permanent basis, working parents need help from time to time.
We have four young working parents in our family. They balance the demands of their jobs and raising young children. That’s my two daughters and our sons-in-law or as my husband called them on Father’s Day, “active duty dads”. And he of course is an “active duty grandpa” when needed.
My oldest daughter is a nurse practitioner who works three 12 hour shifts a week and a fourth shift one week a month. She has an hour plus drive each way to the hospital. She leaves the house before her 1-year-old and 2-year-old children are awake. She gets home in time for bath and bedtime stories.
On the days she works, my son-in-law gets the children up, dressed, fed and off to the day care center. He is a senior loan officer at a mortgage company with an office in downtown Boston. He takes the train in and out and works from home a few days a week. Continue reading
What is a “frenemy”? According to Dictionary.com: “person or group that is friendly toward another because the relationship brings benefits, but harbors feelings of resentment or rivalry”.
Within health care organizations, there is a lot of history between the people who support the medical devices that touch patients and those who support the information systems used by clinicians. It has not always been positive and collaborative. In fact, there are such differences in the culture of each group that they don’t always get along. Maybe they are even “frenemies” in some organizations.
In your hospital, you may know the function as Biomedical Engineering, Biomed, Clinical Engineering or Health Technology Management (HTM) as it is now called as part of elevating the profession within healthcare. Those in the field now refer to themselves as “HTMs”.
AAMI (Association for the Advancement of Medical Instrumentation) is a standards development organization and the professional society for HTMs. AAMI is celebrating its 50th anniversary this year. Its mission is to advance safety in healthcare technology.
Four years ago, I was the first CIO ever to be elected to the AAMI board when AAMI leaders recognized the trend towards HTM and IT convergence and integration. I have provided the IT perspective to the AAMI board as the HTM profession continues to evolve. Continue reading
Last week was teacher recognition Sunday at our church. The many people who volunteer in our children’s religious education program were recognized and thanked for their service.
The title of our minister’s sermon was “A Teacher Is One Who Talks in Someone Else’s Sleep”. With the influence of teachers in all situations in mind, he asked us some key questions:
- Who is speaking to you?
- Who are you speaking to?
- What messages are you sending?
As a leader, this resonated with me. Leaders are teachers in every sense of the word. We teach by what we say and what we don’t say; what we do and what we don’t do. We teach with words and gesture. We teach with how we respond to situations. We teach in how we treat people regardless of their position and level in the organization.
So, what kind of teacher are you? And what kind of teacher do you want to be?
Sheryl Sandberg, Facebook COO, has said, “Leadership is about making others better as a result of your presence and making sure that impact lasts in your absence”.
When I take on a new position, I share with my team my values and guiding principles. I want them to know what is important to me and what I expect. And I continually reinforce those messages as we work together. Continue reading
This week marks three years of blogging for me. People still ask me where I find the time and how I get ideas for topics. My answer is always the same. I make it a weekly discipline – shaping the ideas during the week, writing a near final draft on Thursday night, then finalizing and publishing it first thing Friday morning. The ideas continue to flow though I’ll be the first to admit there are some Thursday nights when I’m still looking for inspiration.
Just think how I felt the Thursday when I saw this tweet from someone I follow?
“Tomorrow is Friday and we all know what that means! No, not just Cinco de Mayo but @sgschade blog comes out! #anticipation”
No pressure I thought. Fortunately, it was the week I had shadowed a nurse and my blog topic was obvious.
By the numbers, there have been close to 75,000 total views. Who would have thought that three years ago? I remember someone asking me who I thought would read my blog besides my family and close friends. Believe me, I have a small family who doesn’t always read it and few close friends. Continue reading
What consultant doesn’t want to work close to home as much as possible? But you go where your clients are and you get used to traveling.
It was one of those weeks. There was the usual 2-hour drive plus the 1 hour ferry ride to my interim CIO engagement on Long Island. Monday was the first time I worried about missing the ferry. My “wiggle room” on the drive part evaporated with bumper to bumper traffic as soon as I got on I-95 in Providence. I sweated it but I made it!
Then there was a same day trip from New York to Chicago for a CHIME Education Foundation Board retreat. It seemed like a good idea when we agreed to fly in and out the same day but reality of that can be brutal – a very long day!
And finally, there’s the commuter rail train ride into NYC to meet my husband for the holiday weekend.
I’m happy to not depend on airports for my current weekly commute compared to many who are truly “road warriors”. I feel a little spoiled. My biggest stress is whether I’ll hit traffic on I-95 and have to take a later ferry.
When I was the interim CIO at University Hospitals in Cleveland last year, it was a predictable 3.5-hour drive from Ann Arbor. A few times I ran into huge traffic jams and a long out of the way road construction detour. But it was mainly a predictable weekly commute. And productive when I could get some calls done during the drive.
Once we moved to the Providence area, it meant a weekly flight. The Providence airport has fewer direct flights. I had to choose between connecting flights which increase potential delays or the longer ground transportation to get direct flights out of Boston. I chose the latter.
Then my current engagement on Long Island came up. Driving through NYC or flying was a non-starter. It was a “go” when I learned about the ferry option. Continue reading
As we all watch events in Washington unfold, each of us knows that the organizations we work for expect us to behave ethically in all that we do. We sign confidentiality agreements; we complete conflict of interest disclosures and we receive ethics training.
Whether you consider yourself a “rules follower” or one who likes to “ask for forgiveness, not permission”, you know that you must act ethically and lawfully.
I appreciate the advice I received from a boss early in my career – always do what’s right for the organization. If there is any doubt when I fill out my conflict of interest form, I error on the side of disclosing more rather than withholding information.
And then there’s nepotism – something both small and large organizations need to manage. They figure it out. Unless you are a family owned business, you should not be hiring or managing family members.
I worked at an organization that was named by the Ethisphere Institute as a “World’s Most Ethical Company” five times since 2012 – University Hospitals in Cleveland, Ohio. Their Chief Compliance Officer, Kim Bixenstine, and the entire executive team took great pride in this honor. And they should. University Hospitals is one of only seven healthcare providers named to the list in 2017.
Ethics starts at the top. Continue reading
I had the opportunity to participate in the CIO panel at the New England HIMSS Chapter Spring Conference this week. The questions for the panelists covered a range of issues that currently challenge healthcare CIOs.
- how mergers and acquisitions impact IT;
- how to improve patient engagement given the move to accountable care models;
- how to provide growth opportunities for our teams and;
- how to find time and resources to drive innovation.
I have been a CIO in a few different healthcare organizations recently, so I could describe multiple experiences with these challenges. While we have similar internal drivers, and face similar external constraints, no two organizations are the same.
These questions connected well with some of my focus areas during this current interim CIO engagement at Stony Brook Medicine. After about a month in the role, I summarized what I thought to be my focus areas and shared them with the executives. The feedback was that it was ambitious but on target.
Here’s that list. It’s generalized so you can consider it a good sampling of what interim CIOs can do for an organization, and what other CIOs may be focusing on: Continue reading
National Nurse Week begins tomorrow. I’m fresh off a 4-hour shift shadowing a nurse on a busy inpatient unit with cardiac surgery patients. I was taking part in the “Walk in My Shoes” program at Stony Brook Medicine where I currently serve as interim CIO.
All the executives were asked to block out 4 hours this week to shadow a nurse. I looked forward to my shift despite the other work on my desk. And as I told the nurse I shadowed, spending time on their unit was more fun than some of the problems I deal with as a CIO.
But I wasn’t there to have fun. I was there to understand what a nurse’s day is like and find ways that administration can help. And as the CIO, I wanted to understand how they use the systems we support and to find opportunities to improve them.
I donned a pair of scrubs, the universal hospital uniform and a fashion neutralizer. It’s amazing how different it feels to be on a nursing unit in scrubs compared to being a “suit” who periodically does rounds with a bunch of other “suits”. The staff seemed more willing to just tell it like it is when I encouraged them to be candid with me.
As soon as got to the unit a nurse realized I was from IT. His first thought was that I was there about a system problem that had been reported in the patient safety system. I introduced myself and my role as interim CIO. I told him that while I was there to shadow another nurse, I wanted to hear about their IT issues. This was my “gemba” walk with a group of nurses. Continue reading