HIEs matter

We have watched with sadness as Hurricane Harvey has flooded first southeast Texas and now Louisiana. We have seen the spirit of the American people at its best. Volunteers from around the countrycanstockphoto30688369 have brought their own boats to rescue residents while thousands have donated money and supplies. As of Thursday morning, there had been over 25,000 water rescues.

Hospitals are meant to operate and care for patients 24/7 through a disaster. But they too were impacted by the rising waters. I took a break mid-day yesterday to watch the news. I saw in that 15-minutes the evacuation of patients from Baptist Hospital in Beaumont, Texas after the city lost its water supply. Without clean water, the hospital had to close and transfer 190 patients.

Patients, many in wheelchairs, needing dialysis treatment were being boarded onto Black Hawk helicopters by teams of doctors and nurses. They were being handed over to military medics to be flown to a hospital in Jasper, Texas – 70 miles away.

The last step in the transfer process was a clinician giving a folded-up paper to the medic. She had stuffed it under her shirt until that point so it didn’t blow away in the wind from the helicopter propellers. We know that this critical paper handoff probably happened over and over this week as patients were transferred to other facilities.

In this age of electronic medical records (EMRs) and health information exchanges (HIEs), we hope that piece of paper is a backup document. Transfers within a health system with a common EMR should be able to rely on the system for access to critical patient information. Health systems that participate in HIEs should be able to rely on some level of data exchange and access between health systems and their disparate EMRs.

I was encouraged to see two health IT articles this week – “As Harvey Devastates Houston, HIE Leaders Move in to Help” in Healthcare Informatics, and “What’s Next for Health Information Exchanges?” in Healthcare IT News. The first article describes the power of the HIE in Texas; portals have been set up in the many shelters so clinicians can access critical health information as they care for people in need of medical attention. The second article talks about the future needs that HIEs could meet and their potential benefits as healthcare continues to evolve. Continue reading

Living your values

This is not about who you voted for in 2016.

This is not about whether you neatly compartmentalize your political persuasions and don’t talk politics at work.

This is about standing up for what you believe and living your values.canstockphoto9176405

The six CEOs who left the president’s manufacturing council after Charlottesville may have done it to protect their businesses and profits. But I will give them the benefit of the doubt; they were unwilling to work with a president who cannot call white supremacists and neo-Nazis what they are.

The last to leave before the remaining members agreed to disband was AFL-CIO President Richard Trumka. He made the strongest and clearest statement of all. He announced he was leaving the council late Tuesday after President Trump defended his original statement on Charlottesville, blaming both sides. “We cannot sit on a council for a President who tolerates bigotry and domestic terrorism,” the organization said in a statement. “President Trump’s remarks today repudiate his forced remarks yesterday about the KKK and neo-Nazis. We must resign on behalf of America’s working people, who reject all notions of legitimacy of these bigoted groups.”

Ken Frazier was the first CEO to step down after Charlottesville. “As CEO of Merck, and as a matter of personal conscience, I feel a responsibility to take a stand against intolerance and extremism,” he said in a statement. He was the only African American CEO on the council and is the only one singled out publicly and criticized by the President.

We live and work and play and study in a global society with great diversity. I embrace that diversity.

When I am coaching leaders I challenge them to share their values with the people they lead. I challenge them to envision the leader they want to be and to take concrete steps to become that leader. And I always encourage them to put aside personal agendas and do what is right for their organization. Continue reading

10 tips for next generation leaders

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 canstockphoto23302155many 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

Passing the baton again

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 canstockphoto13851442starts 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

A greater sense of purpose

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 ofcanstockphoto11710732 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

Leaders as teachers 

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.canstockphoto29495765 (002)

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

Ethics 101, what’s so hard to understand?

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 canstockphoto13989561interest 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

Different organizations, common IT challenges

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 canstockphoto5451287healthcare CIOs.

Some were:

  • 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

Walking in a nurse’s shoes

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 Sue in scrubs cropped (2)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

Lean classics worth a second look

I am a lean leader and always willing to share my learnings. I’ve written several blog posts chronicling my lean experience at different organizations. Some of them have been quite popular with readers. I’ll call them my canstockphoto19155139“lean classics”. Here’s a recap for your reference:

Huddles and Visual Management:

Leadership huddles: not just another meeting – describes my first IT leadership huddle launch back at University of Michigan Health System. As my lean coach said at the time, be willing to experiment, it doesn’t have to be perfect. We learned and tweaked it as we went through the PDCA cycle.

Making the invisible visible – describes the beginning stages of the visual board our IT leadership team created at University Hospitals in Cleveland.

Making the invisible visible – part 2 – describes that same effort several months after we launched it and how we used it as a team.

6 tips for successful huddle boards – based on experience, my advice to those considering their own huddle boards. Remember, you need to be willing to experiment.

Gemba Walks:

Importance of rounding or going to the “gemba” – describes early experience with clinical and operational rounding both at Brigham and Women’s Hospital and University of Michigan Health System. Continue reading