HIMSS Stage 7: what does it take?

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 theHIMSS EMRAM 2018

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

Time to support, not harass women

With the latest sexual harassment and abuse stories in the news, I am reminded once again how important it is for women to speak up. We need to encourage women and girls to pursue their dreams, canstockphoto13989561and support them when they face obstacles.

Like other women leaders, I try to be a role model for young women in all that I say and do. I try to speak up and take on the tough issues that women face in the work world. I encourage young women to figure out who is on their “team you”. And most importantly, I tell them not to put up with crap, from anyone.

I have written many posts over the past few years on women and work and done several talks focused on encouraging and developing women.

Here are some of those posts that you might find useful and maybe even inspiring these days:

Yes we can: women in health IT

Powerful women and their path to success

Investing in the success of others

Equal pay, who can argue?

#ILookLikeAnEngineer

Balancing career and family

I challenge you to look at your own practices and ensure you are doing all you can to support women in your organization so they are comfortable speaking up, able to overcome obstacles they face, and can actually thrive and advance.

Humanitarian crisis, American crisis

A week after Hurricane Maria devastated Puerto Rico, we are hearing that this United States territory is facing a humanitarian crisis. That is a phrase we have all heard before about poor countries in other partscanstockphoto18234898 of the world – it could be the result of a natural disaster or a civil war. A crisis like this saddens us, but it’s usually so far away, and we just move on.

What is a “humanitarian crisis”? Wikipedia defines it as “a singular event or a series of events that are threatening in terms of health, safety or well being of a community or large group of people”. Another way of saying it – when the basics of life are unavailable – food, water, transportation, healthcare, and communications.

Puerto Rico is us, yes US. It is not somewhere far away. It is 1000 miles from Miami. 3.5 million people live in Puerto Rico. It is 3 times the size of Rhode Island – in square miles and in population.

Less than 50% of Puerto Ricans have running water. The entire island is without power, the power grid has been destroyed. Only 29 of 69 hospitals on the island are operational. Hospitals still open are running on generators and quickly running out of fuel. In the capital city of San Juan, 2 people on life support died when their hospital’s generators ran out of diesel.

Interviews with San Juan Mayor Carmen Yulin Cruz on MSNBC brought this home. She could not have been more articulate in her plea for federal help. As she talked about the dire situation and the reality of hospitals running out of power, she described them as places to care for and heal people, not to be death traps.

Luis Guiterrez, U.S. Representative from the Illinois 4th congressional district, whose parents were born in Puerto Rico described in vivid terms what the elderly are going through there. He asked us to think about what it would be like for our own elderly parents who may live alone. What if they didn’t have access to food or water and they needed insulin. He called for the U.S. military to go in and quickly set up a power and communications infrastructure as we know they can and do in wartime.

The USNS Comfort is larger than many of the largest hospitals in this country with 1000 beds. Continue reading

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