You will be hearing a lot about Cuba after the death of Fidel Castro. I am certainly not an expert on Cuba, but I learned a lot about the country and its people recently on an 8-day Road Scholar tour. And I was particularly interested in learning about their healthcare system.
“I wanted to see and experience Cuba before it drastically changes with American influence and investment”. That was the sentiment from many of our fellow travelers.
The trip was called “People and Society: Cienfuegos to Havana”. It included day trips to Trinidad and Santa Clara plus a stop at the Bay of Pigs on our way to Havana. Everywhere we went, we experienced the cultural arts first hand – music and dance from young grade school age students to seniors well into their 80’s. We heard a chamber orchestra and saw a contemporary dance show.
We heard lectures on history, politics, and religion as well as how Cuban millennials view the future. We learned how negatively the U.S. embargo has impacted the people of Cuba. And how they want the embargo fully lifted but with future U.S. investments and development managed.
We had a chance to sit and talk for an hour with a young man who works in a telecom job in health care. I asked about electronic health records and he said they are in the process of implementing a system they have developed.
When I got home and caught up on my email, I learned that a 15-member delegation of healthcare executives visited Cuba while we were there. That delegation was led by former HHS Secretary and Governor Mike Leavitt, and included Dr. David Blumenthal, former National Coordinator at ONC and Stephen Lieber, HIMSS president and CEO. Stephen wrote an insightful blog on the experience. The delegation was a mix of vendor, consulting and provider executives who had gone to see the Cuban healthcare delivery system up close. Continue reading
Are you in your first CIO position? Have you just been promoted by executives at your organization who see what you are capable of? Or have you been tapped by another organization to step into your first ever CIO role? Or maybe find yourself serving as the internal interim CIO during the search for a permanent CIO.
In any of these scenarios you may wonder where to turn for help and advice. Every day there will be situations that you do not feel fully prepared for.
If you’re fortunate, you have already attended the CHIME CIO Boot Camp. It’s a three-and-a-half-day immersion into the breadth of what a CIO needs to know taught by experienced CIOs. Over 1,400 CIOs and future CIOs have graduated from the program over the past 13 years. If you haven’t yet attended, you should consider it.
If your organization has memberships with health care focused services such as Advisory Board, or broader research services like Gartner, be sure to take advantage of those resources. And make them available to your entire IT leadership team.
Be a sponge. Don’t be afraid to ask questions. Find people who are ahead of you and can share their experience. Continue reading
It’s rare that a CIO gets to watch another CIO at work. Yes, we all network regularly at CHIME and other conferences. We learn from each other on topical webinars. And we pick each other’s brains on phone calls about something that is new for us and our organization.
But to see someone working day to day with the executives, their peers and their own leadership team is different: how they set expectations and deliver tough messages; how they make commitments with appropriate caveats; how they answer questions if they don’t have enough information yet.
I’ve been fortunate to watch our new CIO, Joy Grosser, at University Hospitals, at work. I’ve stepped back since she became CIO and serve as an advisor to her during the transition. We look for pockets of time to do transition and turnover.
During these few weeks of transition, we’ve had some production issues and vendor challenges. We are developing next year’s budget. We are finalizing a plan for new hospital integration with the help of a consulting firm. These are big initiatives to walk into, to learn quickly what you need to know, and to lead with authority and confidence.
But that’s what leaders do. They listen and learn. They share their values and vision. They don’t pretend to know or have all the answers. They rely on their team to keep them informed and to solve problems. And at the end of the day they own it. Continue reading
If you are drinking from a fire hose, you need to focus or you will drown. When so much new info is coming your way every day, you need a framework. When I started my present interim CIO engagement, I knew I needed to understand some key areas right away. They included strength of the leadership team, staffing, system performance, user satisfaction, budget, vendor relations, security, and IT governance.
Issues with system performance and dissatisfied users will find you even if you don’t go looking. Without solid system performance for your production environment, it’s hard to discuss anything else with your executives. If the issue affects your clinicians and their ability to see patients and manage their workload, you need to pay close attention. And you need to work with your team to figure out what’s going on and resolve it. System performance affects user satisfaction. Whether users love or hate a system they depend on, it has to be fast and reliable.
To quickly assess the IT leadership team, you need to understand their background and experience, their current scope of responsibility and their primary concerns. What are they struggling with? What help is Continue reading
I am wrapping up week 3 as the interim CIO at University Hospitals in Cleveland, Ohio and I’m drinking from the fire hose. I have to learn a new organization, a new team, a new set of projects and priorities, and a new set of tools. This much change takes patience – first with myself. I realize I can’t learn it all in one day or one week.
The good news is that there are many common themes and issues between health care organizations. With so many years of experience in health IT and leadership roles, I can jump right in. Imagine trying to learn this industry for the first time at this level!
I meet with other executives for the first time in “meet and greet” sessions. I want to get to know them and understand what they need from IT. So, I’m asking each of them 4 key questions:
- What’s working well?
- What’s working not so well?
- Considering I’m interim, how can I have the greatest impact?
- What are the key requirements for the next CIO?
I’ve asked all of my management team in IT to consider these same questions. More good news, Continue reading
Recently I wrote that October was Quality Month and I highlighted Dr. Richard Shannon’s excellent talk, part of our Lean Thinker’s Series. I “teased” that I would comment on the Quality Month poster sessions in an upcoming post.
For two days, 48 quality improvement teams displayed their stories as posters. I spent about an hour checking out the posters and talking with people from the teams. I targeted the ones with potential scalability or an IT connection.
Jennet Malone, a manager at The Briarwood Center for Women, Children and Young Adults, explained how they increased use of the portal.
Here are a few worth noting:
Got Portal? –The Briarwood Center for Women, Children and Young Adults
We rolled out our patient portal more than 3 years ago. Patient enrollment has been fairly successful with over 200,000 active users but this is still not at the level we need. This health center established specific goals for making portal functionality part of everyday clinic workflow and used by patients and families. They increased their marketing efforts and established staff incentives for meeting short term goals. They purchased iPads to help staff sign up patients. They added the portal metric to their daily huddle. The result: Briarwood Center for Women, Children and Young Adults has the highest percentage of patients on the portal when compared to other clinics! Continue reading
It was a long but productive 24 hours. A team of us from the health system flew to Durham, NC, on Tuesday evening, spent a 10 hour day on Wednesday at Duke Medicine, and then flew home. It was a site visit aimed toward learning from each other and determining opportunities for collaboration.
UMHS and Duke have similar profiles: our overall size, IT infrastructure and core applications. We are in similar places on our EHR journey with Epic. And we are both very focused on analytics – the impetus for our visit.
Duke’s CIO, Dr. Jeff Ferranti, and I know each other; we thought the proposal for a visit was a great idea. Our Chief Medical Information Officer, Dr. Andrew Rosenberg, and Duke’s Chief Health Information Officer, Dr. Eric Poon, planned and organized the day’s agenda. We let Andrew and Eric run with it and they did a terrific job!
Two important clinical leaders joined our Michigan team of several senior IT leaders — Dr. Jeff Desmond, our Chief Medical Officer, and Dr. Steve Bernstein, Associate Dean for Clinical Affairs. We needed them there as we talked broadly about analytics and support for population health. Continue reading
I’ve written about gemba walks. Gemba is the Japanese word for “the real place” or that place where the work is done.
I am fond of a quote from President Dwight D. Eisenhower: “Farming looks mighty easy when your plow is a pencil and you are 1,000 miles from the corn field.” While I don’t know the specific context for the quote, it applies to business today. As leaders, unless we see the way work happens on the front line, we cannot understand the problems we need to solve and the barriers we need to remove. That doesn’t happen by just meeting in a conference room.
All hospital leaders were assigned to do at least three gemba walks this summer. The walks are supposed to be an example of each of the following:
- patient and family experience such as observing check-in
- front line staff experience such as shadowing someone or attending a unit’s daily huddle
- “break out of your silo” experience such as observing one of your downstream customers or walking a “value stream” (a high level view of how work gets accomplished across multiple departments and physical locations)
We are expected to Continue reading
Say that title fast! We held our quarterly IT leadership retreat this week. As we continue on our lean journey, I decided a field trip was in order.
James Goebel explains how employee can see their scheduled tasks on the resource management digital board at Menlo Innovations.
We spent two hours at Menlo Innovations getting a private group tour from co-founder James Goebel. To prepare, we read the “The Joy of Lean Innovation: A Case Study of Menlo Innovations” and listened to a Gemba Academy podcast of an interview with Richard Sheridan, Menlo Innovation’s founder and CEO. Many others from University of Michigan Health System have visited Ann Arbor based Menlo over the years. I’d been encouraged to make a visit by my lean coach, Margie Hagene, and our internal UMHS lean champion, Dr. Jack Billi.
Menlo is a software design and development company. But we weren’t visiting to understand their approach to software. Rather, we wanted to understand how they have applied lean principles to run their business and create the culture that Richard Sheridan describes in his book, “Joy, Inc. – How We Built a Workplace People Love.”
Two of our new IT directors are in their third week, so we started the retreat by each describing the most effective leadership team experience we’ve had. The themes that emerged Continue reading
I spent the better part of a day this week at the annual meeting of the Epic Michigan Users Group (we call it eMUG). But I don’t want to focus on Epic. I want to talk about the value of learning from your peers. It could be any vendor or any user group.
This was our fourth annual eMUG conference. Given space limitations, we had 200 attendees last year and with the venue this year we were able to accommodate 400, a significant increase. With 11 health systems in Michigan on Epic, that’s a good size group from each organization.
When asked for a show of hands on how many had been to Epic’s national user group meeting (UGM) before, only 25-30% of the attendees raised their hands. Local user group meetings like eMUG give many more staff a chance to attend and connect with their peers. National user group meetings are costly with airline and hotel expenses for a couple days.
This eMUG meeting was a content rich day: Continue reading