Yearly Archives: 2015

Make your voice heard

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March is Employee Appreciation Month.  UMHS leadership is hosting breakfast, lunch or dinner at all our sites as a way to say “thank you.” We also conduct our annual Employee Engagement Survey this month. There are only two more days to participate in it.

I’m happy to say the IT department is at an overall participation rate of 66% compared to 48% for all of UMHS.  We had a 90% participation rate in IT two years ago. It was my first year as the new CIO and I made it very clear to the people on staff that I couldn’t address problems in the department if I didn’t know what they were. I needed their input!

Based on the survey results two years ago, we established four workgroups to focus on several key areas. Some areas we were definitely weak on and others we were OK but knew we could improve – recognition and appreciation, employee development and training, service excellence and teamwork.

While we’ve made good progress in all these areas, I’m the first to admit there is still far more work to do.

I have been encouraging our IT department staff to “Make Your Voice Heard.”  There are multiple channels for staff to give me and the entire leadership team input and feedback. In addition to Continue reading →

Creating a security culture

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I wrote recently that if the CIO is the only one worrying about the EHR implementation, it’s a problem. Likewise, if the CIO and the Chief Information Security Officer (CISO) are the only ones thinking about IT security, it’s a problem.  You only have to read the news any given week to see the rising number of breaches within health care – the recent Anthem breach being the biggest to date with over 80 million records involved.  And there is a new breach we are all hearing about as of this week – Premera Blue Cross potentially involving financial and medical records of up to 11 million customers.

IT security is a common topic amongst health care CIOs these days. We are continually trying to learn from one another and share best practices.

I recently had a third party IT security assessment done for our health system in order to identify key gaps and get recommendations to strengthen our IT security program. One of the best pieces in the final report was about creating a security culture. So what’s a security culture?

Signs an organization has developed a security culture include the following: Continue reading →

Surfacing problems, prototyping solutions

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According to Wikipedia, “a hackathon (also known as a hack day, hackfest or codefest) is an event in which computer programmers and others involved in software development, including graphic designers, interface designers and project managers, collaborate intensively on software projects”. Hackathons are a great way to surface problems and prototype solutions in a short time period.  I just participated in my first hackathon and what an eye-opener it was.

Last week, four different IT groups participated in “Hacks with Friends”: central campus, school of medicine, school of dentistry, and the hospitals and health centers.  It was a grassroots event organized by staff. It was great to see such talent and creative energy in one room.

Every available surface was used to brainstorm and organize ideas.

For two days, over 100 participants in 20 teams worked to develop projects in 3 categories  – gamification, collaboration, and play (which turned out to be the catch-all category for a problem you wanted to explore or experiment with). Projects could be either externally focused on our customers or internally focused on improving processes for technical staff. Many teams included members from the multiple IT groups solving common problems.

Each team was to develop a minimally viable product (MVP). An MVP is a simple way to address a problem that adds value, is demonstrable. An MVP can be an improved process, a new way of doing things, or an old tool applied in a new way.

Poster presentation proposing FitBit integration with UM’s wellness app.

Each team had to create a winning presentation in three stages. First they needed to create an elevator description of the project, including problem statement, solution and differentiators. Then, they needed a five minute poster presentation. If chosen as a finalist, the team needed to prepare a seven minute demonstration of their product.

To succeed, the team needed to understand the strengths of their team members and welcome a broad range of experiences into the team. Best ideas come from co-design. A great reminder that hackathons are not just for people who can code!

Laura Patterson, the UM CIO, Ted Hanss, the Medical School CIO, and I were the judges. We applied these criteria:

  • Fit to category – how well does the project fit the selected category?
  • Feasibility – would this work in the real world?
  • Completeness – how far did the team get in the allotted time?
  • Documentation – did the team document what they learned?

The winning team, “Magic Mirror,” hard at work.

The products proposed were creative and exciting.  Some examples:

World of Workcraft – a game to track what we are learning everyday – books, articles, courses, conferences.

Active You – integrating FitBit with the ActiveU mobile app. I think a high percentage of the 11,870 participants in this UM employee wellness program would love this!

Rundeck – a way to automate system administrator tasks using the Rundeck tool.

The winner of the Hacks with Friends event was Magic Mirror – putting student photos in their profiles in the new learning system to help faculty get to know students and students get to know one another. The runner-up was Go Phish – an interactive training tool to help people recognize phishing email leveraging gaming technology.

The coveted “golden hard drive” trophy.

But from another perspective, Activity in Motion (AIM) was the winner for me.  This was a team led by Sally Pollock, Manager of IT Service Management from my IT department, that developed a multi-platform application to capture and centralize major incident activity real-time.  Benefits include: providing real-time information, minimizing distractions during the major incident call, minimizing the duration of the major incident, capturing a list of participants, making activity highly visible and storing it in a database, where it can be used for reporting and the post incident review process.

The team’s presentation helped me realize the current state of managing major incidents and how a simple app like this could improve the process. I jumped on it.  I asked the team to present to my leadership group meeting on Wednesday and we gave directional support for this solution. They will come back in a month with recommendations on how to fit this solution into our current major incident process.

A great example of how a hackathon opened one leader’s eyes to a problem that needed to be solved.

Leadership huddles: not just another meeting

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It’s huddle time! No, I’m not joining a sports team.  But along with my leadership team, we are taking the next step on our lean journey. In a few weeks we’ll be starting twice a week 30 minute leadership huddles. This is part of Lean in Daily Work which also includes key visual metrics, visual boards, Everyday Lean Ideas (ELI), and leadership walks.

In a post last summer, I talked about the lean journey.  It is important for leadership to set common expectations throughout an organization.  So if we’re going to practice lean thinking as a department, our leadership team has to set the example.

The goals of this lean experiment include the following:

  • Create a common understanding of what our performance is compared to what we want it to be so that we can understand the gaps and improve
  • Make our work visual and actionable
  • Understand our business more deeply by asking questions and looking at trends
  • Surface, track and trend problems
  • Gain experience and practice with lean

Continue reading →

So you didn’t get the job

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Last week I wrote about how to stand out in the interview for a new job. I promised that I would write about what to do when you don’t get the job.  I’ve been there before and it’s not easy.

You think you’ve nailed the interview. You’ve met with lots of people. You like them and your potential new boss. You think it’s a great opportunity and you are excited about the prospects. You anxiously wait for “the call”. And then it comes. The hiring manager, HR person, or recruiter says “we’re going in another direction” – that common euphemism to say that someone else is getting the job.  They go on to say some nice things about you and that you interviewed well but all you hear is that you didn’t get the job.

Your friends and family are supportive. They may say “it wasn’t the right one anyway”. Or “something better will come along”. They tell you how to feel but what you want to say is what my youngest daughter would say to me – “you can’t tell me how to feel, you’re not inside my body!” Continue reading →

Stand out at the interview

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Interviewing for a new job? Remember when you interviewed for your current position? Any way you slice it, job interviews will cause stress but they can also be a growth opportunity.

In recent weeks I have interviewed several candidates for three different positions. I am hiring a new executive assistant who will work closely with me as a partner for day to day tasks, so I can be more effective and efficient.  On a different level, I’m on the search committee for our University of Michigan Chief Information Security Officer – a critical leadership role at a time of increased security threats. I’ve also interviewed a candidate for a key director position in our IT department at the request of the executive director who is doing the hiring.

No matter the role, there are some common themes: the first impression you make, your engagement during the interview, your core skills, and your previous experience all come into play.

Group interviews are especially challenging. They can seem stilted and scripted as the interviewers take turns posing questions. Interviewers need to balance common questions/scenarios with each candidate for consistency while creating a lively discussion where they get to know the person. Candidates need to adequately cover each question without getting off track and still let them get a feel for the person. Continue reading →

Plans, processes, people: lessons from a successful EHR implementation

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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.

 

Resources 

Harvard School of Public Health’s Executive and Continuing Professional Education program, “Leadership Strategies for Information Technology in Health Care”

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Snow days and everyday heroes

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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 →

Go beyond the golden rule for great customer service

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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 →

Time to listen – voices of the staff

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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 →