Yearly Archives: 2020

Looking ahead to 2021 – predictions, emerging trends, and some advice

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The calendar is a familiar demarcation for the close of one year and the start of a new year. We celebrate together and make resolutions alone. Never in my lifetime has there been a year that I have wanted to see in the rear-view mirror more than 2020. I know that I’m not alone in that sentiment. But the true demarcation will only come later in 2021 when enough people have been vaccinated and we can say this pandemic is largely behind us.

Health IT leaders and their teams across the country have demonstrated incredible creativity, collaboration, resilience, and commitment to their communities this past year. I am in awe of and encouraged by what they have accomplished.

As we come out of this long, dark period in our history with so much loss and so much learned, like others I have some advice for IT professionals next year.

My StarBridge Advisors colleague, David Muntz, has already shared his thoughts on the challenges and opportunities for the coming year as he does each year in a View from the Bridge blog post – “12 Steps to Prepare for 2021 – Big Challenges – Bigger Opportunities”. As always, David has done an excellent job of capturing the key ones with his comments on collaboration, reinventing your IT organization, partnerships, life-work balance, cybersecurity, SDOH, EHR satisfaction, ERP solutions, and more.

I’ll add a few to the list:

    • Capture and institutionalize what allowed your team to work at “COVID speed” – laser focus, fewer concurrent priorities, rapid decision making, and funding.
    • Double down on efforts to increase interoperability within your system and region. Enhance your analytic capabilities. Scale and extend virtual care options which will continue to represent a good portion of care even post-pandemic.
    • Establish the right balance of onsite and remote work for your team once it is safe to return to the office. Account for both the organization’s needs, and your employees needs. Continue to be flexible knowing your team delivers regardless where they are working. Use your new model as an opportunity to rethink your recruitment and talent strategy.
    • As CIO claim your expanded role whether it is as Chief Digital Officer, Chief Innovation Officer, or leading a non-IT operational area. You have more than proven yourself during this pandemic and the rest of the c-suite knows it.

Continue reading →

8 health experts to follow

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In past years, I’ve used the end of the year mark as a way to highlight my most read blogs of the year and encourage you to check them out if you missed them. But who cares about my most read blogs? Instead, I want to amplify the voices of health experts who have educated us throughout this pandemic and who will continue to for many months to come. If you aren’t already following them on social media or listening to their podcasts, I encourage you to do so. They are often interviewed on the major news programs.

Trusting the science, knowing the facts, and maintaining objectivity are critical for all of us to do our part and get safely to the other side of this pandemic.

Here are the experts I recommend you follow in alphabetical order:

Esther Choo, MD, MPH, Co-Founder, Equity Quotient, is an emergency physician and professor at the Oregon Health & Science University. She has been speaking from the front lines of the pandemic since the beginning. She did a podcast series called Doctors’s Log – A Covid-19 Journal in the early months of the pandemic. Twitter: @choo_ek

Laurie Garrett is a Pulitzer Prize winning science journalist and author of several books including “The Coming Plague: Newly Emerging Diseases in a World Out of Balance” and “Betrayal of Trust: The Collapse of Global Public Health”. In 2007, she did a TED talk “Lessons from the 1918 Flu”.  Twitter: @Laurie_Garrett

Ashish Jha, MD, MPH, is an internationally respected expert on pandemic response and preparedness. He recently left his position as faculty director of the Harvard Global Health Institute and became dean of the Brown University School of Public Health.  His recent interview on In the Bubble with Andy Slavitt, “The Next Three Stages of COVID-19”, is worth checking out. And as I just learned, he also has his own podcast series, “COVID: What Comes Next”. He is a frequent contributor on all the major news outlets. Twitter: @ashishkjha

Vivek Murthy, MD, MBA, has been nominated as the next U.S. Surgeon General, a role he also served in during the Obama Administration.  He is the co-chair of the Biden COVID Task Force. His recent interview on in the Bubble with Andy Slavitt, “Inside the Biden COVID Task Force”, is worth checking out. Twitter: @vivek_murthy

Michael Osterholm, MS, MPH, PhD, is the director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota and is a world-renowned epidemiologist who has spent his career investigating outbreaks. He is a member of the Biden COVID Task Force. Continue reading →

Say yes to students – they are our future

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There are just so many hours in the day. We can choose what we say yes to and what we say no to. As part of my commitment to developing next generation leaders, I always say yes to individual requests from students and invitations to be a guest speaker at a school. And I never know what other potential connections might come from it.

One of those requests came in October. I got a LinkedIn message asking to be on a panel at the annual Boston Young Healthcare Professionals (BYHP) conference. The young woman who reached out had been an intern in our program at Michigan Medicine when I was CIO. I quickly said yes.

The conference was on “Expanding Our View and Zooming In: What We Can Learn About Healthcare in Our Backyard and Around the World”. My panel was “Healthcare in a Technological Era: Making Boston’s Backyard Even Bigger”. Robert Schultz, managing director at Massnex, was the moderator. On the panelist prep call, I got to know Robert and the other panelists. Robert and I quickly realized that there might be opportunities to work together in the future, so we scheduled a separate call. That call led to another invitation.

Robert teaches the course “Entrepreneurship in Healthcare Organizations” in the Wagner Graduate School of Public Service MPA program at NYU. He asked if I would be a judge for the final class when the students make their business plan pitches – he said think “Shark Tank” but nicer. Of course, I said yes. Continue reading →

V-Day – With the vaccine comes hope

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The UK administered the first fully tested and approved COVID-19 vaccine this week. The U.S. could be administering the vaccine as early as next week. There is hope!

Projections are that by summer 2021, most everyone in the U.S. who wants a vaccine will be able to get it. There is hope!

The Biden Administration’s health team has been announced. There will be a new reliance on clinicians, scientists, and public health experts. There is hope!

And yet, the challenges are many. To name just a few: overall supply vs demand, distribution logistics and storage, logistics of administering the vaccine, establishing guidelines for prioritized groups to receive it, ensuring both doses are administered at the right time interval, and of course public trust in the vaccine.

As I have read and listened the past week, I have learned how the free market impacts the availability of key components for the manufacturers, that each state can decide on their group priorities after the CDC publishes the guidelines, and that only about 60% of the population say they are willing to take the vaccine.

On a more encouraging note, I have heard how provider organizations have been developing their vaccine administration plan for months and how a leading pharmacy chain is planning to scale administration across their 10,000 locations and has an app ready to go for tracking patients, scheduling appointments, and sending reminders for the second dose.

I encourage you to check out these resources to understand the issues involved:

In the Bubble with Andy Slavitt podcast – Toolkit: Where and When Can I Get the Vaccine? He talks about the science with Dr. David Agus and the logistics with CVS Health’s Tom Moriarty. Together they answer questions from listeners.

Interview with Dr. Atul Gawande in the New Yorker by David Remnick – Atul Gawande on Coronavirus Vaccines and Prospects for Ending the Pandemic. It covers a lot of ground and Dr. Gawande is as insightful here as he is in his regular New Yorker pieces and many books. Continue reading →

Well past time to support our healthcare workers – Part 2

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I knew that Governor Gina Raimondo had announced a two week pause starting November 30th and that there were growing concerns about hospital capacity here in Rhode Island. But when I got this alert pushed to my phone Monday morning like everyone else in the state, it became very real again.

I knew there was discussion about opening a field hospital in Rhode Island. But when I saw that the lead story on one of the national morning news shows was an interview with the field hospital director on opening day December 1st, it became very real again.

I knew that our ED at the largest hospital in the state was at a breaking point as I have been following Dr. Megan Ranney closely on social media in recent weeks. But when I heard her describe what it is like in the ED on this week’s In the Bubble podcast with Andy Slavitt – “Following One Shift in the COVID-19 Unit”, it became very real again. Listening to her describe mentally getting ready for her shift, donning and doffing layers of PPE that is worn the entire shift, assessing and admitting very sick patients, calling families with updates, and heading out the door with her physically exhausted co-workers at the end of a long shift, I came to appreciate even more what our frontline healthcare workers are doing 24×7 in hospitals across the country.

I am not a denialist. Quite the opposite. I have taken this virus seriously since the start. I wear a mask whenever I’m out and can’t be socially distanced. I keep a journal of all our outings and contacts. I have the Crush Covid RI app that includes a location tracker diary for the past 20 days on my phone. I have watched many news stories, read many articles, and listened to many podcasts in the past 9 months. I feel very educated and informed. And at times, I feel very sad – so many stories have brought me to tears.

When I hear about new restrictions in my state, I typically tell my husband no change for us, we’re already living that way.

But it hit me different this week. Continue reading →

With gratitude – yes, even in 2020

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Difficult as 2020 has been, it is my hope that each of us can find something to be grateful for this Thanksgiving. If you have lost a loved one to COVID, I know that no words can take away your pain and grief. If you are a “long hauler”, I hope that you are finding support from others as you navigate your ongoing health issues. If you have lost your employment due to the economic downturn, I hope you are finding support from your network to find a new job.

Many times, during the past 9 months I have said to my family and friends – I can’t complain, I’m healthy and alive. I never really felt my age, but since March I have been reminded that I am an “elder”. I am overall healthy with no underlying conditions but I’m in that over 65 group. My husband is 4 years older than me and does have some medical conditions. We have been mask wearers since mid-March and do our best to minimize our risks.

I have much to be grateful for. Healthcare workers caring for COVID patients on the front lines and scientists working to develop a vaccine. All those who support them in ways we see and don’t see. And yes, that includes the IT and HTM teams in every health system who provide solutions and systems that the clinicians depend on.

I am also grateful for all the essential workers – at the grocery store, providing public transportation, delivering packages, and the police and firefighters who protect us.

My family are my big rocks. And that has never been truer than this year. I am eternally grateful for them. Continue reading →

Well past time to support our healthcare workers

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Any graph or heat map you look at, one thing is obvious – the coronavirus is out of control and spreading rapidly. New coronavirus cases have jumped by more than a third in the U.S. over the past seven days, according to data from Johns Hopkins University, the fastest pace since late March. Every day since Election Day, more than 100,000 people in the country have tested positive for the virus with a daily record of over 187,957 new cases last Friday per Worldometers.info. We went from 10 million new cases to 11 million in just one week. And we have lost over 250,000 lives.

We saw heartbreaking stories on the news from ICUs in the Northeast during March and April. Then stories from southern states. And now from hospitals in the Midwest. But when you look at the heat maps, the virus is everywhere now.

Listen to any healthcare worker and one more thing is obvious – they are exhausted and burning out. They tell story after story of how hard it is to work 12- and 18-hour shifts caring for COVID patients only to drive home past crowded bars.

We have seen exhausted physicians and nurses share their stories for months. I cannot tell their stories, but I can share them. And I can encourage you to do the same. But more importantly, I can encourage you to take the basic steps needed at this point – messages we have all heard for nearly 9 months now – wear a mask, socially distance, and wash your hands frequently.

This virus is not a hoax. It is not something you can ignore or deny. A story from a nurse in the Dakotas is the latest to go viral. She describes patients who yell at her and say she does not need to wear PPE because they don’t have COVID, right up until they are intubated.

Our healthcare workers truly are heroes, but they are at a breaking point. Our hospitals are at or nearing capacity. There are over 73,000 people hospitalized with COVID, another record since the pandemic started. Field hospitals are opening again in many states. Continue reading →

Women need male allies

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One of the last glass ceilings has been shattered. Senator Kamala Harris is now Vice President Elect Kamala Harris. She will be the first woman to hold this office. In her speech on November 7, she paid homage to the women who worked to secure and protect the right to vote and the women still fighting to be heard as she said, “Tonight I reflect on their struggle, their determination and the strength of their vision to see what can be unburdened by what has been. And I stand on their shoulders.”

And to future generations, she said: “But while I may be the first woman in this office, I won’t be the last. Because every little girl watching tonight sees that this is a country of possibilities. And to the children of our country, regardless of your gender, our country has sent you a clear message: Dream with ambition, lead with conviction, and see yourself in a way that others might not see you, simply because they’ve never seen it before. And we will applaud you every step of the way.”

The fight for women’s rights and equity is not one that women can wage alone. We need male allies. The good news is that we have many and probably many more that just need some encouragement.

I am seeing an increasing number of resources available on how men can be better allies and support women. Here are two recent articles worth sharing: Continue reading →

The healing power of humanity

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This is one of those weeks where I struggle for the right words. We are all in wait mode. Regardless of the outcome of the election, our nation needs healing. Your relationships with family members, friends or colleagues may be strained as the divisiveness of recent years has grown during this election cycle.

In health care, we focus on healing and take care of everyone regardless of their politics. For inspiration, the words this week from two national healthcare leaders are worth sharing.

Michael Dowling, CEO of Northwell Health, penned a very powerful piece in Becker’s Hospital Review on November 4 titled, “Look to healthcare to remember what decency means”. He calls on leaders to focus on decency saying, “Considering the contentious rhetoric we have witnessed at the highest levels of government throughout this past election season, now is the time for leaders to emphasize decency as the most important trait any one person can exhibit in their organization.” He talks about how our collective sense of decency has been violated saying, “The end result is a pervasive lack of trust, respect and empathy that prevents us from getting anything done. To solve any problems in healthcare or in broader society, we need to reclaim the value of decency and civility.” In a year that has been incredibly demanding and stressful for healthcare professionals everywhere, he closes with, “In healthcare, our care teams have been role models of decency, and our nation would benefit from a closer study of them.”

Lloyd Dean, CEO of CommonSpirit Health, published a short article on November 4 titled, “We Made Our Voices Heard”. Speaking of the 150,000 people who make up CommonSpirit, he says “We believe in the healing power of humanity, and we are called to heal our patients, our communities, and our country in every way we can.” In his closing words, he calls us all to come together: “Even though we don’t yet have all of the election results, and regardless of how you feel about the outcome, I encourage us to all consider how we can reveal the best of humanity during this moment. Let us empathize with those whose perspectives are different from ours. Let us show others how to bridge our differences and find common ground. Let us help our children and our neighbors feel enthusiastic and empowered to make our world a better place. Most of all, let us always show kindness and respect for one another as we seek to move forward as a country, together.”

Be kind, respectful, and decent to one another in the days ahead.

Make your voice heard, your vote counts!

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Like more than 75 million people, I have already cast my vote. My husband and I were there on the first day of early voting in our state. Millions of voters are willing to stand in long lines to vote. And at a time when new COVID-19 cases are averaging over 72,000 a day.

We are on track for record voter turnout before the election is over. In 2016, about 60% of eligible voters actually voted. Given early voting numbers, the projected 2020 total votes could be record breaking at over 150 million compared to about 135 million in 2016. Voter suppression is real and has taken many forms in this election cycle. It is already too late for mail-in ballots in many states – you will have to take it to a dropbox. And yet, early voting is at a record high.

Yes, I voted for Biden. That should be no surprise if you know me or have read many of my blog posts. I do believe this is the most consequential election in our lifetime. When the votes are counted, it will be either Biden or Trump.

The number of undecided voters is at a record low. If you are one of those undecided voters or leaning towards Trump despite all your concerns, I offer up a few statements for your consideration from some unlikely sources on why they also support Biden:

  • Former Republican Party Chairman, Michael Steele has endorsed Biden. He clearly and thoughtfully articulates his position as a longtime Republican in a recent podcast “My Country Matters: Why I am Endorsing Biden”. In the last few minutes of it, he talks about leadership, decency, and character. He quotes Dr. Martin Luther King, Jr. in saying “Our lives begin to end the day we become silent about things that matter.”
  • A conservative New Hampshire newspaper, The Union Leader, has not endorsed a Democrat for President in a 100 years. Their editorial “Our Choice is Joe Biden” says “We have found Mr. Biden to be a caring, compassionate and professional public servant. He has repeatedly expressed his desire to be a president for all of America, and we take him at his word. Joe Biden may not be the president we want, but in 2020 he is the president we desperately need. He will be a president to bring people together and right the ship of state.”
  • The CEO of Expensify, David Barrett, has publicly endorsed Biden in an email to 10M customers entitled “Protect democracy, vote for Biden”. In his opening he says, “That’s right, I’m saying a vote for Trump, a vote for a third-party candidate, or simply not voting at all — they’re all the same, and they all mean — I care more about my favorite issue than democracy. I believe Trump winning is more important than democracy. I am comfortable standing aside and allowing democracy to be methodically dismantled, in plain sight.” His full email is included in this Business News article.

I saw a story of a 102-year-old woman born before women had the right to vote who said this is the most consequential election in her life as she cast her vote. If she can get out and vote, so can you.

Don’t sit this one out. Make a plan to vote and help your family and friends make a plan. Make your voice heard. Every vote matters. This election must be decided at the ballot box by your vote, not the courts.

Resources and Related Posts:

I Will Vote

When We All Vote

Fair Fight

Vote your values

Forward together

12 more days – forward together