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

From One to Many

In the past four days, I’ve learned about and interacted with ten different healthcare systems. Some are current consulting and coaching clients while others are prospective clients. Their needs for services canstockphoto1878305range from interim management to leadership development to small, discrete consulting projects.

Their challenges and needs are unique, but not necessarily new to me. After 30+ years in healthcare IT, I “know a lot because I have seen a lot” as the insurance company advertises.  But if I am going to be effective in meeting each client organization’s needs, I need to get to know each client organization, the players and the culture.

I enjoy the day to day work of an interim CIO engagement like my recent one at Stony Brook Medicine. It’s very rewarding to be part of a larger team making a difference for patients. But interacting with many different organizations around the country and helping them solve problems is an entirely different kind of challenge. It is fun and rewarding in its own way.

On that first call with a prospective client, you need to establish your credibility and determine if your services are a match to their needs. Listening skills are critical – when talking to a prospective client and once you get the work. You need to go deep to understand their unique issues. And at the same time, you need to apply your experience and knowledge from other organizations.

Five new leads for StarBridge Advisors have come my way this week. I’m chasing them all. Once I understand the unique need, I’ll match one of our advisors and prepare a proposal for the client.

This level of client activity requires good administration, organization, and tools. We have the tools and continue to refine our processes. We’re trying to fully leverage SalesforceIQ and use it consistently as a firm. Leveraging our tools and creating repeatable processes is all part of the work this first year in business. 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

Island adventures

This is not about a fabulous vacation on some distant island.

This is another version of “adventures in a new city”. That’s what my husband and I have called my interim CIO engagements.Sunset on LI

This time “our adventure in a new city” was on Long Island. It was more my adventure than my interim in Cleveland last year; my husband spent more time with me there. We did have two weekends together on Long Island: one in the Big Apple and one to enjoy the island in the summer.

The weekend in NYC was what you’d expect – great restaurants, museums, the subway and a lot of walking. On Long Island, we visited the wineries on the north fork and went to the beach on the south shore. We got more ideas for our garden after a walking tour of gardens and landscapes in Port Jefferson. It made me want to spend more time here and, who knows, with a ferry between New London, Connecticut and Orient, New York, we just may do that.

The island is 118 miles long – the longest and largest island in the contiguous United States. Suffolk County makes up the eastern 2/3 of the island. I learned the history of Long Island’s growth and eastward expansion over the past 50 years and how Stony Brook Medicine fits into that growth, providing quaternary and tertiary care to Suffolk County. Continue reading

Tyranny of the urgent

You have priority work scheduled on your calendar. You have carved out time when not in meetings to get some work done. Yet urgent issues keep finding their way to your office. Sound familiar?canstockphoto28657290

That’s the life of anyone in management, especially in large complex organizations. And it’s a challenge these days as our new Stony Brook Medicine CIO and I try to get through a three-week transition period. The outline of what I need to cover with her is four pages long. And I keep adding more items.

We are ending week two.  By next week, I should be in far fewer meetings as she handles them without me. I should be able to finish my tasks as part of the transition and organize my paper and electronic files to turn over to her. I know she doesn’t like paper, so I’ll be ruthless as I purge and give her only the most important paper files.

We’ve done our best to block out some chunks of time together to get through everything.

But when we sit down together to go over the next block of information, we often end up first dealing with the latest requests and issues. What started as a focused two-hours is suddenly half gone.

What have I learned? 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

Culture matters in mergers   

If you live in a large metropolitan area, chances are you have been either a patient or a visitor in an academic medical center that has 500 to 1000 beds. If you live in a rural area, you are probably more canstockphoto8191068familiar with a small local community hospital with less than 100 beds.

Because of healthcare mergers and acquisitions, these two different kinds of hospitals are likely to be part of one integrated health system. While different in size and scale, they both deliver healthcare to their community 24×7.

Small, independent hospitals are often very agile, extremely customer service oriented and supported by a loyal community. In IT, the staff are often generalists and less specialized. They may have a single integrated system from one vendor with basic functionality and limited integration points with other applications.

In contrast, large academic medical centers can be slow to make changes and appear more bureaucratic. They provide advanced medicine with subspecialists and clinical services not found elsewhere. They have to work harder to create a culture of customer service. Their community is broader and they attract patients from greater distances, including international patients. And their IT teams are larger with many specialized roles. In addition to their core electronic health record, they have many specialized departmental applications, many interfaces. Overall, it’s a far more complex environment.

So how do these different profiles mesh at merger 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

8 tips for telehealth success

Telehealth or connected health as some call it, takes different forms depending on the provider organization and their strategy. The primary driver may be extending geographic reach by providing canstockphoto40754495telehealth services to rural areas. Or it may be largely a focus on consumer engagement.

Regardless, there are common themes for successful initiatives. Based on my experience in several healthcare systems in recent years, I offer these tips for success:

Strategy is key – The organization must first determine what the key drivers are for the initiative. Is it to extend reach or provide an easier patient experience or a combination?

Tactics and specific programs will follow – Once the strategy is clear, which specific clinical services and offerings are needed the most will become clear.

Physician leadership is needed – If the focus is on extending reach of certain clinical services, physicians are at the center and must provide overall direction. For consumer-focused services, ambulatory services or strategic planning leadership may play a more central role.

Operational issues and decisions must be considered early on – There are legal and billing factors along with workflow issues for clinicians and staff to work out before any implementation. 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