On Best Practices

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 →

Doomscrolling? Break the habit with a good book

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I guess I am behind again. The first time I heard the term “doomscrolling” was several days ago when someone tweeted that they looked forward to when they could just read a good book at bedtime instead of doomscrolling. I presume they were referring to getting past the election in two weeks. It resonated with me.

Doing a google search, I see articles going back to the summer months about doomscrolling and anxiety and how to break the cycle. It is described as the practice of endlessly consuming doom-and-gloom news. I find myself looking to see what awful things have happened, been spoken, or tweeted when I get up in the morning and again late at night.

The practice of always having a good book that I’m reading has been harder since this pandemic started. A novel I had just started in early March was set aside for months. I just couldn’t concentrate on reading a book in those early months. A political book I was reading was also set aside. I realized I didn’t need to know the inside story about all the outrageous things that had happened since 2016. I eventually finished the novel though I had to go back many pages to refamiliarize myself with the characters. I have yet to pick up that particular political book again and probably never will.

I just finished a novel that I would highly recommend – “The Daughters of Erietown” by Connie Schultz. It is an excellent story starting in the mid-1940s tracking four generations of women in a northeast Ohio town. It weaves daily life in a blue-collar community with significant historical events including the 1970 shootings at Kent State and the early days of the women’s movement. And yes, I am open to recommendations on my next novel.

I’ve started a non-fiction business book that one of my coachees sent me a while back – “Wisdom at Work: The Making of a Modern Elder” by Chip Conley. It is described as part manifesto and part playbook for how to become indispensable in the second half of your working life. Continue reading →

Digital health has arrived

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Every healthcare organization seems to be focusing on developing their digital health strategy these days. But do we have a common definition and understanding of what digital health means? A few months back I wrote a post called “Knocking on the digital front door” addressing what many organizations mean when they talk about digital health. Meeting patients where they are and guiding them along the right care pathway with efficient, consistent, and easy processes in the background. It was a very popular post, so I guess it resonated with many.

But digital health encompasses far more than just the digital front door. My StarBridge Advisors colleague, David Muntz, has taken on the broader issues of digital health this year in a multi-part blog series on View from the Bridge. Here is his four-part series if you are ready to go deeper on digital health:

Digital Health – Is Healthcare Ready? Are You and Your Organization Ready?

Becoming a Digital Health System

Digital Health – Governance in a Digital Health System

Digital Health – The Role of Empathy and Understanding

If you are interested in future posts in David’s digital health series, subscribe to View from the Bridge to get notifications of new posts. Our team of advisors regularly contributes posts on a wide range of topics relevant to today’s healthcare executives and IT leaders.

And if you are looking for help developing your digital health strategy and roadmap, David or I would be happy to schedule time to talk.

Adapting to virtual project work

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It is encouraging to see major system implementations continue to move forward during this period. Seattle Children’s, UI Health and Steward Health Care are just a few examples of EHR go lives in recent weeks. Kudos to all the teams who are working to ensure they go smoothly and safely as they provide a combination of virtual and onsite support.

My StarBridge Advisors colleague, David Muntz, and I just completed an ERP selection with a client. We have moved into the contracting and planning phase. All our work has been virtual. There was a short period where the client team was partially back in their offices but as case numbers in that state rose, they returned to the work from home arrangement with the exception of senior leaders in the office on certain days. The vendors successfully conducted virtual demos over several days with very high participation and engagement by the client organization.

While the vendor of choice is understandably anxious to meet with the client team in person, that is not happening for the foreseeable future. By the time of go live in Spring 2022, it should be a very different situation with onsite work. But for now, it will be all virtual work. And even when regular travel and onsite work is considered safe, I expect more work by the vendor and their implementation team to be done remotely to save on travel costs and time.

Bottom line, we have all made this virtual way of working a success. Yes, there were a few times when being in person in the same room would have really helped – the initial period of work when we were getting to know the client team and some of the key decision meetings. Learning the culture and “reading the room” can be a challenge in the virtual world but it is all doable. Continue reading →

When healthcare becomes personal

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When you get a call that your husband has been taken to the ER by ambulance, it is hard not to think the worst. I got that call last Wednesday. The good news is that by late Friday night Tom was OK’d for discharge from the hospital. But we still do not have the answers needed. More tests and results should help us better understand what happened and why it happened so together with his PCP and specialists we can develop a go forward plan.

I have worked in healthcare for over 35 years. Our family has dealt with various minor health issues and been able to access the best healthcare available. I have the utmost respect and gratitude for health professionals and all they do.

Through this experience I have seen healthcare through the patient and family lens in a different way. I have several takeaways worth sharing.

Emergency resources – Know when to call your PCP, go to the nearest urgent care center, call 911 or head right to the hospital ER. Minutes can matter.

Friends and family – I can’t say enough here. Tom was visiting a friend when the incident started. She took him to the closest Urgent Care, they called an ambulance fairly quickly and he was taken to the closest ER. The friend reached out to another friend thinking that person might know how to contact me. Fortunately, he did. We are setting up the Emergency Contact feature on our phones for the future. On the first call with the ED physician, I did a 3-way with my daughter who is a nurse practitioner. I wanted her in the loop from the start – to help interpret what I was being told, help educate me, and advocate for Tom.

Clinician in the family – If you are fortunate as we are to have a clinician in your family, let them help you. They are invaluable. Listen to them, loop them in on calls to ask all the right questions, and let them educate you. Our daughter spent ½ hour on the phone with the attending physician before Tom was discharged while I drove to get him. She then explained it all to me and started doing more research on her own.

Accessible and Integrated EHR – Now we are in my domain. Continue reading →

Career advice in a competitive market

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I seem to be getting an increasing number of requests for career advice calls these days. Of course, I make time to talk to people I know and try to be as helpful as I can. No question that there are a lot of good and talented people looking for a new opportunity these days for various reasons.

Here is my current baseline advice when I have these calls:

Criteria: You need to establish your criteria such as type of organization, type of role, title/level, culture, salary, and location. This may sound too basic, but it is critical. Not all criteria are equal so apply a relative weight to each. Once you have this framework, you can evaluate each option against your criteria and stay true to them. You don’t want to compromise and then regret your decision in 6 months.

Market trends: Do your research. What are the new and emerging roles/titles? How does your experience align with them? Do you need to reinvent yourself or develop new skills/knowledge to get a new role?

Search firms: Develop and maintain relationships with a few search firms and recruiters. They need to know who you are, what you are looking for, and what you offer compared to other candidates. They can also be helpful and honest about the market and how you compare to others in search. But remember, you own your career and your next move. Continue reading →