On Best Practices

Healthcare providers on the front lines of Covid-19

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In my blog last week, I consciously decided to avoid the Covid-19 topic. The situation was evolving day to day and I asked myself what useful insights or comments I could possibly have.

Just 11 days ago, the cancellation of HIMSS20 conference was announced. Many of us were hoping for this as we worried about being in a convention center with 45,000 people from not just around the country but around the world. With the cancellations of major sports, Broadway, closure of Disney, limits on the size of large gatherings, and school closings, the times have changed drastically in a matter of days.

We are being encouraged to practice “social distancing”. People who can are working from home.

But hospitals remain open for business as they must. Our nurses and doctors are on the front lines. IT teams and all the hospital staff who support the clinicians are doing what is necessary to ensure that they can deliver care.

While all healthcare organizations have emergency preparedness plans in place for a variety of incidents, this is uncharted territory that tests the limits of those plans. There will be much to learn and share when we get to the other side of it. But in the spirit of we’re all in this together and the culture of sharing best practices we have in healthcare, here are a few links that might be of value in the days ahead.

UW Medicine CIO’s advice: Prepping IT systems for COVID-19 – by Eric J. Neil published in Health IT News, March 12. UW Medicine was one of the first health systems on the front lines of the pandemic in the U.S. Their insight and advice are invaluable to IT leaders around the country.

While you may question the value of Twitter, it is yet another forum where lessons are being shared from the front lines. Dr. Kira Newman has worked in the ICU in Seattle the past week and posted a 10 part thread:

In one part Dr. Newman provided the link to their Covid-19 Resource Site for other hospitals to use.

17 Coronavirus (Covid-19) Actions for Healthcare CIOs – by John Lynn in Healthcare IT Today, March 11. John is continuing to collect info from IT leaders and will share as he does.

Healthcare IT News is maintaining a list of trusted resources that can be found here: Key resources to keep track of the coronavirus pandemic.

Most of my readers probably work in healthcare organizations and fully understand the magnitude of this pandemic. For those of you who don’t and need some convincing, remember that science and math do matter. Here are two of the best articles I’ve seen:

Why Outbreaks Like Coronavirus Spread Exponentially and How to Flatten the Curve – by Harry Stevens in the Washington Post, March 14.

Coronavirus: Why You Must Act Now – Politicians, Community Leaders and Business Leaders: What Should You Do and When? – Tomas Pueyo, first written March 10 and updated on March 13. The author closed with this message: “This is probably the one time in the last decade that sharing an article might save lives. They need to understand this to avert a catastrophe. The moment to act is now.” So, I share with all of you.

And if working from home is new to you, here’s a good resource to check out:

Work in the time of Corona – a blog by Alice Goldfuss on March 11th.

My paternal grandfather died in the 1918 flu pandemic. He was young but married with three small children. My father and uncle were sent to an orphanage and my grandmother and aunt went to live with friends. Yes, it’s not 1918. Healthcare has advanced significantly. But we are an even more global and mobile society. The most important lesson from 1918 is the impact of social distancing which is shown in this graph:

In closing, I want to express a huge thank you to all who work in healthcare. The strain on our healthcare system is real. The stress on our healthcare workers is real. Let’s all do our part to #SlowTheSpread and #FlattenTheCurve.

Practicing SODOTO with a new system

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I know that “see one, do one, teach one” is common in the training of medical professionals. But until I googled it, I didn’t realize it was a known method with an acronym – SODOTO.

With our new implementation of Salesforce at StarBridge Advisors, I am in the SODOTO mode. We are a small team. We recently hired a consultant to help us get it configured and designed the way we need it. My mantra as I worked with the consultant was KISS – keep it simple.

We are in the training, practice, and start to use it everyday phase. While we have a ways to go on data cleanup from our previous version, the new system is in production.

I’ve watched several short videos on how to create lists, reports and dashboards – literally “see one”. Then I made time to set up a few of each before I forgot what I’d just learned – the “do one” part. I think that would be considered “just in time” learning. I will show my colleagues how to do the same encouraging them to watch the videos as well – the “teach one” part. I still need to watch some videos on key features we may want to use so I can advise our team and make decisions together as we optimize the system.

Granted, our system is very small scale compared to the major EHR and ERP implementations I’ve overseen at many healthcare organizations. But here are my key takeaways applicable to any new system implementation:

  • Out of the box – Another way of saying don’t customize unless you really can’t work with the standard system.
  • Decision making – Key stakeholders need to be part of design decisions to ensure all use cases and workflows are identified and there is buy-in and adoption once the system is up and running.
  • Minimum data fields – Between what is available “out of the box” and custom fields you might think you need, be cautious. You can always add something later if you need it.
  • Workflow – Consider all your common use cases and basic workflows to design a simple, streamlined system that meets your unique needs.
  • Reports and dashboards – Data fields and workflows are too often the primary focus, but you need to be able to get the data out of the system in a usable format.
  • Adoption and consistent use – With any new system, all users need to understand what’s expected of them.

Major system implementations typically have optimization phases post go live. As much as the project team tries to account for everything, there are always changes requested once users start to actually use the system. It’s fair to say that I’ll be working with our own small-scale optimization phase of Salesforce in the next few weeks.

Related post:

Something new every day

 

It’s handoff time again

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This week I will do a handoff to the new Chief Technology Officer (CTO) at the University of Vermont Health Network (UVMHN), Seth Maynard. I’ve been serving as interim CTO since late May of last year. Seth recently served as CTO at Yale New Haven Health System and is ready to take over from me. We have already had several transition conversations, but we have plenty more to cover in the coming days as part of the handoff.

Anyone who has relocated to join an organization at a senior management level knows there is much to learn. It’s a new market, a new organization, a new set of leaders, a new team, a new culture, a new set of projects, and new issues. Yes, there is much similarity between health care organizations, and you have your experience and knowledge to draw on from the past. But the learning curve in a new organization is still a steep one.

My overarching goal for this week is like my previous interim to permanent handoffs – provide as smooth and comprehensive a handoff as possible. Ultimately, I’m there to ensure the permanent leader gets off to a good start and is successful. That means:

  • Sharing background information that is most critical and useful passing along as much needed knowledge and insight as possible
  • Conducting the meetings that are a critical part of the handoff including focused time with the management team, an introduction at the monthly all staff meeting, as well as initial discussions with key partner departments
  • Ensuring that together we don’t miss a beat on current issues that need leadership direction
  • Stepping back and letting the new leader start making decisions and address issues providing support as needed

When I started this interim, Continue reading →

Struggling to get (or stay) organized? You are not alone

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When I wrote my “Value of podcasts for professional development” blog a few weeks ago, I asked readers for their favorites podcasts. One of my directors at UVMHN suggested the GTD podcast series. I’ve known since I met Greg Van Buren at the start of this interim CTO engagement back in May that he was a big fan and proponent of the Getting Things Done (GTD) approach from David Allen. I told Greg early on that I’d like to take some time to learn how he applies it in his work.

There are many personal productivity systems and methodologies out there. I’m familiar with GTD concepts but have never really gone deep with it. So why not learn from someone who has? After all, what’s not attractive about the idea of “stress free productivity”?

Greg is paperless from all appearances – how he shows up at meetings and in his office. He uses a mobile device to capture all his notes and to dos. If he does momentarily have paper with handwritten notes, he scans it and copies it into the appropriate note for future reference. And as I have more recently seen he appears to have mastered an organization system for all his notes and tasks within OneNote.

After listening to a few GTD podcasts, I realized again that none of this is rocket science. It’s basic organization of your ideas and work at all levels – from the macro long term goals, to the house and family tasks of today and everything in between. And I realize that I could make a lot of adjustments to improve how I work. That sounds better than saying I’ve realized I’m out of control! Continue reading →

Value of podcasts for professional development

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The start of a new year is often a time to establish or renew professional and personal goals. There are common myths that it takes 21 days to form a new habit though researchers who have studied this say it could take from 2 to 8 months to build a new behavior into your life. The end of January marks the first 30 days of the new year. I’m not going to ask how you are doing with your gym goals and whether you are on the road to changing your behaviors about regular workouts. Rather, I’ll ask you if you have a professional development goal for this year.

With tight budgets and busy schedules, finding time to fulfill professional development goals can be challenging. You may or may not be able to get to a training program or conference. And finding time to read publications or electronic newsletters may be wishful thinking given how much work email and reading you already have to do.

I highly recommend the practice of listening to podcasts as part of your ongoing professional development and learning. You can even mix it in with your workout goal. Listening to a 20-30 minute podcast while working out, walking the dog, or on your daily commute is easy and it’s free!

I have subscribed to many different podcasts but my “go to” in order to learn from health IT industry influencers and keep up on industry news and analysis is “This Week in Health IT”, launched by Bill Russell two years ago. Bill has served on executive teams in healthcare, higher education and Fortune 500 consulting practices including serving as Chief Information Officer for St. Joseph Health, a 16 hospital $5 billion system, for nearly five years.

With his podcast series, Bill uses his extensive experience to help leaders, innovators and organizations share their stories in a conversational style to capture the wisdom of the industry and share it with his listeners.

After a successful year one of his weekly podcast, Bill listened to his audience and greatly expanded his offerings. Continue reading →

Major implementations need experienced leadership

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What CIO hasn’t worried about a major EHR or ERP go live? Despite the years of work by your dedicated and talented team alongside your software vendor and possibly an implementation partner consulting firm, you still worry. The Go Live Readiness Assessments (GLRA) at 30-60-90 days have level set all involved on what is complete/ready, what is on track to complete, and what needs help.

It’s that last piece – what needs help or is significantly behind schedule – in bright red on the status report that requires attention. There could be many reasons it’s red, but bottom line it is red. Do you have enough of the right resources and enough time to get it done? Do you have to adjust scope? Do you have to put more money into it? You certainly don’t want to sacrifice quality. And with the scale and complexity of most major implementations, you don’t want to move the go live date. Any good project manager knows that those are the only four levers you have – scope, quality, money, and schedule.

Everyone who has done this before tells you that there will be some yellow and red areas yet at the 30-day GLRA. But they should be minimal and able to be addressed in time for the go live.

If you have a major implementation in 2020 and don’t have an implementation partner or lack full, unbiased confidence in your implementation partner, you might consider a little more help in those final 90-120 days. And not just more staff resources. As the CIO, you may need to bring in an experienced senior IT leader who can assist you by doing a quick project review and risk assessment. Someone who can identify the key areas you need to focus on and if needed bring the expertise and leadership to address them in time for a successful go live. Someone who, at a modest cost, will help you sleep better at night.

At StarBridge Advisors, we have a team of senior IT leaders serving as advisors who have significant experience leading successful implementations in all sizes and types of healthcare organizations. We know what can go wrong and how to avoid it. We know what it takes to be successful. And we will tell it to you straight. Our approach is practical, unbiased, open, and plain speaking. We offer you frank and honest opinions based on real-world experience.

If you have a major implementation in 2020 that you are worried about, let’s talk.

Related Posts:

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

Epic Go Live – report from the field

9 Tips for Go Live support success

10 best practices for project success

10 Go Live Command Center lessons from the field

Crunch time and why IT matters

Most popular blogs in 2019

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It’s the new year and time for top 10 lists and countdowns so I’m adding mine to the mix. These are my most read blog posts in 2019. If you missed any of them first time around now is your chance to check them out.

I am a practitioner and always willing to share experiences pulling lessons from everything that I do. I continue to cover a range of topics from leadership to women and work to technology and healthcare. It looks like my readers appreciate the variety. Here are the top 10 as measured by total views:

A passion for health care – a classic one from previous years about why we do what we do

6 tips for successful huddle boards – another classic from previous years that doesn’t go out of style

“We’re at meeting norms” – this one is about best practices I learned from my IT colleagues during my interim CTO engagement at University of Vermont Health Network (UVMHN) this past year.

10 best practices for project success – another one from my experience at UVMHN as we approached the November Epic Go Live.

Where do new ideas come from? – another back to the classics from a previous year.

Develop women leaders, transform leadership – at StarBridge Advisors, we launched a new service early in 2019 call C-Change focused on developing women leaders in health IT. Continue reading →

Taking stock – goals for your next decade

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January 1, 2020 marks more than just another new year, it marks a new decade. And a good time to take stock.

What are your personal highlights of the past decade? What does the new decade hold for you? Are you living the life you want to live?

I have never been a “bucket list” kind of person, but I did set four big, broad goals for myself early in this decade. They involved family, work, travel, and friends.

My family goal involved grandkids that weren’t yet born. I told my husband that I wanted to spend a lot of time with my grandkids if I was fortunate enough to have them someday. That someday came for us four times between 2012 and 2016. Happy to say, I’m meeting my family goals. Once we had grandkids, there was no question I wanted to make the changes needed to live near them so I could see them often. We made the move back to New England in 2016 and it was one of our best decisions ever. They are now 7, 5, almost 5, and 3 ½. I fondly call them the “Fab Four” and we see them often.

That decision to move was tightly coupled with a major career decision. Leaving a fulltime position as a healthcare CIO to start down a path of interim management, consulting and leadership coaching. It’s a decision I have never regretted as I now have more control and flexibility in my career and work. This period has included launching and growing a successful health IT advisory firm, StarBridge Advisors, with two colleagues for the past 3 years. Continue reading →

Bridging the gap with an interim leader

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My husband and I have both served in interim roles this year. Tom left IT in the mid-1990s to become a Unitarian Universalist minister. He is now a retired minister who does a lot of guest preaching and writing and is very active in our denomination nationally. He did part-time interim ministry at two different churches in our area this year. The first was for 3 months early in the year, and the second was for 4 months this Fall. He was filling in for ministers who were on sabbatical. His role was to preach and lead worship on Sundays, work with the board and staff, and be available as needed for pastoral care.

Compare this to the interim CTO engagement I’ve done since late May. A full-time role keeping infrastructure projects moving forward, helping to ensure a successful Epic go live, dealing with day to day issues, and helping recruit the permanent CTO.

Interim leadership roles take different forms. They range from “keeping the seat warm” to turnaround situations where significant change is needed. Regardless of the role, an interim needs to be able to confidently step into the role, build relationships, gain respect, and get up to speed quickly. Continue reading →

Getting ready for 2020 – 10 steps for health IT leaders

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One of my greatest joys when we started StarBridge Advisors back in 2016 was to be able to partner with someone as smart and insightful as David Muntz. He has a long career history as a healthcare CEO, a CIO and as a senior leader in the Office of the National Coordinator. I continually learn from David and appreciate his provocative thinking,

David’s advice for 2020 is no exception. In his recent post, “10 Steps to Prepare for 2020 – Big Challenges – Bigger Opportunities” on our StarBridge Advisors blog “View from the Bridge”, David starts off by challenging CIOs to begin thinking of themselves as CDSOs – Chief Digital Services Officer. He goes on to highlight the importance of encouraging innovation, embracing AI, addressing governance issues, physician burnout and more. And ever mindful of how leaders must take care of themselves to be at the top of their game, he closes with a message on self-care.

Here’s David’s blog post in its entirety:

10 Steps to Prepare for 2020 – Big Challenges – Bigger Opportunities

It’s that time of year again when prognosticators and futurists compile a top 10 list for the upcoming year. Please joining me in welcoming 2020 with a call to action for our wonderfully challenging and opportunity rich healthcare IT environment.

Before starting the list of recommended actions, I suggest that we IT professionals change the way we refer to ourselves — now, even before the turn of the year. Please join me in a self-directed evolution by shifting our reference from IT to Digital Services. That change would suggest using the title CDSO instead of the familiar CIO. The rationale for doing so, though relatively obvious, will be suggested in another blog.

Digital Service (DS) leaders will need a steady hand on the rudder to lead their organizations through some rough waters. Some of the themes below are repeated from last year…they still deserve your attention and efforts. Continue reading →