On Best Practices

HTM and IT: frenemies or collaborators?

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What is a “frenemy”? According to Dictionary.com: “person or group that is friendly toward another because the relationship brings benefits, but harbors feelings of resentment or rivalry”.canstockphoto5722510

Within health care organizations, there is a lot of history between the people who support the medical devices that touch patients and those who support the information systems used by clinicians. It has not always been positive and collaborative. In fact, there are such differences in the culture of each group that they don’t always get along. Maybe they are even “frenemies” in some organizations.

In your hospital, you may know the function as Biomedical Engineering, Biomed, Clinical Engineering or Health Technology Management (HTM) as it is now called as part of elevating the profession within healthcare. Those in the field now refer to themselves as “HTMs”.

AAMI (Association for the Advancement of Medical Instrumentation) is a standards development organization and the professional society for HTMs. AAMI is celebrating its 50th anniversary this year. Its mission is to advance safety in healthcare technology.

Four years ago, I was the first CIO ever to be elected to the AAMI board when AAMI leaders recognized the trend towards HTM and IT convergence and integration. I have provided the IT perspective to the AAMI board as the HTM profession continues to evolve. Continue reading →

Planes, trains, automobiles and ferries too!

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What consultant doesn’t want to work close to home as much as possible? But you go where your clients are and you get used to traveling.

It was one of those weeks. There was the usual 2-hour drive plus the 1 hour ferry ride to my interim CIO canstockphoto21462750engagement on Long Island. Monday was the first time I worried about missing the ferry. My “wiggle room” on the drive part evaporated with bumper to bumper traffic as soon as I got on I-95 in Providence. I sweated it but I made it!

Then there was a same day trip from New York to Chicago for a CHIME Education Foundation Board retreat. It seemed like a good idea when we agreed to fly in and out the same day but reality of that can be brutal – a very long day!

And finally, there’s the commuter rail train ride into NYC to meet my husband for the holiday weekend.

I’m happy to not depend on airports for my current weekly commute compared to many who are truly “road warriors”. I feel a little spoiled. My biggest stress is whether I’ll hit traffic on I-95 and have to take a later ferry.

When I was the interim CIO at University Hospitals in Cleveland last year, it was a predictable 3.5-hour drive from Ann Arbor. A few times I ran into huge traffic jams and a long out of the way road construction detour. But it was mainly a predictable weekly commute. And productive when I could get some calls done during the drive.

Once we moved to the Providence area, it meant a weekly flight. The Providence airport has fewer direct flights. I had to choose between connecting flights which increase potential delays or the longer ground transportation to get direct flights out of Boston. I chose the latter.

Then my current engagement on Long Island came up. Driving through NYC or flying was a non-starter. It was a “go” when I learned about the ferry option. Continue reading →

What to expect from your vendors

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You are past the big go live. You and your team are focused on optimization, enhancements, ongoing support issues, and upgrades. So, what should you expect from your vendor in this ongoing relationship?canstockphoto10856287

I have worked with all the major EHR players and many other IT application and infrastructure vendors over the years. I have worked with three of the major EHR vendors just in the last 18 months given my interim CIO engagements.

My post “Keys to successful vendor management“ covered the importance of the product roadmap, service, total cost of ownership, reputation, contract, implementation, and escalation.

It’s time to look at the ongoing vendor relationship that clients should expect. Vendors, take note. I assume most of your clients would share this view. There’s a reason that the KLAS Research reports carry a lot of weight for CIOs, they are vendor evaluations from their peers.

Whether it is a large, proven vendor or a small start-up, here’s what you should expect: Continue reading →

Take time to reboot

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It’s that time of year. Maybe you just did a spring break trip with your kids or you are planning your summer getaway. Whatever it may be, you need to take time to reboot. Aruba sunset

Leave the job behind and leave good people in charge and covering for you. Companies give vacation and PTO time for just that – Personal. Time. Off.

Over the years, I have gotten better at checking out and turning it off. I learned my lesson the hard way on a vacation many years ago with my family. It was ruined by being totally available for problems that arose back at work. I spent most of my time either on the phone or worrying about what was going on. Turns out, it wasn’t even concrete problems that needed to be addressed; it was just work politics.

I’ve shared my thoughts on the importance of taking time off openly so others don’t have to learn the hard way like I did. And I encourage my staff to take their vacation time and check out while away.

As it is, the days leading up to a vacation and the days following are tough enough. There’s everything you think you need to get done that just can’t wait a week or two on the front end. And then thinking you are a super human who can get through all their email for a week or two on the first day back. For those of you who can, is that badge of honor worth it? Continue reading →

Lean classics worth a second look

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I am a lean leader and always willing to share my learnings. I’ve written several blog posts chronicling my lean experience at different organizations. Some of them have been quite popular with readers. I’ll call them my canstockphoto19155139“lean classics”. Here’s a recap for your reference:

Huddles and Visual Management:

Leadership huddles: not just another meeting – describes my first IT leadership huddle launch back at University of Michigan Health System. As my lean coach said at the time, be willing to experiment, it doesn’t have to be perfect. We learned and tweaked it as we went through the PDCA cycle.

Making the invisible visible – describes the beginning stages of the visual board our IT leadership team created at University Hospitals in Cleveland.

Making the invisible visible – part 2 – describes that same effort several months after we launched it and how we used it as a team.

6 tips for successful huddle boards – based on experience, my advice to those considering their own huddle boards. Remember, you need to be willing to experiment.

Gemba Walks:

Importance of rounding or going to the “gemba” – describes early experience with clinical and operational rounding both at Brigham and Women’s Hospital and University of Michigan Health System. Continue reading →

The power of co-location

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There continues to be a lot of focus on telecommuting and open office space for knowledge workers in large organizations. Both are important yet not everyone agrees they are good – a lot depends on the canstockphoto12582566 for colocationorganization and the culture.

But I want to focus on another “space planning” topic, co-location. As health care organizations grow, administrative departments including IT often end up being spread out in many office buildings, sometimes at great distances from the hospital with a lot of traffic in between.

The investment needed to centralize all the administrative functions in one building often takes backseat to investing capital in clinical space. No surprise. Video conferencing is always an option for bridging the miles. This technology continues to advance and become more of a commodity. National and global companies must leverage technology but health care systems are mostly local or regional.

In my many years of health IT management, I’ve experienced a variety of space situations: Continue reading →

6 tips for successful huddle boards

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I recently had an opportunity to advise an IT department on their overall lean initiative. While no two organizations have the same lean journey, there are common challenges. Visual management and huddlecanstockphoto19155139 boards are components of a lean management system. Here are some of the common challenges you can expect to encounter and tips for success:

“Perfect is the enemy of good” – You must be willing to experiment and get messy. Visual boards take many shapes and forms. Do they help you focus on the right work and metrics as a team?  It’s less important that they look pretty to the outside observer.

Standard framework with room for variation – Even if there is a standard for what all huddle boards in your organization should look like and include, there must still be room for variation by unit or team. What’s important to one team may not be important to another. If you’re ready to get started and wonder if there will be an organization standard at some point, don’t wait for it. Just get going and adapt later if a standard appears. Continue reading →

Learning from the annual industry list ritual

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Holiday gift lists, baking lists, family fun lists while kids are out of school and “honey do” lists while off from work…..we have personal to do lists everywhere. But as the year ends, it’s interesting to canstockphoto18647021look back on some of the industry based 2016 lists and look ahead at what to expect in 2017.

I’ve compiled some of the most interesting health care and technology lists to share as we approach this annual turn of the year. You’ve probably seen some of them already.

There are the best places to work lists where we can all learn best practices to attract and retain talent in a competitive market: Modern Healthcare’s Best Places to Work in Healthcare 2016 and Becker’s 150 Great Places to Work in Healthcare 2016. And more specific to IT, there is Healthcare IT News’ Best Hospital IT Departments 2016. Check out their profiles and possibly get some new ideas to apply in your own organizations. Continue reading →

Aspiring to Stage 7

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I recently participated as the CIO reviewer on a HIMSS Analytics Stage 7 validation. The long travel to the West Coast aside, I was happy to contribute my time and expertise to be exposed to an advanced

Source: HIMSS Analytics

Source: HIMSS Analytics

organization and to meet a wonderful group of leaders. The review team also included a Chief Medical Information Officer and the HIMSS Analytics Regional Director for North America.

As of the 3rd quarter this year, only 4.6% of hospitals have achieved Stage 7 while 30.5% have achieved Stage 6. Just over a third of hospitals are currently at Stage 5.

All three hospitals I’ve served as CIO have achieved Stage 6. Getting from Stage 6 to 7 is a significant leap. There is a greater focus on analytics and using the data from the electronic health record to improve patient outcomes.

From the HIMSS Analytics website, here is how Stage 7 is described: Continue reading →

Ensuring smooth leadership transitions

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Transitions of leadership are going on all the time in our organizations: a new CEO, a new VP, or new management at another level; it is change.

As I’ve written about, I just completed such a transition. I have served as an interim CIO for 8 plus canstockphoto33589643months. The agreement for the engagement was that I’d stay through the successful transition to the new CIO. We envisioned a 30 day overlap.

As the start date for the new CIO approached, 30 days seemed very long. Wouldn’t the new CIO want to get in and get started without me around? But as she and I started planning that time, 30 days seemed reasonable for all that we needed to do. When it came time to start the transition, there was so much else going on each day we found it hard to find the time to focus on the transition work. In the end, we both agreed 30 days was the right amount of time and extremely helpful to her.

But a 30-day overlap and transition period can be a luxury. Organizations often go through leadership transitions with far less time or even no time for the old and new leaders to work together. When I took the interim engagement, I had an hour conversation with the previous CIO on his second to last day; that was it. Continue reading →