On Best Practices

Make the most of HIMSS15

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The health IT event of the year is almost here. Yes, just a few more days until HIMSS15 and time for education, networking and vendor exploration. Whenever HIMSS is in Chicago, some people worry about the weather. But it looks like we’ll have high temps in the 60’s so you southern and west coast folks can leave behind your boots and gloves!  I am sure the Boston attendees will not bring snow.

March to HIMSS Post Icon-Sue Schade BlogI’ve attended HIMSS many times and have learned how to make the most of my time there. So, whether it’s your first HIMSS or you are a veteran, here are some useful tips:

Education sessions – The best ones will be standing room only.  If you really want to hear a particular presentation, get there early. Room locations may be very far apart so map out your next session. Pay attention to the session designation in the listing – basic, advanced, or intermediate.  The last thing you want to do is walk half a mile to get to a session that is targeted at a different level audience.

Networking – Networking is one of the greatest values of this annual event. HIMSS provides many ways to find people with similar interests as yours. Plan ahead: Continue reading →

Surfacing problems, prototyping solutions

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According to Wikipedia, “a hackathon (also known as a hack day, hackfest or codefest) is an event in which computer programmers and others involved in software development, including graphic designers, interface designers and project managers, collaborate intensively on software projects”. Hackathons are a great way to surface problems and prototype solutions in a short time period.  I just participated in my first hackathon and what an eye-opener it was.

Last week, four different IT groups participated in “Hacks with Friends”: central campus, school of medicine, school of dentistry, and the hospitals and health centers.  It was a grassroots event organized by staff. It was great to see such talent and creative energy in one room.

Every available surface was used to brainstorm and organize ideas.

For two days, over 100 participants in 20 teams worked to develop projects in 3 categories  – gamification, collaboration, and play (which turned out to be the catch-all category for a problem you wanted to explore or experiment with). Projects could be either externally focused on our customers or internally focused on improving processes for technical staff. Many teams included members from the multiple IT groups solving common problems.

Each team was to develop a minimally viable product (MVP). An MVP is a simple way to address a problem that adds value, is demonstrable. An MVP can be an improved process, a new way of doing things, or an old tool applied in a new way.

Poster presentation proposing FitBit integration with UM’s wellness app.

Each team had to create a winning presentation in three stages. First they needed to create an elevator description of the project, including problem statement, solution and differentiators. Then, they needed a five minute poster presentation. If chosen as a finalist, the team needed to prepare a seven minute demonstration of their product.

To succeed, the team needed to understand the strengths of their team members and welcome a broad range of experiences into the team. Best ideas come from co-design. A great reminder that hackathons are not just for people who can code!

Laura Patterson, the UM CIO, Ted Hanss, the Medical School CIO, and I were the judges. We applied these criteria:

  • Fit to category – how well does the project fit the selected category?
  • Feasibility – would this work in the real world?
  • Completeness – how far did the team get in the allotted time?
  • Documentation – did the team document what they learned?

The winning team, “Magic Mirror,” hard at work.

The products proposed were creative and exciting.  Some examples:

World of Workcraft – a game to track what we are learning everyday – books, articles, courses, conferences.

Active You – integrating FitBit with the ActiveU mobile app. I think a high percentage of the 11,870 participants in this UM employee wellness program would love this!

Rundeck – a way to automate system administrator tasks using the Rundeck tool.

The winner of the Hacks with Friends event was Magic Mirror – putting student photos in their profiles in the new learning system to help faculty get to know students and students get to know one another. The runner-up was Go Phish – an interactive training tool to help people recognize phishing email leveraging gaming technology.

The coveted “golden hard drive” trophy.

But from another perspective, Activity in Motion (AIM) was the winner for me.  This was a team led by Sally Pollock, Manager of IT Service Management from my IT department, that developed a multi-platform application to capture and centralize major incident activity real-time.  Benefits include: providing real-time information, minimizing distractions during the major incident call, minimizing the duration of the major incident, capturing a list of participants, making activity highly visible and storing it in a database, where it can be used for reporting and the post incident review process.

The team’s presentation helped me realize the current state of managing major incidents and how a simple app like this could improve the process. I jumped on it.  I asked the team to present to my leadership group meeting on Wednesday and we gave directional support for this solution. They will come back in a month with recommendations on how to fit this solution into our current major incident process.

A great example of how a hackathon opened one leader’s eyes to a problem that needed to be solved.

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

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I had the opportunity to talk about lessons learned from EHR implementations as part of the faculty for the “Leadership Strategies for Information Technology in Health Care” course at the Harvard School of Public Health (HSPH) last week.  And yes, I was fortunate to make it in and out of Boston between snowstorms for the one day I was there.

The course is part of Executive and Continuing Professional Education at HSPH. It is a two week course with 4 modules.  The first week covers Module 1 on IT Strategy and Governance and Module 2 on the EHR.

The faculty lineup for the first week is impressive.  John Glaser, CEO Health Services at Siemens Healthcare and former CIO at Partners HealthCare System, lectured on “IT Strategy Considerations.” John Halamka, CIO at Beth Israel Deaconess Medical Center in Boston covered “The National Perspective and IT in the Era of Health Care Reform.”  Vi Shaffer, Research Vice President and Global Industry Services Director at Gartner, provided an “Overview of the IT Industry.” Meg Aranow, Senior Research Director and Health Care IT Advisor at The Advisory Board Company, discussed analytics. New care models including telehealth, retail clinics, and accountable care organizations were also covered by various faculty members.  Mary Finlay, Professor Simmons School of Management and former Deputy CIO at Partners, discussed IT Governance. Mary is the program director for the course and does a terrific job.

Students come from various roles in health care. The course has also become well known internationally at this point – with about 30% from other countries. For this session some students came from as far away as Australia and India.

I was happy to be part of the faculty and get a chance to hear a few other lectures that day as well as interact with the students over lunch. Here are some of the EHR implementation lessons I shared in my talk:

  • The CIO and executive leadership in health care organizations have many priority initiatives at any given time. The EHR implementation will become a primary focus, especially as it gets closer to the go live date. As the CIO, you need to know where and when to be deeply involved vs. maintaining an overall awareness of the project’s progress, being ready to address issues as they are escalated.
  • Engaged executive sponsors are needed throughout the life of the project. If the CIO is the only one worrying about the project, there’s something wrong. At the same time, the CIO should avoid saying “it is not an IT project”. To be successful, it has to be a true partnership between clinicians, operations, and IT.
  • An EHR implementation has a significant impact on your entire organization and all staff members. A robust change management program is critical given the multi-disciplinary effort that EHRs require.
  • Many decisions get made through the life of the project. Establish early on very clear decision rights. Know which group makes what decisions and define the escalation path when issues can’t get resolved at lower levels of the project governance structure.
  • Your plan should include a “Go Live Readiness Assessment” at 120, 90, 60 and 30 days prior to go live. All teams are expected to report out their progress and open issues in detail. Project leadership then creates a readiness scorecard. This allows leadership to focus on the areas that are behind schedule and address issues to ensure an on-time, successful go live.
  • Contingency planning needs to be part of the overall plan. Any major system implementation needs a back-out plan if something goes wrong. But you also need to account for the operational impact. You can’t stop the flow of patients into the emergency room but do you reduce your surgical or clinic schedules? Each organization has to determine what’s right for them. And then there’s the unrelated and unanticipated crisis that you have no control over – it could be a major facility issue like a power outage, a weather incident like the snowstorms we’ve seen the past few weeks, or a mass casualty incident in your area. Be sure to include your organization’s emergency management team in your activation and contingency planning.
  • At go live, it’s all hands on deck in the command center and throughout the organization. Everyone has their specific roles. Leaders need to be present. The CIO may not be running the project but maintains a very visible presence in and around the command center. It’s a 24/7 operation for the first few weeks after go live. And be sure to round – find out how things are going for front-line staff and thank them for their work.
  • Once the system is up and running, you have to recognize that optimization is ongoing. Don’t minimize the requests. Listen carefully to your users. At the same time, manage expectations about how much will get done and by when. Help shape the message. Multiple communications channels are important. Structured processes for intake of requests and a formal prioritization process with agreed upon criteria are critical. While optimization for your organization and the unique workflows is needed, don’t get stuck there. Learn from others how they have leveraged the product. Reach out to your colleagues and learn from them. Many have gone before you at this point.

And when you’re ready, be sure to share your own lessons with others.

 

Resources 

Harvard School of Public Health’s Executive and Continuing Professional Education program, “Leadership Strategies for Information Technology in Health Care”

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Go beyond the golden rule for great customer service

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We’ve all had those bad customer experiences: rudeness, “not my problem” attitude, bounced from person to person, being left on hold too long, not hearing back from someone as promised. You know what I’m talking about.

And we’ve all had those excellent customer service experiences: think about the difference. Was it the smile, the caring attitude, the problem solving focus, the level of ownership, the offer to help before you could even ask for help? These are just some of the attributes of good customer service.

If you provide a product or service to anyone in the work you do, it’s a good idea to look at your own customer service and how you stack up. And,who doesn’t provide some kind of product or service to others? You may have both internal or external customers.

When I started this position in late 2012, I laid out my core principles and values to my staff. Customer Service was one of them – as I said then, “while we don’t touch patients directly, we are all part of the extended care team; clinicians and caregivers rely on the systems we provide and support to care for patients in a safe manner. Excellent customer service in all our interactions is critical.” Continue reading →

Making time for reflection

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“Hansei” is the Japanese word for reflection. One of my UMHS colleagues, Dr. Jack Billi, told me he’s impressed that I am writing a blog and sees it as an example of Hansei. He says as leaders we don’t take enough time to reflect. I agree.

A typical day for me is running from one meeting to the next, driving back and forth from my office to the hospital campus, and squeezing in email when and where I can. Evenings are more email and prepping for the next day’s meetings.

The practice of writing a blog has indeed caused me to be more thoughtful about a range of topics. I find myself observing things differently. I reached out to one of my industry colleagues, Anthony Guerra, Editor-in-Chief of healthsystemCIO.com, for advice when I first considered writing a blog earlier this year. He encouraged me to do so. He told me that through the practice of writing a blog I’d start looking at things differently, observing things in new ways. He was right. Continue reading →

Email overload — does anyone have the answer?

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Spoiler alert! I don’t have the answer either and want to learn from others.

I remember the old days before email: we relied on talking to each other and on written communications that came on paper. On the day before a vacation I would finalize reports, make copies, Connected emailand stuff them into inter-office envelopes after I’d taken care of all my follow-up phone calls. Now on the day before vacation I have to get through all the email that can’t wait another week and generate new ones as I work through my to-do list.

It seems endless. Everyone complains about too much email. Can’t we just shut it off?  No, it’s the way we work now and there’s no going back.

Here are some of my tips:

Triage – I quickly scan for priority emails by subject, who it’s from and importance (some people actually use those flags as intended). Deal with what you have to in as timely a manner as possible. Continue reading →

Culture change, slow and steady

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You start in a new leadership position and you want to make changes.  Should be easy, right? After all, you’re the boss. You call the shots.Culture change

Not so.

You inherit a history and a culture, ways of working and thinking and behaving. You inherit a leadership team and a staff. You inherit a department that works within a broader organization and its culture. Still, you are the leader; you can make some changes, but it will take more time.

When I started at UMHS, there had been a 6 month gap with an internal interim CIO. She had kept things going but was happy to handoff to me. Continue reading →

Networking, learning and giving back

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I’m heading to the CHIME Fall Forum for a few days. Many of my health care CIO colleagues will be there. I look forward to the chance to network and learn from them in track sessions, and hear from keynote speakers. I’m even being pressed into service on a panel called “Leadership Stories Worth Telling” as there was a last minute cancellation.

I have been active in professional organizations for many years. Anyone who doesn’t take the opportunity to get involved in such organizations is limiting their own professional development and, in turn, limiting what they can offer to their employer.

I remember many years ago when I attended my first professional conference. Continue reading →

Operation Baby Blanket

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Operation Baby Blanket? What’s that? Is that the code name for a new software implementation?

This CIO is the grandma of Hannah, an adorable two year old; two more grandbabies are on the way.  While I’ve done various crafts in my adult life, I don’t do it enough to call it a hobby. And my crochet experience is limited. I did make a baby blanket for one of my daughters 30 years ago.

So I surprised my family two years ago when I told them that I would make a baby blanket for Hannah, and I actually did it. Now, a second grandchild is due in December. Could I make a baby blanket for her in time? Would I be able to squeeze enough time out of my evening email work session to get one done?

I needed to design and create a baby blanket in time for the baby shower.

I am happy to announce that I presented a finished crocheted baby blanket to my daughter, Katie, at the shower last weekend.

How did I meet this goal? Basic Project Management! Continue reading →

Plan for the future, manage for today

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How often have you heard an IT leader say they want a position that’s “more strategic” and “less operational?”

The reality is that there is always a balance of both, depending on the level you work at in your organization. Sometimes, it’s not the balance you’d like to see.

Me too.

As the CIO, my typical day is back to back meetings. Plus, I squeeze in email and phone calls on a range of additional issues. I read and answer email well into the evening after I get home.

In the past week, I’ve reviewed presentations and read articles on health care in the future and how technology enables innovation: reflective thinking and planning.  Continue reading →