On Leadership

COVID-19: Health IT collaboration and best practices

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We are an industry that shares best practices and continually learns from one another. As we all deal with uncharted territory, that sharing is needed more than ever before. In conversations with healthcare CIOs it

Message from Brigham and Women’s Hospital OR nurses: #StayHome

is obvious that the amount of work currently being undertaken by health IT teams is extraordinary.

In that spirit, this week I’m highlighting several resources that might be useful to health IT teams:

Through ThisWeekInHealthIT Bill Russell has produced valuable podcasts for health IT professionals for the past two years, interviewing healthcare executives and IT leaders across the country. Last week he pivoted to focus on COVID-19 with two new services:

COVID-19 Resources is a page dedicated to COVID-19 resources during this time. It’s a resource site for health IT teams when they are asked to stand up a relevant technology or implement a technology enabled process. Visit the page now to see what’s already been shared. And you can help him help others. Just forward any resources for health IT that you are willing to share to Bill at hello@ThisWeekinHealthIT.com

Podcast interviews with health IT leaders on the front lines of the pandemic who are willing to share some of their preparedness challenges, lessons and best practices:

COVID-19 Prep with Baptist Health KY

  • Standing on the lessons of the past
  • Protecting the care providers during COVID-19

COVID-19 Prep with Asante Health OR

  • Establishing communication in crisis
  • Preparedness huddles
  • Prioritization of IT work
  • Leadership skills needed

Continue reading →

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.

#EachforEqual

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That’s the hashtag for International Women’s Day (IWD) 2020. The theme this year is “an equal world is an enabled world”. Sunday, March 8th, was IWD. According to the official website, “International Women’s Day has occurred for well over a century, with the first IWD gathering in 1911 supported by over a million people. Today, IWD belongs to all groups collectively everywhere. IWD is not country, group or organization specific.”

But it needs to be more than a day to celebrate women, it needs to be a yearlong commitment by all of us. Fighting for gender equality every day in every situation you are in. At work, at school, in your community, with your friends and family, and in politics.

Speaking of politics, I can’t help but go there. While nearly all the female candidates for president have suspended their campaigns, I wonder if I will see a female president in my lifetime. I truly want to believe it’s not if, but rather when. As one of those candidates, Senator Elizabeth Warren, met thousands of young girls across the country, she used the phrase “that’s what girls do”. Meaning, they run for president. She made a pinky promise with them that someday there would be a woman president.

Several well qualified women ran for president. Why they didn’t get enough support to win the nomination is not one common story. But I do believe they were all held to a different standard than the men running – as women often are. For one, there’s the notion of “likable”. Something that doesn’t get asked about male candidates.

I’ve read many articles and analysis about Senator Warren who appeared to have the best chance at the nomination. I’ve heard stories that a high percentage of people said they would vote for a woman but they didn’t think their neighbors would. That old self-defeating thinking. Men are often judged on their potential while women are often judged on their performance. Can enough people picture a woman president to someday make it a reality?

Like many women, I’m tired. Continue reading →

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 →

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 →

Martin Luther King Day and why it matters – 2020

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I wrote my first Martin Luther King Day post four years ago. How much has changed since then? And is it really for the better? On one level, it’s very hard to say ‘yes’. Our country seems more divided. Hate crimes and mass shootings continue. In the past year we’ve seen shootings at a Jewish temple and someone “hunting” for Hispanics in El Paso, Texas.

2020 is an election year and a consequential one at that. Who we are as a country and what kind of future we want for our children and grandchildren is at stake. As our minister said in this week’s sermon honoring Dr. Martin Luther King, we have to see the wrongness of now and the rightness of tomorrow, we need to see it and believe it.

Appreciating and embracing diversity is what we as leaders must demonstrate every day in every part of our lives. Fighting for social justice and showing up for others must also be a part of our everyday lives.

A few years ago on this day, my oldest brother called and told me about our first social justice lesson as children. I was only 7 and he had just graduated from high school. The four of us kids and our mom lived in an all-white neighborhood in Minneapolis. My mom took us on a family trip to Hot Springs, Arkansas in 1960. I don’t remember a lot of it. My brother told me about how our mother took us all into a restaurant in Little Rock, saw a sign that said “colored people aren’t allowed” and marched us right back out. She gave us our first social justice lesson there on the sidewalk. I was young. I wish I remembered this myself but I’m so glad he told me the story.

I’m not exactly sure what our children learn in school these days about Dr. Martin Luther King, but I do know they learn that the color of one’s skin doesn’t matter. I asked my oldest granddaughter who is in first grade what she knew about Dr. Martin Luther King. She said he’s brown and that he used his words, not his hands to fight. Guess that’s one way to describe the gospel of non-violence.

Many healthcare organizations have a Chief Diversity Officer and EDI program. For the IT folks reading, that’s not EDI as in electronic data interchange, but EDI as in Equity, Diversity and Inclusion. 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

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 →

10 Go Live Command Center lessons from the field

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Week 2 post Epic Go Live has begun. We continue to learn and adjust. Building on my previous Epic Go Live and Command Center planning posts, there are more lessons to share.canstockphoto15204222 (1) keep calm

The last point in my most recent post was about camaraderie – defined as “mutual trust and friendship among people who spend a lot of time together”. I should add, in close quarters!

I continue to be impressed with the hardworking, dedicated IT team at the University of Vermont Health Network. I have seen many examples of teaching, helping one another and stepping up to new roles since the November 9th Go Live.

The rate of new tickets slowed down as Week 1 ended but the issues became more complex as expected. We have resolved over 65% of the tickets opened since cutover and addressed many cross cutting issues.

As promised, more lessons to share:

  • Handoffs between shifts – Ensure that key issues and work in process is reviewed and turned over to the next shift to keep things moving smoothly. Try to have people scheduled several days in a row for continuity vs on one day and off the next.
  • Seeing the “forest for the trees” – In the first few days, the focus is on closing tickets but as cross cutting issues and themes emerge, the focus needs to shift. As broad issues are defined, you need clarity on what teams and modules are involved, who is on point to lead the issue resolution, and what help is needed.
  • Escalations – It is very helpful to have highly engaged executives and operational leaders rounding and raising up the greatest pain points for users that need more focus. These escalations may come through in-person visits to the command center or email.
  • Ticket analysis – Have resources available who know the tool and can slice and dice the data to help leaders and teams see trends and where to focus.
  • Hospital daily huddle – If the organization has a daily huddle, the command center lead should attend. It’s good way to hear firsthand how all departments are doing and what their key concerns are.
  • Command center “walk-ins” – If the main command center is at the hospital you may get walk-ins – well intentioned users who want to escalate a specific ticket or issue. Command center leaders should manage this so the teams working tickets aren’t given conflicting direction on priorities.
  • Email management on steroids – Staff working tickets stay in the system and don’t watch their email. But leaders get a lot of emails and it’s hard to keep up given the pace. At the end of each command center shift, go back through your inbox to ensure that any escalations are dealt with – other email can wait.
  • Multiple locations for support – If there are a main command center and multiple other locations for support staff and triage, ensure they are well coordinated with good communication between.
  • Document management – Everyone involved needs easy online access to reference material. Dynamic information such as shift schedules need to be maintained. Having at least a few binders of printed reference information helps as well.
  • Ramp down plan – When you start adjusting command center hours, it will help to have a checklist ready on what needs to be considered and implemented (i.e. staff schedules, re-location of teams, communication to users, logistics like food and transportation, etc).

Stay tuned for more reports from the field….

Related Posts:

Epic Go Live – report from the field

9 Tips for Go Live support success