On Leadership

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

Epic Go Live – report from the field

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Many of you have been through a major EHR implementation and go live. I’ve been through them before as well. The teamwork of a go live is like nothing else I’ve ever experienced.canstockphoto16071239 (1) teamwork

There is the overnight cutover period that was practiced numerous times as “cutover dry runs” with the goal of making sure it goes smooth and can be done in the shortest time possible. After all, you are asking a hospital to go to downtime procedures until you can bring up the new system.

There is the excitement as others gather for the proverbial “flip the switch” moment. The applause and high fives for people who have been working hard towards this moment for many months. The appreciation from operations leaders on hand.

There is the wait for the first user calls and tickets to roll in. The wondering if all the planning for the command center and support structure was on target.

There is the settling in as ticket volume increases, teams start working them, and tickets start getting resolved.

There are the periodic reports from operational leaders who are rounding on the floors. They report on the pulse of staff who are dealing with a new system while trying to care for patients. They report on the issues that seem most problematic.

There is the dashboard monitoring to see which teams are getting the most tickets and whether adjustments in staffing need to be made. There is the ongoing review of tickets to ensure they are prioritized appropriately. Continue reading →

Leaders as mentors

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Since late May, I’ve had the chance to work with a new group of talented and committed IT professionals at the University of Vermont Health Network. Everyone is working hard towards a common goal with our canstockphoto13471338 (1) mentorupcoming Epic go live. I am impressed every day with the depth of knowledge, flexibility, resilience, and dedication of so many.

I’ve learned much from all of them and would like to think they have learned from me as well. I try to be a good role model in all my words and actions. But no one is perfect! With the pace we are all working these days, it’s a very dynamic environment. We’re heads down addressing issues and getting final tasks done.

If we really believe as leaders that our people are our greatest asset, then in spite of being in crunch time, we need to ensure we are modeling the right behaviors and fostering the kind of culture that people can thrive in. Hard as that may be on our busiest of days, we owe it to our teams.

In a few weeks, we’ll be working long shifts together in the 24/7 command center. There will be many issues to address and problems to fix. The stress will be high. But we will also be sharing the joy of having crossed the finish line together. I have been with this team on their Epic journey for only a few months. Most of them have been on this journey together for a few years. Continue reading →

10 best practices for project success

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It’s the final few weeks before our major Epic go live at the University of Vermont Health Network on November 1st. Yes, we have some parts of the project still in yellow or red status as of our 30 day Go Live canstockphoto19779100 (1) gearsReadiness Assessment (GLRA). But the majority are green (on track) or blue (complete).  I’m seeing many best practices that have us on a path towards success. Individual and team behaviors and practices that are worth sharing:

Flexibility – On any given day, you don’t know what issues you might need to deal with or what meeting you’ll have to add to your calendar.  Be willing to adjust as needed throughout the day and know what can wait for another day.

Raising issues – Don’t be afraid to raise issues that need resolution. Don’t assume someone else has more time or knowledge to handle the issue – be willing to take ownership if you can.

Utility players – You need generalists who can be put into a variety of situations to temporarily help. If you are one of these people, don’t hesitate to raise your hand when you see gaps.

Step up and lead – Leadership takes many forms. Even if you may feel unready, don’t be afraid to step in and fill a leadership gap if needed.

Cross coverage – Being dependent on one person’s knowledge and skills can create delays when that person is unexpectedly unavailable. Knowing who you can hand off to and having confidence in that person stepping in is critical to projects staying on schedule. Continue reading →

Project in trouble? Some dos and don’ts

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If you work in IT, you’ve probably seen your share of projects that need help getting back on track. I could share a lot of stories from my many years in IT in multiple organizations. The complexity and scale of what canstockphoto12827499 (1) dowe do in IT continues to amaze me. Drawing on that experience, I want to share my tips on what to do and not to do if you find yourself taking on a troubled project.

What to do if you want to ensure success:

  • First, stop the churn
  • Get up to speed on the project scope, issues, and challenges as quickly as possible
  • Seek to understand enough of the past to inform the future
  • Focus on getting the project back on track and moving forward
  • Figure out who’s who, what their respective roles are and who owns what
  • Assume positive intent
  • Show respect and gratitude for all involved
  • Ensure all issues are surfaced, assigned to an owner for resolution, and tracked
  • Remove obstacles as they arise
  • Be transparent with leadership about the status and issues
  • Track progress using key metrics
  • Use daily huddles to ensure team members are on the same page, focused, and raising issues
  • Manage expectations for all involved and impacted
  • Document decisions so you don’t have to revisit or rehash them later
  • Consider what levers you can pull such as timeline, resources, budget, or scope
  • When you can’t change the timeline, be ruthless about scope changes
  • Keep calm – reduce team stress, diffuse conflict, and avoid finger pointing

And some tips on what not to do: Continue reading →

Working together, we improve people’s lives

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That’s the vision of the University of Vermont Health Network (UVMHN) where I’m currently serving as the interim Chief Technology Officer. It’s a simple but powerful statement and a great reminder of the canstockphoto10098870 (1) working togetherimportance of “we” and the work we do together. With our major Epic go live less than two months away, we are constantly reminded what a critical foundational  piece the common, integrated EHR is for the health network. No pressure!

I described the scope of our Epic project in my post “Crunch time and why IT matters” and shared stories from our 90-day Go Live Readiness Assessment (GLRA) in my post “IT takes a village”. Our 60-day GLRA was a few days ago. Dr. John Brumsted, UVMHN CEO, and the presidents from the hospitals and the medical group kicked off the day thanking everyone involved and describing what the common, integrated EHR will mean for our patients. And as Dr. Brumsted noted, the Epic project is the biggest undertaking to date for the organization as an integrated network.

UVMHN is not the first nor the last organization on the journey to create an integrated care delivery system to serve the patients in a region.  To be a truly integrated network, common values and strong relationships are key. Continue reading →