On Leadership

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 →

Never too busy to take care of ourselves

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I have been impressed with my University of Vermont Health Network colleagues this summer on many fronts. Not the least of which is their level of physical activity. All summer I’ve heard about long bike rides, YourHealthYourChoicehiking, kayaking, mountain climbing and even a relay race overnight through the woods, called Ragnar.

They have motivated me to get back into my own workout regimen. Something I put on the back burner for three months. The last time I’d been to the gym was the week before I started this interim engagement in late May. I’ve been walking every night for 20-30 minutes but that is not the same as cardio and weight training at the gym. Classic story – you get busy and something must give. In my case, it was my workout routine.

Happy to say I started back at the gym two weeks ago and have worked it into my weekend and weeknight routine. Does it mean a few emails might not get answered some evening? Yes. But it’s critical to maintain balance and take care of ourselves – especially during busy periods. And especially when you are away from home in a hotel room each night where it’s all too easy to work until you turn the lights out for the night.

If one of my busiest colleagues who is routinely doing email very late at night can get up early and do a 20 mile bike ride before work, then I can make time to get to the gym a few nights a week.

We are about 60 days from our big Epic go live on November 1. It will only get more stressful and busier from here on, not less. As a leader, helping others maintain balance is best done if we too maintain balance in our lives. Continue reading →

What’s the why?

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Yet another best practice from my IT colleagues at the University of Vermont Health Network (UVMHN). We emphasize “the why” in all our work and communications. From the updates on our upcoming Epic go canstockphoto4362942 (1) the whylive to agenda topics to user communications about scheduled downtimes, explaining the why helps everyone understand the context and reasons for what we do.

Our University of Vermont Medical Center (UVMMC) Chief Nursing Officer, Kate Fitzpatrick, reconnected us all to “the why” again at our IT All Staff meeting this week. With about 70 days left until go live, she spoke to the staff who are working long hours to implement a common, integrated EHR throughout the network.

She drew on the stories that were part of the Green Mountain Care Board Certificate of Need (CON) presentation when UVMHN first got the project approved.

Those stories were like those of every other healthcare system with a regional reach that cares for their patient population through integrated and coordinated services provided by an academic medical center and community hospitals. A common patient health record accessible by clinicians at all care locations.

I remember when my daughters were very young. Continue reading →

Hate has no place

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The most recent horrific mass shootings are not due to video games, the Internet, nor mental illness. There are more guns in the United States than people. Let that sink in.canstockphoto45815739 (1) no hate

Hate speech, racism, and white supremacy exist and are tolerated by some of our elected leaders who are supposed to keep us all safe. Let that sink in.

This is not who we want to be as a country. It is time for responsible, moral leaders to act.

I am saddened and outraged yet again by the mass shootings in El Paso, Dayton and Gilroy. We have seen hate target Jewish people at worship in Pittsburgh. We have now seen hate target Hispanic people shopping on a Saturday. These are people like you and me who go to stores, festivals, and churches like you and me.

I have no new messages. I have said it all before in one way or the other.

I wrote about every day racism last year after stories surfaced about incidents at a Starbucks, an Airbnb, a common dormitory room, and a college tour: Teaching moments – every day, everywhere

I wrote about the inhumane treatment of immigrants at the border: Heroes among us: pediatricians

I wrote about the strength and leadership of the Parkland students who started a national movement for gun reform after a mass shooting at their high school: What will you speak up for? and This can’t be the new normal

I wrote about gun control after the largest mass shooting in this country at a music concert in Las Vegas: When can we talk about it?

I wrote about the mass shooting at the Pulse nightclub which targeted gay people: Who do we want to be?

I wrote about what I want for my grandchildren as I watched a gun control debate back in 2016: On being a grandparent

And I wrote about the need to build bridges as I listened with both sadness and fear to the divisive rhetoric during the 2016 presidential election: Build bridges, not walls

We must speak up for love and justice every chance we can. We must challenge those who hate and divide us as a people. And we must vote for the kind of leaders that we are willing to trust the future of our children and grandchildren to. Please join me.

IT takes a village

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GLRA is an acronym recognized by anyone who has been through a large-scale system implementation. Spelled out it is Go Live Readiness Assessment. It is typically done at the 90, 60, and 30-day mark before canstockphoto16594838 (1) hands puzzlea go live. At the University of Vermont Health Network (UVMHN), our 90-day GLRA for Epic Wave 1 was this week.

Dr. John Brumsted, UVMHN CEO, kicked the day off with a powerful message on how important the Epic project is to the network and our patients. He talked about why we are doing this for the region that includes six hospitals, a medical group, many ambulatory locations and home health and hospice in both Vermont and New York. He set realistic expectations saying it wouldn’t be perfect and there would be issues. But he expressed confidence in the project, and everyone involved in making it a success. His presence for a good portion of the morning spoke volumes about his support for this massive initiative and appreciation for all involved. The network CFO and the University of Vermont Medical Center (UVMMC) president, CNO, CMO and VP for Medical Group Operations were also there for a good portion of the morning.

Dr. Adam Buckley, UVMHN CIO, followed Dr. Brumsted by talking about how the journey to a common, fully integrated EHR began back in 2013.  A journey that included a Certificate of Need (CON) review and approval by the Green Mountain Care Board. He too set realistic expectations about how many tickets we’ll have at go live just like every other major EHR implementation around the country and thanked the interdisciplinary team involved.

Lori Boisjoli, UVMHN VP Application Portfolio, then framed the day for everyone. The morning would be focused on the UVMMC with revenue cycle and the full suite of specialty modules going live. The afternoon would be focused on the three affiliate sites where ambulatory clinical and revenue cycle are going live. She highlighted that GLRA is the time to raise any significant issues and risks so project leadership can capture them for follow-up. Continue reading →

Crunch time and why IT matters

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It’s crunch time. Every day counts. Can’t miss a deadline. All hands-on deck. Go live readiness assessments (GLRA). If you work in health IT and have been through a major EHR implementation, canstockphoto60328456 (1) EHR UVMHNyou’ve heard all these phrases.

At the University of Vermont Health Network (UVMHN), the Epic Wave 1 go live is less than 5 months away. The University of Vermont Medical Center (UVMMC) has been on Epic for inpatient and ambulatory core clinicals for years. Wave 1 includes the full revenue cycle, lab and anatomic pathology, radiology, OR and anesthesia, cardiology, ophthalmology, orthopedics, behavioral health, rehab, wound care, infection control, and predictive analytics at UVMMC.

Wave 1 also includes the first Epic implementations at three Vermont and New York hospitals in the network starting with ambulatory systems for billing and clinical functions. Waves 2 (2020) and 3 (2021) will be the full suite of inpatient systems at those same hospitals – Central Vermont Medical Center in Berlin, Vermont; Porter Medical Center in Middlebury, Vermont; and Champlain Valley Physicians Hospital in Plattsburgh, New York. Yet to be scheduled are Elizabethtown Community Hospital in Elizabethtown, New York; Alice Hyde Medical Center in Malone, New York; and Home Health and Hospice.

The core infrastructure is largely in place to support the November 1st go live though we have more to do at the device level. Over 10,000 users will be trained in a 6-week period. The first GLRA at 120 days pre go-live is coming up soon.

When I saw Epic on the agenda for the UVMMC quarterly leadership meeting, I assumed it was a project status update. How wrong I was. Continue reading →