On Leadership

Rounding in a virtual world

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If you are a regular reader of this blog, you know I am a fan of lean concepts and practices. In fact, my posts on lean have been some of the most popular ones over the years. So, it is no surprise that I have embraced a form of rounding or “gemba” now that I am serving as interim CIO at Boston Children’s Hospital.

As part of our commitment to being a High Reliability Organization (HRO), Boston Children’s Hospital has a program called “Rounding to Influence” (RTI). With this program, senior leaders meet with staff in their areas to discuss a specific topic and solicit input. The Rounding to Influence program is facilitated by David Davis, Vice President, Patient Safety, Quality and Regulatory Affairs. When I learned about the RTI program several weeks into my interim engagement, I was quick to start participating.

My first experience was tagging along virtually with Laura Wood, EVP Patient Care Operations / System CNO, on her rounds with clinical staff along with a few of my IT leaders. Given the topic for that session was about having the right information to perform your work, it was a great place to start and hear from our clinicians and support staff. Here were the questions:

Having the right information and data is important to everyone in order to perform their roles effectively.  Depending on your role, do you have trouble finding the information or data you need to do your job?  Do you know how and where to get the information/data you need?  Do you have concerns you are seeing incomplete or unreliable data?  How would you know?  How can we be more reliable in our information and data sharing?

The obvious next step was to start virtual rounds with our own IT staff. Here is how it works. Continue reading →

Yes, culture matters

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“I love this organization”. That is exactly what I said to my husband last Thursday after hearing several presentations in three different forums as part of the team at Boston Children’s Hospital. It started with the monthly Department Heads meeting that opens with a patient and family story and closes with an inspirational quote.

That meeting was followed by a lunchtime every other week series (dubbed Fireside Chat), open to all employees focusing on how we are supporting our patients and each other. Dick Argys, Chief Culture Officer and Chief Administrative Officer is the host. As part of our Juneteenth series of events, the topic was “The History of Juneteenth”. Our guest speaker, Theodore Landsmark, PhD, JD, Distinguished Professor of Public Policy and Urban Affairs at Northeastern University along with Peter Faiteau, Patient Services Administrator for Oncology/Hematology/HSCT, talked about the history and significance of Juneteenth.

The Juneteenth series was announced in an email from Dr. Kevin Churchwell, President and CEO to all employees last Monday – before it was declared a national holiday. He acknowledged that it was only the second year Boston Children’s was celebrating Juneteenth and closed his email with this: “Boston Children’s celebration about Juneteenth is all about learning from each other. And the more we learn about our history, the better equipped we are to build a brighter and more inclusive future for all”.

That was followed by an open forum for all employees, “Transforming Tomorrow: Investing in Children, Families, and Communities”. Dr. Churchwell and a panel of leaders described the new inpatient building opening in summer 2022 (far enough along for an inspiring video) and the new ambulatory centers being planned in nearby towns making care more accessible to families in the broader Boston area.

And earlier in the week we had all been invited by Dr. Churchwell to a virtual celebration to announce and congratulate the entire Boston Children’s team on being ranked the number one children’s hospital in the nation in the 2021-22 U.S. News & World Report “Best Children’s Hospitals” rankings. Continue reading →

7 years later

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I started this weekly blog 7 years ago right before our major Epic go live when I was serving as CIO at University of Michigan Hospitals and Health Centers. Given my decades of experience in health IT leadership roles, I decided that I had plenty of lessons and experiences to share. A blog seemed like a great forum to do so.

7 years later, I am still writing. I have shared lessons and experiences that have included my interim CIO and CTO engagements at three other healthcare systems since I left Michigan – University Hospitals in Cleveland, Stony Brook Medicine on Long Island, and University of Vermont Health Network. Since March, I have been serving as interim SVP and CIO at Boston Children’s Hospital.

I often wonder how much longer to keep this going. How much more do I have to share and who cares? The feedback and appreciation I get in notes and comments from readers keeps me going. And the topic ideas keep coming.

I was asked recently how I find time to write each week. Good question. I am pretty busy. I am a full-time interim CIO and am helping my colleagues keep things going at our firm, StarBridge Advisors. My response to the question is that I have a lot of ideas and not enough time to write. With this week’s post I am changing when I publish. I will try to write on the weekends and publish early in the week instead of percolate an idea all week and then finally write it Thursday night when I am exhausted.

And while I have a lot of topic ideas, I am definitely open to suggestions from my readers. I was recently asked by a CIO colleague if he could suggest topics – of course I said yes.

At this 7-year mark you might be interested in knowing which posts have gotten the most attention. In the world of social media, keywords, amplification, and cross linking are key. The top 5 most read posts since I started are:

It is worth mentioning that #6 is “New year, next chapter”. Continue reading →

One year later – an increased focus on diversity, equity and inclusion

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A year ago this week a small number of Minneapolis residents witnessed the death of George Floyd. Within days, the world knew what had happened and responded. There were mass protests in cities across the country and the world.

It was a time to reflect as companies across the country looked internally at their own practices and culture. Many started programs focused on Equity, Diversity, and Inclusion (EDI). Those with programs already in place revisited and strengthened them. At Boston Children’s Hospital where I am currently serving as interim CIO, they reaffirmed their commitment. This past week, Dr. Kevin Churchwell, President and CEO, sent a note to all staff outlining some of the work that has been done in the past year in support of their six core EDI commitments with the subject: “One Year after George Floyd’s death, our work continues…..”

The core commitments are:

Goal 1: We will be truly inclusive.

Goal 2: Our team will be as diverse as the patients and families we care for.

Goal 3: We will eliminate racism from our processes, practices, and guidelines.

Goal 4: We will continue to educate ourselves to be an inclusive working environment.

Goal 5: We will work to eliminate health disparities in our community and across the nation.

Goal 6: We will develop and use metrics to continually improve our performance in equity, diversity, and inclusivity.

As Dr. Churchwell said in his message, “George Floyd’s name became a rallying cry for millions and yet another compelling reason to discuss tensions around racism and social injustice. One man’s life became a symbol of so many lives lost needlessly. Disparities and inequities long considered to be “part of the system” became impossible to ignore. Here at Boston Children’s, we took a hard look at ourselves, and we realized that we need to be part of the solution to these important issues.”

Many of you or your CIO may be members of CHIME. In 2020, I joined the CHIME Diversity and Inclusion Committee which was established in early 2019. Continue reading →

Remote work – what next?

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After 14 months of remote work for many, organizations are making plans to bring people back to the office. Most healthcare CIOs that I spoke with in the past year plan to have their staff either remain fully remote or back in the office part-time for a “hybrid model”. Only one CIO that I spoke to had his full IT team onsite throughout the pandemic. They were considered critical support staff and available to augment staff in other departments if needed.

With this transition there are many articles covering all sides of the topic and the challenges facing organizations and employees. Two recent articles from Harvard Business Review are worth checking out.  The first one, “What Mix of WFH and Office Time is Right For You?”, is aimed at individuals assessing their own workstyle when it comes to work location. If the employee has a choice, the article suggests they do a self-assessment and then discuss with their boss what would work best for them. The second one, “How To Do Hybrid Right”, is aimed at organizations trying to determine the right hybrid model in terms of employee types and workspace design.

A recent opinion piece in the Boston Globe by Jon Levy, “The Hybrid Workplace Probably Won’t Last”, talks about the pendulum swinging back to onsite work. Jamie Nelson, CIO at Hospital for Special Surgery, made similar projections in her recent podcast with Bill Russell on This Week in Health IT and talked about being onsite herself through the pandemic and the importance of leaders in healthcare organizations being present.

Bill and I covered the topic extensively on This Week in Health IT Newsday show earlier this week. A few of my thoughts on the topic: Continue reading →

Resources for your digital health journey

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My StarBridge Advisors colleague, David Muntz, wrote an excellent blog series on Digital Health over the past year. His latest in the series is titled, “Digital Health – Planning for the Virtual Campus”. David’s ability to define digital health and provide a blueprint for organizations is impressive. This most recent post does not disappoint. He describes the changes that health systems have made in care delivery during the pandemic and poses the question – where do we go from here? He outlines 12 steps organizations should take. Here is a partial list just to whet your appetite:

  • Embrace the same discipline and framework to create the virtual campus as for a traditional campus
  • Query a broader representative sample of stakeholders than you have in the past
  • Plan for the underserved and those who might be excluded because of the digital divide
  • Personalize the experience for providers, patients, and families
  • Use augmented intelligence (AI) and machine learning (ML) during the data collection process

I encourage you to check out the entire post. If you are interested in any future posts in David’s digital health series, subscribe to View from the Bridge to get notifications of new posts. Our team of advisors regularly contributes posts on a wide range of topics relevant to today’s healthcare executives and IT leaders.

The New England HIMSS 2021 Annual Spring Conference: “Empowering People to Impact Health Through Information and Technology” was this week. Continue reading →

Career advice revisited

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It seems that I am getting a lot of requests to provide career advice these days. I did formal career coaching for a few people in recent months and am currently participating as a mentor in the Boston Young Healthcare Professionals (BYHP) mentor program. In all these situations, I point people to my many previous blog posts on career advice to supplement what we discuss.

For general career advice, they find these “classics” useful to review:

Career advice in a competitive market

5 job search challenges in 2020

You need to own your own career

Taking control of your life

Make career choices right for you

New year, new job?

Time for a job change?

Stand out at the interview

So you didn’t get the job

In this new virtual world of recruiting, I tell people not to underestimate the power of LinkedIn. It is an online professional directory that recruiters look to for candidates. Optimize your profile. Ensure the one liner under your name is a good description of your role since that is what people see when you invite them to connect with you and when you are found on searches. Use the about section to describe what you offer and how you can add value – don’t just copy and paste your current job description summary. Be active which shows you are current and engaged – that means sharing content yourself and commenting on other people’s posts. And if you are actively looking for a new job, check the “open to work” box – don’t worry, you can control who sees it.

If you are thinking of using a coach, check out these two posts:

When to use a career coach

Investing in you, the value of a coach

Looking for a new job can be exciting and hard at the same time. Hopefully, the lessons and tips in these posts will make it a little easier.

It’s transition time again

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“Until every child is well” is the tag line used by Boston Children’s Hospital, the number one pediatric hospital in the nation as ranked by U.S. News and World Report. I am thrilled to share the news that I started as their interim SVP and Chief Information Officer two weeks ago. What an incredible organization to be able to serve. I am excited to be part of a healthcare provider organization again – even though it is temporary.

Boston Children’s treats more children with rare diseases and complex conditions than any other hospital. In addition to caring for the sickest children in the Boston area as well as nationally and internationally, Boston Children’s is a leading research institution. It is home to the world’s largest pediatric research enterprise, and it is the leading recipient of pediatric research funding from the National Institutes of Health.

Boston Children’s is investing $24M in digital health initiatives (D2.0) over a three-year period with solutions for patients, their families, clinicians and administrative staff. Under the leadership of Chief Innovation Officer, John Brownstein, they have an Innovation Digital Health Accelerator (IDHA) which is partnering with many technology start-ups to provide solutions both internally and broadly to others in the healthcare community.

And let us not forget about the importance of an organization’s culture. The public statement on their website says a lot about the kind of organization they are and strive to be:

“Boston Children’s is dedicated to creating a culture where all patients, families, clinicians, researchers, staff, and communities feel empowered and supported. We are committed to working together to support health equity and promote anti-racist practices. This is not merely an aspirational goal, and in August 2020, we shared our formal Declaration on Equity, Diversity and Inclusivity that will be our guiding compass in making this goal a reality. We will continue to evolve to ensure we provide a welcoming, inclusive environment for all staff and families. Our diversity makes us stronger.”

As the search for the permanent CIO continues, I will be focused on moving the current IT strategic plan forward, gaining alignment on the EHR strategy, and assisting the search firm, AMN Healthcare, to find the best candidate for the future. Continue reading →

Systems at scale and optimized workflow

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IT teams work at scale all the time supporting thousands of users. Workflow optimization is often a goal for new systems. The mass vaccination sites and events are at scale and depend on an optimized, efficient workflow. With over 2 million doses a day being administered now in the U.S., these sites and events are becoming more prevalent and will continue over the next several months. While there was much publicity of the problems in the vaccine rollout early on, there have been many improvements in the tools to find vaccine locations and schedule appointments, and the administering of shots. In part that has been due to improved technology and better workflow design.

Two health systems doing mass vaccination sites/events have shared their playbooks in recent weeks for others to learn from. UCHealth in Denver is offering a playbook, “COVID-19 Mass Vaccination Drive-Through Playbook”. It is a 59 page comprehensive and very detailed playbook covering organizational structure and partner involvement, pre-event planning, contingency planning, patient communication, staff, provider and agency recruitment, vaccine storage and handling, and media communications. The Atrium Health playbook is a higher-level guide for leaders – “A Leader’s Guide to Safer, Faster and More Equitable Community Vaccination Events”. Both are valuable tools whether you are in the planning stage or tweaking your current operation.

To build on these tools, I recommend checking out two recent interviews that Bill Russell did at This Week in Health IT.

Continue reading →

Role models who inspire

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Who inspires you? Is it an historical figure, a well-known contemporary figure, or someone you know personally? If you are like me, it is probably a number of people. I pose this question to you during Women’s History Month and must ask myself that same question.

Being on zoom calls from my home office every day, people are quick to notice and comment on the Ruth Bader Ginsburg portrait on the wall. She was truly an inspiring role model and her legacy lives on. The portrait is by a local artist, Taryn Nunez. I bought it at the 2020 Women’s Fund of Rhode Island (WFRI) annual fundraiser and silent auction (all virtual of course). WFRI invests in women and girls through research, advocacy, grant making, and strategic partnerships designed to achieve gender equity through systemic change. I support WFRI both financially and with volunteer time. I love that my RBG art is a conversation starter for both men and women who I “zoom” with. And I often hear stories of their daughters who consider RBG their hero.

I also have a picture on my desk that only I see. It is my mother a few years before she died from cancer. I am now the same age that she was when she died – a rather sobering fact. We grew up in very different times. She did not live long enough to see my life as a wife and mother beyond the first few years nor how my career has evolved. She was widowed in her early 40s and raised the four of us on her own. She inspired me at a young age to be strong, independent, and giving. Volunteer work was something we all did. We did not have much, but we could always help others who had less.

I must admit that growing up I didn’t have female heroes, but I read a lot of biographies of famous women. Continue reading →