Crowdsourcing – looking for your stories on digital transformation 

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I am trying something new with this week’s blog post. I will be doing a talk titled “Digital Transformation: Emerging from COVID19” at an upcoming virtual conference. I will be working on it in my spare time (aka the next two weekends) so it can be recorded in advance.

For many organizations, Digital Health means the “digital front door” and an increased focus on patient or consumer facing applications. But it is far more than that. My StarBridge Advisors colleague, David Muntz, wrote an excellent blog series on Digital Health over the past year. His first post attempted to frame what we mean by Digital Health – “Digital Health – Is Healthcare Ready? Are You and Your Organization Ready?”.

He starts by trying to define it and acknowledge that the Wikipedia definition is good but not great: “Digital health is the convergence of digital technologies with health, healthcare, living, and society to enhance the efficiency of healthcare delivery and make medicine more personalized and precise.” As David expands on his definition, he says ”Digital health requires harnessing the energy from the data tsunami that includes all sources, not just provider-controlled databases. We need to synthesize data from existing sources and use patient generated data, social determinants of health, census information, AI engines, and so many other sources.”

As I work on my upcoming talk, here is my “crowdsource” ask if you are willing to share your stories and anecdotes on any or all of these questions: Continue reading →

Renewal, big rocks, and the elusive work life balance

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Spring is a time of renewal and rebirth. I see daffodils, crocus, and blooming trees everywhere on my daily walks.  After the last 12+ months we have experienced and the vaccine rollout giving us all new hope, it is a time of renewal and rebirth unlike in previous Springs. In past years, I have written about my “big rocks” at this time of year. In April more than any other month I am reminded of my big rocks – it is when my siblings and I lost our father to cancer at a very young age. I turned four years old the day of his funeral.

Over 570,000 families in this country alone have lost one of their “big rocks” to COVID-19. For some families, it has been multiple losses. The stories of a husband and wife dying just hours apart are truly heartbreaking. I am fortunate that all my big rocks here in New England and back in Minnesota where I grew up are healthy and well. And all of us “elders” are vaccinated.

So, in this time of renewal and being two weeks post my second vaccine dose, I look forward to breaking bread this weekend with family members. It will be the first time since an outside, socially distanced, early Thanksgiving we had on November 8th. I told my husband back then that it could be a long, isolating winter as we would not be able to spend time outside with family nor have meals together. After a relatively mild winter, I am happy to say my daughter who lives only 20 minutes away came over on some weekends with her two young daughters to walk the dogs with me and to visit. Some of the visits were outside socially distanced and some were inside with masks.

Thinking about my big rocks is a reminder to take care of myself and maintain a reasonable work life balance, or life work balance as my StarBridge Advisors colleague, David Muntz, likes to call it. Taking on the interim CIO role at Boston Children’s Hospital means I am back to long days and catching up on the weekends. My personal gauge for work life balance each day during this period will be whether I’ve gotten out for walks to hit my 10,000 steps daily goal and if I’ve played the piano. Continue reading →

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 →

The year we meet again

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This is one of those weeks where I throw out what I was writing to mark an historic moment. It has been one year since the worldwide pandemic was declared. We all remember that week. It was a week when suddenly everything we knew as normal changed.

But a year later, this same March week feels like a hopeful turning point. The CDC has released guidelines on what fully vaccinated people can do. Congress has passed the American Rescue Plan and President Biden has signed it. The President is projecting we will reach 100 million vaccine doses in arms by his 60th day in office (next week) compared to his original goal of 100 million in the first 100 days. And he has directed the states to make the vaccine available to all adults by May 1 while the federal government mobilizes thousands of vaccinators and launches a new website to help people find the vaccine site closest to them.

I wrote last week that my husband and I have received our first dose. Our “magic date” as I call it is April 10 (though I know it is about science, not magic!). That is the day after our 45th wedding anniversary. That is when we will be fully vaccinated – two weeks after our second dose appointment on March 27. Like everyone who has missed spending time with their families we are looking forward to breaking bread together again. My husband and I are talking about which of our favorite restaurants we will go to for an inside meal for the first time in over a year.  And we are making plans to go somewhere for a long weekend.

I have shed tears many times this past year as I saw story after story of healthcare workers struggling to deal with overflowing ICUs and families describing the loved ones who they lost to COVID. This week I had tears reading the story of a young EMT in my town who transported many COVID patients to the hospital every day in March, then got COVID himself in April and nearly died. After many months of recovery, he is now back on the job. I had tears listening to the COVID-19 briefing on Monday. My emotions were a combination of sadness and anger as I listened to the experts unfiltered and thought about all the lies and misinformation and ignoring of science that we lived with the past year. We know the pandemic didn’t have to take the toll on this country that it did. Continue reading →

We got our shot!

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My husband and I got our first dose vaccine shot on Saturday. And yes, there is a sense of relief to be at this point a year after it all started.

March 5, 2020 feels like the last normal day for me. I had lunch in a restaurant with my daughter who is an NP at a Boston hospital. I was anxiously waiting to hear that HIMSS20 would be cancelled and wondered what they were waiting for. I discussed the risks of going with my daughter. I decided during that conversation not to go even if they held it (I got the cancellation notice as we were leaving the restaurant). I asked her about the Coronavirus from a clinical perspective. She said we’re “f’d” and projected 100,000 cases in the U.S. by April 1st. We now know it was to be far worse.

As a frontline healthcare worker, she was fully vaccinated by early January. Two weeks ago, she helped about fifteen of her husband’s 65 years and older family members and their friends navigate the somewhat confusing multiple websites in Massachusetts to schedule first dose appointments.

Here is my Rhode Island story. The vaccination site was a junior high in our town. Overall, it was a smooth process. When we pulled into the parking lot there was a sign that said wait in your car until 5 minutes before your appointment to avoid people crowding at the door. Our town Mayor was there working – that was a pleasant surprise. He took temperatures and asked initial screening questions at the door. I greeted him and commented on the fact that he was working – his somewhat joking reply was, “I have to earn my keep”.

Next, we went to the “check in” table. We gave them our IDs and they looked us up on the list of people scheduled for an appointment that day. The list was in no sort order, so it took a while. We then moved into the gymnasium where there were about eight vaccine stations. Firefighters and EMTs gave the actual shots. My husband was considered to have moderate risk of a reaction, so his PCP advised him to stay for 30-minute observation. When he shared that information, a physician was called over to ask him a few questions before he got the shot.

With information on how to sign up for the CDC’s v-safe app (after vaccination health checker), and our vaccination cards in hand we went to the observation area with many seats set up socially distanced. There were several people wandering around the area offering to help you make your second appointment or you could just use the QR code they provided on posters visible on the backs of the chair in front of you to sign up for 4 weeks out.

If you know me well, you know that I always have an eye out for process improvements. Continue reading →

What is a “Digital Dog”?

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My colleague, David Muntz, coined the term “digital dog” this week when he described to our StarBridge Advisors team how my two little dogs are so well informed as they walk with me every day while I listen to podcasts. I loved the term and the image!

There is so much great content to listen to. I sometimes feel like my little dogs with their short legs trying to keep up with me as I try to keep up with my two favorite podcasts – This Week in Health IT and In the Bubble. Yes, I subscribe to many more, but these are the top two that I keep up with best I can.

This Week in Health IT is three different weekly shows (each approximately 45 minutes long) – Newsday (Monday), Solution Showcase (Wednesday), and Influencers (Friday). And starting this year Bill Russell decided his audience could benefit from another option so he launched a daily news show on a separate channel – Today in Health IT (shorter at 8-10 minutes each).

I agreed to be one of the rotating co-hosts on Newsday this year. My second episode with Bill was this week – Newsday – Drive-Thru Vaccine Distribution, Reaching the Marginalized, and CIO Priorities. The first topic we covered was the UC Health Mass Vaccination Playbook – a comprehensive resource that is worth downloading. Even if you are already doing similar mass vaccine sites, I am sure there is something to learn from their playbook to refine and improve your own operation. Best practice sharing is what we do in healthcare! Check out the podcast to hear all the stories we discussed.

So that’s my plug for the best podcast series to keep up with what’s happening in health IT.

Turning to my other top podcast, In the Bubble. This is how I stay educated on COVID-19 and all things related. Continue reading →

Ensuring go live success for large scale IT projects

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Since the pandemic, major system implementations at health systems have continued with successful go lives supported by virtual or hybrid remote/onsite teams. Many organizations have “go live” success stories in this new world of remote work. While virtual support may change some things and certainly presents new challenges, the core work of a successful go live is still the same.

In late 2019, I published several blog posts on successful go lives based on firsthand experience with a major Epic implementation. Here they are again with basic lessons and tips:

10 Go Live Command Center lessons from the field

Epic Go Live – report from the field

9 Tips for Go Live support success

I welcome your comments on any virtual or hybrid go live experiences you have been involved in during the past year. If I get enough new lessons and tips, I will write a new blog so all can benefit. After all, continual learning and sharing best practices is at the core of what we do in healthcare.

Why this topic this week? I am currently working with a client who is less than six weeks out from an ERP go live so it is on my mind a lot. We are doing what we refer to as an Independent Verification and Validation (IV&V), a framework that facilitates audits of major IT projects regardless of area and complexity.  We explore 11 categories in-depth.  The topics range from governance and budget to training and QA.  The detailed analyses for each area involve document review and interviews to ascertain the status of the project.  A risk score is assigned in each of the 11 areas and mitigations are suggested based on the findings.  Ideally, over the life of the project there are three IV&V sessions conducted prior to go live and one session after go live to ensure that projects stay on course, make corrections as necessary in a timely manner, and achieve the defined objectives.

If you think an IV&V from my advisory firm, StarBridge Advisors, is something that your organization can use, please contact us to discuss.

Vaccine rollout – it takes a village, part 3

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Let’s start with the big picture and some good news. There are downward trends in the key COVID-19 indicators – the number of new COVID cases, hospitalizations, and deaths. But we know there is no good news in 3,000 deaths per day and nearly 500,000 deaths since the pandemic started a year ago.

In terms of the vaccine, there is good news at a macro level. According to the Bloomberg COVID tracker, 48 million doses have been given in the U.S. with an average of 1.62 million doses administered per day, 14.6 doses have been administered for every 100 people, and 70% of the shots delivered to states have been administered. (as of 2/11/21 at 6:25PM)

There are more examples of mass vaccination sites with thousands being vaccinated in a single day at stadiums around the country. UC Health in Denver is offering a playbook for mass vaccination sites to other health systems – best practice sharing is something we do very well in healthcare.

Dr. Anthony Fauci projects that by sometime in April, the vaccine will be available to anyone who wants it. That seems very optimistic considering many states are just now in mid-February beginning to vaccinate anyone over age 75. President Biden says there will be enough vaccine supply to vaccinate 300 million in the U.S. by the end of summer.

Access issues continue with a lot of confusion and frustration for those in qualified groups trying to make appointments either online or by phone.  It has become a family affair for many as younger family members try to help their elders figure out how to get vaccine appointments when there are multiple channels possible in their state or city and multiple different websites to go to. I applaud the various initiatives of software engineers in Massachusetts and New York who based on their own frustrating family experiences created a way for people to check availability of vaccine appointments. But we should not have to rely on such solutions. I would expect our government agencies to have made it simpler to begin with.

I just learned of another tool that notifies people via text message when there are leftover doses in their zip code so no dose goes to waste – Vaccination Standby  List. According to the website, their mission is  “to reduce COVID vaccine waste, reduce unnecessary lines and crowds at stores, reduce misinformation of leftovers, and allow as many people as possible to take advantage of any leftover doses”.

Disparities in vaccine distribution are real. We need more examples like the one in South Los Angeles where Dr. Jerry P. Abraham and the Kedren Community Health Center set up a walk-in site described in the Los Angeles Times article by Erika D. Smith on January 29, “Column: How a South L.A. doctor is beating the system and distributing vaccines equitably”. In Dr. Abraham’s interview on MSNBC’s Rachel Maddow Show on February 5, he said that he and his team are extremely solutions oriented and recognized that people with no car, no Internet access, and no email needed a workaround. Continue reading →