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

Most popular blogs in 2019

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It’s the new year and time for top 10 lists and countdowns so I’m adding mine to the mix. These are my most read blog posts in 2019. If you missed any of them first time around now is your chance to check them out.

I am a practitioner and always willing to share experiences pulling lessons from everything that I do. I continue to cover a range of topics from leadership to women and work to technology and healthcare. It looks like my readers appreciate the variety. Here are the top 10 as measured by total views:

A passion for health care – a classic one from previous years about why we do what we do

6 tips for successful huddle boards – another classic from previous years that doesn’t go out of style

“We’re at meeting norms” – this one is about best practices I learned from my IT colleagues during my interim CTO engagement at University of Vermont Health Network (UVMHN) this past year.

10 best practices for project success – another one from my experience at UVMHN as we approached the November Epic Go Live.

Where do new ideas come from? – another back to the classics from a previous year.

Develop women leaders, transform leadership – at StarBridge Advisors, we launched a new service early in 2019 call C-Change focused on developing women leaders in health IT. Continue reading →

Taking stock – goals for your next decade

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January 1, 2020 marks more than just another new year, it marks a new decade. And a good time to take stock.

What are your personal highlights of the past decade? What does the new decade hold for you? Are you living the life you want to live?

I have never been a “bucket list” kind of person, but I did set four big, broad goals for myself early in this decade. They involved family, work, travel, and friends.

My family goal involved grandkids that weren’t yet born. I told my husband that I wanted to spend a lot of time with my grandkids if I was fortunate enough to have them someday. That someday came for us four times between 2012 and 2016. Happy to say, I’m meeting my family goals. Once we had grandkids, there was no question I wanted to make the changes needed to live near them so I could see them often. We made the move back to New England in 2016 and it was one of our best decisions ever. They are now 7, 5, almost 5, and 3 ½. I fondly call them the “Fab Four” and we see them often.

That decision to move was tightly coupled with a major career decision. Leaving a fulltime position as a healthcare CIO to start down a path of interim management, consulting and leadership coaching. It’s a decision I have never regretted as I now have more control and flexibility in my career and work. This period has included launching and growing a successful health IT advisory firm, StarBridge Advisors, with two colleagues for the past 3 years. Continue reading →

Holidays aren’t fa-la-la for everyone

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In past holiday seasons I’ve written about managing stress and remembering your big rocks, STEM gifts for kids, and girl power gifts. What to say that is new and different? Not to be a downer, but this year I want to comment on loss.

My husband and I visited Washington DC the past several days for a mini vacation. We saw two excellent plays, went to a holiday choral concert, and spent a day touring the Capitol including visits to both the house and senate galleries. We visited several museums, saw the lights at the national zoo, shopped at the holiday market, and had several delicious meals. And after 43 years of marriage, we continued to enjoy each other’s company everywhere where we went.

But of all those outings, what struck me the deepest was the Judy Chicago exhibit at the National Museum of Women in the Arts called “The End: A Meditation on Death and Extinction”. The artist who is famous for her feminist and minimalist art turned 80 this year. In her words, she has been thinking a lot about her own mortality. While the doctors and nurses I know may be more used to dealing with mortality, it is a subject most of us try to avoid thinking about.

This powerful art exhibit is divided into three sections. The first depicts the five stages of grief – denial, anger, negotiation, grieving and acceptance. The second begins with a sculpture of an older deceased woman clearly at peace followed by pieces that speculated on how the artist herself would die – in peace, in pain, or you can imagine. The third was about extinct species – a very powerful message in a different way forcing the viewer to think about how we are slowly destroying wildlife through our actions and inaction.

I know several people who have lost someone they loved dearly this past year. Some said goodbye to elder parents and grandparents after long illnesses. Others in my circle of friends and family had more sudden and unexpected losses – a beloved spouse, a parent, a brother, a sister, a child. Many people say the first holiday season after losing a loved one is the hardest. I have no doubt about it.

As you celebrate the joy and wonder of this holiday season, make room for those who are grieving. Find kindness in your heart for all around you but give special support and love to those who may need it the most at this time of the year. If you have experienced loss, let those close to you surround you with their love.

May your holiday season and new year be one of peace, health and happiness.

Related Post:

Do you know your big rocks?

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 →

Conducting project “lessons learned” as continuous improvement

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As I caught up on my industry reading this past weekend, I saw several implementation best practices articles – advice from experts on EHR, Telehealth, Pop Health, and Medical Device implementations. These kinds of resources are always helpful to think beyond your organization’s experience, get a different perspective, and learn from others.

At the same time, conducting lessons learned sessions internally after major projects is critical. While it’s still fresh in your mind, being able to look as a team at what worked well and what didn’t work well over the life of the project is an important step before moving on to the next project or next phase of a multi-year project. This should be done in the spirit of continuous improvement. Ask yourself, what can be learned from this project that can be applied to future projects. And be sure to document that in a way that is referenceable in the future.

We are just over 3 weeks post go live for Wave 1 of our Epic project at the University of Vermont Health Network (UVMHN). We start a series of lessons learned/debrief sessions this week. IT managers have been asked to think about three questions and submit them in advance so they can be compiled for review and discussion:

  • What worked well?
  • What didn’t work well that we should modify?
  • What didn’t work well (or was unnecessary and we should no longer do)?

As we planned for the sessions, I suggested that we have a few guidelines – no blame, assume positive intent, and ensure everyone is heard. UVMHN has a very collaborative and team-oriented culture so that shouldn’t be difficult.

Often, it’s easy to go right to what didn’t work well. Those examples may be top of mind. But there is so much in a project of this magnitude that is done well. Capturing those points and making sure you repeat them in the future is important.

Wave 2 planning started before the Wave 1 go live. Certain lessons have already been looked at as part of that planning. But the upcoming sessions will be an opportunity to look more broadly and get the input of all areas involved. Given I’ve been interim CTO since late May, my involvement did not span the entire project but rather certain aspects in the last few months including the go live. I look forward to hearing everyone’s perspective on how we can do better and build on the successes to date.

Related posts:

10 Go Live Command Center lessons from the field

Epic Go Live – report from the field

9 Tips for Go Live support success

Plans, processes, people: lessons from a successful EHR implementation

With Gratitude

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I was struck by the recent Becker’s Hospital Review article highlighting healthcare CEO messages of thanks to their staff. I saw gratitude, humility, commitment, servant leadership and a true passion for what we do in healthcare and how we serve our communities. Jim Hinton, CEO of Baylor Scott & White Health (Dallas) said Thanksgiving is his favorite holiday because the focus is not on gifts but rather on thanks. He quoted John F. Kennedy who said, “We must find time to stop and thank the people who make a difference in our lives.” So true. And so important.

I am thankful for my family who are my “big rocks”. My husband, Tom, has been my best friend for over 45 years. My daughters, Katie and Ann, now have families of their own. We all get along and live close enough to see each other often. My grandkids who I fondly call the “fab four” bring energy and fun to every get together. And I am thankful for my siblings and their families who I do my best to keep in touch with halfway across the country.

I am thankful to my StarBridge Advisors colleagues, David Muntz and Russ Rudish, who started this adventure with me three years ago. And I am grateful for the talented team of advisors who have chosen to work with us and to all the healthcare organizations who have trusted us enough to hire us as interim leaders, advisors and leadership coaches the past few years.

I am thankful for my team at the University of Vermont Health Network where I have served as interim Chief Technology Officer since late May. I am grateful to everyone who is part of “team Epic” and worked so hard to ensure a successful go live a few weeks ago. The staff who worked many 12-hour shifts, the operational leaders who partnered with IT, and all the users who were patient with us as we diligently fixed issues.

I am thankful to all my health IT colleagues across the industry who I continue to learn from and who help make me a better person.

And I am thankful that I work in an industry that makes a difference in peoples’ lives every single day.

Related posts:

Crunch time and why IT matters

A passion for healthcare

Do you know your big rocks?

 

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 →