Tag Archives: leadership

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 →

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 →

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 →

Vaccine rollout – it takes a village, part 2

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Last week’s blog post on vaccine rollout took longer than expected to write as I compiled multiple resources and articles to comment on and share. With the vaccine rollout as massive an undertaking as it is and so many stories (good and bad), I decided to do part 2 this week highlighting best practices, technology challenges, and health disparities.

Best Practices

Last week, I mentioned Atrium Health and their local partnership to do mass vaccination events. It was encouraging to see their update on vaccinating over 20,000 people had a special emphasis on underserved communities.  We need more focus on underserved communities – more on that in a bit.

Another health system doing drive thru vaccination clinics at scale is Memorial Hermann in the Houston area. They are getting calls from health systems across the U.S. asking for guidance on how to design similar large-scale vaccination events and are more than willing to share their blueprint for others to replicate according to Binita Patel, Vice President of Pharmacy Services for Memorial Hermann Health System. The location (NRG Park) and staffing (700 people including many volunteers) were key to their success.

We cannot forget that there are many people leery of the vaccine, sometimes referred to as “vaccine hesitancy”. Education and public health messaging campaigns will be key as the vaccine rollout continues over the next several months. Based on the Kaiser Family Foundation’s latest COVID-19 Vaccine Monitor report, there are key messages that resonate with people. They are listed in this short article from Becker’s Health IT : “8 most convincing messages to promote COVID-19 vaccines”.

Many health IT vendors pivoted their products and services to support COVID-19 over the past year. Vaccine scheduling is the latest focus area for vendors like Kyruus which shared best practices and insights from their customers in their recent blog: “Eight Best Practices for COVID-19 Vaccine Scheduling Online: Insights From Our Health System Customers”. A great transition to the next topic.

Technology Challenges

I mentioned the Vaccine Access Management System (VAMS) in my post last week as a system provided by CDC to states and other organizations for pre-screening, registration, scheduling and tracking. Not surprisingly, a software solution developed quickly and made available for many different but similar situations and workflows has experienced problems as captured in this article from MIT Technology Review. I would hope the problems can be resolved so organizations using it do not have to switch systems midstream with vaccine rollout already in process and moving rapidly. Continue reading →

Vaccine rollout – it takes a village

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The vaccine is top of mind for many of us and a lead news story most days. Whether we are in a prioritized group wondering when/how/where we will be able to get the vaccine or are helping a family member in one of those groups sort it out. We are disappointed to hear the supply from Pfizer and Moderna is so limited at this stage. We are frustrated and anxious not knowing when we will be able to get the vaccine.

I share all those feelings. I am anxiously waiting to learn when my state of Rhode Island will start vaccinating 65+ so I can get my husband and I an appointment. With the percent of doses administered overall in Rhode Island only 56% of what has been distributed and our state currently receiving just 14,000 new doses each week, I am not optimistic that it will be soon.

In spite of any frustration you may feel about your own state’s progress, the good news at the macro level is that in the last week, an average of 1.25 million doses per day were administered in the U.S. That is even better than the goal of 1 million per day for the first 100 days of the Biden Administration. And there is more good news regarding the supply – 200 million more doses were ordered by the Biden Administration this week with the expectation that there will be enough doses for everyone who wants the vaccine by sometime this summer.

We know that vaccine plans vary by state. How to Get a COVID-19 Vaccine: A State-by-State Guide from the Wall Street Journal provides state website links and brief description of each state’s status. States vary on how groups are prioritized, the scheduling process and systems used, and the total number of doses available. In the 65+ group, I have friends and family who have driven more than 500 miles around their state for separate husband and wife appointments that they could only make at two different locations due to the demand, a couple who was only able to register for a lottery with 8000 doses to serve 250,000 people, a couple who relatively easily made appointments at their grocery chain to receive the vaccine from the pharmacist, and a couple who relatively easily made an appointment at a local community vaccine site.

The New York Times has a vaccine calculator – Find Your Place in the Vaccine Line – that puts it into perspective. You enter a few key data points and can see where you are in line within the U.S., your state, and your county – in other words how many thousands or millions of people are ahead of you. The graphic it produces helps you understand the order of groups and their relative size.

There are two trackers you might find interesting. The Johns Hopkins Coronavirus Resource Center tracks cases, testing and vaccines by state. You can see how your state is doing and where it ranks on vaccinations. The Bloomberg tracker shows how your state is doing by percent of doses used and number of doses administered.

There is a software system available from the CDC for states, counties and other organization to use – Vaccine Access Management System (VAMS). It handles pre-screening, registration, scheduling, and tracking. My state of Rhode Island will use PrepMod – a software solution in use by several states. Health systems appear to be using their own systems and assuming that patients can schedule through their patient portal or by phone. Some allow you to create an account if not already a patient.

I think we can all agree that front line health care workers needed to be first in line for the vaccine. But there have been stories of health systems vaccinating employees who only work from home, volunteers who aren’t coming into the hospital during the pandemic, board members and others who don’t appear to be in priority groups per the CDC guidelines. These systems have defended their actions by saying the more people vaccinated and the sooner is good for the community and that all staff are critical to the hospital’s operations. I can understand the frustration of people who are patients of those systems and in a prioritized group (such as elders or with underlying conditions) yet still waiting to learn when they will get the vaccine.

Let’s pivot to some positive stories of vaccine partnerships involving health systems to deliver shots in arms at scale. Continue reading →

400,000 lives lost – finally a national strategy

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On December 14 with the first frontline workers in the U.S. starting to receive the vaccine there was great optimism and hope that we had entered a new chapter of this pandemic. But six weeks later over 100,000 more people have died of COVID-19 and only 16.5M of the total 36M vaccine doses distributed have been administered. 5% of the U.S. population has been vaccinated though only 2.1M people have received the full two doses.

On Tuesday night, on inauguration eve, the new administration held a National Moment of Unity and Remembrance. A simple ceremony in front of the Lincoln Memorial to mourn and honor the over 400,000 people who have lost their lives to COVID-19 in less than a year. President Joe Biden and Vice President Kamala Harris spoke briefly, an ICU nurse from Michigan sang Amazing Grace, and 400 beams of light were lit up along the reflecting pool in front of the Washington Monument – one for every 1000 lives lost. Across the country bells tolled and buildings were lit up. It was a simple yet moving and much needed moment for all of us.

Five hours after President Biden took the oath of office on Wednesday, he was signing his first set of executive orders. Three of them including the very first were directly aimed at the pandemic – “100 days masking challenge”, rejoining the World Health Organization (WHO), and creating the position of COVID-19 response coordinator. Dr. Anthony Fauci is the U.S. representative to the WHO executive board and joined his first call on Thursday. Jeff Zients, who served as chief performance officer under President Barack Obama and led the rescue of HealthCare.gov, has begun his work as the COVID-19 response coordinator. Zients is “ready to manage the hell out of it”, as Biden said last Friday.

The new administration is getting right to work, and the pandemic is a top priority. A National Strategy for the COVID-19 Response and Pandemic Preparedness was released yesterday. Continue reading →