Tag Archives: leadership

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 →

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 →