Tag Archives: lessons learned

HTM and IT: frenemies or collaborators?

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What is a “frenemy”? According to Dictionary.com: “person or group that is friendly toward another because the relationship brings benefits, but harbors feelings of resentment or rivalry”.canstockphoto5722510

Within health care organizations, there is a lot of history between the people who support the medical devices that touch patients and those who support the information systems used by clinicians. It has not always been positive and collaborative. In fact, there are such differences in the culture of each group that they don’t always get along. Maybe they are even “frenemies” in some organizations.

In your hospital, you may know the function as Biomedical Engineering, Biomed, Clinical Engineering or Health Technology Management (HTM) as it is now called as part of elevating the profession within healthcare. Those in the field now refer to themselves as “HTMs”.

AAMI (Association for the Advancement of Medical Instrumentation) is a standards development organization and the professional society for HTMs. AAMI is celebrating its 50th anniversary this year. Its mission is to advance safety in healthcare technology.

Four years ago, I was the first CIO ever to be elected to the AAMI board when AAMI leaders recognized the trend towards HTM and IT convergence and integration. I have provided the IT perspective to the AAMI board as the HTM profession continues to evolve. Continue reading →

Another anniversary worth noting

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canstockphoto13207113This week marks three years of blogging for me. People still ask me where I find the time and how I get ideas for topics. My answer is always the same. I make it a weekly discipline – shaping the ideas during the week, writing a near final draft on Thursday night, then finalizing and publishing it first thing Friday morning. The ideas continue to flow though I’ll be the first to admit there are some Thursday nights when I’m still looking for inspiration.

Just think how I felt the Thursday when I saw this tweet from someone I follow?

“Tomorrow is Friday and we all know what that means! No, not just Cinco de Mayo but @sgschade blog comes out! #anticipation”

No pressure I thought. Fortunately, it was the week I had shadowed a nurse and my blog topic was obvious.

By the numbers, there have been close to 75,000 total views. Who would have thought that three years ago? I remember someone asking me who I thought would read my blog besides my family and close friends. Believe me, I have a small family who doesn’t always read it and few close friends. Continue reading →

Planes, trains, automobiles and ferries too!

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What consultant doesn’t want to work close to home as much as possible? But you go where your clients are and you get used to traveling.

It was one of those weeks. There was the usual 2-hour drive plus the 1 hour ferry ride to my interim CIO canstockphoto21462750engagement on Long Island. Monday was the first time I worried about missing the ferry. My “wiggle room” on the drive part evaporated with bumper to bumper traffic as soon as I got on I-95 in Providence. I sweated it but I made it!

Then there was a same day trip from New York to Chicago for a CHIME Education Foundation Board retreat. It seemed like a good idea when we agreed to fly in and out the same day but reality of that can be brutal – a very long day!

And finally, there’s the commuter rail train ride into NYC to meet my husband for the holiday weekend.

I’m happy to not depend on airports for my current weekly commute compared to many who are truly “road warriors”. I feel a little spoiled. My biggest stress is whether I’ll hit traffic on I-95 and have to take a later ferry.

When I was the interim CIO at University Hospitals in Cleveland last year, it was a predictable 3.5-hour drive from Ann Arbor. A few times I ran into huge traffic jams and a long out of the way road construction detour. But it was mainly a predictable weekly commute. And productive when I could get some calls done during the drive.

Once we moved to the Providence area, it meant a weekly flight. The Providence airport has fewer direct flights. I had to choose between connecting flights which increase potential delays or the longer ground transportation to get direct flights out of Boston. I chose the latter.

Then my current engagement on Long Island came up. Driving through NYC or flying was a non-starter. It was a “go” when I learned about the ferry option. Continue reading →

What to expect from your vendors

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You are past the big go live. You and your team are focused on optimization, enhancements, ongoing support issues, and upgrades. So, what should you expect from your vendor in this ongoing relationship?canstockphoto10856287

I have worked with all the major EHR players and many other IT application and infrastructure vendors over the years. I have worked with three of the major EHR vendors just in the last 18 months given my interim CIO engagements.

My post “Keys to successful vendor management“ covered the importance of the product roadmap, service, total cost of ownership, reputation, contract, implementation, and escalation.

It’s time to look at the ongoing vendor relationship that clients should expect. Vendors, take note. I assume most of your clients would share this view. There’s a reason that the KLAS Research reports carry a lot of weight for CIOs, they are vendor evaluations from their peers.

Whether it is a large, proven vendor or a small start-up, here’s what you should expect: Continue reading →

Lean classics worth a second look

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I am a lean leader and always willing to share my learnings. I’ve written several blog posts chronicling my lean experience at different organizations. Some of them have been quite popular with readers. I’ll call them my canstockphoto19155139“lean classics”. Here’s a recap for your reference:

Huddles and Visual Management:

Leadership huddles: not just another meeting – describes my first IT leadership huddle launch back at University of Michigan Health System. As my lean coach said at the time, be willing to experiment, it doesn’t have to be perfect. We learned and tweaked it as we went through the PDCA cycle.

Making the invisible visible – describes the beginning stages of the visual board our IT leadership team created at University Hospitals in Cleveland.

Making the invisible visible – part 2 – describes that same effort several months after we launched it and how we used it as a team.

6 tips for successful huddle boards – based on experience, my advice to those considering their own huddle boards. Remember, you need to be willing to experiment.

Gemba Walks:

Importance of rounding or going to the “gemba” – describes early experience with clinical and operational rounding both at Brigham and Women’s Hospital and University of Michigan Health System. Continue reading →

The power of co-location

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There continues to be a lot of focus on telecommuting and open office space for knowledge workers in large organizations. Both are important yet not everyone agrees they are good – a lot depends on the canstockphoto12582566 for colocationorganization and the culture.

But I want to focus on another “space planning” topic, co-location. As health care organizations grow, administrative departments including IT often end up being spread out in many office buildings, sometimes at great distances from the hospital with a lot of traffic in between.

The investment needed to centralize all the administrative functions in one building often takes backseat to investing capital in clinical space. No surprise. Video conferencing is always an option for bridging the miles. This technology continues to advance and become more of a commodity. National and global companies must leverage technology but health care systems are mostly local or regional.

In my many years of health IT management, I’ve experienced a variety of space situations: Continue reading →

One of those weeks…

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People often ask me how I find time to write a weekly blog with a big, busy CIO job. I tell them all the same thing – it’s a discipline. I try to start early in the week with an idea, draft it one night, come back to itcanstockphoto6248723 the next night to finalize and then post it on Thursday or Friday morning. Topics are often timely; something strikes me and I tell myself “that will blog”. I add the idea to my running list. This week it included tips on doing presentations for executive groups, personal organization challenges and tips, and what’s possible to accomplish as an interim leader in just 6 months.

But this week I had as many as five new ideas but no time to start writing any of them. By Thursday night if I haven’t settled on a topic and started, I’m in trouble. Taking time to write may compete with critical work I need to finish up by the end of the week. This week was one of those weeks.

This week started out with a bang.  By 9AM Monday, I was juggling 4 different issues. Continue reading →

Teamwork at its best

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If you are an IT professional supporting major production environments and applications, you have most likely experienced a significant system outage at some point. We had one of those events thiscanstockphoto16328410 week. As in previous experiences in other organizations, I saw people at their best come together as a team working diligently to restore systems. This team included IT, clinical and operations staff.

I know CIO colleagues who recently managed through a week long outage of their business systems in one case and a multiple day outage of their electronic health record in another. They could probably share similar lessons following those experiences. 

In the spirit of teaching and learning from one another, I offer these key points if you have a significant event: Continue reading →

What upgrade?

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This past weekend we did another major upgrade – this time the ambulatory EMR. It went extremely well and was met with smiles and kudos from our senior executives. While we’ve done several major upgrades canstockphoto13469755recently including revenue cycle and acute EMR, this one had a lot of eyes on it. Those same senior executives have been rightly concerned about the performance of our ambulatory EMR while we worked through some significant issues during the past several months, including software, hardware and infrastructure. So, kudos to the team that turned the corner on those issues and pulled off a very successful upgrade with minimal issues and disruption to our physician providers and operational practice teams.

We called our 200+ physician practices before the upgrade to make sure they felt prepared.  A few actually said “what upgrade?”. Apparently they had not read the any of the advance communications. So we worked with each of them to make sure they were ready.

The command center was open all week and will close early today as we have fewer and fewer calls.  Over 62% of the reported issues had been resolved as of late yesterday. Our users gained a lot of new functions and features which has made everyone happy.

In addition to a strong and collaborative relationship with your vendor, here are some critical success factors for any major software upgrade: Continue reading →

Who’s on first?

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Picture this. One of your IT leaders tells you they have been pulled into a project by a senior executive; they are trying to figure out who in IT owns it. You tell them that another of your leaders owns it. They arecanstockphoto2538045 working out the specific issues with yet another leader. The first person says it’s still not clear. So you pull all three of them together for 15 minutes and try to sort it out.

With a collaborative team that works well together, that 15 minutes is relatively easy. Your first question is who’s on first? You want to know who owns it and what’s going on.

My team has learned that one of my questions about problems is “who wakes up in the morning worried about it?”  Not that I want people worrying and losing sleep. But, it’s a way to identify who owns something and is accountable for it. “Who’s on first?” is another one of those questions. It may be a messy, complex project. It may be off to the side or on the fringe but it still needs a clear owner.

After just 15 minutes, my three leaders and I confirmed the right roles for each of them, and next steps. And of course we talked about lessons learned. So what did we learn again in this situation?

Role clarification – this is critical for all projects, small or large, high priority or not. Clarifying and communicating sponsor, business owner, project manager, and decision makers is key.

Communication – proactive communication throughout the life of a project to all members of the core team and the stakeholders is another key.

Setting and managing expectations – this is especially true when dealing with many concurrent efforts with the same set of users and stakeholders. It’s also important when a project that seems simple actually has a lot of complex issues:  technical, operational, legal or something else.

I’ll bet you can think of a messy project in your experience that swirled or stalled. You might have some bad memories. Most likely, what went wrong ties back to one of these basics. So clarify roles, communicate, and manage expectations, but make sure you know who’s on first.