Tag Archives: technology

Practicing SODOTO with a new system

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I know that “see one, do one, teach one” is common in the training of medical professionals. But until I googled it, I didn’t realize it was a known method with an acronym – SODOTO.

With our new implementation of Salesforce at StarBridge Advisors, I am in the SODOTO mode. We are a small team. We recently hired a consultant to help us get it configured and designed the way we need it. My mantra as I worked with the consultant was KISS – keep it simple.

We are in the training, practice, and start to use it everyday phase. While we have a ways to go on data cleanup from our previous version, the new system is in production.

I’ve watched several short videos on how to create lists, reports and dashboards – literally “see one”. Then I made time to set up a few of each before I forgot what I’d just learned – the “do one” part. I think that would be considered “just in time” learning. I will show my colleagues how to do the same encouraging them to watch the videos as well – the “teach one” part. I still need to watch some videos on key features we may want to use so I can advise our team and make decisions together as we optimize the system.

Granted, our system is very small scale compared to the major EHR and ERP implementations I’ve overseen at many healthcare organizations. But here are my key takeaways applicable to any new system implementation:

  • Out of the box – Another way of saying don’t customize unless you really can’t work with the standard system.
  • Decision making – Key stakeholders need to be part of design decisions to ensure all use cases and workflows are identified and there is buy-in and adoption once the system is up and running.
  • Minimum data fields – Between what is available “out of the box” and custom fields you might think you need, be cautious. You can always add something later if you need it.
  • Workflow – Consider all your common use cases and basic workflows to design a simple, streamlined system that meets your unique needs.
  • Reports and dashboards – Data fields and workflows are too often the primary focus, but you need to be able to get the data out of the system in a usable format.
  • Adoption and consistent use – With any new system, all users need to understand what’s expected of them.

Major system implementations typically have optimization phases post go live. As much as the project team tries to account for everything, there are always changes requested once users start to actually use the system. It’s fair to say that I’ll be working with our own small-scale optimization phase of Salesforce in the next few weeks.

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Something new every day

 

HIMSS20 – are you ready?

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If you work in health IT, you know that the annual HIMSS conference is the biggest industry event each year whether you are headed to Orlando in three weeks or not. The number of emails, blog posts, social media posts, and articles providing guidance and recommendations on HIMSS20 grows with each passing day.

In the next two weeks I’m wrapping up my current interim CTO engagement at University of Vermont Health Network and handing off to the new CTO. If like me you are super busy at work, making your game plan for HIMSS20 is probably low on your priority list. With so much info out there, I decided to pull together some resources that might help in your preparation.

Whether you are attending in person or following the happenings from a distance, the Official HIMSS20 Hashtag Guide will help you focus in on your areas of interest. My top picks this year are #WomenInHIT, #HealthcareStartup, #HealthcareInnovation, and #PatientEngagement. And of course, you’ll want to follow all the HIMSS digital influencers. You can follow and engage with them using hashtag #BeTheChange. If you’re looking for who the 2020 social media ambassadors are, the digital influencers have replaced them with a new and more expansive program.

Several recent blog posts are worth checking out for more previews and tips:

With my focus on developing women leaders in health IT, I’m looking forward to the Women in Healthcare and Tech: Closing the Gap to Strategic Leadership session on March 10 from 10:30AM-11:30AM. A panel of trailblazers with backgrounds in healthcare and technology will discuss empowering women and closing the gap to strategic leadership. 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 →

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 →

12 tips for effective vendor management

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An EHR implementation involves more than just the EHR vendor. As we approach the November 1st Epic go live at the University of Vermont Health Network, the interfaces and interdependencies with other canstockphoto26237556 (1) VRMvendors become more critical. As we review issues and risks that need executive level attention, multiple vendors are involved. Whether it’s ensuring their system implementation and interfaces are ready on or in advance of November 1st, or it’s a product that we already use that just needs to work in a new environment, we are counting on them to share our sense of urgency and deliver as expected.

As I assist with some of these vendor relationships and escalations, I’m drawing on many years of experience with IT vendors – both software and infrastructure. We are fortunate to have a strong supply chain management team that partners with IT. They are involved from early on in vendor evaluations through contracting. They stay connected to IT and step in to lead or assist when we have vendor issues after implementation.

Two of my previous blog posts provide guidance on creating win-win relationships with vendors. In “Keys to successful vendor management” I outlined some key success factors:

  1. A good product roadmap: It should be clear what core solutions are available now and what their path forward is for the next several years.
  2. More service than sales – a strong service culture should be evident in the sales cycle and demonstrated throughout the duration of the relationship. A focus on service should be engrained in every one of their employees.
  3. Total Cost of Ownership (TCO) – you and the vendor should develop this together. It should include initial one-time fees, ongoing costs for their products and services, all required 3rd party products, and your internal staff. There should be no hidden costs or “gotchas” later.
  4. Reputation – be sure to do your in-depth reference checks. Colleagues in similar organizations are a great source of honest, candid information and experience – good and bad. If your vendor is going to host or manage the application/service for you, check on the change management and operational maturity with colleagues and references. Resources like KLAS, Gartner and others can be leveraged as needed.
  5. Solid contract – once it is negotiated and signed, you may never have to look at it again. But if you do, ensure you are protected.  There is growing market consolidation among larger vendors; start-ups are often acquired by larger firms. Ensure you are protected under these scenarios. Ideally you have someone in your Legal or IT department who focuses on technology contracts and knows the common issues and standard terms.
  6. Implementation – your vendor should provide onsite resources that are integrated with your internal team. Issues tracking and resolution is a joint effort. Status reporting should be a shared effort with a very objective, accurate view.  It should include an executive dashboard on status, milestones, issues and budget.
  7. Escalation – problems will inevitably occur. Escalation process should be clear from the start with a point person for both the vendor and your organization.

Continue reading →

Press 1 for… Press 2 for…

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Does hearing this cause anxiety and impatience? Or do you think, great, I’ll soon be talking to the right person to help me? I am usually impatient when it comes to getting help with something. I find it frustrating canstockphoto20456258to listen to a long list of phone options, to wait for someone to be available, then get bounced around between call center staff and repeat my information multiple times.

But call centers and automated attendant systems are our new reality. There will be more use of artificial intelligence (AI) and Chatbots in the future. If designed properly, the customer experience can be a positive one.

I admit that I quickly forget the experiences that are smooth and positive. But I remember the ones that aren’t. I had one of those not so positive experiences this week.

While driving on the freeway last Friday, something flew off a truck and hit my windshield creating a crescent like crack the size of an orange. Not something to ignore and put off.

Making the call to my insurance company and being routed to the auto glass service they partner with involved getting redirected to different numbers, providing the same information multiple times, and still not getting the result I needed. In the end, I got it worked out when I contacted the service provider directly.

This not so positive experience reinforced how important it is for us to design the optimal flow and support structure for our command center (a call center on steroids) during our upcoming Epic go live at the University of Vermont Health Network. Customer service encounters in some form are an everyday experience. They should be easy, quick, and have a positive outcome. Continue reading →

Crunch time and why IT matters

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It’s crunch time. Every day counts. Can’t miss a deadline. All hands-on deck. Go live readiness assessments (GLRA). If you work in health IT and have been through a major EHR implementation, canstockphoto60328456 (1) EHR UVMHNyou’ve heard all these phrases.

At the University of Vermont Health Network (UVMHN), the Epic Wave 1 go live is less than 5 months away. The University of Vermont Medical Center (UVMMC) has been on Epic for inpatient and ambulatory core clinicals for years. Wave 1 includes the full revenue cycle, lab and anatomic pathology, radiology, OR and anesthesia, cardiology, ophthalmology, orthopedics, behavioral health, rehab, wound care, infection control, and predictive analytics at UVMMC.

Wave 1 also includes the first Epic implementations at three Vermont and New York hospitals in the network starting with ambulatory systems for billing and clinical functions. Waves 2 (2020) and 3 (2021) will be the full suite of inpatient systems at those same hospitals – Central Vermont Medical Center in Berlin, Vermont; Porter Medical Center in Middlebury, Vermont; and Champlain Valley Physicians Hospital in Plattsburgh, New York. Yet to be scheduled are Elizabethtown Community Hospital in Elizabethtown, New York; Alice Hyde Medical Center in Malone, New York; and Home Health and Hospice.

The core infrastructure is largely in place to support the November 1st go live though we have more to do at the device level. Over 10,000 users will be trained in a 6-week period. The first GLRA at 120 days pre go-live is coming up soon.

When I saw Epic on the agenda for the UVMMC quarterly leadership meeting, I assumed it was a project status update. How wrong I was. Continue reading →

Partnering for your health

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You go to a conference, hear many great speakers, take some notes, learn about some new firms, make new connections, and catch up with colleagues. There are usually one or two key takeaways. Those btn_epatient_spm (002)stories or presentations that make a significant impression on you.

At the New England HIMSS Chapter Annual Spring Conference this week, that moment came during the session by Dave DeBronkart, known as e-Patient Dave, and Dr. Daniel (Danny) Sands, his primary care physician and faculty member at Beth Israel Deaconess Medical Center. Together they were two of the twelve founders of the Society for Participatory Medicine and the inaugural co-chairs.

Prior to the conference, I knew who e-Patient Dave was and had seen him on social media, but I had never heard his personal story nor met him. Their session demonstrated the power of storytelling at its best. Now I understand why Dave is so passionate about patient engagement.

Their session, “Hot or Not? A Doctor and Patient Role-Play the Archaic and the Modern Way to Engage” was a combination of role play and presentation. Dave started by describing the moment when he was diagnosed with a stage 4 cancer in 2007 following an incidental finding from a shoulder x-ray. He learned early in his journey that the median time left for a patient with his diagnosis was 24 weeks. He thought then that he had at most 6 months to live. That got my attention!

Their role play illustrated what may be the typical patient – physician interaction vs what should be a true patient – physician partnership. They covered communications (email, texting), patients doing their own online research and sharing information with their physician, timely access to results on a patient portal, and disease specific online support groups.

The Society for Participatory Medicine focuses on the power of partnership between patients/families and clinicians. They describe “Participatory Medicine” as a movement in which patients and health professionals actively collaborate and encourage one another as full partners in healthcare. They believe this leads to improved health outcomes, greater satisfaction, and lower costs. Continue reading →

Finding your passion

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One piece of advice I give young people is that they don’t have to decide what they want to do for the rest of their life at age 22. Just think of all the jobs that didn’t exist 10 years ago and what might exist 10 yearscanstockphoto19577734 (1) finding passion from now.

As we acknowledge the nurses among us for National Nurses Week, think how much the nursing field has changed over the years and how many opportunities and different paths nurses can take these days. There is a growing need for nurses with informatics training but that is just one possible path among many.

My oldest daughter is a nurse practitioner. But she didn’t start there when she went to college. She got her undergraduate degree in hotel and restaurant management with a minor in business. She wanted to do travel and tourism – and see the world. On graduation day she looked at me and said, “Mom, I don’t know what I’m going to do with my life that’s meaningful, but I don’t think it’s travel and tourism”. I looked at her and said, “Just get a job and then figure it out”. That was the response of a parent having just put their oldest of two children through college and anxious for her to get started in the full-time work world. Can all you parents of young adults relate? Or did I sound like a callous and unsupportive parent?

She floundered for a year or two after college with a couple different jobs including work in the travel industry for a short time. But she started thinking early on after graduation about becoming a nurse. Whenever she talked to me about it, I told her she’d be a great nurse – super organized, able to multi-task better than anyone I knew, with fabulous people skills. But I also told her that she’d have to buckle down and study the sciences if she wanted to be a nurse.

She considered her options and decided to pursue a combined nursing / nurse practitioner program getting her second bachelor’s degree then her masters. She had found her passion! Continue reading →

It’s IT’s fault

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I was surprised to hear this from a front-line airline worker when I checked in at the gate. I probably shouldn’t have been surprised after all my years in IT. As I deplaned on the first leg of my flight, I realized canstockphoto7753679 (1) blameI didn’t have a mobile boarding pass for the second leg. I usually print my boarding passes – just seems easier to keep track of and quickly access than trying to find the specific email on my iPhone with the boarding pass link. But I had checked in for the flight from my hotel room late the previous night so opted for a mobile boarding pass.

The connection was going to be tight anyways. And then my first flight was 35 minutes late departing and I was sitting towards the back of the plane. I was connecting at O’Hare so I hustled from the H gates to the L gates fast as I could. When I got to the gate and said I didn’t have a boarding pass, the airline employee said, “it’s our IT department”. He told me how IT has some explanation about how the mobile boarding passes aren’t intended for connecting flights for security reasons. But I don’t recall any message during the online check-in saying I had to get my second boarding pass at the airport. Then he said it’s because they inherited the IT department from the other airline they had merged with.

As a healthcare customer, I’ve often heard registration clerks and other front-line workers blame “the system” for being slow or not working the way they’d expect it to. Another “it’s IT’s fault” explanation. But given I usually received my care at the provider organization where I was the CIO, what I heard was it’s my team’s fault.

After doing an IT review at a client where we talked with probably 60 leaders and staff, I saw how the “it’s IT’s fault” takes on many flavors. A sobering reminder of just how hard IT’s job really is, yet how much IT needs to listen to their customers and partner with them. Continue reading →