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The answer to that question, says Beth Israel Deaconess Medical Center CIO John Halamka, MD, is that we need the right amount of the right regulation and legislation.  

Many organizations have a Project or Program Management Office (PMO). If not at an organization wide level, at least within the IT department. There are different models. Some PMOs provide standards, tools, methodology and overall tracking. Others provide this foundation as well as a team of project managers (PMs) who can be assigned as needed to major projects. Our PMO at University Hospitals is the latter model. Our PMO has evolved under our new manager, Joe Stuczynski. He and his team are making significant improvements with the support of IT leadership. They have developed a roadmap for further changes and improvements for the next year. It is refreshing to be in an organization where we are not debating about the tools and whether they are good enough. We are not debating about what projects need to run through the PMO and if everyone needs to follow the standards. Instead, we are embracing and leveraging the tools and the PMO is able to focus on what it should be – tracking projects and providing PMs to manage projects. Our 90 minute weekly PMO meeting is attended by department leadership and PMs. It has a standing agenda that includes: Action Items from previous weeks – represents a level of accountability and tracking Process Updates – keeping everyone informed on changes New Project Requests – these are later vetted through the IT governance process Project Successes – acknowledging what was completed the previous week Architectural Review Overview Dashboard – shows total number of projects with Green, Yellow, Red project health by major area and change from previous week Detailed review of each project in Red Program review – each major area (i.e. business, clinical, ambulatory, infrastructure, security) is on a rotation for deeper dive Scope Reviews for new major projects – provides chance to “connect the dots”, discuss any interdependencies and ask questions Outputs from this weekly review that get posted on our IT visual management board are: Project successes Dashboard of all projects by health status For each project in “Red,” we cover the issues, impacts and the action plan to resolve, as well as risks and mitigation plans. The green/yellow/red is noted for the project overall, as well as scope, schedule and cost. With this information at a glance, it is easy to identify where help is needed and what it will take to move the project from Red to Yellow or Green. Scope reviews for new projects include summary, scope, business objectives, budget, timeline, and team members. Having a chance to discuss interdependencies and raise any questions or concerns is critical for a new project. The PMO has a number of goals. Two are particularly pertinent here: Improve Project, Program, Portfolio Management maturity – “get everyone on the same page” Incorporate a continual self-evaluation process Looking at the last few months, these two goals are clearly being met. And that’s powerful. Blog originally posted on www.sueschade.com.

My fourth grandbaby was born this week. I helped out by taking care of his 19 month old big sister while his parents were at the hospital. Being able to be present to give this support to my daughters is one of the reasons I started my next chapter back in January. Why is it so important for me to spend time with my family as my four grandchildren grow up?  My father died when I was just 4 years old. His death left my mother to raise my 3 older siblings and me alone. Her parents lived 3 hours away.  We only saw them a few times a year – a 3 hour drive for a mom and four kids was a big deal back then. My father’s parents had died before my parents were married. And my own daughters grew up without grandparents. By the time my husband and I were in our 30’s, all of our parents were deceased. None of them lived to age 70. As a professional woman, I have worked far more than 40 hours a week since my late 20’s and been in management since 1984. When I had babies, a 6-week maternity leave was the norm. Both my daughters went to infant programs in daycare centers when I went back to work. I learned that babies start to smile at their parents (and it’s not just gas) at around 6 weeks old. I realized that I would miss her first smile being back at work. I treasure the times I have now with my grandkids. My daughters are appreciative of the help I can give but don’t want it to be a burden. I have heard people my age say being a grandparent is great but it’s really nice to be able to hand the kids back to their parents. Yes, kids are demanding and tiring when you are no longer young. And as the grandparent there is so much we don’t know about their specific routines even though we successfully raised our own kids many years ago. My 19 month old charge this week has had a fever and an ear infection. I had to figure out how to get her to take her medicine on top of the normal routines. I’ve quoted various articles and leaders in previous posts, but never a children’s book. As we read the popular and prize winning book “Olivia” by Ian Falconer at bedtime last night, the closing struck home: When they’ve finished reading, Olivia’s mother gives her a kiss and says, “You know, you really wear me out. But I love you anyway”. And Olivia gives her a kiss back and says, “I love you anyway too”. I hope to be a positive role model for my grandkids as they grow up. I look forward to all the fun times we’ll have together. As I watch the debate about gun control in Congress, I hope that our leaders will do the right thing and help move us toward the safe and loving country we want for our children and grandchildren. One of the most powerful health care organizations, the American Medical Association, took a big step last week in calling gun violence a public health crisis. I applaud them for that. Blog originally posted on www.sueschade.com.

This week we all grieve for the families and victims in Orlando.

We define “health” broadly in Health Populi and in our work at THINK-Health, so I am thinking about health disparities today that people in the LGBT community face every day. Let’s call them out.

Putting patients at the center of preventing mortality from blood clots, and being more aware of them in recognizing their onset, is key to stemming the disease burden. We can do more to engage with information, tools and other patients and programs to help monitor this condition.

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 are 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. Blog originally posted on www.sueschade.com.

At the start of 2016, the current installed base of wearable activity tracking devices was just over 33 million in the U.S.

Despite the ever increasing pace at which the healthcare industry—and HIM—is moving forward, through information governance (IG) pilot programs, we also see leaders making time to envision a future with IG playing a central role.

The first three months of my interim CIO engagement at University Hospitals has flown by. I’m fortunate to be working with a very talented IT team and we recognize there is always room for improvement. We have already made some very positive changes and improvements. We are tightening up how we manage and monitor the production environment to reduce preventable incidents. We do a root cause analysis on every major incident and review them as a team at our bi-weekly leadership meeting, tracking all subsequent action items. We are making progress on numerous major priority projects and there have been several system upgrades and go lives during this period. We are doing detailed planning for our new hospital integration efforts. We are launching our visual management board and leadership huddle next week as part of our lean efforts. And we have re-established an executive level IT steering committee addressing the critical need for IT governance. Our third IT steering committee will be Monday evening. Our CEO and other senior executives are engaged – exactly what we needed. They are developing a deeper understanding of our current work and the many new requests we have received since this year’s budget was approved. We have reviewed with them how our work aligns with UH strategic goals and ranked the projects in relative priority order. At the upcoming meeting we will discuss our strategy for new hospital integration. In particular, we will look at the impact of system-wide requests before all hospitals are on the core systems. And we will look closely at the new requests – why are they needed this year and how do they align with UH strategy. There is an insatiable demand for IT at UH — just like at every other organization I’ve worked for.  But the “yes machine” can’t continue unless there are tradeoffs. IT leadership teams appreciate it when executives say “it’s OK to say no” and that “there can’t be back doors and end runs when something is not approved”. And that approving new projects at this stage in the year means making tradeoffs –  something has to come off the list or get pushed down to make time for a new project. The scope of responsibilities for our executive IT steering committee is not unique or earth shaking – it is the basics you would expect to see: –      Primary governing body for IT strategy and operations –      Communication ambassador for IT –      Planning for future initiatives and direction –      Balance conflicting priorities –      Guidance on specific projects as needed –      Approve unplanned projects –      Provide input and oversight on IT policies Basic but needed. One of the 4 questions I asked in every executive meet and greet session was: how can I have the greatest impact as an interim?  IT governance was a common response. Just over three months on the job and we are having our third steering committee. I listened and they were ready. For a CIO, that’s a good place to be. Blog originally posted on www.sueschade.com.