Resourcing Large Projects

When discussing large projects (like an EHR, ERP, or replacing an HMO claims processing system) I often use the phrase “all hands on deck.”  I am trying to convey that these projects not only expend IT resources, but those business leaders that need to re-develop all of their core business processes around the new technology.  Additionally, there is a ripple effect that impacts senior leadership and even those in departments that you would not expect to be effected.

But, I am starting to think that isn’t an effective way to communicate the resource-intensive nature of these projects. Often I am asked what I mean by “all hands on deck.” Secretly, I fantasize about re-enacting this scene from The Professional:

Of course your business cannot come to a halt for a single project.  You still need to advance other strategies and respond to competitive threats.  You need to make sure you are still providing a quality service to your customers.  But, I believe most organizations err to underestimating the effort.   Large IT projects will impact what you can hope to acheive in other areas and if leadership’s ambitions are not scaled appropriately you will end up with overly-stressed staff and a project that doesn’t seem like it can ever get the attention it needs to finish.  So, it maybe beneficial to be a little melodramatic when explaining the resource need.

How much email do you receive?

I decided to count how many emails I received today: 165.  My email volume has been increasing.  I don’t know if that is related to my changing responsibilities or a continued cultural shift toward email as the communication vehicle of choice.  Conversely, I get very few phone calls and voice mails.  Of course, I am generally in meeting most of the day, so folks may realize that is a long shot.

I love email.  But is often a bad way to communicate.  If somebody has something to say that is referential (like instructions on how to do something) that is better done as a post to an Intranet page or similar knowledge sharing tool.  The burden should not be placed on me (the recipient) to store, organize, retieve and purge such communications.  This is inherently rude (asking me to do your job for you).  What’s worse, it is wasteful.  Don’t ask hundreds of people to handle these publishing tasks for you when you can do it once for everyone.

I would love to hear your email rants in comments.

CIO Job Description

I know that there are folks out there looking for a job description for a healthcare CIO. So, I am posting mine to aid those people in their search. Feel free to leave a comment if you have any thoughts or questions.



This leader is the Chief Information Officer (CIO) for the Ministry Health Care System and will lead the transformation to a centralized Information Technology (IT) service through an Information Technology Shared Services Organization. The CIO will provide technology vision and leadership for developing and implementing information technology initiatives. This individual is responsible for the planning and execution of an information technology vision, goals and initiatives that support the long term objectives, mission and vision of Ministry Health Care (MHC) across North Central Wisconsin and at each of its sites. This leader will collaborate with leaders at the highest level of the organization and manage a team of professionals who are accountable for the delivery of all information technology services in the System. This position will be located in Central Wisconsin, in Wausau, Weston, Stevens Point or Marshfield. The CIO will report to the Senior Vice President and General Counsel. This individual will work in a manner that is consistent with a tax exempt Catholic health care organization that supports the mission of the Sisters of the Sorrowful Mother.


IT Governance and Portfolio Management

  • Lead a governance structure that aligns IT initiatives with business priorities while balancing resource constraints (human and fiscal) to optimize IT investments (The IT Portfolio). This governance process will produce an annual IT plan and budget that is integrated into the system planning and budgeting processes.
  • Responsibility for the selection, acquisition, development, installation, maintenance and support of information technology for Ministry.
  • Manage, in conjunction with other leaders, the project approval and selection process.
  • Ensure that all initiatives in the IT portfolio have clear business goals and success metrics.
  • Monitor and report on the performance of the IT portfolio including actual vs. expected results, budgets and project duration.
  • Perform an ongoing assessment of IT capabilities of employees and contractors and IT performance on behalf of entities across the System. Evaluate performance and skill against Ministry needs.
  • In conjunction with other leaders, understand and establish the working relationship with the Project Management Office or similar business unit responsible for organizing the timely completion of Ministry projects.
  • Oversee relationships between Ministry’s IT resources and external entities (e.g. government, vendors, researchers and other health care organizations).

SSO Development, Operations and Technical Support

  • Management responsibility for all IT activity under a matrix reporting structure from the date of hire and thereafter in accord with the structure of the Shared Services Operation (SSO).
  • Develop the Information Technology SSO and develop a permanent reporting structure and a service delivery model for the SSO. Establish processes and metrics necessary to make the SSO successful.
  • Understand application architecture and technical infrastructure (including Marshfield Clinic components) of MHC information systems and regularly assess the MHC vision and direction.
  • Develop a strategy and plans for the technical infrastructure and application architecture for MHC and execute the plan. The plan shall include standards and protocols for data exchange, communications, software and interconnection of information systems.
  • Develop a service level organization that establishes service standards for corporate office and each entity served by the Shared Services Operation. Capture the service level commitments in a Service Level Agreement between each entity served (including corporate office) and the SSO.
  • Establish and maintain a service orientated, customer focused IT function that supports ongoing operations that drive efficiency, quality, customer service and growth. Develop service level agreements and manage to agreed upon performance levels for application availability, response time and network performance.
  • Ensure that enterprise information systems operate according to internal standards, external accrediting agency standards and legal requirements.
  • Ensure the protection of IT assets and the integrity, security and privacy of information entrusted to or maintained by MHC.
  • Develop and maintain a business recovery plan to ensure timely and effective restoration of data and IT services in the event of a disaster.
  • Oversee the negotiation of all IT contracts.
  • Identify and implement formal training and education as needed throughout IT in conjunction with the Education SSO.
  • Complete Talent Reviews and development plan for IT personnel.

Clinical Transformation

  • Work with other leaders to identify the role of the Office of Medical Informatics and the roles of the Chief Medical Informatics Officer (CMIO) and other medical informatics leaders and their relationship to the CIO.
  • Assess existing efforts, initiatives and successes in working to establish an electronic medical record, lead the initiative to establish a new vision and strategy for a platform to support the provision of clinical services and execute the identified clinical information strategy.

Communication and Collaboration

  • Provide advice and counsel concerning IT issues and industry trends.
  • Communicate to Ministry’s business leaders the plans for continued standardization efforts of information technology (IT) across the system and collaborative efforts with Affinity Health Care. Clarify their role and the need for collaboration across the system to achieve standardization. Provide methodologies for working together toward standardization. Assign resources to areas where standardization is being achieved. Re-direct efforts that lack a system-wide approach.
  • Conduct IT planning in conjunction with the Marshfield Clinic to facilitate co-dependency and appropriate alignment between the organizations.
  • Develop positive relationships with MHC leaders by understanding business priorities and IT enablers.
  • Participate in the strategic planning process and share in the development of Ministry vision, goals and initiatives.
  • Frequently and effectively communicate the IT vision and plans throughout Ministry. Use targeted communications that are appropriate to the various stakeholders. Build excitement around the planned changes and understanding for the selected priorities.

Mission Integration

  • Work in a manner that reflects the mission and philosophy of MHC and the Sisters of the Sorrowful Mother, including but not limited to compliance with the Ethical Decision Making Process.

Other duties as assigned.

  • Under the supervision of the Senior Vice President, perform other duties as assigned.



  • Bachelor’s Degree in Information Systems, Engineering or related area from an accredited institution is required. A Masters Degree is preferred.


  • Demonstrated experience with IT systems and IT management as a senior level with a sequence of increasing responsibilities in large and diverse business settings. Familiarity with health care or health care related organizations is expected.
  • Experience with and understanding of strategic and business planning methods, tools, and processes.
  • Experience in working through major organizational change

Specific Qualifications:

  • Familiarity with the health care industry – its critical issues and major challenges
  • A track record of working in a geographically diverse complex organization
  • A track record of successful large project implementations
  • Demonstrated business savvy to work effectively with other Executives to achieve key business and technology goals.
  • Demonstrated project management skills.
  • Lean Six Sigma experience a plus.


This individual will understand and have a commitment to the philosophy, mission, values, and vision of Ministry Health Care. The individual will be able to demonstrate these values with his/her leadership practices. This person will possess personal and professional integrity, strong communication skills and an excellent professional appearance and presentation. Strong analytical and decision-making skills along with considerable tact and diplomacy are important considerations. The individual must possess strong leadership and managerial skills, strong interpersonal skills, a good sense of humor, high energy level and a positive outlook. Other attributes include the following:

  • Is respectful, honest and demonstrates integrity and ethics.
  • Listens effectively, shares ideas and information openly and facilitates relationship building by establishing trust.
  • Experience in building a new model to serve the IT needs of a complex organization
  • Has functioned at an operations level and in a complex multi-facility environment.
  • Interested in serving as a mentor to others.
  • Possesses initiative, good judgment and the ability to problem solve.
  • Possesses strong business acumen with proven experience in thinking strategically and implementing tactically.
  • Has handled demanding workloads to meet objectives.
  • Is customer focused/service oriented, and has effectively affected change.
  • Works effectively with physician leaders and, in particular, a chief medical informatics officer.
  • Broad IT infrastructure and application architecture knowledge.
  • Experience in portfolio management
  • Is driven, compassionate, and creative.
  • Embraces positive conflict.
  • Team player.


  • Moderately quiet office environment.
  • Ability to travel, sometimes overnight, by auto or small plane.
  • Occasional lifting of 10-20 pounds.
  • Sufficient vision acuity for routine computer use, and moderate to heavy reading and writing responsibilities.
  • Position requires walking, sitting and standing at moderate levels.
  • Stamina able to be maintained to manage a work level that normally exceeds 40 hours per week.
  • Position requires a high level of all forms of communication skills: written, verbal, listening.

Is Epic MyChart Struggling with Vista?

Even though my hospitals run MEDITECH or GE Centricity, I have an Epic MyChart account.  I really wanted to see how well Epic worked in the clinic and I wanted to be able to see their MyChart patient portal.  So, I scheduled an appointment with a competing health system to check things out.  It was actually very interesting experience and worth the time (despite a thorough physical exam).

I was most impressed with MyChart.  It far exceeds what anyone esle has, including niche vendors in this area.  With the exception of e-visits, it is a fairly comprehensive system.  Perhaps the most impressive is the ability to do true round-trip scheduling.  This isn’t the ridiculous “request an appointment” blank forms that take more time and effort than driving to the clinic.

Frankly, MEDITECH has fallen so far behind in this area it is disappointing.  While they have a product, I am unaware of anyone that has implemented it.  Maybe they have something up their sleeve.  But as of now, they are way I believe that are way behind Epic in this area.

While MyChart is way cool, they seem to be having trouble with Vista.  At least the provider I went to is having a problem.  I suppose it could be something unique to their implementation, but that seems unlikely.  Here is an excerpt from an email that I received from that provider:

If you have Windows Vista, please do the following to maximize the performance of <snipped provider name> on your computer:

Within Internet Explorer, open Advanced Internet Options from the Tools menu Scroll down to the Security Section and disable TLS 1.0

Yikes.  I think your average patient would struggle with these directions.  I wonder if there are any applications that would break as a result of disabling Transport Layer Security.  I am unaware of any.

Computer Security Education Without the Caffeine

I am a big fan of podcasts, I listen to them as I drive across Wisconsin.  Mostly, I listen to podcasts related to my hobbies (Daily Giz Wiz, Grammar Girl, and Endurance Planet).  But there are a few podcasts that are educational.  One of them is Security Now, a podcast discussing various aspects of computer security.

Now, the only thing I find more boring than computer security seminars is compliance training.  But it really does not have to be that way.  It is fascinating and scary to understand how people are exploiting the Internet, networks and the desktop for nefarious purposes.  Security Now keeps me interested and helps me ask good questions about our preparations to prevent various threats.  Check it out.