Web 2.0 Favorites

I love some of the web 2.0 tools.  I use a lot in my personal life and some have even crept into the enterprise…

QuickBase

I have blogged in the past about QuickBase.  This web-based tool allows the average person to create a simple database application.  It has taken off like wildfire in our organizations.  You know something is meeting an untapped need when you see this kind of organic growth.  The other validation is the acceptance by our partners.  Consultants, vendors and others take to QuickBase quickly.  Because it is web based you can add an external person without going through IT.

We have over 3,000 applications in QuickBase.  The vast majority are created by non-IT users.  There are some common applications like team workspaces and contract issue tracking.  Some are more unique like the one we created to track schedule our interpreters and track their time.  I am aware of scores of niche applications that we have been able to eliminate or avoid because we were able to meet the need with a QuickBase application.  It is a great value and QuickBase has proven to be enterprise-class in its stability.

Gliffy

Gliffy is a web-based drawing program ala Visio.  It is much simpler than Visio and the missing functionality appears to be the kind of stuff that the average user does not miss.  I have been using Gliffy quite a bit lately and an considering using it as a less expensive Visio alternative.

Twitter

My use of twitter seems to inconsistent.  at time I track my ever move.  Then I get out of the habit of updating it for a few days.  Because I record how I spend my time it helps me keep a history of what I do.  More importantly, it is a great way for my folks to keep tabs on my.  My 160 team members are spread across Wisconsin.  This is there way to see if I am reachable and how to best reach me.

Does anyone out there have other web 2.0 favorites?

Your starting pay will be $2.50 per hour

I have never striven for 0% turnover in the departments I manage. I think it is great for new people to enter our organization and bring new ideas and renewed energy. I also think it is good for people to be exposed to different careers, especially when they are young. So, when someone announces their departure I usually accept the news in good spirit. This time was different.

Sue announced that she will be retiring from Affinity Health System in June. She was employee number 2 in the Information Technology department (back then it was data processing). This was several years before we had our first computer. Instead, Sue was responsible for organizing key punch jobs that were sent to a mainframe computer that was shared by several hospitals.

Sue has always kept meticulous records. I always found it ironic that someone with this much IT experience loved her paper records. I suspect she has seen a lot of computer disasters. As proof of this behavior, I submit to you this:

Header from Sue’s Offer Letter

This is the letterhead from Sue’s offer letter which is still in her files. Did you notice the date? I would encourage you to click on the image so you can see the entire offer letter. It includes an attempt to phototcopy a picture of the equipment (graphical printing did not exist). There are some precious historical references here, including:

  • Sue’s starting salary was $2.25 per hour (she makes more now)
  • Sue’s supervisor felt compelled to explain the function of a CRT
  • The Data Processing department consisted of the following state-of-the art hardware:
    • Control Data Corporation (CDC) 200 User Terminal
    • (2) IBM 1050 Data Terminals
    • (2) 029 Key punch machines

Sue, thanks for your years of service. Your willingness to keep learning has allowed you to adapt to multiple generations of technology. More importantly, you have touched many lives, including a lot of patients you never got to meet. Enjoy your much deserved retirement.

I need a consultant

The problem with not using consultants is that when you do want one, they are hard to find.  I had been keeping in touch with Andy Smith since I left FCG 18 years ago.  So, I sent him an email today asking if he could help me with something and his email bounces back from the FCG server.  Sheesh.

So, I am trying to do some good old fashion benchmarking of similar-sized IT organizations.  I know that HIMSS Analytics has some data.  But, I really need a consultant to help me with data gathering on my side and turning that data into some insightful analysis.  My plan is to present this to my IT Customer Advidory Board (aka Steering Committee) in the first week of February.  They have been asking how we compare to similar organizations, which is a good question.

If anyone has an idea who might be good at this please leave a comment here on the blog (so everyone will know).  This is a rare opportunity for a healthcare IT consultant to make a connection with our organization.

My ePrescribing experience

One of the best moves I have ever made was selecting and installing the Purkinje ePrescribing product. Purkinje sells an EHR product too, but I really cannot speak to that.

Purkinje uses the Software as Service model, so there is no server hardware to manage. You just need to set-up a secure connection to their data center over the Internet. The software is web-based, so we did not have a special client to install.

We have been using their ePrescribing tool for nearly 5 years and our physicians really have embraced it. It is very simple and our incidence of downtime and unavailability have been well within our expectation. Purkinje had some great functionality that the bigger players did not have when we made the purchase. Most importantly, the system has a lot of clinical content that reminds our doctors about clinical research and costs specific to the illness they are treating. So, for example, if a doctor is treating a hypertensive patient for the first time the system will provide the doctor a quick, unobtrusive alert that reminds them diuretics are the preferred first line of therapy in most patients and a fraction of the cost of most alternatives.

Purkinje Screen Shot (fit)

We were able to get rid of the prescription pads quickly.  I have heard many anecdotes about the system catching medication and allergy conflicts that might have otherwise been missed.

Through interfaces to our MEDITECH Magic HIS the doctor’s are able to select patients from their schedule that appears in the ePrescribing system. Each time the medication list is updated we send a report in MEDITECH so our patient’s medication list is available in MEDITECH’s PCI.

This is why I support Medicare’s push for electronic prescribing. Unlike the Leapfrog group’s poorly considered call for CPOE, ePrescribing is easily accomplished, commercially available and proven to truly be be beneficial to the health, safety and pocketbook of patients.

Another CIO Junket Offer

When will they learn to stop sending me these inappropriate offers of free travel and resort hotel stays?  Here is the latest one to come into my mailbox.  The rooms at this hotel start at $500 per night.  I am used to the Stevens Point Fairfield Inn where I get a $59 per night rate.  I can’t believe anyone would find this ethical:

Hello Will, I’m pleased to invite you to a 1-½ day event that will be well worth your time: a leadership retreat with [vendor] executives and a small group of your peers from other companies. [vendor] will sponsor your stay at the St. Regis Hotel in Monarch Beach, California covering one night room accommodation and air travel if needed.Our goal is to help you identify areas where you can develop technology pathways that satisfy your unique organizational goals.You can expect the following benefits from this event:

  • Collaborative solutions to your complex technological challenges
  •  Access to the collective knowledge and expertise of peers and leaders
  • Discovery of potential knowledge gaps
  • Strategies for supporting service-level alignment between IT and your business
  • Real-world approaches to managing the complexity of IT

Please let me know if you would like to receive more information on this or to register.

I really hope you can make it!

Best regards,
[snip]

Random Thoughts to Start 2008


{ Good morning 2008 *~
Originally uploaded by » GUM «

My New Year’s resolutions:

  • Run more
  • Post more

So far, post more is ahead of run more.

Books I am reading:

The whole concept of Search Engine Optimization (SEO) is wasted energy. I can’t believe that there are books, conferences and gigabytes of web pages dedicated to the idea of gaming the google page ranking system. All of that energy should be spent on creating compelling content that people want to read.

I got my wife and daughter a MacBook for Christmas. They want to create some videos. So, I also got them a Flip video camera that stores all of the video in solid state memory. This was going to be the ultimate in easy movie creation. Except, the iMovie 08 does not import the .avi files that the Flip camera creates. The previous version of iMovie did this, butI guess the Apple folks decided this would be a good thing to remove in the latest version. So, now I have to teach them how to convert the video. What was going to be simple is now complex. Why is my home life so much like my work life?

I upgraded my PC running Windows Vista with a new hard drive. My plan was to store all of the data files on one drive and to keep the OS and applications on the existing drive. This was easy in XP, you simply right clicked on the Documents folder and changed the target location. But the data folder structure has changed in Vista. The top data folder is called Users. There is no easy way to move Users and all of the sub-folders to a new location. I have seen some ways to do it through registry changes, but it was too complex, time-consuming, and risky. My new drive is sitting empty in hopes that Microsoft will address this. I guess this is just another reason to avoid Vista.

One more home electronics rant…when will gadget makers realize that tiny raised icons on black background is not the way to sell to those of us over 40 that can afford to buy them?

First 2008 HIMSS Invite

Congtats to Picis for sending me my first 2008 HIMSS networking (party) invite:

Meet healthcare IT professionals who aren’t

Join Picis at a grooving cocktail reception at the
House of Blues Voodoo Lounge.

Monday, Feb. 25, 2008, 6-8 PM

Cocktails
Hors d’oeuvres
Music
Entertainment 

1490 E. Buena Vista Drive, Lake Buena, Fla.

If you eat enough of those hors d’oeurves you can make it a meal.  You might want to consider bringing you own large Chinet plate with you to circumvent the provided small plates.

As for me, I am on the fence about attending HIMSS.  I have sat out the last couple of years and have not missed it.

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.

POSITION DESCRIPTION

SCOPE OF RESPONSIBILITY

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.

PRINCIPAL ACCOUNTABILITIES

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.

EDUCATION AND EXPERIENCE REQUIRED

Education:

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

Experience:

  • 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.

PERSONAL AND PROFESSIONAL ATTRIBUTES

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.

PHYSICAL REQUIREMENTS

  • 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.