Thursday, November 24, 2011

There is Hope

Every Thanksgiving I reflect on the state of the world, the state of Healthcare IT, the state of my various roles, my family, and my life.

My message this year - there is hope.

Some may think that the tone of my blog has changed in 2011 - from a focus on cutting edge technology that will revolutionize healthcare to themes of compliance, limited resources, unbridled demand, urgent unplanned projects, and security challenges.

That's a valid observation.

In my 15 years as CIO, I've evolved from creating innovative applications to maintaining customer relationships.     I've gone from strategic visionary to resource planner.

This transformation is not about me or my jobs, it's about the world we live in.   According to the Center for Health System Change, households with Broadband in the US increased from 47% to 66% from 2007-2010.  Smartphones are ubiquitous and the majority of households in the US are IT savvy.  That creates a very different expectation for Healthcare IT service delivery.

When I first started as a CIO, mobile devices had not yet been invented, computers were the domain of geeky early adopters, and solutions to problems involved workflow change, not automation.

Today, most of my work is managing demand.   I aim to complete 80% of the requests I'm given.   I've been told that 50% is typical.  Few other industries move so fast and yet have so little tolerance for mistakes.

So, why do I have hope?

I recently met with a Clinical Fellow who is very likely going to be chair of an academic department or a senior hospital administrator some day.

We spoke about the need to understand workflow, the need change behavior, and the critical role of piloting new processes before automating them.

We talked about the need to balance functionality, security, and maintainability.   We talked about defining requirements before selecting a solution.

In my blog about Content verses Context, I described the job of the CIO as becoming increasingly impossible because many people expect flying cars when we live in an era of IT bicycles.

However, it is clear that the next generation of leaders, who were born in the 1980's personal computing era, understand that technology is the easy part - policy and process are the hard part.

Also, I have hope because I believe the BIDMC FY12 IT Operating Plan is well aligned with the needs of the business.  Today I did a "Venn analysis" of 5 resources

*The BIDMC FY12 IT Operating Plan
*BIDMC FY12 requirements from key customers
*The BIDMC FY12 Annual Operating Plan
*The Meaningful Use Stage 1 and recommended Stage 2 Standards and Certification criteria
*Emerging Compliance projects

I found that the existing BIDMC FY12 IT Operating Plan addresses the needs of all these stakeholders.  There are only a few items to defer or reconsider.

Today, the CEO of BIDMC, Kevin Tabb, sent out his Thanksgiving message and highlighted BIDMC Information Systems: "We were named the #1 health care IT organization in the United States for 2011 by Information Week 500, and BIDMC was the first hospital in the country to achieve Meaningful Use of electronic health records, meeting a key set of new federal government standards."

I'll transition my Harvard Medical School CIO role by February 2012.  I serve on the search committee, which is following a multi-stakeholder process to find a visionary CIO to lead a great organization.

In my International, National, and State lives, I've worked with incredible people and the trajectory is very good.   In 2011, we completed a  healthcare IT plan for Japan and for New Zealand.    The content, vocabulary, and transport standards for the US are submitted to ONC, completing the foundational work for Meaningful Use Stage 2.   The State of Massachusetts has submitted a new State Medicaid Health Plan and completed a new HIT Strategic and Operational plan.

But most importantly, my family life is earning an A.

My daughter has blossomed into a resilient college woman with clear goals, deep friendships, and a very positive self-worth.   She's excelling in her coursework, immersing herself in the culture of Tufts University, and traveling to Japan as part of study abroad program this winter.    I'm so proud that she has left the nest and is building a life on her own.

My wife and I are planning the next stage of our lives and we'll be in Vermont this weekend visiting farm properties.   I'll be 50 this year and  although I have many years to go before retirement,  it seems the right time to find a property to grow organic vegetables, raise chickens/goats/llamas, and revel in a self sufficient lifestyle, learning to live nearly off grid.

My parents are doing well in a new house and enjoying time with friends, cultural events, and gardening time.

So, there is hope.   The world is experiencing a challenging time marked by economic fragility and social unrest.   The Occupy movement is raising our consciousness about the disparities in the US.    However, it is possible for a strong team of people working hard to excel in healthcare IT.   It is possible for your family to thrive based on love, trust, and lifelong learning.

Revel in the next few days of Thanksgiving (we're roasting root vegetables, Brussel spouts and tofu).   When you receive your next challenging email or are asked to define a timeline before you understand requirements, scope, or resources, take a breath.  There is hope!


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