Anticlue

What is a Program?

2013-04-15T16:04:05Z

Ah the eternal question, to define what something is so that one understands it. The question arises what is a program? I'm not referring to our friendly and ever evolving computer programs here, but in more of a strategic and project management perspective.

According to the authoritative Project Management Institute, a program is defined as " A group of related projects, subprograms, and program activities that are managed in a coordinated way to obtain benefits not available from managing them individually."

The Take Aways

Examining this definition there are three key takeaways:

A related project, subprograms, and program activities:
Managed coordinately to obtain additional benefits
the additional benefits not available from managing them individually

Let's go a bit more into the weeds here to assure we have a good sense of each takeaway. In business, we often have strategies for example offer a world class cardiology program to Northeast Florida. However taking that strategy and breaking it down to its pieces and parts may equate to several different things. It may start with the fact that we need to expanding the cardiology department, and increase the footprint of the physicians group. It may have a component that we need to update the clinical technology offered, which may need a update of the infrastructure in place. We may need to expand the department with new roles and coordinators. We may need new biomedical equipment. We may need to improve customer services, so those waiting aren't waiting that long. We may need to recruit additional physicians. In other words there is a lot to this work. But let's start out with the healthcare information technology side. Just purchasing new technology, isn't the panacea normally described by those in sales. There is the new workflow to consider, making sure the foundational infrastructure can support the new cardiology system, deploying the system, and finally getting the adoption of the new practices offered by the system. Yes, we can manage each of these pieces individually, but combining them under a program effort offers a way to synergize the initiatives and gain greater benefits. So for examples, if we were deploying WYSE devices with a Citrix backend and single sign-on offered via Impravata to update the infrastructure, we could include this testing with the workflow development. As clinicians gain familiarity with a technology that allows for a proximity to a device to bring up their existing session, there will be enhanced opportunities. Thus in this scenario a program management approach to these individual technology projects makes sense.

PMI Global Congress 2011 - North America Dallas Texas

2011-10-29T12:13:31Z

This past week was an exciting week. I had my first opportunity to attend the PMI Global Congress in North America. Thanks to PMI for covering the conference fees and selecting our presentation on engaging leadership for the healthcare track. I would definitely recommend making it to the local congress if you can. It is a wonderful networking and learning opportunity. Below are several conference highlights.

The Healthcare PMI Community of Practice has released a healthcare standard. It should be posted upon their website shortly. It went like hotcakes at the conference, so I'm hoping to get a copy soon.

The conference has your global sessions, and then areas of focus. Several others have commented upon the global sessions, I'm going to drill on down to the some of the education sessions I had an opportunity to attend. I did focus upon the Agile Track.

My favorite session of the congress was Natalie Nee's Agile: Still the Magic Bullet or Do you need a blended solution? The presentation depicted a well thought out approach of how to adopt agile. It was considerate of the environment needed to make agile successful and how to facilitate the adoption in a pragmatic manner within the organization. A key take a way was that agile does not need to be applied careless to every project. The methodology should be utilized when it makes sense for the project given the environment.

The other two agile sessions I attended were Taking off the Agile Training Wheels, Advanced Agile Project Management using Kanban by Robert Tarne and Large Scale Program and Portfolio Management with Scrum and Kanban by Mike Cottmeyer. Kanban refers to having a repeatable process and tracking user stories across that repeatable process to determine the sprint completion timeframe. Scrum refers to the process of having a daily standup meeting engaging the committed members to relay what they have accomplished yesterday, what is planned for accomplishment today, and what obstacles can get in their way while looking at the current product backlog for this sprint. Both presentations offered excellent insights into apply agile to small organizations. It is obvious that this methodology still continues to evolve as organizations begin to adopt and apply the practice.

Ginger Levin presented Mentoring: A Key Competency for Program and Project Professionals. She portrayed the criticality mentoring is for career success for the mentee and how to develop and implement a mentoring program. A key learning from this presentation is that mentoring programs should be a part of the enterprise PMO's repertoire and be managed as a project with a business case, clear success factors and desired business outcomes. - a great suggestion for developing yourself, others, and your workforce. Ginger Levin has several books on the market. She's a pretty smart and experienced lady so if you have a chance to buy and read her works, it is time well spent.

Another session I was fortunate enough to attend was Nayan Patel's a pragmatic journey to project portfolio metrics for a CIO. The presentation shared Baylor Health's PMO growth and development to the current practices. I'm glad to know we all suffer the similar growing pains as we first try to capture the project efforts in a dashboard to developing governance and determining which projects are priorities. The key also of resource forecasting and current utilization was quite thorough. Baylor has about 3900 beds and 650 IT Staff, so they have a large centralized IT department. Even in these tough economic times, the information provided from the pmo has enabled the growth of the department as the organization strives to achieve ICD10, meaningful use and several other endeavors.

All in all it was a good congress, Hopefully I'll be able to attend the next one.

Cherish the competitive edge

2011-10-15T14:04:58Z

Remember the cavalier way of implementing a solution back in the good old days. In some manner, a request was approved for a new system. Instead of looking out for a canned commercial solution, there would be a meeting a gathering of business requirements. There would be an in depth understanding of the existing paper business process and a way to automate it. Afterwards, there would be the construction, testing, deployment and fine tuning. Oh the chaos, and oh the understanding of how the hospital business worked.

Perhaps we need to consider what we have lost as we have moved to implementers of packaged applications. Rare is it now that a solution Is built from scratch. We all know the reasons, it is costly to construct and maintain. However, as we strive to implemented canned commercial applications for achieving meaningful use, icd10, or some other supply chain initiative. We have to consider what we have at risk and take some of those key solution development practices over to implementation of commercial packages.

As IT, we need to still utilize those practices of requirements gathering and weighing the must haves with the nice to haves. We should be vigorous in understanding the existing business process and what needs to change to adopt the new solution. Most of all we should convent and understand what gives our hospital the competitive advantage of other facility up the road. We should assure the solution will give the opportunity for that competitive advantage to have an agility as it matures.

After all, with the growth of software as a service and cloud computing, the one thing which should not be standardized is that which gives us our competitive edge.

IT Management Review - Eighth Edition

2011-04-03T12:19:32Z

The time has come around again to post the Eighth Edition of the IT Management Review. As you know the IT Management Review is a sharing of the blog posts on Informaiton Technology Management.

Mandy Chatsworth presents Seeing Green: Ideas for a Better Data Center posted at Finally Fast, mentioning, "This post discusses several steps all IT administrators, regardless of their place in "legacy system" spectrum, can take toward greening up IT their infrastructure and saving significant energy costs that impact the bottom line."

A. Lee presents Best ITIL Books for the ITSM Professional in 2011 posted at CRM Help Desk Software.com, saying, "Top ITIL recommendations of last year are 'must have reads' this year. Here are top 3 books to read..."

Demian presents What are the Windows A: and B: drives used for? posted at demiankasier.

Bob Lieberman presents Letting Go Of The Task posted at Cultivating Creativity - Developing Leaders for the Creative Economy.

That concludes this edition. Submit your blog article to the next edition of IT management review
using our carnival submission form.

The Schedule Killer - Achieving Perfection

2011-03-12T14:19:57Z

On projects and delivery there comes a time when you just need to move forward and get it out of the starting gate to the box. The ugly truth is that most corporations can't afford perfection and we need to deal with good enough. Those engaged in design, construction and implementation are focused on a flawless implementation which has minimal impacts to our colleagues. We are relentless in looking for flaws, but at what point does good enough mean move forward?

What does Good Enough Mean?

Let's look at Good enough and what it really means. Good enough is the state when the remaining flaws do not impact system adoption in a meaningful way. The balance that needs to occur is comparing functional use with the pain of deployment, and these are at different ranges.

Let's compare our ICD10 Program implementation. There will come a time when we will deploy all of the updated systems with new functionality to achieve the ability to bill in a hybrid ICD10 and ICD9 format. The date is set on when the fiscal intermediaries will be accepting ICD10 codes. Now the pain of that deployment will be large for not only will there be a large system implementation upgrade window, but also an education and training for physicians, coders, and report analysts. Not to mention the conversion of all those reports in our environment for their extraction clause especially if an Ecode is utilized.

The Take Away

The truth of the matter is that there will come a time, when it is time to move forward. Recognizing that good enough has been achieved, and any further customizations will just lead to overdesigned solutions in our search for perfection is key to a project being on time. Remaining in analysis paralysis and perfection will just delay timelines and project costs as the team looks for the panacea. As a project manager you need to be familiar enough with the risks and rewards to recognize a true opportunity to improve deployment versus a hopeless clinging to perfection.

VMWare View and HIT Deployments

2011-03-12T13:29:03Z

With the XOOM and the IPAD, the need to have end-user device agnostic deployments is rising. Long gone are the days of standardizing on Windows XP Desktops with IE 7. Today's Healthcare IT organizations need to have flexibility and approach the world from a device agnostic perspective.

Enter VMWare View, and its recent client release for the iPad. I can only foresee the future release of a client for the XOOM. Here we have a separation of the desktop from the hardware, so we can theoretically offer that Allscripts Ambulatory right on the iPad to follow the physician on their daily journal.

The bleeding edge is showing the way. Recently, Southern California's, Children's Hospital Central California, deployed a "Follow-me Desktop" which goes along with clinicians and staff as they round. With this new release of VMWare View, the possibility now exists to deploy the approach to an ipad. Given the quick rate of adoption ipads are having with physicians and c-suites, it's a good move, just be sure to review the security approaches with your privacy and security officer.

To read more on the deployment, check out the article here.

Know your Technical Debt Burden

2011-03-04T11:40:08Z

If you work in IT, you have felt the joys of technical debt. Technical debt is the catch phrase that captures all that built up debt every time a solution is "good enough with a smidge of manual intervention". Often in projects the lack of planning and the longer implementation forthcoming increases your technical debts. The manual intervention and tweaking done in system administration is another component. Additionally those old legacy applications still in use are another component of technical debt.

5 Places to Check to Quantify

As a leader, it is time to figure out how much technical debt your it department has incurred over the years. Let's talk a bit about places to examine for metrics to see what your current run rate on technical debt is.

Track Break Fix Time -Create a standardized time reporting structure within your department, and an awareness campaign to assure all understand the categories. Review the categories with your leadership team to assure everyone agrees on the items to track. Often in this category there are the incidents and problems being managed. The goal here is to uncover your resource allocation.Determine what percentage of overall time is spent on break fix activities.

Get a sense of the daily, weekly, and monthly operational tasks - We are the automation department, however it is time to look under the covers and find out how truly automated we are. Besides the computer operations team, how many of your team are accountable for manual operational tasks? What are those tasks? What is the frequency?

Infrastructure components over 5 years old or End Of Life - What percentage of your infrastructure is over 5 years old? Over 8 years old? What percentage has moved to End Of Life/Support? What mission critical application run on this infrastructure? Check out the PBX and voicemail systems too, it is not a good idea to leave telecom outside.

Ascertain Applications which haven't been updated in 5 years - What percentage of your organizations applications have not been updated in the last 5 years? Are you still running Office 2003? It is important in this exercise to include all applications not just the ones supported by IT.

Implement an Event Monitoring and Tracking Process - It is important to track outages and events to determine the level of brittleness of your it environment. Once I watched a hospital billing team have a horrid oncall for years. When the team reported to me, we quantified what the main repeatable problems were. It turned out most of the staff spent time managing file sizes manually, instead of letting the mainframe do it for them. We implemented the solution working with the mainframe system programmers, and it was a good first step. The end of the story is unless you shine a light on the problem and know what is breaking and how often it may not come to light. When you determine what is breaking with frequency, you will now focus on percentages and resolve the heavy hitters.

Once you have a sense of the technical debt, it is time to clarify how this impacts your agility to respond to organizational requests. After all our goal is to be able to deliver the business outcomes our hospital is focused upon achieving.

The Take Away

Once you have a sense of your technical debt, you can plan to address it. This will probably mean needing resources and a bit of money. You will also need to have transparency with your customer base explaining the small amount of resources dedicated to resolving technical debt. However in the long run, reducing technical debt will improve the agility and responsiveness of your department.
These are a few suggestions of where to examine, have you checked out others?

Ascertaining your current Email Systems and Application Dependencies

2011-03-02T04:23:40Z

Congratulations, you have decided to take the plunge and investigate outsourcing your email system. Now is time to take a good frank look at what you currently have in-house for email, and the application dependencies upon the email system .

Let's put our detective hat on and start accessing where we are, in an ideal utopian world this is a quick check of our infrastructure and application configuration database. Viola! We have all the email systems and applications which rely upon those systems. Okay, now it is time for reality check, unless you have adopted ITIL and done all the inventories, you probably don't have the information hidden in a database.

If your organization has not implemented ITIL, check out the business continuity disaster recovery office. There may be a couple of email technical application recovery plans that have been developed. This will give you a great starting place to understand the current state.

If you still come up empty handed, the knowledge is tucked away in the system engineers, application implementers, and application developers minds. The most successful technique deployed is to develop a survey asking clear questions on the email dependencies. This survey should cover the type of email system, basic email policies implemented, and then review unified communications, smtp application processing, applications which query ldap for email address, faxing, and any other dependencies. Dig a little more into the details on the encryption platform, perimeter defense for asav, and email routing appliances.

Also clearly discover who provided the information, set up a follow up discussion to discuss the findings. This will help to clarify the captured information and perhaps prime the pump for a bit more information.
After a reasonable amount of time and a bit of detective work, you will begin to understand the current state of your messaging systems.

Developing Effective Work Relationships

2011-02-28T12:15:13Z

As project managers we understand the art of influence. We understand the need to motivate and listen, and develop a working productive relationship with our colleagues. We collaborate with the team and find a way to make progress. Often this activity involves active listening more than active speaking.

It is important to empathize with your colleagues, understanding their motivations and concerns. The best way to gain this understanding is to ask, and the listen intently to the answer - don't whip out your iphone. As you listen you will learn a bit more about your colleague, understand better where they are coming from and what they are worried about or glad about. This also helps to build a sense of trust and level sets our expectations.

Another key to effective work relationships is to treat everyone with respect. This often means not doing water cooler gossip discussions on your colleagues. However it is more. There is a sense of purpose in the work we do in healthcare it. Often we are doing the best we can given circumstances and history. So as we discuss what occurs, or what big boulders we have to move on the project, we should never place blame on the existence of the boulder. Boulders and problems come into being over time, and have often been inherited. We should work and making the boulders smaller together.

This brings us to a point in time with differing opinions, the trust not to mindlessly agree. I have seen many a yes-men in my career. I have also seen that phenomenon of a brilliant leader surrounded by several yes-men. It is our differences which make us a stronger unit not our similarities. Having constant yes chorus often brings about poor behaviours in the background such as withdrawing, grumbling, plotting or fighting. However having a good discussion on differing opinions and melding the two often brings about a better solutions with buy-in from all participants.

Tips for developing effective work relationships

Recognize all relationships are important - Once you come to the realization that all relationships are important, you will begin to invest time and energy with people to work through issues. You will also have a genuine sense of interest in your colleagues not just the work at hand. After all the critical part of people, process, and technology is always the people.
Learn to listen and leave judgement at the door - Listening without judging, helps put you in a position to understand where the individual is coming from and allows the individual to share.
Get out and about with the team in a comfortable setting - Cubicle land is not the most comfortable of all settings and inductive to developing productive work relationships. Neither is the meeting room or the virtual conference call. If the opportunity presents itself, go to lunch with the team or colleague. Get out of the office for a cup of coffee, have the discussions on neutral grounds.
Develop a culture where colleagues feel empowered to express their opinion - A culture based upon fear will get you to where you need to go for the short time, but it is not a good culture to develop a company upon. Focus on developing a culture of empowerment and trust. It is just a good thing to have a team of empowered individuals working on a common outcome.

The Take Away

It is key as a manager, leader, or teammate to have effective work relationships not demeaning the differences but welcoming them. The first step to developing an organizational culture is to walk the walk by showing respect and listening to colleagues.

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Technologies to watch in 2011

2011-02-28T01:13:29Z

A couple of months ago, Gartner placed out the new list of technologies to watch for 2011. Good news is there are some new ones, and some old ones. A couple have been dropped from last year's watch list. Without further ado, let's dig into those technologies we should be checking out.

Cloud Computing - The cloud has been out there for a while. The perspective of Software as a Service(SOA) and the various virtualization models, organizations will need to determine which mixture meets to their needs. An individual will need to be accountable for deriving and delivering the organizations cloud strategy finding the balance in the public, private, and hybrid cloud models.

Mobile apps and media tablets - Apple has changed the game when it leveraged iOS on the iPad. We will need to consider in the future how to deliver applications to multiple platforms including this medium.

Next-gen analytics - Truthfully reporting is often the last item considered when implementing a new solution. Being able to harvest all that information and predict future opportunities will be very useful. That being said, organizations continue to stumble in providing killer "reports"

Social analytics - Social Networking has taken corporate America by storm. The responsiveness of social media has been a key to marketing campaigns and hearing the voice of the customer. However given the multitude of social networking venues, it would be useful to analyze this information to increase customer loyalty

Social communications and collaboration - As stated above Social Networking is not a part of corporate America's marketing campaign. A key factor in this is to have a reasonable policy within your organization and for yourself.

Video - Does your company have a youtube page? What's the quality of the video? Now a days we are using video for E-learning, marketing, webinars, and the hope that latest youtube video will go viral. How are the videos being managed? Archived? Updated? Approved for wide scale distribution? Perhaps it is time for a video management system

Context-aware computing - Let's say we started drilling on into where our customers are, so when they are checking out in the grocery store, we can shoot them a quick tweet on the latest must have item and a coupon. Not so sure this would be an improvement or an increased spam noise level, however context aware computing is on the horizon.

Ubiquitous Computing - We are beginning to look like camel geeks, with our smartphone, ipad, laptop, and mifi. How many computing devices do you pull out of your laptop bag when going through airport security? As this continues to evolve to further devices to add to our laptop bag, computing technology will spread further into our daily lives.

Storage Class Memory (SCM) - Imaging having the positive features of storage and memory rolled up into one new class of data storage memory. SCM is non-volatile, has short access times, cost per bit is decreasing, and doesn't have any moving parts. This has the potential to be a game changer but it hasn't hit the tipping point yet.

Fabric based infrastructure and computers - The key here is that the rack mounted server expands beyond the box. A fabric is a high-performance computing system which weaves together storage, network and paralle process tied together by 10 Gigabit interconnects (or higher). When pondering the fabric based infrastructure consider Microsoft's Azure Services Grid.

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Where is the Healthcare Cloud?

2011-02-26T17:43:26Z

Once again we had a great HIMSS in Orlando. It was good to see everyone, as usual, I took the Wednesday opportunity to walk the vendor floor. One thing I noted was that the floor was missing "the-buzz" of Cloud Computing in healthcare it.

Perhaps you have heard about Cloud Computing, perhaps not. However, one thing is certain, with our shrinking budgets and large project endeavors of ICD10 and to achieve Meaningful Use then next big thing in healthcare it will be the cloud.

The power of the healthcare it cloud will be the transition of the datacenter and reporting functionality to the cloud. Currently, several facilities maintain a datacenter which hosts upwards of 150 applications. These applications can be served up on mainframes, mid-ranges, blades, rack mounted servers, and vm pods with SAN backend. The data center is in most cases a 1970s design, and has not grown or developed to the modern age. Additionally often the space is not ideally located, and could be used for another purpose by the Health System. Healthcare Delivery Organizations (HDO) do not have the capital to fund refurbishing these facilities.

The purpose of meaningful use is to assure clinical automation is being utilized. Once this occurs, we will be in position to provide advanced analytics to improve care. However, currently most clinical systems reporting capabilities are an afterthought. Additionally the processing power is often limited. However with the cloud, processing power is expanded to met the need. As we mature, the security and availability concerns will be handled and the need for good reports will grow. Here the cloud also offers a great opportunity.

The Take Away

Software as a Service (Saas), Service-Oriented Architecture (SOA), and Cloud Computing are innovating new concepts and ways to deliver IT services to our health systems. As they mature and become mainstream, the timing will be just right as we emerge from the meaningful use and ICD10 stormy waters.

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Performing Program Rescue - Measuring Impending Failure.

2011-02-14T14:00:11Z

Sometimes, the view from the inside looking outside, is very different from the view of the outside looking inside. As a program manager you need to be cognizant of the Warning Signs of a failing program and know how to right the ship - especially if you have just inherited a program. Over the couple of weeks, we will go through performing program rescue and to address each failing attribute.

We all know programs and projects are deemed a success or failure commonly by two attributes:

On Time

On Budget

But frankly it goes a little deeper than that polyanna perspective. Were the desired business outcomes achieved? Why or Why Not? That is your true measure, after all we do programs and projects to achieve a tactical or strategic goal. So did you get the goal, why or why not? Will you get the goal? What do you need to change to achieve the goal?

Let's take a look at a program, choose one of yours, and I'll go through one of mine. Recently, I inherited a massive directory services consolidation. We are consolidating 65+ directories down to 1 as a foundational program for an enterprise wide ERP system. The goal is to lay the foundation and have everyone on a single directory structure at least 6 months before the ERP system project kicks off at the health system.
So what is our program's measure of success? Assuring the legacy Microsoft and Novell directories are consolidated, 6 months before the ERP system project kicks off.

Will you get the goal?

Now is the time to look at on-time and budget from a grand scale. Let's start with budget. The budget for the whole program is amount YY, however for this fiscal year I have FY10 dollars. Overall my budget is a eighth of the overall. Now let's look a little deeper, what is in the budget. I have software purchases for tools, contractors, and travel.

Next take a look at on-time, we have to complete the consolidation on 8 health systems. However we have only completed 1. We have 2 starting up and 5 to go. Additionally we have 3 of the hardest directories to consolidate on point for this year. This is a 3 year program, and we are expected to convert a third of the volume.

There is a warning sign, we have eight of the overall budget, and need to complete a third of volume. How did you do on your project or program? Please share your comments in the comments section.

What do I need to change

Taking a look at the ERP Program, currently they only have three published schedules. So I need to assure I will meet those 3, and they are currently underway with 1 done and 2 ongoing. Going a bit into the weeds for the 2 in process health systems, it appears as if we are slipping on milestones, due to not having resources on boarded. We will need to change the schedule while still keeping it aligned with our commitments to the ERP Program and close the gap between anticipated funding and anticipated conversion volume. Take a close look at your program, for the goal to be achieved what needs to be changed?

The Take Away

When starting to determine if you have a failing program take a look at the big picture, what are the desired business outcomes, is the budget and schedule on target to achieve the goal? If it is we will need to look at warning signs, if not what needs to be done to correct the problem?

Branding your Program

2011-02-12T19:10:43Z

Currently healthcare organizations have entered into the perfect portfolio storm. We have some big ones on the horizon, ICD10, Achieving the HITECH Stimulus, Assuring the infrastructure is up to date to run the HITECH Stimulus, and several growth and community initiatives within the health system. As a result, we have a lot of opportunities to take executive and operational focus away from your program. We all know programs without focus have untold wealth in resource constraints, funding constraints, and missing desired business objectives.

While adversity is a wonderful teacher, it is time to highlight on your program so it can SHINE!

How do you rise above the wave of projects and programs in the portfolio? How do you assure your program isn't lost in the crowd? It is time to take that step forward away from the crowd and branding the program is a great starting step.

Why should I brand my program?

We, program managers, have a lot on our plates, and the idea of developing a quick catchy name or an elevator pitch for your program may seem like a waste of time. Consider a moment things a little bit deeper, branding is about creating an identity for your program which can inspire team members and stakeholders. As soon as someone sees the logo or name, they instantly associate your branded catch phrase. If it something to inspire in a very tangible way, all the better. Imagine for a moment, you are in a leadership position reviewing a program update. In your organization there are several key cultural issues, and the lack of funding is generally a problem. What is the first item that enters your head when you hear One Team, One Mission? Now how about the Email Services Consolidation Effort? Just for a second, your first thought might have been positive and enlightening - a good starting place. Additionally the communication is now associated with your program.

Another benefit of branding is the team building opportunity. A brand should not be created in a vacuum, it should be something the team derives and owns. Quite often in projects, it is the first time a team begins to work together. As the team develops from forming to performing, how about engaging in a branding exercise while in the forming stage. After all the storming phase is the phase when everyone is feeling each other out, Having a discussion on branding and developing a brand is a good way to set the stage for dealing with conflict in a good respectful way and to have the team work towards a common goal delving into the details of the importance of the program. The resulting branding effort will help the team have their first true sense of ownership and empowerment on the program, plus distinguish it from the plethora of other communications.

From the outsiders or stakeholders window view into the program, a brand is a quick way to identify program related information. It is a simple way to relate the communication to the program, and help to keep the program on the stakeholder's radar screen. Now the next step is getting the stakeholders to care about the program.

What does your brand stand for?

So how do you have your brand trigger connections with the motivational values of your colleagues and stakeholders? Illustrate the benefits and business outcomes which will come from your program. By tying back to the share vision of the program, colleagues will want to be affiliated with the program's potential success. To assure the association, you and your team need to clear and consistent illuminating the benefits the program will deliver. Overall this helps to keep everyone on the same page and driving towards receiving these benefits. Here is an excellent place to lead by example, so assure you are walking and talking what your preaching. Additionally it will be helpful for the program leadership team to have the same talking points. Taking an hour and crafting talking points will be well worth the effort.

The Take Away

Branding your program is a way to share the vision of the program, distinguishes all program communications, and associates the program with core values of the organization. Its always to show what the program is about and what the team is accomplishing. Branding will be the first step to help achieving the focus of the organization on your program.

EMR Expertise in the Top 7 Needed IT Skills

2010-12-04T16:48:04Z

Interesting items from this past week, looks like actual Electronic Medical Records expertise is one of the Robert Half Technology Survey skill sets desired in potential employees. Needless to say we have come a long way baby!

In a TechRepublic blog post on IT skill sets in demand, EMR expertise was added to the bottom of the list, but still made the listing.

1. PROGRAMMING - SPECIFICALLY, KNOWLEDGE OF .NET, JAVA, MYSQL, PHP, SILVERLIGHT, FLEX AS WELL AS PORTAL TECHNOLOGIES LIKE SHAREPOINT.

2. A BUSINESS MINDSET - MENTIONED FOR SEVERAL YEARS RUNNING, THE NEED FOR THIS SKILL SET IS NOT GOING AWAY. ORGANIZATIONS ARE YAMMERING FOR THOSE PEOPLE WHO UNDERSTAND HOW TECHNOLOGY SUPPORTS BROADER BUSINESS OBJECTIVES AND WHO HAVE THE MANAGEMENT SKILLS TO MAKE THEM HAPPEN.

3. TECHNOLOGICAL PROFICIENCY - THOSE WITH KNOWLEDGE OF ONE OR MORE OF THE MAJOR ERP PACKAGES ARE IN DEMAND SINCE FIRMS ARE SEEKING TO MAXIMIZE THEIR EXISTING INFORMATION SYSTEMS OR TO RESTART INITIATIVES THAT WERE PUT ON HOLD LAST YEAR.

4. SECURITY - COMPANIES WANT PEOPLE WHO CAN KEEP THEIR INFORMATION SAFE AND SECURE.

5. INFRASTRUCTURE SUPPORT -- COMPANIES ARE HIRING SUPPORT PROS AND PC TECHNICIANS, PRIMARILY ON A PROJECT BASIS, AS THEY UPGRADE THEIR OSS.

6. NETWORKING -- WITH IMPLEMENTATIONS OF VIRTUALIZATION AND CLOUD COMPUTING TECHNOLOGY, FIRMS ARE SEEKING IT PROS WITH A BLEND OF SERVER, SOFTWARE, AND NETWORKING SKILLS.

7. ELECTRONIC MEDICAL RECORDS -- HEALTH CARE FIRMS ACROSS THE U.S. ARE IN NEED OF IT PROS WITH THE EXPERTISE TO INSTALL AND SUPPORT MEDICAL RECORDS SOFTWARE.

What is truly interesting is that implementing an EMR is actually the combination of the above needed skill sets. It truly does take a team with understanding of Healthcare nuances. You will need individuals with programming expertise and will probably specialize in integration expertise as far as HL7 and with the fiscal intermediaries. A business mindset and technical proficiency is just a necessary component of any IT professional, should be standard as showing up to work dressed in clothes. Security is definitely up there as needed in EMR implementations. Understanding role-based security, forensic reviews to see who looked at what information at what time, assuring e-phi and company specific information is safe also a key component. Infrastructure support and networking are needed components as after all most hospitals have 1970 designed nursing stations and facilities. It is rare to have a new digital hospital from the ground up. Going to need the infrastructure and networking understanding to have the EMR application deployed.

So all in all, while it is a needed skill it is a part of the skill set, while also understanding what orders are? and speaking the workflow healthcare lingo. So we are making good progress towards understanding the need of EMR expertise.

Hosted Exchange - A utility type of IT Investment

2010-11-29T16:40:45Z

Within your portfolio you have a mix of investments, there are strategic transformational and growth investments, and then there are the utility investments. Those essential services needed to run the business but in a cost-effective manner. The decision to move to a hosted exchange environment is a utility investment.

There are some positives within the move to hosted exchange. First, there is the general "greening" of the datacenter as you remove from your carbon footprint a rack full of hub, bes, mail store, and encryption servers and appliances. The other is this is a better way to manage IT risk. You can contract for increased availability, and a time window for remaining current on new releases. Additionally, the expertise for handling email systems is high priced and specialized. There is not a large pool of exchange rangers working at health systems. The risk management methodology is one of transition to the vendor. This is a key point to consider when moving to hosted exchange as you negotiate to find balance between email service quality and the cost of the service.

On the matter of IT staff, don't fool yourself, there is not a reduction in IT Staff. It is more a change up on which expertise you will need. Currently you may have high end architects, mid-tier engineers, and ticket neutralizing technicians. In the hosted environment, you will need a different expertise and it also depends on what is negotiated in the contract. If you move level 1 support to the hosted vendor, those technicians may not be needed. However, this is an expensive option and it maybe worth only having the outsourced exchange vendor support level 2 and level 3, and keep several ticket neutralizing technicians on staff. Your high end architects will probably be moved to other transformational investments. However you will need a good sourcing manager to manage the vendor.

On financing, it will be a change from capital investments for servers, software and appliances to an operational expense for email service. The benefit here is that it will be easy to create useful ways of how much this service runs for the institution. Just be sure to include the new expanded internet pipe or mpls wan connection for larger systems.

As always, it is a good idea to vet the idea out in a business case. Clarify the project's objective, total cost of ownership, return on investment, and internal rate of return. As you explore vendors they should help you determine if this is an endeavor worth planning out, and how many resources are needed to implement and sustain.