As the year ends, I've spoken to many CIOs. 2011 was a hard year filled with Meaningful Use (including many upgrades to certified systems or self-certification), 5010 (the deadline for upgrading billing systems is January 1, 2012), accelerating compliance demands, new security threats, rapidly evolving technologies, and unprecedented demand for new projects driven by the consumerization of IT.
At the same time that CIOs and IT professionals are running marathons, they are being held accountable for events that are not directly under their control. They are not being congratulated for the miracles they create every day, but are being criticized for not moving faster.
What do I mean?
One CIO received a negative audit report because new generations of viruses are no longer stopped by state of the art anti-virus software. Interesting. The CIO cannot control the virus authors, nor the effectiveness of anti-virus software. No one in the industry has solved the problem, but audit firms revel in creating fear, uncertainty and doubt at the Board level as it enhances the reputation of the auditor.
Another CIO was held accountable for infrastructure demands that were not forecasted, planned, or communicated. CIOs do their best to be proactive, but in the world of Big Data, past trends may not predict future needs.
Another CIO was was given 10 goals and 5 unplanned urgent projects. She completed 8 of the planned goals and all the urgent projects, yet was told she only met 80% of expectations.
In a world that expects leaders to continuously perform miracles with constrained resources in limited time, we all need to step back and take our own steps to stop the madness.
With your own staff, celebrate the joy of success and focus on what really matters.
Did you achieve Meaningful Use?
Did you support compliance requirements on time to meet regulatory deadlines?
Did you maintain employee satisfaction and minimize turnover?
If so, you're an IT Leadership hero.
Did your Board or senior management note that a new application or website launched a few weeks late because you wanted additional testing time to minimize risk?
No one will ever remember.
Did you defer a "nice to have" project because an unplanned "must have" occurred mid year?
Good for you.
Did you have a brief infrastructure failure that led to a major improvement in security, reliability, and maintainability because the staff rallied around a tricky problem caused by a combination of rapid technology change and exponential increases in customer demand?
You'll be stronger in the future because of it.
We have to break the cycle of negativity that makes IT leadership so challenging. Create a culture that thrives on the projects you did well and does not focus on what remains undone because of circumstances beyond anyone's control.
Leaders at all levels - from Board members to team leaders need to realize that shouting louder does not make the rowing staff move the boat faster.
So celebrate the accomplishments achieved by your and your staff in 2011. It was one of the hardest years in the history of IT and we doubled EHR adoption in the US from 20% to 40%. We need to focus on that success, leveraging our energy and optimism to finish the 60% that remains.
A wonderful column, as usual, Dr. Halamka, but do you think that, in general, your message percolates up to the board level, let alone to other senior administrators?
ReplyDeleteYour column gave me a good understanding of the impact the external forces are from your perspective. I just read Inside Healthcare IT Today, an eGuide put out by Computer World just prior to reading your post. There is so much going on right now!
ReplyDeleteYou are right, most CIO's are just right in the middle of the journey at this point. Those at the top really need you though, so hang in there. They are also responsible for these large looming requirements and most have no idea what they really need to do. They need a guide. They need information.
EHRs are just the beginning of the answer to meaningful use. How does one prove they are using it effectively? The article I referenced said, "For bonus payments through federal Medicare and Medicaid programs by 2015 prescriptions should be written electronically, incorporate test results into patient records, and report to federal officials on overall compliance with various benchmarks, coordinate patient care between inpatient and outpatient settings and demonstrate actual improvements in health outcomes to pass federal scrutiny." I'm thinking senior administration will be looking for you to pull those rabbits out of hats next.
Do you have a strategy for collecting metrics to prove quality of care?
I wish you luck. It's a large endeavor.