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This video is a discussion with Rich Pollack with Starbridge Advisors about innovation busts of 2018 and changing care settings.
February 8, 2024
“What do you mean “there is an executive level downtime committee that meets weekly”?
As I stated this, I must admit I was a bit incredulous. Although it was only my first week as CIO at a large academic medical center, I had never encountered in my prior 8 years as CIO in both large and mid size health systems.
Before I return to this experience, let me first try to explain what is meant by “technology debt”, or at least my interpretation. For CIOs, now appropriately focused on innovation, AI, ML and digital transformation, it is a given that the organization assumes the CIO has already locked down a solid and reliable foundation of infrastructure to support these go forward efforts. While foundational “chips” in the CIO game, it’s often surprising how weak that “hand” is. This is often as a consequence of the historical accumulation of funding shortfalls or investment compromises that supersede the CIO’s judgment, pleas, and warnings.
The nature of substandard or compromised IT infrastructure, be it network switches, WiFi, PCs, storage, etc is that, in the short term, they may appear to meet the need, but eventually cause havoc. The funny thing about IT infrastructure is that you ignore it at your peril. Sooner or later, it turns on you, often at the most inopportune time.
November 20, 2020
“Crack!!”, a loud sound, as I sat in front of my home PC, startled me. My anxiety increased when I looked down and saw that the 2 TB external drive I had stored 50,000 family photos (from past 20 yrs) on, had dropped 18 inches from the precarious perch on top of my Dell tower PC onto my wooden floor. A direct result of my foot getting tangled in the USB cord. I picked up the now hopeless drive, heard clicking noises and noticed the case partly cracked open. I had only myself to blame for my negligence for not one, but two things – the placement of my drive and for mapping only my C-Drive to my new external backup services. I never got around to mapping my external drives, the way I had done previously with my old backup service.
Like the proverbial shoemaker’s son that has no shoes, this former CIO, an evangelist for disaster recovery (DR), was wholly embarrassed by my own ineptitude. It was a failure on multiple levels. But it did get me to reflect upon my long focus on disaster recovery and downtime mitigation – a focus that had so dominated much of my CIO career.
April 16, 2018
Unlike many other industries, complete IT outsourcing in healthcare provider organizations is a fairly rare bird. There are reasons for this, technical, financial and cultural.
On the other hand, selectively outsourcing defined and limited subcomponents of a healthcare IT department can be both a successful and prudent way to optimize limited in-house expertise, allow for rapid resource expansion when needed and improve the reliable delivery of services to the rest of the organization.
In my career, I was fortunate to work for a short time in a large academic healthcare organization that had fully outsourced nearly all aspects of IT. It was a great learning experience. I had to understand how to manage that outsourcer’s performance against a set of 26 well-defined Service Level Agreements (SLAs). While it had its challenges, overall the outsourcer performed well. They had hired the original IT staff before I arrived and quickly cut the bottom 20% of poor performers – a task that would have been much more difficult to achieve thru the usual performance process. They established solid PMO and CRM teams and effectively oversaw major infrastructure improvements.
However, after two short years, the organization decided to re-insource IT. Why?
November 15, 2017
Our industry is slowly winding down from the frenetic pace of EMR implementations the past 10 years and now looks to derive the sophisticated insight needed to address a new climate of measured value in care.
Institutions and leadership are turning their focus evermore on the use of analytics to derive that insight and intelligence. After all, leadership feels we are now awash in data from decades of automating all the paper processes of the past. The electronic medical record being the most recent manifestation of that.
We learned (sometimes painfully) that deploying an EMR product without the concurrent efforts around transformation will not work. As IT leaders, we must embrace the need to create a supportive ecosystem of analytics while pursuing the build or buy of any specific enterprise data warehouse product.
