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Provider Translation?

August 3, 2010
by Bobbie Byrne
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About seven months ago, I made the movement back to a provider organization after seven years in mostly industry and a little bit of policy work in health information technology. A lot of organizations hire into the CIO role someone who has grown through the analyst-manager-director path. There are a lot of terrific CIOs with that background. I am just grateful that my organization saw some value to a pediatrician who had never managed an hospital IT department before, but had been around the block in a few other capacities—consultant, vendor, CCHIT devotee.

I think because I did not grow up in this organization, I spend a lot of time with people looking at me like I am speaking Swahili or some other really foreign language. Some of the very few things that get the widest eyes:

“So, when will that be done?” If something is worth doing, it is worth putting a date to it. I know that I get this from working in a publicaly traded company where my diurnal rhythms were almost second to the quarter close. Even if the deadline is only for yourself—everything has to have a date.

“We are not a democracy.” If I heard one more time “They wanted their own system” in the first week, as I discovered application after application after application, I was going to scream. Not everyone gets what they want. If you want special treatment, get a massage.

“I know that was not planned, we are doing it anyway.” Some doctors, patients, programs are strategic enough to our growth that they get whatever they want. It isn’t fair and I know you don’t have time but it still will be done…and can I have a date please?

Lest I portray that I have been doing all talking and no listening, remember the old adage about how we have two ears and one mouth, and they should be used proportionally.

Nice is important. I thought that as a pediatrician, I understood nice. The kicker is that in an organization where people stay for 20 years or more, nice may be almost as important as outcomes. For sure, a nice, incompetent person will not last, but neither will a jerk who gets the job done. Nice buys you some time to prove your value.

Taking time to discuss and celebrate successes is not time wasted. I previously had only had conversations with my colleagues, bosses and team about what needed fixing, not what was working well. It was hard for me to take time away from projects for what I saw as a time-wasting, self congratulatory activity. I actually now believe that we learn powerful lessons from mistakes, but what you can learn from successes have their own more subtle intelligence.

Open your ears to alternative sources of information. In a corporation, you are surrounded by folks who eat, drink and sleep HIT. In a provider organization, you look to the left and you look to the right and you then realize that neither of them spends much time at all thinking about information technology—at least not in the same way that the CIO does. However, there are items that I don’t know as much about: unionization, real estate, HR benefits costs, Case Mix Index variation, volume in the OR etc. I learn more about our business every day. The more I know about our business, the better I can assure our systems support it.

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