j e s r u s h . c o m

Career mentor extraordinaire Patty Azzarello recently made a suggestion to me that I take the ‘StrengthsFinder 2.0‘ assessment. This is a 175 question online timed test which asks questions like, “Which describes you more strongly: You get things done on time or You get things done correctly”. Painful! You want to choose both, but have to favor one or the other. The assessment was designed by Gallup and supposedly incorporates data from millions of people.

I’m notoriously skeptical of these kinds of things, especially after the Myers Briggs told me I was an introvert (my wife enjoyed a good laugh over that one). But I took the dive on Patty’s recommendation and have to say I’m really impressed. Out of the 34 “strengths”, the assessment tells you your five most prominent and this thing was spot on.

It said my strengths were that I’m:

Reading the descriptions of these was pretty amazing. They fit me to a “T”.

Why is this useful? Because so much of success both in your career and in your personal life depends on the extent to which you position yourself to take advantage of your strengths and minimize your weaknesses.

If you’re interested in taking the test yourself, you have to buy the accompanying book, which gives you an “access code” for the online test.

The new act contains a bunch of things interesting to those involved in healthcare information systems, and the best way to get up to speed is probably to read this from the New England Journal of Medicine. Following is a short clip:

Although the federal government has long spent billions on health care, there is no precedent for the act’s massive investment in accelerating the adoption of health information technology — or for the expanded leadership role that government will assume in this arena. At present, perhaps only 17% of U.S. physicians and 8 to 10% of U.S. hospitals have at least a basic electronic health record system. Far fewer have — and routinely use — the types of comprehensive systems that would allow them to fully realize the potential of the technology.3 However, such technology will lead to improvements in the quality of care and savings on other health care costs only if the implementation is done right.

In 2004, the Bush administration, by executive order, created the Office of the National Coordinator for Health Information Technology as part of the DHHS. But Congress had never established the office in law, and its funding has been only about $60 million a year. The stimulus legislation codifies the national coordinator position and office, provides $2 billion for discretionary spending, primarily for grants and loans, and sets a goal of “utilization of a certified electronic health record for each person in the United States by 2014.” It establishes two federal advisory committees on health information technology — one on policy and one on standards — through which the government will work with the private sector and consumer groups to develop the specifics of a nationwide health information network. These include the design of “interoperable” electronic health records that permit the seamless exchange of data among physicians, hospitals, laboratories, pharmacies, and other health care organizations, as well as methods for ensuring the privacy and security of patient data. Standards are to be developed in 2009 and tested and certified in 2010; the DHHS will certify specific products.

Beginning in 2011, Medicare and Medicaid will provide financial incentives over multiple years of up to $40,000 to $65,000 per eligible physician and up to $11 million per hospital for “meaningful” use of health information technology, such as the electronic exchange of data and reporting of clinical quality measures. Starting in 2015, physicians and hospitals that do not use certified products in a meaningful way will be penalized. The Congressional Budget Office projects that the incentives will boost the proportions of physicians and hospitals adopting comprehensive electronic health records by 2019 to 90% and 70%, respectively, from the 65% and 45% that would be expected to do so anyway.

Meanwhile John Halamka has some good thoughts on achieving EHR implementations through regional centers.

A friend in IT recently asked me to explain cloud computing to them. It’s a complicated question because 1) personal cloud computing (think Sugar Sync, etc.) is very different from enterprise cloud computing (think Amazon S3, etc.) and 2) The vendors offering cloud services are offering really different products from each other.

I gave my friend the best summary which I could, but later I referred him to this old but excellent summary of the state of cloud computing. It has great great play-by-play on the offerings from each of the major vendors.

Things have shifted a little bit since then, but this is still the best summary I’ve seen on the web. And Amazon is still kickin’ everyone else’s butt with their simple image-based solution.

Hard drive loss (at home) is something nobody wants to think about. Imagine losing all of your music, financial data, documents, and perhaps most importantly — family photos. It could be caused by a virus, mechanical failure, fire, or even theft.

To mitigate the risk, you can backup your data to an external drive or use an online backup service like carbonite or mozy, but neither solution is adequate. Your external drive would be barbecued in a fire or gone in a burglary and the online backup services become too slow/expensive when you try to store 300+ GB’s of photos, videos, music, and movies.

Enter the ioSafe solo, a 1.5TB external backup drive encased in a fire resistant, water resistant, shell which can be tethered (locked) to a desk. This is a brilliant product. Highly recommended.

CIO.com has a good interview with IBM’s CIO Mark Hennessy, “Inside the New Big Blue.” Hennessy talks about global consolidation, virtualization, and web 2.0. However, my favorite part was this tidbit which Hennessy offered when asked how IBM’s new internal blogs, wikis, and collaboration tools:

CIO.com: What are you doing to help optimize the value of the social networking tools you’re using?

HENNESSY: I find it very important to try and understand the value of each of these different tools, and I do that in a number of ways. How many ideas are created by a particular tool? How many get sponsored by somebody that has a budget? How many are collaborated on? How many actually make it to market? What revenue is generated by those ideas? I have a set of tools now that I use to track the ideas and the innovations that come out of the different tools so that I can better align my investments to the tools that are driving the better and more innovative ideas. That’s something that I spend a lot of time with other CIOs around the world talking about — the ROI of social networking.

This is excellent stuff. I love hearing about a CIO who is A) Actively experimenting with edgy social networking tools in a traditional\conservative organization and B) Objectively trying to track the value of these things.

I love to study why some people are more successful and effective than others.  Over the years, I’ve noticed three specific habits commonly employed by effective people, and tried to integrate them into my own work life:

1) Weekly Status Reports. Every Friday send your boss a one page report summarizing your activities over the past week.  This is as much for you as it is for your boss.  It protects you from being over-assigned (they can see how busy you already are).  It prevents the, ‘you did not tell me about this’ situation.  It reminds them of everything you do and how valuable you are (esp. useful during downturns). And it ensures that you are staying on top of your tasks and not forgetting anything. I don’t actually do this every week, but I should, and I’m trying to become more consistent.

2) Follow up every day.   At 4:30pm every day, a reminder automatically pops up on my screen: “Follow up!  Tie up all the loose ends!”  I stop what I’m doing and spend the last 30 minutes of the day doing exactly that.  Reviewing what I did and did not accomplish today.  Notifying others as to the state of those tasks.  Updating calendars and todo lists with anything that came up.

3) Over-prepare –Don’t waste people’s time.  Before you meet with someone (in a professional capacity), spend a few minutes asking some simple questions:  What does this person want to accomplish?  What questions could they conceivably ask me?  Do they have sufficient control and visibility to feel comfortable and make wise decisions?  Send out an agenda beforehand (and ask for comments).  Take meeting notes and send them out immediately afterward to detect any misunderstandings.  This habit is especially important when meeting or working with people over your pay grade.

It’s amazing how far these three little practices go towards making you more competent, organized, and reliable.  I recommend them to everyone.

Cornelius Fitchner has put together another great episode over at the project management podcast, this one is an interview with quality expert Stacy Goff.  Goff has some great insights into how and why project quality suffers and what PMs can do about it.

My favorite nugget came when Fitchner asked Goff whether good processes are the key to good quality.  Goff asked Fitchner to imagine a project where the goal was to bake a great cake.  A fantastic cake recipie was located for the endeavor… it was clear, descriptive, straightforward and produced consistently excellent results.  In other words, the process was a very good one.  However when the cake was actually made, the cook had to use a cheap chocolate because it was the only thing locally available.  They had to use a hand mixer (poor aeration) since there was no counter-top unit in the kitchen.  They followed the process word for word, but the end result was of mediocore quality.

I love this example because it illustrates the need for holistic quality management: Even the best process fails when the inputs are off.

Mark Cuban — billionaire owner of the Dallas Mavericks — has a fascinating contest going on over at his blog. Apparently he wants to help stimulate the economy, so he’s openly taking business plan ideas for new startups. If he likes the idea, he’s willing to fund it immediately.

What’s the catch? You have to post your biz idea publicly where it can be copied and stolen. Mark actually wants it to be copied and stolen, he wants good ideas to take off and begin generating jobs and product. The other major caveat is that the business must break even within 60 days!

Hundreds of clever ideas have already been submitted. I added four ideas here.

Meanwhile, Seth Godin and friends were inspired by the contest to come up with 999 business ideas, and they’re actually pretty good! Of course, ideas are easy, it’s the execution which matters.

All year I’ve been listening to what I thought was an obscure little album: ‘Raising Sand’ by bluegrass queen Alison Krauss and Led Zeppelin frontman Robert Plant. The two got together for a studio experiment to try and pair Alison’s angelic voice with Plant’s brit-rock craziness. They agreed that if it wasn’t working three days in, they would scrap the project.

Well, it worked. ‘Sand’ is an incredible album: A haunting, mesmerizing piece of musical genius that’s unlike anything I’ve ever heard. If you like classical rock, or bluegrass, or Americana — you will like this album. To my incredible surprise, it just took top honors at the Grammy’s, winning record of the year!

Incidentally, that makes AK the winningest artist (in terms of Grammys) of all time. Wow.

I wanted to share a handy little tool which I picked up awhile back: The PIECES framework. This short checklist is simply a list of things to think/worry about when designing, building, or implementing a system or application.

I suppose there are a lot of frameworks and checklists floating around out there, but this one happens to be really good. I use it not only for design, but also for change management to make sure I’m not forgetting anything. I have no idea who created it, but I’m forever in their debt!

Performance
   -Throughput
   -Response Time
Information (and Data)
   -Outputs
      +Lack of any information
      +Lack of necessary information
      +Lack of relevant information
      +Too much information – information overload
      +Information that is not in a useful format
      +Information that is not accurate
      +Information that is difficult to produce
      +Information that is not timely to its subsequent use
   -Inputs
      +Data is not captured
      +Data is not captured in time to be useful
      +Data is not accurately captured – contains errors
      +Data is difficult to capture
      +Data us captured redundantly – same data is captured more than once
      +Too much data is captured
      +Illegal data is captured
   -Stored Data
      +Data is stored redundantly in multiple files and/or databases
      +Stored data is not accurate
      +Data is not secure from accident or vandalism
      +Data is not well organized
      +Data is not flexible – cant meet new info needs from stored data
      +Data is not accessible
Economics
   -Costs
      +Costs are unknown
      +Costs are untraceable
      +Costs are too high
   -Profits
      +New markets can be explored
      +Current marketing can be improved
Control (and Security)
   -Too little security or control
      +Input data is not adequately edited
      +Crimes (e.g. fraud, embezzlement) can be committed against data
      +Ethics are breached: data or info gets to unauthorized people
      +Redundantly stored data is inconsistent in different files or databases
      +Data privacy regulations or guidelines are being (or can be) violated
      +Processing errors are occurring (people, machines, or software)
      +Decision- making errors are occurring
   -Too much control or security
      +Bureaucratic red tape slows the system
      +Controls inconvenience customers or employees
      +Excessive controls cause processing delays
Efficiency
   -People, machines, or computers waste time
      +Data is redundantly input or copied
      +Data is redundantly processed
      +Information is redundantly generated
   -People, machines, or computers waste materials and suppliers
      +Effort required for tasks is excessive
      +Materials required for tasks is excessive
Service
   -The system produces inaccurate results
   -The system produces inconsistent results
   -The system produces unreliable results
   -The system is not easy to learn
   -The system is not easy to use
   -The system is awkward to use
   -The system is inflexible to new or exceptional situations
   -The system is inflexible to change
   -The system is incompatible with other systems
   -The system is not coordinated with other systems

Patty Azzarello — career mentor extraordinaire — has a great post this week on the issue of liking your job. Does it really matter whether you like your job? And more importantly, if not, what can you do about it?

As usual, her advice is on target. If you don’t like your job, you need to “tune it” over time:

Imagine two different project managers in this same situation, with two different sets of gifts and dislikes. (Notice how the content of the business and the technology itself, don’t factor into either the problem or the solution.)

Person #1: You have a gift for analysis, and are a good writer. You do not like giving presentations or arguing with people. You hate your job because you have to deal with annoying people all the time.

Person #2: You have a gift for empathy and engaging and motivating people. You are not very detail oriented, and do not care to publish documents. You hate your job because you are stuck dealing with detailed project plans, and technology issues.

Tune your job to suit your strengths, and minimize your dislikes.

Person #1: Think about negotiating with your manager over time to take on a broader role to support all the project managers by improving the overall process, creating templates and workflows, managing data, etc. Build on your analysis and writing strengths, spend less time fighting dragons, and add real value to the business by creating infrastructure, process, and efficiencies.

Person #2: Ask for new projects that span organizations, need publicity, and have within them, more technical people and support you can rely on. Build on your people strengths, spend less time in the weeds, and help the business achieve significant outcomes on the biggest, messiest programs, that require lot’s of hand-holding and finesse with people.

People who like their jobs work harder so it benefits the organization as well!

CIO has a good Harvard Business Review article about people transitioning into leadership roles. The most interesting part is Van Buren’s response to the question of, ‘What is the most common mistake new leaders make?’

Almost universally, we saw the one mistake that seems most pernicious is having an excessive focus on details. It’s important for managers to know the ins and outs of the projects they may be managing, but if it becomes excessive, they lose sight of the bigger picture of what’s going on in the organization, and they lose the ability to prioritize. The urgent often outweighs the important. This is often true of IT leaders; heavy emphasis on details can be their greatest weakness. Given the highly detail-oriented nature of IT work, it’s very hard not to be constantly supervising.

How true. I’m regularly amazed by the inappropriately high level of interest which organizational leaders take in operational details. I think much of this stems from simple distrust: Leaders don’t trust their teams to properly execute the work. Occasionally this distrust might be truly justified, but usually it’s just paranoia and micromanagement.

Scott Staples as a nice article over at CIO.com about revisiting outsourcing arrangements to save additional money. My favorite point:

People-based outsourcing contracts are the equivalent of paying rent. The rent is due each month regardless of use. In a “rental agreement” there is no mechanism or incentive to drive productivity improvements, efficiencies, higher-value-add-services, faster time-to-market, and deeper cost cutting efforts.

Amen.

Janet Rae-Dupree has a good article over at the NY Times about the problems of modern health care and the promise of integrated technology. She writes:

Two main causes of the system’s ills are century-old business models, for the general hospital and the physician’s practice, both of which are based on treating illness, not promoting wellness. Hospitals and doctors are paid by insurers and the government for the health care equivalent of piecework: hospitals profit from full beds and doctors profit from repeat visits. There is no financial incentive to keep patients healthy.

But technology is changing that.

Some health care suppliers have set up fixed-fee integrated systems, and accept monthly payments from members in exchange for a promise of cradle-to-grave health care. Each usually also charges a small co-payment for treatment. Routine cases are handled through lower-cost facilities, leaving more complicated cases to higher-cost hospitals and specialists. Such systems include Kaiser Permanente, Intermountain Healthcare in Utah, the Mayo Clinic, the Geisinger Health System in Pennsylvania and the Veterans Health Administration.

By creating a continuum of care that follows patients wherever they go within an integrated system, says the Princeton University economist Uwe Reinhardt, care providers can stay on top of what preventive measures and therapies are most effective. Tests aren’t needlessly duplicated, competing medications aren’t prescribed by different doctors, and everyone knows what therapies a patient has received. As a result, integrated systems like Kaiser’s provide 22 percent greater cost efficiency than competing systems, according to a 2007 study by Hewitt Associates.

Beautiful. The bones of KP’s system is Epic.