How to Ryan
Hi, welcome to the team. I'm so glad you are here at \$COMPANY.
It's going to take a solid 90 days to figure this place out. I understand the importance of first impressions, and I know you want to get a check in the win column, but this is a complex place full of equally complex humans. Take your time, meet everyone, write things down, and ask all the questions - especially about all those baffling acronyms … healthcare is full of them
One of the working relationships we need to define is ours. The following is a user guide for me and how I work. It captures what you can expect out of the average week, how I like to work, my north star principles, and some of my, uh, idiosyncrasies. My intent is to accelerate our working relationship with this document.
Our Average Week
We'll have a 1:1 every week for about 30 minutes. I try to never cancel this meeting so it might get moved around a bit. I would like to apologize for this in advance.
If you are curious about the 1:1s I have with my manager I’m more than happy to tell you about their frequency and duration. I meet with my boss at least once a week for anywhere from 30 - 90 minutes. It just depends on the week.
The purpose of our meeting is to discusses topics of substance, not updates (there are other platforms for that). Sometimes they can morph into update type meetings. I’ll do my best to keep that from happening, and I ask that you do the same. I have a running list of items that I will want to discuss with you and I encourage you do have the same.
We have scrum every day. The purpose of the scrum is to tell the team three things:
- What I did yesterday
- What I’m doing today
- What, if any, roadblocks I have
The scrum master will make note of the roadblocks and work to remove them as quickly as possible. Sometimes this is fast, sometimes it’s not.
If I am traveling or will be out of the office on PTO (yes, I take PTO and you should too once you can), I will give you notice of said travel in advance. Depending on the type of travel I may need to cancel our meeting.
Sometimes I work on the weekends. Sometime I work late. Unless we have a big project that you are working on and it needs to get done I don’t ask anyone else to work late or on the weekends. I want you to have a life outside of work.
North Star Principles
Humans first. I believe that happy, informed, and productive humans build fantastic products. I try to optimize for the humans. Other leaders will maximize the business, the technology, or any other number of important facets. Ideological diversity is key to an effective team. All perspectives are relevant, and we need all these leaders, but my bias is towards building productive humans.
Leadership comes from everywhere. My wife likes to remind me that I hated meetings for the first ten years of my professional career. She's right. I've wasted a lot of time in poorly run meetings by bad managers. I remain skeptical of managers even as a manager. While I believe managers are an essential part of a scaling organization, I don't believe they have a monopoly on leadership, and I work hard to build other constructs and opportunities in our teams for non-managers to lead.
It is important to me that humans are treated fairly. I believe that most humans are trying to to do the right thing, but unconscious bias leads them astray. I work hard to understand and address my biases because I understand their ability to create inequity. I am not perfect, but I try to be better today than I was yesterday. Sometimes I succeed. Sometimes I don’t.
I heavily bias towards action. Long meetings where we are endlessly debating potential directions are often valuable, but I believe starting is the best way to begin learning and make progress. This is not always the correct strategy. This strategy annoys those who like to debate.
I believe in the compounding awesomeness of continually fixing small things. I believe quality assurance is everyone's responsibility and there are bugs to be fixed everywhere… all the time.
I start with an assumption of positive intent for all involved. This has worked out well for me over my career.
Feedback Protocol
I firmly believe that feedback is at the core of building trust and respect in a team.
At \$COMPANY, there is a formal feedback cycle which occurs once a year per employee.
During that formal feedback cycle (also called the Annual Review) we will discuss the previous year. There’s a form (\$COMPANY loves forms). I’ll fill it out and we’ll discuss it.
This means that at anyone time I could be finishing up 5 reviews or 1.
Notice I say finishing up. I try to make the reviews I write as living documents so I can capture everything from the year, and not just everything from the last month.
If during the Annual Review you are surprised (positively or negatively) by anything, I have not done my job. Please let me know. Feedback is the only way we know we are doing something well, or not well.
I won’t assume you know what I’m thinking, and I ask that you don’t assume I know what you’re thinking.
Disagreement is feedback and the sooner we learn how to efficiently disagree with each other, the sooner we'll trust and respect each other more. Ideas don't get better with agreement.
Meeting Protocol
I go to a lot of meetings. In the morning scrum many times I will indicate that today I have several meetings. I don’t enumerate all of them because I don’t think everyone wants to know specifically which meetings I’m going to. If I think it’s important for the team to know, I will say, I have meeting X today. If I don’t indicate what meeting I have and you want to know, ask. If it’s not private / confidential I will tell you.
My definition of a meeting includes an agenda and/or intended purpose, the appropriate amount of productive attendees, and a responsible party running the meeting to a schedule. If I am attending a meeting, I'd prefer starting on time. If I am running a meeting, I will start that meeting on time.
If a meeting completes its intended purpose before it's scheduled to end, let's give the time back to everyone. If it's clear the intended goal won't be achieved in the allotted time, let's stop the meeting before time is up and determine how to finish the meeting later.
Nuance and Errata
I am an introvert and that means that prolonged exposure to humans is exhausting for me. Weird, huh? I tend to be most active when I’m not running the meeting and there are fewer people. If I’m not running the meeting and there are many people I am strangely quiet. Do not confuse my quiet with lack of engagement.
When I ask you to do something that feels poorly defined you should ask me for both clarification and a call on importance. I might still be brainstorming. These questions can save everyone a lot of time.
I tend to be very reserved but this is not a sign that I am uninterested, it is just who I am. Every once in a while that reserved facade is cracked and I display emotions. That’s when you can tell I’m really excited about a thing (either good or bad).
During meetings in my office I will put my phone on DND and log out of my computer if we won’t be using it. If we will be using my computer I close Outlook and only have the applications open that need to be open. During meetings I will take notes on my phone. I have a series of actions programmed on my iPhone to help keep me on top of things that I need to do. Rest assured, I’m not texting anyone, or checking the next available movie time. When I am done typing a note, I will put the phone down.
During meetings over Zoom, Slack, etc. I will put all communication apps on DND and close Outlook. Some people like to use the camera during meetings. Others don't. I am good either way. During team only meetings I do like that everyone has the camera on. I will typically use my iPad to take notes during meetings. As stated above, I have many workflows built into my phone and the use of my iPad helps to keep things straight for me. Rest assured, I'm not checking the score of the big game.
Humans stating opinions as facts are a trigger for me.
Humans who gossip are a trigger for me.
I am not writing about you. I've been writing a blog (off an on) for a long time and continue to write. While the topics might spring from recent events, the humans involved in the writing are always made up. I am not writing about you. I try to write all the time.
This document is a living breathing thing and likely incomplete. I will update it frequently and would appreciate your feedback.
- Original Date: June 15, 2018
- Updated: March 20, 2021
Getting CPHIMS(R) Certified - Part III
I walked into the testing center at 8:30 (a full 30 minutes before my exam start time as the email suggested I do).
I signed in and was given a key for a locker for my belongings and offered use of the restroom.
I was then asked to read some forms and then was processed. My pockets were turned out and my glasses inspected. I signed in (again) and had the signature on my ID scrutinized with how I signed on test day. It only took three tries ... apparently 19 year old me doesn’t sign his name like 39 year old me.
Now it was test time ... even if I could remember any of the questions I wouldn’t be able to write about them ... but I can’t remember them so it’s not a problem.
It took me 80 minutes to get through the real test of 115 questions (15 are there as ‘test’ questions that don’t actually count). The only real issues I had were:
- construction noise outside the window to my left
- the burping guy to my right ... seriously bro, cut down on the breakfast burritos
- one question that I read incorrectly 4 different times. On the fifth time I finally realized my mistake and was able to answer correctly (I think). As it turned out I had guessed what I thought was the correct answer but it was still a good feeling to get the number through a calculation instead of just guessing it
When the test was completed and my questions scored the results came back. A passing score is 600 out of 800. I scored 669 ... I am officially CPHIMS. The scoring breakdown even shows areas where I didn’t do so well, so I know what to focus on for the future. For reference, they are:
- Testing and Evaluation (which is surprising for me)
- Analysis (again, surprising)
- Privacy and Security (kind of figured this as it’s not part of my everyday job)
Final Thoughts
When I set this goal for myself at the beginning of the year it was just something that I wanted to do. I didn’t really have a reason for it other than I thought it might be neat.
After passing the exam I am really glad that I did. I’ve heard myself say things and think about things differently, like implementation using Pilots versus Big Bang or By Location versus By Feature.
I’m also asking questions differently of my colleagues and my supervisors to help ensure that the we are doing things for the right reason at the right time.
I can’t wait to see what I try to do next
Getting CPHIMS(R) Certified - Part II
Signing up for the actual exam may have been the most difficult and confusing part. I had to be verified as someone that could take the test, and then my membership needed to be verified (or something).
I received my confirmation email that I could sign up for the exam and read through it to make sure I understood everything. Turns out, when you sign up for the CPHIMS you need to use your FULL name (and I had just used my middle and last name).
One email to the HIMSS people and we’re all set (need to remember that for next time ... this exam is the real deal!)
I was going to be in Oceanside for the Fourth of July Holiday and decided to sign up to take the exam in San Diego on the fifth. With a test date in hand I started on my study plan.
Every night when I got home I would spend roughly 45 minutes reading the study book, and going over Flash Cards that I had made with topics that I didn’t understand. Some nights I took off, but it was a solid 35 days of studying for 45 minutes.
Now, 2 things I did not consider:
- Scheduling an exam on the fifth is a little like scheduling an exam on Jan 1 ... not the best idea in the world
- The place my family and I go to in Oceanside always has a ton of friends and family for the weekend (30+) and it would be a less than ideal place to do any last minute studying / cramming
I spent some of the preceding weekend reading and reviewing flash cards, but once the full retinue of friends and family arrived it was pretty much over. I had some chances to read on the beach, but for the most part my studying stopped.
The morning of the fifth came. I made the 40 minutes drive from Oceanside to the testing center to take the CPHIMS exam for real.
Getting CPHIMS(R) Certified - Part I
One of my professional goals for 2017 was to get my CPHIMS (Certified Professional in Healthcare Information and Management Systems). The CPHIMS certification is offered through HIMSS which “Demonstrates you meet an international standard of professional knowledge and competence in healthcare information and management systems”.
There was no requirement for my job to get this certification, I just thought that it would be helpful for me if I better understood the Information and Management Systems part of Healthcare.
With not much more than an idea, I started on my journey to getting certification. I did some research to see what resources were available to me and found a Practice Exam, a Book and a multitude of other helpful study aids. I decided to start with the Practice Exam and see what I’d need after that.
In early March I signed up for the Practice Exam. I found all sorts of reasons to put off taking the exam, but then I noticed that my Practice Exam had an expiration date in May. One Sunday, figure “what the hell, let’s just get this over with” I sat down at my iMac and started the exam.
I really had no idea what to expect other than 100 questions. After about 20 minutes I very nearly stopped. Not because the exam was super difficult, but because I had picked a bad time to take a practice exam. My head wasn’t really in the game, and my heart just wanted to go watch baseball.
But I powered on through. The practice exam was nice in that it would give you immediate feedback if you got the question right or wrong. It wouldn’t be like that on test day, but it was good to know where I stood as I went through this practice version.
After 50 minutes I completed the exam and saw that I had a score of 70. I figured that wouldn’t be a passing score, but then saw that the cutoff point was 68. So I passed the practice test.
OK, now it was time to get serious. Without any studying or preparation (other than the 8+ years in HIT) I was able to pass what is arguably a difficult exam.
The next thing to do was to sign up for the real thing ..