Hello, and welcome to the course, The Strategies for Successfully Leading Change in Health Informatics. My name is Ashwini Davison, and I am so excited to be one of your instructors for this part of the specialization in clinical informatics. I feel privileged and honored to be an instructor alongside Dr. Peter Greene, who is our Chief Medical Information Officer here at Johns Hopkins Medicine. I am currently the Associate Director of Education for the Division of Health Sciences Informatics and although I'm biased, I have to say I think this is such an excellent time to be covering the content that we'll be going through regarding leading change. So, one of the questions that arises would be, "Hey, I am in clinical informatics specialization on Coursera, what does leading change have to do with this?" It makes sense with informatics that you'd be covering things like databases, the data information knowledge pyramid, decision trees, algorithms. It makes sense to be going over things like querying EHRs and population health informatics. But what about things like Plan Do Check Act? What about change management, strategic planning, organizational culture? What do those have to do with informatics? They are essential to the field. We will be introducing you to topics related to strategic planning tools such as strength, weaknesses, opportunities and threats so you'll know how to do a SWOT analysis. We'll go over what you might need to do to lead a scenario planning session at your next work retreat. What is the PDCA or PDSA cycle? As a part of workflow re-engineering and change management, it will be essential that you get familiar with the steps involved in this particular cycle. Let me ask you a question about why this is important. True or false? Now that the vast majority of office-based physicians in the United States have adopted EHRs, change management is no longer an essential skill for leaders in health IT in the public or private sector. So true or false? We are well into the meaningful use era, the HITECH Act with years ago, but the answer is false. Issues related to change management leadership are more important than ever and don't just take it from me. Other experts in the field feel the same way. In a 2017 article in health care IT news, the CEO of HIMSS, Hal Wolf, was speaking to his audience when he told them to think about the front line staff that were providing patient care every single day and how they were being forced to change and adapt with each new health IT system roll out. He told them, "What do you think it feels like for the front line staff who are providing this care having to adapt so frequently?" Hal Wolf was quoted as saying, ''This is change management of the highest level, and if you think the economics today are hard, give it five years. It's going to get worse. You have to ensure that the stakeholders are aligned to implement your changes.'' Another expert in the field Dr. David Blumenthal, President of the Commonwealth Fund published an article that same month in the Harvard Business Review. Now you might recognize Dr. Blumenthal's name because he was a former leader of the ONC Office of the National Coordinator for Health IT. In this HBR article titled The Critical Skills for Leading Major Change in America's Health System, Dr. Blumenthal wrote, ''At a time of profound volatility in the US health system, change management is an essential skill for public and private leaders alike. For these leaders and young people aspiring to careers as health care managers, one very practical question emerges: 'What are the critical skills for leading a major change in our health system?''' As you can see by the quotes from Hal Wolf, CEO of HIMSS, David Blumenthal, President of the Commonwealth Fund, the topics we will cover in this particular course will be invaluable to your future careers as clinical informaticians. In addition to those quotes from leaders, my perspective, Dr. Greene, RCMIO's perspective, the topics of leading change are also on the minds of question writers for the Clinical Informatics Subspecialty board exam. You met Dr. Harold Lehman who was the instructor of your previous course, and he talked about his board certification in clinical informatics. Dr. Lehman and I both took the exam in 2014 and in addition to our primary specialty, his pediatrics and mine internal medicine were both sub-specialty certified in clinical informatics and our diplomats of the American Board of Preventive Medicine. So, what is the core content of the exam? There are four main categories: fundamentals, clinical decision-making and care process improvement, health information systems and the fourth core content category, leading and managing change. When they were coming out with the core content publication long before the exam had even been offered, in 2009 a JAMIA publication by Gardner et al was titled Core Contents of the Sub-specialty in Clinical Informatics. In this, they wrote, ''Successful implementation of information systems requires behavioral, cultural and social change within an organization. Thus, clinical informaticians require knowledge and skills in understanding and analyzing organizational culture, planning organizational change, building and working in effective multi-disciplinary teams," and the list goes on and on. Now let's play a game of associations. I'll state a phrase and you have to think of the individual that comes to mind. So if I said social networking, who were you thinking of? Perhaps Mark Zuckerberg based on his success with Facebook. If I were to use the phrase assembly lines, who would come to mind? Henry Ford based on his innovation over a century and a half ago in the automotive industry. Now, when we mention leading change, after this course, the person that should come to mind is John Kotter. As a Harvard faculty member, his seminal work on leading organizational change and successfully transforming organizations has been lauded worldwide. As a matter of fact, if you go back to healthit.gov and look at some of the documents that were put out back in 2013, helping organizations deal with meaningful use in EHR adoption, you'll find Kotter's work quoted and used as the framework and the recommendations provided by the federal government for ACOs, hospitals, health systems, patient-centered medical homes and other health IT organizations. John Kotter's work and his publications has led to his famous eight-step process for leading change. During this particular course, we'll go over each of the steps. You'll become familiar with step one, create a sense of urgency; two, build a guiding coalition; three, form a strategic vision; four, enlist a volunteer army; five, enable action by removing barriers; six, generate short-term wins; seven, sustain acceleration; eight, institute change. Kotter's eight-step model for change is something that's known around the country and around the world and we'll provide examples of each step and why they can be essential and effectively leading you to tackle the big opportunity within your organization. During this particular course, we'll be talking about the distinction between clinical governance and corporate governance. You'll be provided with examples about the role of governance in clinical decision support systems. We'll also be talking about effective multi-disciplinary teams and even the role of virtual teams that you'll inevitably be a part of. In addition to the first module focused on leadership and effective teams, we'll then go into a module on the basics of project management as it relates to the careers of health informaticists. Our third module will be on strategic planning. Then we'll talk about workflow re-engineering and change management. You'll get a sense of why it's so essential for individuals to take into account the existing clinical workflow and even the existing daily workflow and patterns of the consumers who might be using many of these health IT interventions that you're about to deploy. I'm so excited to be serving as one of your instructors for the strategies for success in leading change in health informatics. We have a lot to cover, and over the course of these few modules, we think you'll get a very good sense for what it takes to be an effective leader in the field. Dr. Peter Greene and I teach students at Johns Hopkins annually about these topics, medical students, graduate students with a wide range of backgrounds. Some are analysts, some have a background in engineering. We teach dentists, we teach physicians who've been in practice for several decades. We have pharmacists, nurses, social workers, case managers in our degree programs and what I can say is for all of them looking to succeed and have a career as health informaticists, these topics and these skills are one that they carry with them for years to come. As a matter of fact, if you go on to any job search engine, as you look for your next potential role, if you search for terms like digital health informaticist, you'll find that at any given health system, some of the required or preferred job criteria, the criteria for the role, will mention things like wanting someone who's familiar with ambulatory or inpatient workflow processes and redesign. Perhaps you want to be the VP of population health informatics at a large health plan. If you look up that particular phrase in any search engine, it wouldn't be surprising to see that one of the skills they want you to have is the ability to take place in strategic planning including vendor selection. If you look for other roles, you'll find terms that will be populated throughout this particular course in each of our modules. So again, welcome to this particular course. My name is Ashwini Davison and I look forward to working with you, teaching you and encouraging you to learn from each other. Welcome to The Strategies for Successfully Leading Change in Health Informatics.
