Healthcare is a unique industry, and Deborah Heart and Lung Center in Philadelphia occupies a unique corner of it. When new IT staff members arrive there, they’re usually seasoned technology professionals. But it would be a big stretch to expect them to fully understand the intertwining of tech and complex work processes that take place at a healthcare provider.

A lot more customer contact

“We also are a small department, and our team members often wind up having a lot more customer contact than they might in other places,” said Richard Temple, vice president and CIO at Deborah Heart and Lung Center.

“Knowing the players, understanding in detail the role each department plays, and knowing how different systems interact are all major barometers of success in our world” is critical, he said.

Because of all these things, and the IT team’s commitment to effectively develop its members, allowing the new team member to shadow other, more established members of the team gives them a first-person view into the dynamics at Deborah, Temple explained.

It also provides a forum for allowing them to ask directly relevant questions to people who can provide answers and allow them to gain a detailed context around what they are learning, he said.

“Our information systems department comprises many people who have been with Deborah for decades – Deborah is a very appealing place to work – mixed with newer team members who have joined us as our role in facilitating business strategies continues to expand,” said Temple. “Our IS department takes great pride in the depth of knowledge we have not only as it relates to technology, systems and infrastructure, but about Deborah as an entity.”

As new people are onboarded, veterans want to share their knowledge with them, so they can contribute to the strong value proposition the IS department offers to the organization, he added.

How does the program work?

Deborah has a formal orientation program that starts out with an all-day, hospital-wide orientation session – it’s not IT-specific – that introduces the new employee to Deborah, shares background on the organization’s history, and lays foundations about the culture and things like security and privacy.

“After that first day, the employee is introduced into the department and welcomed by the members of the department,” Temple explained. “Our assistant director of IS takes the lead in facilitating this and has a formal checklist from human resources as to what needs to be addressed during the new team member’s initial 90 days.”

"The new team member will be at the elbow of the preceptor as that individual navigates through his or her day."

Richard Temple, Deborah Heart and Lung Center

The new employee is assigned to a peer who has done similar work at Deborah throughout the years and that peer explains how they do their job and the rules of the road for the IT department. Things can be somewhat unstructured there (for example, no formal checklist beyond the HR checklist), but it is very rigorous in terms of ensuring that the new team member is getting the full range of experiences and that honest feedback is provided to the new team member regularly, Temple said.

“A typical day is hard to nail down because we work in such a fast-paced environment that we all sometimes have to roll with things and improvise as new situations present themselves,” he said. “That said, though, the new team member will be at the elbow of the preceptor as that individual navigates through his or her day.”

The preceptor will provide technical training, explain context for meetings, conference calls, etc., as these take place, and give the new team member some small assignments to allow them to get their feet wet and test their learning retention and skill set.

With experience comes more responsibility

Increasingly, as the new team member has more days under their belt, they will be asked more and more for input on various situations and their formal assignments will take up an increasingly large percentage of their time.

“All new team members go through the shadowing process,” Temple explained. “We have seasoned people on our team with an incredible depth of experience and technical acumen and, because of many of these people’s longevity, have gone through this process repeatedly and know what it entails and know how to disseminate knowledge and quickly pick up cues regarding the new team member.”

The tightest part of the shadowing program can last at least a couple of months; sometimes longer if circumstances warrant.

“However, it is in no one’s interest to cut the new team member loose, so to speak, after that, as our general sense is that it takes many months – up to a year in some cases – to get a new team member fully up to speed so they can operate more or less autonomously,” Temple said.

“After a couple of months, we start easing up a bit on the full shadowing and pivot to more standalone assignments, with the preceptor still playing a significant role in overseeing the quality of how those assignments are carried out,” he explained.

Human resources checks in

Deborah’s initial evaluation period is 90 days, and HR will generally check in at around 75 days to see how things are progressing and see if there are other interventions that may need to be taken. Also, the aforementioned HR checklist has to be completed within this timeframe. If the new team member is cleared to continue after 90 days, that is a significant milestone in their development.

“Over the course of their time getting ramped up, new recruits will be exposed to the technical aspects of their role and will be able to be gauged on how good they are with those,” Temple stated. “They also will have been exposed to a multitude of different scenarios and will be expected to have been able to apply lessons learned in one scenario to others that will inevitably come their way.”

Gary LaFetra, network systems engineer at Deborah Heart and Lung Center, remembers his time shadowing expert staff upon his arrival as a new recruit at the provider organization.

“It has been eye-opening to see how much different aspects of the hospital tie in together,” he said of how health IT in particular works. “In previous jobs, we would look at different platforms/solutions and they would be compartmentalized from each other. We would bring up a system to perform a specific function and it would do that one thing.”

Healthcare requires integrated information

Since he has been at Deborah, LaFetra has been shown that there is a need to have information move from one platform to another – patient data, lab work, reporting, billing, statistics, etc. So when IT looks to bring in new systems, there is a need to be able to have that information shared with existing systems in order to operate more efficiently, he said.

“With all of the different systems we have in place, there is great need to maintain secure access to ensure that only the right people have access to those systems as well as the transmission of data to and from those systems, especially with regard to HIPAA,” LaFetra said of his shadowing education. “There is a certain way to set things up and communicate with the vendor supplying the system.”

He was working on one system and before he granted access to the vendor, he was shown how to grant access to that specific system only. Also, when transmitting the information on how to connect to that system, IT has to encrypt it so that the information is not sent via plain text, he added.

“In other jobs we could transmit data simply via email for the most part,” he explained. “With healthcare, great care needs to be taken to stay within HIPAA guidelines. When this system was online, I was shown that when sending any data out of that platform we must be careful to remove any patient health information that may be contained before transmission.”

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com