Wednesday, March 28, 2007

Disconnecting Input and Output

Before the Electronic Health Record, doctors scribbled incomprehensible code onto pieces of paper that wound up in a large manila folder on a shelf. These were called clinical notes. The doctors refer to these clinical notes to treat patients.

With the advent of the Electronic Health Record, doctors now enter their clinical notes in one of 3 ways:

- The stubborn ones continue to scribble incomprehensible code on pieces of paper - which are then scanned into the Electronic Health Record.

- More sophisticated users type their notes directly into the Electronic Health record. The ones who hate to type dictate their notes using a dictation service or voice recognition software. The transcriptions are then imported into the appropriate patient record.

- The most sophisticated users enter information into the Electronic Health record and have this information Auto-Cite into their notes. This reduces the amount of typing required and, if a doctor is really savvy, allows the doctor to request reports on their patient pool.

The problem with all of these inputs and the current generation of Electronic Medical Records is that there is a 1 to 1 relationship between input and output. You have to input separate clinic notes, patient letters, and provider letters. Oftentimes, the production of patient letters and provider letters is left to the administrative staff. For those working with docs of the stubborn variety - this means having to interpret the code....with occasionally interesting results.

The new version of the Electronic Medical Record I am working with has disconnected the input from the output. 1 to many.

What this means: I can enter the information on the clinic visit once (history, problems, medications, orders, assessment, plan, etc) and produce multiple outputs at the same time (a chart note, a letter to the referring provider, a letter to the patient, etc). These outputs can include or remove anything to suit the audience. The information is still available in the patient's record.

The level of complexity when setting this up is much higher. The amount of time it takes - much longer. The paybacks, though, will be worth it. Especially for the patients. Better tracking. More accurate information. Less guesswork.

So the next trick, after getting the docs through the pain of the upgrade, is getting them to work with us to build these notes.

To make matters even more interesting, the organization is going to force the docs to use this system to enter notes. I'm already seeing peer pressure between docs to stop the handwriting. There is also pressure from the administration to stop dictating.

Because these notes take so long to build - we are currently planning to stop developing custom notes for every doctor. Instead, they will have to work together to make a decision about their specialty's notes as a group. Doctors are independent beasts by nature. I have a feeling that politics will make our job much harder. This will be an interesting process.

Tuesday, March 27, 2007

Beyond Fear

Kathy Sierra has received attacks beyond anything I was afraid of when I started blogging.

What is happening to her makes me ill. Really ill.

The message those threats sends - Don't aim too high. Don't speak your mind. Don't do anything extraordinary.

Yes - I'm a Z-list blogger. I'm thankful that people read me. I'm thankful I reside in a friendly and supportive corner of the bloggosphere.

And I'm not going to stop speaking just because a collection of people(known and unknown) choose to spend their time attacking others in progressively uglier ways. For no real purpose.

Hope they catch 'em Kathy.....

Saturday, March 24, 2007

Still Another Update

Brent told me how to add people without spamming them (thanks).

Best to let this experiment evolve. There's gotta be something about the buzz....

Update on the Twitter Experiment

Thursday night, I had a productive Skype chat with Brent Schlenker and Paul Fender. We talked about our respective projects, blogging, educational theory and the like....

Inevitably, Twitter came up.

I'm writing this from my sketchy memory. I am certain that the order of the conversation is completely wrong. And I hope I'm properly attributing who said what.

Brent, Paul - I trust you to correct me. It was a blast talking to both of you.

---------------------------------------------------------

Paul: I know you 2 have been experimenting with Twitter - I don't see it.

Wendy: There's a couple of things I want to investigate. Right now, I tend to agree with you. The only interesting thing worth reading I've posted so far is a play by play of my friends playing Tiger Woods 2006

Paul: That sounds kinda cool

Brent: You know - after playing with it, I'm not quite seeing it either. I can see maybe a close group of 10 - 20 people as a private circle contacting each other when they're out. Or a small group trying to get together at a conference or something. I'm hearing stories of people having huge text message bills because they are getting mobile feeds for lots of people.

Wendy: I've read that some groups are using Twitter as a project management tool. Sort of a semi-asynchronous IM.

Brent: Or an always open chat room.

(Grunts of agreement from Paul and Wendy)

Brent: I think of MicroBlogging when I see this.

Wendy: I'll admit - I much prefer long-form blogging. I can't imagine having anything interesting to say in this medium. Watching TV. Petting the cat. That sort of thing.

Paul: I doubt that I will find much use for Twitter


Brent: Yeah, I wonder if it's just a fad or if this is really gonna stick. There's so much technology change occurring, it's really hard to predict or seriously keep up.

(Paul and Brent had a lengthy interchange about technology adoption on an individual and social level. What they actually said was infinitely more intelligent than any paraphrase I could come up with 2 days after the fact.)

Wendy: You know - whether we find the technology individually useful or not, it helps to be somewhat aware of what that thing does. Because you KNOW that, with all of the press Twitter is getting right now, someone is going to come up to you and say "Hey, we should use that Twitter thing in our organization." It helps to know what they are talking about and tell them why it would or wouldn't work for whatever issue they have.
-------------------------------------------------------

At this point - the conversation turned to encouraging people to play with new social technologies - blogging, Twitter, Skype and all that. That was a whole 'nother productive line of thinking that I would have even less success recreating than I did the above.

Brent has managed to get more out of Twitter than I have so far. Which probably isn't saying much.

I'm still trying to figure out how to follow people without spamming my friends. I need to dig through the help pages more carefully. Maybe I'm dense, but unless I'm sending e-mail invites - adding other Twitter users is not intuitive.

I did attempt to put a hyperlink into Twitter - thinking it would be cool to be able to point to a shared Google doc or cool links. I don't think it's designed to do that. If someone knows how to put a hyperlink into a Twitter post - please comment.

The biggest issue I am having with Twitter as a personal tool is that it does not solve a problem I have. Or didn't know I had.

The other issue I am having with Twitter is that it is one more thing for me to keep up with. I don't have individual interesting thoughts that often. Or none that I particularly want to share in public. And I have enough other stuff on my plate that keeping up with a microblog is a low priority. I am having a hard enough time keeping up with my regular blog!

I'm going to experiment with this a bit longer - just to make sure I'm truly not missing something.

I have a feeling I will be putting this toy down.

Thursday, March 22, 2007

More Thoughts on Supporting Managers

Alarm bells go off when I hear someone say "Our company has this management training program..." Usually this means that the company is either checking a box and/or is planning to shove another pet theory down throats - which then become ill-advised "teamwork" sessions when the manager gets back to the office.

"Oh no - the boss has been to another management training session. I wonder if I have enough vacation days...."

And I'll admit to having that reaction when I first read the question....hence my initial tactic.....

Storytelling

In my response to the Big Question, I told a story about my favorite manager. I was secretly hoping that someone would "get it", connect some of the dots, and outright suggest what I was hinting at. Thanks Dave!

I sense that facilitating this type of storytelling among your new managers, their employees, and the managers managers will be a cheap way to mentor and support ANY manager. Not just the new ones....

You get case studies of what good (and bad) management looks like.

By asking the employees, the new managers get a feel for how each employee would prefer to be managed. What is important to them. What will make them run screaming out of the company (because one's experience in a company is directly related to their relationship with the person directly above them).

If you ask an employee "So....how do you like to be managed?"- you probably won't get a straight answer.

The other benefit I see is that you start developing a culture of communication and, dare I say it, trust.

The folks at Anecdote have a number of white papers on facilitating this type of interaction.

Resource Hunting

Management has multiple facets. People, time, resources, etc.

Have the manager identify where he or she feels the weakest - then have them go hunting for cool stuff to help them feel stronger. Maybe 3-5 items. Blogs, sites, books, videos. Anything the manager found really helpful.

Have the manager comment/blog about the item they found. What type of information they found useful. How they applied the resulting knowledge to their work. That kind of thing.

Share all that on a resource wiki or site.

Stealth

Ultimately, whether any of this works is dependent upon the culture you are working in. If the original classroom training was developed so that the corporation could brag that they provided "management training" - you probably don't have a training issue. You have a culture issue.

Training can help change a culture - but the senior management has to be serious about supporting the plan and its outcomes. They have to be serious about supporting their employees - at all levels - in the first place.

If you have a culture issue, you can always use stealth.

"Hey, I'm trying to put together a management training and support system and am putting together some case studies. Who was your favorite manager in your career and why?"

Ask anyone you can get time with - top to bottom.

Who knows - maybe you'll trigger some learning......

Monday, March 19, 2007

A Chaotic Theory of Learning Design

I read Tom Haskins' post on Blogs Defy Categorization. As usual, he got me thinking:

What if blog postings are emergent outcomes? What if we don't make blogs happen, they simply happen to us and through us? What if our blogs are really out of our control? What if blogs are co-created with every other blogger interdependently? What if the boundaries between blogs are illusions? What if blog postings come about synergistically: by the countless interaction effects between all the blogs we subscribe to and read (and blogs that link to those). What if blogs are fallout (side effects, unintended consequences) from intentional processes of thinking and writing?
My first thought: "I wonder if chaos is where the formal theories of instructional design are headed?"

I always viewed instructional design and the development of the supporting products (eLearning tutorials, documentation, exercises, etc) as creative acts. Blogging is also a creative act.

Creativity is a messy process. Despite our attempts to organize, codify, and systematize things.

So I'm going to take Tom's idea in a different direction:

- What if instructional design is something that happens to and through us? What if the results are truly out of our control? I think we're seeing some of that with the anguished discussion of "informal learning".

- What if instructional design is truly created synergistically - the result of the influences of blogs, books, media, conversations and experiences. More access to information and people = more influences.

- What if instructional design is a truly living beast - never static, always evolving. The result of consequences - both intended and unintended. The good instructional designers I know seem to constantly evaluate their work. Good trainers reorganize and repurpose the products of instructional design during delivery to meet the needs of their class. There seems to be a constant feedback loop in play. Michael Lorenzen's article on Chaos in Education puts it nicely:

Education and teaching are forced to deal with chaos. The initial, and all subsequent conditions, are not know to an infinite degree of accuracy with any given student or class. Hence, chaos must ensue. This chaos can be seen in two ways. First, every class session is uncertain until it occurs. Despite the best developed lesson plans and class management techniques, the class will be subject to an infinite number of possible occurrences. Second, it is difficult to see the connection between teaching and learning. How can a teacher know what is taught is best for the student's learning in the short and long terms. Sometimes, good assumptions can be made by studying students. However, all students are subject to a variety of chaos in their lives at school and in the world. Which effect beyond teaching could have effected the result? Educators will always deal with uncertainty in both how and what they should teach.
I think some of us may be looking for a level of stasis that just doesn't exist....and never has....in our quest to find theories we can hang our instructional design onto.

Saturday, March 17, 2007

Changing Blogger Templates

With the move to New Blogger, I finally decided to change the appearance of my blogger site. For folks who read this in a reader - you won't see much difference. For folks reading directly from the site, please let me know what you think.

How I did it:

1) I copied my old template into an MS Word document (you could use wordpad too) - in case I couldn't get the new template to cooperate.

2) Within the document - I marked all of the customized code so that I could quickly find it and add it to the new template.

3) I chose the new template. (I'm using Rounders 4)

4) I copied my customizations from the old template document into the new template. Pay real close attention to the location of the code in the old template. Make sure you don't copy your markers into the template.

5) Save your changes after each customization. Click Preview to see if everything is in the right place. Check any new links or buttons to for functionality.

6) when finished, view your blog and marvel at your genius.....

Douglas Bowman beautifully organized and documented the code in this template. As a result, it was easier to put customizations in the right place.

I also like the Links section in this template. On my new blogger site - I've added some helpful resource links and my current del.i.cious links. Google News is standard with the template.

If anyone has further recommendations for resources to add to my site - let me know.

Results of the Staff Training Pilots

We have finished another round of training pilots. This time, we've focused on the week 1 trainings for 3 general staff categories:

- Clinical Staff (Nurses, Medical Assistants, Technicians)

- Front Desk staff (the people you meet when you check in for your appointment)

- Administrative Staff (Medical Secretaries, Managers, other administrators)

Our findings:

- With our emphasis on basic navigation, similarities with the old version, and general workflows - we easily cover the material in less than 80 minutes for the clinical staff and administrators, less than 50 minutes for the Front Desk. This included technical problems and user questions. It's nice to hit your benchmarks.

- By the end of the class, all 3 groups felt comfortable with the program - especially since we told them that there was a 2nd opportunity to get the material the next week and that there was going to be significant online support during go-live. Telling them they had a safety net seemed to open all 3 groups to learning and made them feel better about the program and the process. We found it best to tell them first thing in the training rather than waiting until later, or when we were asked. Receptiveness was higher the earlier we told them what their safety net was.

- The groups also liked that we seemed to understand that the "real learning" would occur in the clinic during those go-live weeks - rather than expect them to know everything when they walked out the door. We designed the upgrade training to essentially get them started. NOT tell them everything.

- We found a couple of minor educational gaps, that we will add to the final training. Fortunately, these additions will not impact the time significantly.

- The client (us) trainers will have to lead the morning classes the Monday of training week. The questions the vendor trainers will receive during their practice trainings to our Super Users will not reflect the types of questions they will get during the training week. This will give the vendor trainers an opportunity to observe before we throw them to the wolves. We are also realizing that there is no way we can give them the amount of corporate context they will need in the time we have to develop the train-the-trainer sessions.

Overall - we were THRILLED that these pilots went so well. All of us have been worried that our staff end-users would have difficulty with this upgrade and that there was no way we could train them in the limited time available.

Our next plan ... let things sit for a week. Late next week, we will invite the users from these pilot classes back to a "2nd training". The 2nd training will consist of assessing how much they retained.

We're treating this as a way for us to see how effective our plan is. Not as a penal thing for them - since many of our end-users suffer from serious classroom anxiety. We plan to make this plan very very clear to the users. Besides, our pilot students now have extra exposure to the product. If the project keeps getting pushed back - we will repeat this process in 3 week cycles with a new batch of people. That way, when we get to the real training, more people will have touched the product.

Friday, March 16, 2007

If we ever need to explain ourselves....

Patrick Dunn has created a neat flash piece that summarizes exactly what is happening in the e-learning space.

It's a promo for his consulting service - but I think it makes the point beautifully.

Thursday, March 15, 2007

Cool Firefox tricks....

Beau and Christy both noted that you can customize Firefox with extensions.

It never dawned on me that you could actually CUSTOMIZE a BROWSER!!!!!

I never realized how much I had been sucked into the Microsoft machine....

Beau was kind enough to give me his list of extensions. He also has a really interesting Podcast list and some World of Warcraft info in this link.

The link to the Firefox extensions themselves is https://addons.mozilla.org/firefox/recommended/

I just added the WebDeveloper extension. Rapid install, includes a cookie administrator, and all of the pieces seem to work.

This is SOOOOO COOOOL!!!!!!!

BTW: apparently, Paul Fender agrees....

Being a Degenerate Blogger

Until I read Tom Haskins' post, A degenerate form of blogging, it never occurred to me that I could be degenerate and blog at the same time.

A challenge too good to pass up.

So I signed up for a Twitter account. Because, dangit, if I'm gonna throw stones - I want to know what I'm throwing at.

My gut inclination is to agree with the Twitter critics. Why in the world do we feel a need to tell the world about what we are doing every 5 minutes or less? This can't be remotely interesting or useful.

But Bren over at Slacker Manager got me thinking - even if this is not the type of media I prefer to work in, lots of people do. There's gotta be a way to USE this thing for my own purposes.

Bren came up with a series of tips to help noobs (like myself) get over the learning curve and avoid a Twitter account that looks like this:



Bren's first recommendation: Make the right friends.

So - this is an open invite....

Please let me know if you have a Twitter account, or if you are willing to perform this little experiment with me.

Let's see how this bad boy works......

Wednesday, March 14, 2007

Playing with Firefox

Last night, I installed Firefox on my laptop.

I've heard good things about Firefox. More secure. Less buggy. Better navigation.

I've procrastinated for a couple of years because:

1) I was afraid it would be hard to install and bungee up my computer

2) The application I use for work only supports IE

3) I had no pressing reason to do so.

4) Change requires work and, given a choice, I am fundamentally lazy

Installation only took 4 minutes. And it worked perfectly right out of the box.

I don't remember the last time I've installed a program that worked perfectly the first time out.

Even more exciting - page loads are much faster. Damn near instantaneous and fewer of those pesky pop-ups.

And my favorite feature - if the system freezes, it can go back to whatever I had open at the time. This includes all tabs and browser windows.

And it's FREE!!!!! Thank you Open Source Developers!!!!!!!

Why didn't I do this sooner!!!!!!

The reason why I finally bit the bullet and did this - I want to try out Freebase - the application that is supposed to be the first major Web 3.0 app. Freebase only supports IE7 (that I can't upgrade because the application I use works only in IE 6) and Firefox.

I want to figure out what the buzz is about. The librarian in me is very curious about the potential for newer, smarter searching.

And, if I'm gonna throw stones, I might as well know what I am throwing at....

Meanwhile, the nice people at Freebase told me to wait until Beta before I can play in their sandbox. Ah, the joys of being a Z list blogger....

At least I have my new browser to play with....

Supporting New Managers - 4 Questions

My response to March's Big Question:

When I think about managers (new to managing or new to managing me), I think about the characteristics of one of my favorite bosses.

Rick Yeatman was the Technical Director for the Singletary Center for the Arts at the University of Kentucky. I worked for him as one of the stagehands while I was in graduate school.

Inspired by my experience with him, this is the list of questions I ask myself whenever I find myself managing people.

1) Would I do what I am asking my employees to do? Rick would NEVER ask us to do something he wouldn't do himself. If we ran into problems during setup - he was right there - handing us equipment, sheperding people (usually out of the way), running cable, cleaning bathrooms, anything that needed to be done at the time. He also knew when to stay out of the way....

2) Am I in a position to teach? Rick had a lot of experience as a stagehand and a roadie. He knew all of the shortcuts (and when not to take them). He treated his managerial position as a teaching opportunity and was tremendously patient when we decided not to listen to him. Of course, he was always right.

As an employee, I have to work for a manager who has experience in the field where they are managing. I tend not to stay long with managers who got there through politics. If this is your situation - this would be a good opportunity to start learning from your underlings ... and listening to them.

3) What battles should I fight? Rick had only 2 things that would set him off.

Safety. The only time I ever heard him raise his voice was when I was about to do something incredibly stupid. Accidents, he tolerated (such as accidentally dropping a leko off the ladder). Stupidity, he didn't (if the leko fell because you didn't put the safety cable around the pole - god help you when you came off the ladder).

Abusing his employees. Rick was a large man. Watching him go toe to toe with the management of some large touring companies when they mistreated his employees was a wonder to behold. He was calm - but intimidating. If one of his employees was in the wrong, he would talk to them first to get all sides of the story, come up with a solution with the employee, then bring the employee with him to discuss the issue.

As long as we completed show prep on time - nothing else mattered.

4) Is there something my employees need to know? We never had to guess what other variables might affect how we worked. When Rick had news, he shared. Especially if it impacted our decision-making that day. If the President of the University was going to be in the house - he told us. If we had a short in a circuit - he told us. If our turnaround between events was shortened by 3 hours - he told us. There was absolutely no guessing with him.

Communication is CRITICAL. Communication takes effort. It is way too easy to assume that we know everything we need to know to make decisions. Of all of the managers I've had, Rick was the best at this form of communication.

Keep asking yourself these 4 questions on a regular basis and you might turn into someone I would be willing to work for.

Last I heard - Rick was teaching at the University of Texas, El Paso. It's been 10 years since I've talked to him. I don't think he works there anymore

Rick - if you find this post - thanks for everything.....

Monday, March 12, 2007

Playing Games: Big Mutha Trucker

My friends have decided it is time to educate me on the finer points of Xbox.

As a result, I spent another fine Saturday evening, controller in hand, playing Big Mutha Truckers.

I question their taste in games....

The premise: Ma owns a trucking company in Hick County. She wants to retire. She has 4 kids and can't decide who should get the company. To prove that you are worthy, you need to make as much money as possible in 60 days hauling stuff around the county.

As you may have guessed, all characters are American redneck stereotypes. For those of us who have spent quality time in the Deep South, the sidebars and soundtrack are kinda funny. A couple of Budweisers consumed while playing helped set the mood.

Mary Jane Irwin, at IGN.com accurately described the game as "2/3 arcade trucking and 1/3 economic simulation."

It's a simple buy low / sell high model with some extra opportunities on the side. Beating rival truckers to the next city. Performing "special projects" - such as mowing down all of the newspaper stands on the route. That sort of thing.

Of course, you make the most money by causing vehicular mayhem. Hit 1 car, $1000. Multiple cars, more money. If you manage to plow through everything on the highway in an impressive manner - $100,000. Decimating your fellow commuters is more profitable than hauling stuff. Not quite the lesson you want to teach kids close to driving age.

Come to think of it....I have a feeling many DC commuters learned to drive playing Big Mutha Truckers....

This game is an interesting introduction to small business economics. You have to pay for supplies - gas, repairs, beer. You also deal with the unpredicability of the market.

While playing, certain decisions have to be made:

If I mow down these 3 trucks and the bus - will the resulting money cover the cost of repairs?

What should I haul to get the most profit? Hint: Beer is profitable. Canned peaches are not.

Is this really a good price for my load? Should I try to sell in another city?

You get some hints within the game - but I didn't play long enough to find out the answers. It got dull after 20 minutes.

For an economic "simulator," I'd probably choose a game like eBay....

Working Past Overwhelm

I spent a large part of last week paralyzed. Hours spent starting at my monitor, looking at my "to do" list and thinking:

Ya know - I don't want to do any of this.

So I tried to focus on something mindless that needed to get done. Like adding training patients and schedules to our electronic medical record. It needs to be done. It was mindless. But I felt I should have been doing something else. Like testing. Nevermind that the rest of the team is testing and no one else is building the training environment or exercises.....

So I looked at my to do list again.

Ya know - I don't want to do any of this.

Maybe if I wrote something for my blog. That should get me out of my slump. Nothing doing. Instead of staring at the electronic medical record I've been working in, I'm now staring at Google Docs & Spreadsheets. I hear crickets.....

Ya know - I don't want to do any of this.

I attended the obligatory meetings and performed the obligatory trainings. I would go back and sit at my desk staring at the "to do" list, then my monitor. Grab some tea. Stare somemore. Attend a meeting. Stare somemore.

I grabbed a pen and paper thinking the change in media would help kickstart my motivation. So now I am staring at a blank sheet of paper.

OK. Maybe if I read some of the new documentation I received. Same ol'same ol'. Not inspired. If anything, even more confused.

So what finally got me out of this rut? Getting away from the office.

Saturday: I spent a quick hour testing yet another new build, then spent quality time with friends.

Sunday: I tried to get into the system to continue testing and found that the system had crashed with yet ANOTHER new build. FREEDOM! Suddenly - freed from the confines of the computer, I was able to prioritize what needed to happen - then walk away to do more important things - like reacquaint myself with my friends and family.

I've been more productive this morning than I've been in 2 weeks.

Stress shuts down decision-making. Looking at the amount of things I have to get done and the lack of time to do it in made me hit the paralyzation tipping point. When I finally relaxed, I was able to prioritize what needed to happen and when. Also to decide what could drop if it needed to.

The creative process requires some downtime. Things happen when they are darned good and ready. No amount of forcing the issue will change that.

______________________________________________________

BTW: A fantastic interview over at Life Coaches Blog with Matt Cornell, a productivity expert:

I think of (productivity) as nested circles: On the outside are all the people who are overwhelmed in work and life (a lot). Inside that are the people who know it. Going deeper are those who are willing to change themselves to get relief.

Sunday, March 11, 2007

What I do for a living

This video is the most apt description of how I spend a large chunk of my workday.

Warning: The video is in Scandinavian with English subtitles. The experience, however, crosses time and culture.....

Saturday, March 10, 2007

Searching for Something....

There is something about the "Web 3.0" hype that is fundamentally bothering me.

I can't quite put my finger on it.

Nicholas Carr has found what he considers the "first major Web 3.0 application" in Freebase.

If Web 2.0 was about social connection. Web 3.0 seems to be about "mining meaning". Oh, and maybe having your software help you find that meaning for you.

Hmmm.......

Each time I read information on Web 3.0 apps - I keep thinking of librarians.

Many librarians I know help teach you how to analyse information. Who is presenting the information? What's the bias? Can you put the pieces together into something that makes sense? Have you looked at the question from all angles? Given the information, what is your conclusion and does your evidence support it?

Simple human analysis.

With the wealth of information available at our fingertips - the ability to assess and organize information is more important than ever.

I doubt that "Web 3.0" applications will change that.

More Training Pilots

I received a lot of spam with links to information for airline pilots with my Training Pilots post, so I'll be curious to see what I get this time....

I know I have been quiet about the project recently. I am trying not to think about it during my few off hours.

To get you up to date....

Our go-live date has been pushed back to TBD. The vendor is going to try and give us a working build to go live with on March 18. Another decision will be made March 19. I know the vendor is pushing to have us go live by the end of first quarter (April 15). Our upper management has finally realized that WE are the customer. The only thing we have agreed to is a go-live date 21 days after a reasonably bug-free build. We expect them to miss the March 19th date too.

The longer the vendor takes to get us a solid product - the better off we are. Between our 40 person SuperUser group (made up of staff across the specialties), our 12 person Physician Advisory Group (also multi-specialty) and our 15 -20 person Internal Medicine Pilot group (our most sophisticated users) – we have almost 70 people getting repeated exposure to the product. We finally released user IDs and passwords for our upgrade system to these groups this week. I’m amazed at how antsy these groups have been to get into the system.


With each passing week – we’re getting a more concrete feel for how we are going to train our end-users. Our current working plan:

Week 1 – Basics, split up by job description.

Room 1 – MDs. There is still a possibility that we will have some of the attending physicians from the Internal Medicine pilot group serving as the MFA representative in this room. (90 minutes)

Room 2 – Clinical Staff (Nurses, Medical Assistants, Technicians). Their training will be similar to the MD training – without some of the approval tasks that doctors have to perform. (90 minutes)

Room 3 – Administrative Staff. Their training will focus on simple data entry and administrative processes. (90 minutes)

Room 4 – Front Desk / View Only. Their training will be the shortest. Most of the time will be spent on how to find information and print items. (60 minutes)


Week 2 – Review and Workflow-specific issues

Room 1 – Basics – Clinical. This will be the same training as the MD training from last week

Room 2 – Basics – Administrative. This will be the same training as the administrative staff training from last week.

Rooms 1 and 2 are meant to catch stragglers and anyone who was not comfortable after the training from last week and who do not need to attend the trainings in rooms 3 and 4.

Rooms 3 and 4 – Advanced workflow training. About ½ of our organization will need to go through this training since they use more of the system. At least ½ of the material in this training will be review from the previous week.

We are going to be piloting the Clinical Staff, Administrative Staff, and Front Desk trainings next week with a fresh group of people who have had limited exposure to the product. With fresh eyes, we should get more accurate feedback on how the training works for them. This will also allow us to expose more people in the organization to the new upgrade.

The more the merrier.

And what about the residents? We have blocked all 4 classrooms from 1-2:30pm both weeks just for residents. They will also all go through the advanced workflow training since many of them will rotate into departments that use the advanced features.

After crunching the numbers – it appears we will have a fighting chance of touching everyone in the organization.

The training team is still hashing out the details and putting together training guides. If it was just the in-house trainers, we wouldn’t bother with the training guides. Since we have outside trainers coming in (and only 1 of them even remotely familiar with this software) – we are going to be spending the 2 business days before the training week doing “train the trainer” classes. It’s somewhat sad that the customer has to lead these classes rather than the vendor – but such is the nature of this project.

If the go live date gets pushed back far enough – I may be able to reincorporate online materials. This would be a good thing since, as of right now, we are looking at yanking access from all of the medical students for the duration of the implementation. We don't have the classroom space or time to train them during the 2 training weeks or address their needs during the support weeks. This decision makes a number of our docs unhappy – but since many of the med students are being “misused” (i.e. being given more responsibility than they legally should have) by some of the preceptors – the upper management and medical school is using this implementation as an opportunity to re-think their policies on medical students and electronic medical record access.

Tuesday, March 06, 2007

Working in Circles

I've been pretty quiet recently - primarily because my life has become an endless round of software testing for the vendor.

- Get a new build
- Test the things that are supposed to be fixed
- Find the things that are REALLY fixed
- Find another bug for each item fixed
- Get a new build........

My weekends for the past 1.5 months have been eaten up with testing the software. It will continue to be this way for the forseeable future.

Yesterday, the vendor came up with the idea that we now need to get builds every 2 days. The problem with this theory - the client team now has no time to do anything else required for this project. We have become the QA department for the vendor.

I haven't touched anything smacking of education - besides the stuff we've already committed to. No documentation, no planning, no lesson prep.....

The team members who are supposed to be doing system configuration (especially after we lost everything during one build upgrade) are spending all of their time testing the builds.

Support for our current system has dropped to near zero - which is starting to frustrate our users....

The only good news ... we are not going live until we deem we have a clean build.

Of course, at the rate we are going - this may be 2009.

So, if I somehow find time to continue my instructional development efforts, I may have a fighting chance of having everything together for this massive training we have to do.

This assumes there are 48 hours in a day and endless reserves of energy.

In the meantime our team is going to....

- Get a new build
- Test the things that are supposed to be fixed
- Find the things that are REALLY fixed
- Find another bug for each item fixed
- Get a new build........

Thursday, March 01, 2007

More Everything and Nothing

Another theme floating around the bloggosphere is the question “how do you use media?” A nice thing about the way bloggers share is that we help each other find cool stuff. I suspect that whole "media meme" is just a "brainy" way to ask - "So what cool stuff have you found recently?"

Tony Karrer attempts to flip that into a more educational question – how do you use media these days to support your learning?

My reaction…do we always have to be “learning” something? Geez…that doesn’t sound like much fun. Besides, it’s nice to sit in front of the TV set letting your brain slowly dissolve into a pile of goo as you catch an update of Britney Spears’ latest escapade from her public psychological meltdown.

Admit it – you like mind candy too….

So I’m gonna take a cue from my friend Beau…. He was right when he said that the web (and, really, all forms of information) is full of everything (the important stuff) and nothing (mental junk food).

Everything: Chances are, I read the same blogs you do. All of the stuff on my Google Reader focuses on education, technology, business, and psychology. Eventually, I’ll put a blogroll on my blog. Maybe this spring……

Nothing: After writing the above section, I realized I don’t have any blogs I read solely for “entertainment.” The closest is Scott Adams’ Dilbert Blog. This seems to be where he is expending most of his creative energy these days. You may or may not agree with him, but he sure makes entertaining reading…. I think I need to go look for more “fun” blogs…..

Everything: Netflix is the greatest thing since sliced bread! I’m not a huge movie watcher, nor am I a big fan of series television. As a result, I usually walk away from video rental joints empty-handed. The great thing about Netflix – they have a bunch of stuff I want to watch. Right now: I have a whole bunch of James Burke videos, Joseph Campbell’s interview with Bill Moyers, and a wide collection of PBS documentaries on my Netflix queue.

Nothing: Netflix also has some great documentaries on bands I grew up with – Fugazi, the Pixies, King Crimson, Primus. And they have the Muppet Show! If you have not watched the Muppet Show since you were a kid – you are soooo missing out.

Everything: I’m a huge fan of public libraries….though I’ll be the first to admit that my book consumption has dropped dramatically since my discovery of blogs. I’m a non-fiction freak. I’ll read about almost any subject. One caveat – no more jargony academic tomes. After 4 years of graduate history education, 2 years working on a 2nd masters, and a 75 book a year average (up until this year), I think I’ve earned the right to put down a book if it’s not engaging.

Nothing: Yes – I read fashion magazines. The past few years, it’s pretty much been limited to the September and March issues. I read them to see the stuff I won’t be wearing this season. Despite years of reading these fashion magazines, my fashion sense has not improved (see above picture for case in point). I suspect that if it weren’t for working in a semi-professional environment, I’d probably still be wearing flannel shirts, tank tops, jeans and combat boots. The grunge refugee look.....

Everything: I won a video iPod at the last eLearnDevCon. This little monster is my new commute buddy and another thing that has dropped my book consumption to almost zero. I’ve gotten into this weird habit of starting my day with CNET’s Buzz Out Loud podcast. Great information on technology trends and issues. I also have a lot of NPR programs on my iPod. Shoot, if it weren’t for Wait Wait Don’t Tell Me, I probably wouldn’t bother to keep up with current events.

Nothing: Yes…I too have drunk Ze Frank’s kool aid. He is one of us. I love duckies…..

-----------------------------------------------
The amount of information we have at our disposal is daunting.

I have found that it’s easier for me to “consume” information if I have a mental project happening. Something to focus on.

And I think it’s those weird little mental projects that help drive personal learning forward. Even if it is a “nothing” project like finding a good driver. Who knows, I might even be able to apply that to my e-learning life…..

The Trainer's Nightmare

Name a trainer's nightmare, and chances are, I've lived it.

"You have a class of 20 people, here's some software you've never seen before. Good luck."

"Hey - the servers are down...can you wing it?"

"I know we wanted you to talk about (thing you've prepared). Can you talk about (thing you know nothing about)?"

Scott Adams describes a situation I've been in on all sides of the equation.
- The speaker / trainer who has to think fast because NOTHING works
- The A/V tech telling the speaker / trainer that NOTHING will work anytime soon
- The audience who, if the speaker and the A/v tech are professional, is clueless about the drama that is occuring.

My takeaway: this guy is a professional.

So what would you do?