Today we're featuring an interview with Brian Hoth, who has served a variety of organizations in his 16-year career in IT and healthcare IT. He is currently a remote Sr Project Manager for McKesson, based in Salt Lake City. Here's his bio:
Brian Hoth is an experienced healthcare project manager with over 16 years of experience in roles in Healthcare IT, Senior Implementation Project Management, IT Director, Program Management, and IT Technical Project Management. Since 2006, Brian has served as a Senior Implementation Project Manager for Radiology/Cardiology PACS and Hemodynamics systems (specifically Emageon PACS/UV front end and HeartSuite Vericis/HeartSuite Hemodynamics, which are very similar to McKesson's Horizon Cardiology Suite). He currently works for McKesson Provider Technologies and is based in Salt Lake City, Utah.
Your recent experience is in support of McKesson's Horizon product for several nursing implementations. Since you're not a clinician, but you do have many years of experience working in and around hospitals, how do you manage to be effective, especially since you often work remotely? Do you hit any snags since you are not a RN - real snags or imagined?
I think you have to define what a project manager's role really is, first of all. The expectation of a project manager should be that the project manager can't ever know everything about what they are managing. But they do have to know who to call to get the information they need in a timely manner. Because in your role as a project manager you can pick up a lot, but being an expert at each area is never your number one priority. Learning does comes with time as you roll out these applications, but I keep my clinical and technical team phone numbers at hand, and we talk daily.
As a follow up, when you're working on a nursing implementation, does it ever happen that someone wants to imply or state that there's some reason you can't handle the effort because you're not an RN?
I've never had someone point blank tell me that. I do find nowadays that almost every customer I work with asks for and wants to know my qualifications. As a matter of fact, it's become so common that about 6 or 8 months ago, our McKesson management team actually sent out an email to all project managers that said, "We need you to create a bio that will be presented to customers when they ask, that gives your background, types of implementation you've done, how long you've been a project manager, and so on." They basically said this will be used like a resume, and they sent a template to us for us to use. I picked up two more projects in the last week, and both of the customers asked about my background and experience.
So going back to the previous question, you've got to be willing to make phone calls and know who you need help from?
Absolutely, I never consider having nursing clinical knowledge as part of my specific role as a project manager. However, I do consider my role to pick up the phone and call those who do have the clinical knowledge needed.
What perceptions, if any, have you seen in hospitals now that McKesson has announced it is phasing out Horizon and focusing instead on Paragon? Did this change your efforts? Did it cast any doubt in the end-client's mind?
I've only had one customer open up to me. They were not pleased, but they are in the midst of a stage 1 implementation, and it's too late to get angry at anyone. They've been a McKesson customer for years and they're hoping for attestation in 2012. So it's way too late in the game to call another vendor or be upset. Besides they can't slow down. The go live is January 31st and we'll make it too.
What is it like working remotely?
Implementing any application in a hospital environment is a lot different than when I started in this business in 2004 (vendor implementations). In 2004, IT departments were not nearly as savvy as they are now. They relied on the vendor to come in and do everything, in person. But since then, CIOs have been forced to work more closely with clinical departments within healthcare organizations, where they really didn't do this before. So now they are more closely knit and they know they have to keep costs down, which they can do using remote help. Healthcare organizations have learned to do more on their own.
When I was a hospital IT director in 2002 and 2003, we had a weekly one hour meeting with the CEO and CNO. I was the CIO, and that was the end of any discussions with any clinical departments. We really didn't work closely with them at all. We all worked within our own silos, which wasn't our intention, but that was the way it was then.
You worked with one of the busiest emergency rooms in Utah as director of IS. How did your project management background help make you successful in such a chaotic setting?
We were constantly rolling out new applications. A big part of a project manager's job is prioritizing your day. Because you've got 20 million things on your plate and all these balls you're juggling. How do you keep all of them moving forward but yet continue to prioritize and understand what things have to be done, in what order?
There were two big projects that I did while I was there. One, we rolled out a new ER software application that was basically a forklift upgrade. It wasn't minor. It was changing vendors completely and it was a huge deal. We also changed the workflow by going paperless. Before that, a nurse walked into an ER room and they got patient information on a sheet of paper.
So we went paperless at the same time, and we did research on carts, and brought those in with laptops with UPS devices so we could be much more mobile. Then we had to bring in a new wireless system because the old one couldn't handle the traffic. So one thing led to another and that was a huge effort.
The second large project I did was a PACS implementation - radiology PACS. That was also a huge effort. Talk about changing workflows! We went from film to reading everything digitally, and it was a huge effort. Now days, if you've got a radiology tech who's only been out of school 3 years, PACS is all he knows. If you talk about film, he looks at you like you're crazy.
What I find interesting about your background is you've been in the hospital directly and alsoas a consultant. Do you do anything different in a consulting role than you did in the hospital?
I have to as a vendor, sure. Vendors are always trying to add the features our customers are clamoring for, but we're also always working to get things as stable as possible. Healthcare software is so technical and so complicated that as long as I've been in this, it's nearly impossible to get it perfect if you're always adding features to stay competitive. So knowing how to balance nice-to-have features with stability is important. I have a lot more perspective on this now that I can see both sides of things.
At Intermountain Healthcare, you worked at a very large health system supporting 22 hospitals as an enterprise PM. What can you tell us about the challenges that face a project manager across so many hospitals? What's unique about project management at that large an operation?
In a huge organization it can be difficult. I think what you have to do first is understand who calls the shots at each facility. And then you make sure you work directly with that person if possible, or indirectly, if there's some second-level people to work with. Every one of these hospitals now has a CIO so you may not be working with them directly. You're probably working with someone who has been given oversight.
But back when I was with IHC, hospitals weren't project-oriented organizations, in my experience. It was all about ownership - so you had to work with the leaders who owned "pieces of the pie" in terms of technology from one facility to another. There was a silo mentality then, so as a project manager I had to really work closely with people to make sure we got things done. We have come a long way in healthcare since those days.
Last question. How'd a guy with a master's in public administration get into technology and healthcare? We don't let anybody off the hook without a little personal trivia.
And I also have a finance degree! I got my start right out of school at Utah State University in 1993. In my last quarter there, a couple buddies of mine and I were sitting in the cafeteria, and one had gotten an offer from KPMG in Portland, Oregon. So 3 or 4 of us decided since we were about to graduate, let's all buy tickets to Portland and find jobs. And we did. I wound up working for a bank. Got promoted, loved the job, but then ran into a situation with a bad boss.
So I found a job with a company that provided third-party telephone support for an accounting software application. And I knew some accounting with my finance degree. When I got the job and got exposed to technology, I couldn't get enough of it. I loved it. I read, I studied, enjoyed every minute of getting a background in technology.
A year later my brother told me about a job at Intermountain Healthcare, and I got that job. And I was off and running. Years later I added a master's in public administration because I wanted to add a management masters degree. I wound up getting an Executive MPA at Brigham Young University. I knew I wanted to stay in healthcare, and an MPA was perfect for healthcare!