Interview with Mony Weschler, Chief Technology & Innovation Strategist at Montefiore Medical Center

March 8, 2016

Direct Consulting Associates recently had the pleasure of interviewing Mony Weschler, Chief Technology & Innovation Strategist at Montefiore Medical Center.

Please tell us a little bit about yourself.

I am a creative and driven leader with extensive experience (25+ years) spanning the full range of clinical IT and MIS operations in various leading academic healthcare systems and institutions. While specializing in imaging informatics, my subject matter expertise extends to all healthcare and IT including strategy and operations, with clinical expertise in Radiology, Cardiology, Pathology, Perioperative, Perinatal, Surgery, Pediatrics, Nuclear Medicine, Orthopedics, Ophthalmology, Pharmacy, ACO’s, Population Health, Bio-Medical and Innovation.

In the course of my career, I have had the opportunity to establish and solidify Montefiore’s reputation as industry leader for testing and integrating groundbreaking technologies, result in multimillion dollar cost savings by pioneering an innovative cross-training support model, maximize operating room availability and spearheading the clinical use of innovation and mobile solutions.

What fascinating projects are you currently working on?

Mentor to startups at Junto, PilotHealth and BluePrint Health, bringing new innovation and technology to improve healthcare.

3D printing – How to incorporate and expand the usage of 3D printing to improve personalized medicine and outcomes. Imagine printing an airway for an infant or a printed custom hip replacement. How about a printing the before and after for conjoined twins that need to be separated?

Population engagement – communicating with your clinical providers using secure texting and smart Apps. Getting appointment reminders, nutrition guidance from your health system.

Wearables – Advanced activity monitors being handed out in the school systems to help change behavior and tackle pediatric obesity and diabetes with wellness and no drugs.

What is the most challenging aspect of your job?

Changing culture in a system that is resistant to change.

You have over 25 years of experience in HIT. What or who do you attribute your success to?

A love and passion for what I do. No one can escape the healthcare system sooner or later a loved one or ourselves will need care. I am privileged to have made a difference and improved the care and experience of millions of patients.

Did you have a mentor(s)?

Yes, my career began at NYP in 1989 and back then it was called Columbia Presbyterian Medical Center. I was fortunate to have had mentors like the world renowned Dr. Paul Clayton, Dr. Bob Sideli, George Hripcsak, Clair Hill, and other great mentors and friends. What I really enjoy is mentoring others and infecting them with a passion for Healthcare IT.

How has healthcare IT changed since you entered the industry, and where do you see it going?

EPIC was but a thought in Judy’s mind. IBM, 3M and DuPont were in the clinical space mostly with the beginnings of Lab systems. Most large academic medical centers had large programing staffs on hand and were building their own systems on mainframes and AS400’s. There was very little technology and informatics being used in healthcare. In fact, when the first digital imaging modalities like CT’s arrived we printed films to read the studies. Everything was paper and sharing vital information to treat a patient was very difficult.

Today, one can say that technology is completely integrated and integral in how we treat patients. Without technology a system could not properly treat its patients.

With the current pace of innovation and technology we can see the vast improvements in care and outcomes. I see healthcare becoming better and more accessible to everyone. I see great changes similar to the changes in the banking industry experienced. I grew up going with my mother to the gothic bank my children have never been inside a bank. Patients in the near future will have access to virtual visits with their physicians and with the next generation of wearables and implantables your physician will be able to take care of you even before you get sick.

I recently published a piece on the clinical tricorder and how the Star Trek Vision is becoming a reality.

How will the emphasis on patient engagement change healthcare in the future?

We’re already communicating with our patients using SMS text and mobile smartphone technologies. The government has pressured healthcare providers to shift from a fee for service to a fee for performance that makes the system accountable for the health and well-being for the patients it serves. This is a big step in the right direction but it can’t be successful without the patient being engaged and taking care of themselves. Mobile and other technologies allow the provider to help the patient and care giver become engaged in their care. Key communications such as appointment and medication reminders, nutritional guidance, activity coaching and encouragement are essential in improving care and reducing costs. New technologies can monitor patients at home while providing early warnings of decompensation and risks.

How do you incorporate leading-edge healthcare technology systems at Montefiore?

Our innovation process enables me to be a mentor at local accelerators and incubators like Blueprinthealth, PilotHealth and Junto Health. As a member of HIMSS, RSNA, mHealth, MEMS, CES and others I have the opportunity to engage startups early and select the solutions that solve our biggest and most important challenges. Having 25 years of operational and strategic informatics experience I can best champion the new technologies across the Montefiore systems which includes the medical school, acute and ambulatory care, home health, care management, school health and everything in between.

A few years ago you said your challenge was to reliably deliver data to physicians regardless of their physical location in ways that fit and enhance their workflow. Is that still a challenge?

Yes, but it is much better in the last 5 years we really took advantage of mobile devices so today our clinicians have access to Fetal monitoring strips from labor and delivery, cardiac EKG’s, PACS images, EMR data, analytics, communications, collaborative platforms and secure image capture from anywhere. Tele-psychiatry is rolling out, Tele-stroke is next.

What has been the hardest part of pioneering the integrated healthcare delivery network at Montefiore?

It’s always the culture and the ability to take risk. You can’t change and service model if you don’t have the vision and the authority to go in and shake it all up. What makes is most challenging in healthcare is that lives and real people are involved.

What’s the most cutting edge application you’re seeing now? What other innovations might we see in the near future?

TYTOcare this is a device that enables a person to do self-evaluation that captures key vitals and images that enable a clinician to properly diagnose during a virtual visit.

Siri, Amazon Echo, Google Talk, these are just the beginnings of machine learning and what was once known as artificial intelligence. The next big change in how we interact with computers will make the keyboard obsolete and move us into the era of natural language processing where we can communicate with the computer simply by speaking to it. In the clinical world it will allow the clinician to focus once again on the patient and not struggle with the keyboard.

How do you find and develop talented employees at Montefiore?

NY is a great place for talent as the city is home to many universities, prestigious healthcare organizations, financial Mecca. Investing in and growing staff is important but key is partnering with the clinical teams and the knowledge that the systems you support directly impacts on the care that is being delivered to our patients. The best talent like to create and implement new and revolutionary technologies and at Montefiore that’s what we do. Being the parent company to Einstein School of Medicine and the top performing ACO in the country helps as well.

How do you retain top industry talent?

Mentor each staff member, know your people and put them in positions that helps them succeed.

What soft skills do you look for when hiring new talent?

Very soft… Bright, wants to learn, team player, motivated like to ask questions.

What are the most important characteristics an HIT leader needs to be successful?

A leader needs to lead and think out of the box and be willing to take risk. Healthcare is changing at an extraordinary pace the likes of we have never experienced before. IT is critical in the survival of our healthcare systems if a CIO makes the wrong call or no call at all the implications will resonate at the system level.

I have seen IT leadership undergo many phases during my career.

In the 90’s, IT was the dictator; we did things and the business had to do what was mandated. In 2000, after the Y2K nonevent, IT was beaten up and the clinical folks took over; we were servers and did whatever the business asked for even if it was not the right thing to do. Outsource years.

By 2010 CIOs were back at the table but reporting to CFO’s with limited influence there were also many transplants from the financial world and that is not a good fit.

My approach and advice is to always be a true partner with the clinical leadership and to do that you must understand the business you are in. Be a change agent, understand the big challenges and provide the solutions, engage clinical champions and break the mold by introducing new innovation and technology. Only the best and most confident HIT leaders will step into this role. Unfortunately, most fall short and that is a major reason that HIT lags so far behind other industries when it comes to accessibility, ease of use and the inability to share data between systems. There is hope though the population is demanding change and technology is a major change agent. HIT has come a long way in the past 25 years but I’m optimistic that the next 25 will be legendary.

Reasons to Step-Up Your Job Search this Holiday Season

December 1, 2015

It’s tempting to put your job search on-hold until after the holiday season. But it’s to your advantage to resist this temptation and continue your search efforts. The holiday season is actually an opportune time to find your next job and here’s why:

1.There’s more time to search for a job since your work has slowed down. If you’re currently employed and seeking another job, chances are that you will have some down time during the holiday season. Use your down-time wisely and boost your job search.

2.Your competition is likely taking some time off. With so many people competing for the same job and so many taking a break from their search efforts over the holidays, you have the opportunity to blow past your competition. Take this opportunity to contact companies through their websites, blog posts, social media, direct phone calls, etc. Also, don’t be shy about asking for an interview. Many companies want to close out their open requisitions and have a new hire start in the New Year.

3.Holiday networking opportunities are plentiful. With all the holiday parties, open houses, happy hours, etc. your networking opportunities are abundant. In addition, everyone is usually in a festive mood at these events, making it easier for you to meet new contacts and engage them in conversation.

4.Use the Holidays to reconnect. Think of how many people you know and those that you only see or hear from over the holiday season. Get in touch with all of them by sending a holiday greeting. Believe me, they’ll welcome it. Include neighbors, extended family, former professors, former bosses and co-workers, college roommates, etc. A greeting from you puts you back on their radar.

5.Hiring authorities might be actually be answering their phone this time of year. With the administrative assistant probably on vacation, you could end up talking directly with the hiring manager. However, you’ll only have a few seconds to grab their interest. Be ready to draw them with a good conversation starter.

Putting a little extra effort into your job hunt and increasing your networking opportunities this time of year may be the best gift you could give yourself!

Interview with Joe Vincent, Senior Vice President of IT, FirstMerit Bank

September 29, 2015

Direct Consulting Associates recently had the pleasure of interviewing Joe Vincent, Senior Vice President of IT for FirstMerit Bank. Mr. Vincent was kind enough to answer questions about his career, trends in technology, daily challenges he faces, and how he finds and develops top talent. 

Please tell us a little bit about yourself.

I am a Senior Vice President in IT for FirstMerit Bank. I’ve been at the Bank for 23 years in a variety of Technology and Management positions over that time, with considerable experience in IT Governance, and major technology initiatives. Over the past 5 years alone, my responsibilities have included 3 very successful mergers and acquisitions, as well as a major upgrade to our Branch infrastructure and Teller system software. I am a person who loves new technology, but also loves to work with people to determine technologies that can help them be successful, and ensure they can meet their goals.

I also have a passion for supporting Education. I taught Adult Education for quite a few years, and currently volunteer my time in support of Kent State’s Center for Information Services Program. As part of that work, I’ve participated in Business Leader meetings to review trends in the workplace, as well as actually participating in classes acting as a mentor to project teams. Amazing how real world the classroom can be – right down to one of the teams losing all of their work due to no backups!

What is the most challenging aspect of your job?

I typically see two challenges: effectively managing and motivating people, and managing customer expectations.

Most employees desire to do a good job, yet everyone is motivated differently. Identifying that motivation, and finding ways to cultivate it, takes time and dedication on the managers’ part. The flip side of the coin is that this is also the one of the most rewarding aspects of the job. Identifying someone’s true motivation, and finding a way to utilize it for the betterment of the employee, as well as the company produces a very highly motivated and high performing workforce. It is truly a sight to behold.

Managing expectations can also be a very difficult part of running an IT organization. There are always more desires, with competing priorities than time and resources available. Having a great working relationship with the business lines, and transparency on work being done are keys here.

How can IT identify what their businesses actually need and make sure the technology they choose is the right fit?

This is a great question, and one that I find absolutely critical. The answer is “Listen.” Empowering IT to develop a close relationship with the business ensures they have a greater understanding of the operation of the business, and its many needs. Many IT organizations have seen their business units hiring IT staff (commonly referred to as “shadow IT”) to ensure they get the appropriate technology in place to attain their goals. This is a direct reflection of IT not servicing their business requirements sufficiently. Many centralized IT staffs are very in-tune with their responsibilities for running the IT side of the shop, but fail to spend the appropriate amount of time understanding the needs of their business customers, to allow them to serve in a true consultative role. This, in my opinion is a critical mistake.

The other half of the equation is keeping up with the latest technologies. IT must be able to provide leadership to the business line once they have a full understanding of their needs. Only the combination of the two – listening, and understanding the latest technologies, can lead to a truly successful partnership.

How do you find and develop talented employees? How can organizations find, train, cultivate and retain championship-caliber IT players?

We find that talented employees tend to know one another, so employee referrals are vital to helping an organization find top talent. Once on board, identifying the employee’s goals, and ensuring appropriate training and mentoring to meet those goals is very important.

The other key to retention is creating a work environment where employees understand and embrace the IT strategy, feel empowered to ask questions, and come up with ideas to support it, execute on those ideas, and receive the credit for achieving the desired results.

Is the rise of “hyperconverged” data center platforms driving IT leaders to take another look at Virtual Desktop Infrastructure?

I believe it is. Even 5 years ago, Virtual Desktop Infrastructure technology was in its infancy stage. From a management standpoint, implementation was a very large investment in both time and people, which in many cases still resulted in suboptimal implementations. It is very different to put all of the desktops into a single environment, similar to terminals attached to a mainframe, but without the maturity in processes and systems within the environment that the mainframe has developed through many years of service. To think that a server, or storage could go down, and no one would have a desktop to work with was very unsettling to many managers at that time.

Today’s “hyperconverged” data center platforms are much more robust, and mature, providing a viable solution for virtual desktop implementation. Virtual Desktops still require a significant investment in hardware, software, and engineering resources, but the underlying technologies have begun to prove themselves much more redundant and reliable, thereby alleviating some of the earlier concerns.

How do you foresee fraud and cyber security evolving in 2015? How should leadership teams at financial services organizations approach this threat?

Cyber security will continue to be a major threat in 2015 and beyond. Organizations continue to ramp up spending to attempt to proactively address key security concerns such as patching, email phishing attempts, etc., but proactive efforts will never be enough.

With so many incidents of compromised customer credit card data, compromised personal data, and espionage being reported in the news, there is a real risk of damaging a company’s reputation, and alarming the consumer, either of which can be fatal to a companies survival.

The current belief is that it is not if a company will get hacked, but when. This has caused significant increases in expenditures throughout the industry for new and better detection and containment technologies, in addition to the normal focus on enhancing prevention of a cyber crime.

I believe integrating Security teams throughout the organization is key. Whether it is project architecture, coding architecture, or every day processes and procedures, the IT security team needs to be involved.

Are you seeing any trends right now in the industry?

Within the banking industry the major trend continues to be customers banking remotely. Foot traffic for monetary transactions in the physical branch continues to decrease as the Baby Boomer generation dies off, with more and more customers doing their banking online, and via their mobile devices. We consistently see reports in the news of banks consolidating their physical locations. This will likely continue in the years to come.

You have over 25 years of experience in IT. What or who do you attribute your success to? Did you have a mentor(s)?

I like to listen – listen to the needs of my customers, listen to the needs and ideas of my staff, and provide them the freedom to get the job done.

My success has been directly attributed to the teams I work with. With three major acquisitions / conversions in the past 5 years, our teams have just done an outstanding job working together. Teamwork is always the key!

How do you retain top industry talent?

Understanding the motivations of your top performers is key in their retention. With the labor market being as tight as it is, just offering a competitive salary is not going to get it done. Your top employees need to understand and believe in your mission, and need to feel empowered to make a noticeable contribution toward its success.

I also believe it is a mistake to micromanage. Top performers like to figure out the best way to accomplish the task at hand, then get it done. Micro-managing drains the creative energy right out of a top performer.

What soft skills do you look for when hiring new talent?

I look for interpersonal communication skills and teamwork. In this ever increasing digital age, interpersonal skills are becoming more difficult to find, and thus a key differentiator in candidates coming out of school. These skills are critical to their success in managing peer relationships, as well as relationships with supervisors and successful participation on project teams.

In my experience, a well functioning team will always significantly outperform the individual contributions of its members. It is truly fun to watch as a team tries, then comes together to exceed it’s goals!

What are the most important characteristics an IT leader needs to be successful?

For their customers, an IT leader needs to be a visionary. They need to understand the requirements of their business partners, and work tirelessly to ensure the latest, most effective, and most efficient technologies are made available to them to ensure they have every potential advantage in the marketplace.

For their teams, they need outstanding leadership and people skills. Their success, and the success of their teams and business partners, often require heroic efforts to meet timelines and achieve results required to give their business partners the “edge” they are seeking with technology implementations.

One final characteristic that I believe truly sets successful IT leaders apart is transparency. Individuals, regardless of standing in the organization need to know what you are thinking. I make it a point to ensure that in all of my interactions, I am as honest as possible with an individual. In discussions with others, this has consistently been one of the traits highlighted as truly important to them, and factoring in to their overall satisfaction with their manager, and subsequently their jobs.

Interview with Shirley Nickels, Founder and President of Sentact

August 20, 2015

Direct Consulting Associates recently had the pleasure of interviewing Shirley Nickels, Founder and President of Sentact. Shirley was kind enough to answer questions about herself, her career, how she acquires new talent, and advice she would give other women starting their careers in the IT industry.

Please tell us a little bit about yourself.

I am the founder and President of Sentact LLC. Since our founding, my role has evolved as our Company has progressed through its exciting lifecycle; from a start up with only a business concept, to an organization that supports healthcare organizations throughout the country. With our growth and the addition of great Sentact team members, I primarily focus my attention on our technology platform and how our existing (and future) healthcare users can more efficiently and effectively meet their objectives with its use in their delivery of care. That includes bringing use-case concepts to life with our expert development group and spending significant time with customers and potential customers understanding their needs today and in the future. Pairing those valuable insights from healthcare experts with Sentact’s core competencies produces exciting possibilities. Identifying future needs that we believe we can most effectively address, become the fabric of our technology road map.

My prior career experiences were focused on solving business process challenges in the IT services industry. I enjoyed breaking down a process into definable elements, assessing each step’s value and efficiency, then putting them back together in a manner that met a specific business need. In essence, that same concept is the foundation behind Sentact’s business model.

Ultimately, I am passionate about leveraging technology to simplify processes and maximizing resources to drive tangible outcomes.

You have over 15 years of experience in IT. What or who do you attribute your success to? Did you have a mentor(s)?

I attribute much of my success to my parents and upbringing. As a first generation American-born child of a large Filipino family, strong work ethic and values were instilled in me at a very early age. My parents immigrated here because of the great opportunities our country provided. They made sure that every one of us understood what was available to us if we applied the right effort. It has been the foundation of who I am. I was taught that you need to earn your keep and value every opportunity no matter how large or small.

Having that upbringing and the good fortune to be part of organizations and great leadership that fostered personal growth gave me the exposure needed to evolve my career path. I have also surrounded myself with like-minded individuals that have challenged both my personal and business goals.

Are you seeing any trends right now in the healthcare IT industry?

As the market expands and IT evolves and becomes more abundant, I find that integration with other systems to provide a broader solution is essential. By allowing for integrations between systems, healthcare organizations have a true solution that allows them to become more efficient as well as productive.

Another key trend in the healthcare industry is mobility. We are seeing more and more mobile devices being deployed throughout healthcare networks. Technology companies are challenged to offer mobile applications allowing support staff, physicians, nurses, and other healthcare employees in the field not returning back to a central office.

What is the most challenging aspect of your job?

We are extremely fortunate to have a customer base that includes many of the leading hospitals and brightest minds in the healthcare industry. It’s always exciting when they come to Sentact with new development ideas or use cases. The challenge however is ensuring that we stay focused on our platform’s core functionality and purpose and not steer away from the long term plan for our services. Maintaining a cohesive service platform that scales and can be appropriately supported by your organization today and in the future is critical.

How has Sentact been able to be so lean and continue to grow rapidly and stay ahead of the competition?

We’ve applied the same rigors to the composition of our organization that we do when we approach an implementation of Sentact for our customers. We simplify our internal processes, leverage technology and constantly re-evaluate our group’s effectiveness relative to our business objectives. It ensures maximum efficiency in everything we do. Our team reflects what we think is a thoughtful approach to making sure our customers receive the best service and support. You can’t grow without satisfied customers. In fact our customer referrals have been the number one source of new business opportunities for us. We have also designed Sentact’s technology to in part, minimize the typically required resources for onboarding a customer, administration of the application, and developing or enhancing the platform. Our resources are freed up to focus on new ideas and value enhancements that keep us a leader in our industry.

It’s exciting that you just went mobile! What else can you tell us about as far as what is on the horizon for Sentact?

Mobile is a big step for us. We recently launched our new platform that features enterprise capabilities, mobile solutions, interactive reporting, and analytics to enhance the user-friendly experience. This was a big undertaking for us and we are currently working on transitioning all of our customers to the new platform.

We are also very excited about the redesign of our BI reporting capabilities. By increasing the reports available to our users and enabling more analytics, our customers gain more insight into their operations to make an impact with the information. Additionally, we continuously explore strategic API’s to leverage our technology and expand its value within our customer base.

How do you find and develop talented employees? How can organizations find, train, cultivate and retain championship-caliber IT players?

Our best source for finding new associates has come from our existing team and in some cases, recruiting partners. Our ability to attract talented individuals lies in the excitement around our technology platform and its impact on the healthcare industry. I’d like to believe that prospective associates sense our passion and become more interested in being a part of it. Our ability to retain talented individuals lies squarely with our culture. Things like compensation and benefits are important. You have to be competitive. But we’ve found that Sentact’s culture is what keeps people here. We empower our team to innovate and lead. We foster and embrace a strong team environment that allows individuals to refine their skill set and enhance their professional experience and personal goals. There are always new and exciting challenges at Sentact that give our associates an opportunity to grow.

What soft skills do you look for when hiring new talent?

Communication and creativity are valued assets. Our development cycle moves fast and we need good communicators to voice their opinion and have thoughtful feedback. Being able to challenge existing process and workflows for alternative solutions keep our services ahead of the curve.

What are the most important characteristics an IT leader needs to be successful?

IT leaders today need to be able to listen and adapt. IT and healthcare are changing so rapidly that it can be difficult to keep up. A good strategy driven by the market is important, but adjusting your tactics to the current climate is critical to success and even survival.

We recently started a “Women in Business” group here at Direct Consulting Associates. As the founder of Sentact and with all of the success you have had, what is the best piece of advice you can give other women in the tech industry who might be starting out or facing challenges in their career?

That’s an interesting question. I’m mindful that we don’t live in a perfect world. Early in my career I didn’t view things through a gender identity prism. However, after my first experience being the only female as a quality assurance consultant of a large financial institution’s help desk of 10 males, I quickly realized how gender can indeed play a role in impacting the success you attain in your job. That experience taught me how important it was to persevere and maintain my confidence to make an impact.

And after many meetings where I’d find myself in a male dominated room, whether it is IT, facilities management, or C-suite executives, I know it’s imperative to make that first impression count as it can eliminate any underlying gender, age or race bias to allow you to really control the outcome.

Job Hunting While Still Employed

July 14, 2015

By John Yurkschatt, IT Director, DCA

For most workers, there comes a day when it’s time to look for a new job or career path.  However, how do you look for your next opportunity while still working full-time at your current job?  Very carefully!

Here’s what to keep in mind when you’re determined to move on:

Keep job search quiet.  It’s best not to confide in any of your co-workers that you are job hunting.  Big news like that often gets leaked. Above all, do not tell your boss.  In doing so, you will compromise your current employment.  As soon as your boss discovers you’re looking, he/she will start looking for your replacement. Consider your good name and job toast.

Don’t use company resources.  It’s tempting to use your company’s copier, fax machine, and email to send your resume to prospective employers. But it’s also a huge no-no to use your mobile devices if they were company issued.  In addition, it’s just not a good idea to look for your next job while on their clock. Use off hours. These days everything is digital and your job hunt is no longer restricted to an 8 to 5 time frame therefore, apply for jobs at home after hours.

Maximize your day.  Get up an hour earlier and commit that hour to planning, searching and following-up on leads. Also, use that time to send emails, prepare for an interview, or any other job-search related activity.

Stay employed.  It’s easier to find a job while still employed. Employers prefer to hire someone who is currently working since they are perceived as more desirable and valuable.  There’s no question that discrimination against the unemployed does happen.  Hiring managers wonder what caused the unemployment and if a candidate’s skills are up-to-date or if training will be required.

Be smart with social media.  Using LinkedIn is crucial to your job search but try not to do a massive renovation to your profile all at once. This might send a red flag to your current employer. Instead, update your profile during lower traffic times like at night or on a weekend or holiday. Also, be smart about your settings.  Modify your broadcast settings so your connections aren’t alerted of every update you make.

Schedule your interviews wisely.  When you get to the interview stage of your job search, ask that interviews be scheduled at times that won’t conflict with your work schedule, such as early morning, during lunch, or after hours. Many employers will accommodate you.  If you absolutely have to interview in the middle of the day, try to use vacation time or a personal day.

Be careful with references. Accidentally using your boss or supervisor as a reference is a big mistake. Just think how they will take it when being contacted by an employer checking up on your references. References should be given upon request only and then even then with the caveat that your job search is confidential for the time being.