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 Today in Health it, the story is Project Management 1 0 1. Identify the right problem. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping health IT staff current. I. And engaged. I provide executive coaching through today's sponsor health lyrics.

If you want to put me to work for you and your health system, check out health lyrics.com. Alright, today's story. Today's story comes from the New York Times. It's an editorial that Drex de force shared in three x Drex. This week if you haven't already signed up, text Drex, DREX to 4 8 4 8 4 8. He's gonna be a guest on the this week in Health it Newsday show on Monday.

So I'm looking forward to that conversation. We'll probably end up talking about this, this story. Uh, the title of the article is Biden's c Ovid 19. Plan is Maddeningly Obvious. Ezra Klein misses the point almost entirely as he tries to paint a politically charged indictment of former president. Trump, at least it should be.

Former president by the time you listen to this. Uh, let's look at this through a project management lens. This is today in health. It, so we're gonna, we're gonna look at it from a project management standpoint. Ezra leads with the absolute right organizing statement. Vaccines don't save people vaccinations, do.

If that is your organizing statement, you then develop plans, resource those plans, and measure the outcomes based on your ability to get shots in arms, right? Vaccination, save people, we've gotta get shots in arms. The plans of the, the Trump administration had in place was to develop a vaccine as quickly as possible.

Operation warp speed, which solved the most pressing problem. No vaccine, no vaccinations, right? That I, now, I have two problems with operational warp speed. I'll get to that in a minute. But let's fir first start by saying, uh, the program was spot on. The results speak for itself. I spoke with someone early on in the pandemic that said that, uh, operational warp speed was a pipe dream.

My two problems is that it feels like we just started planning for distribution, uh, late last year. Uh, and, and, and also we weren't addressing the biggest problem. I'm gonna come back to the biggest problem, but the distribution plan should have been worked out and communicated early on operation warp speed.

I, I, if you believe . Uh, in a success, which, which the team obviously did, you have to plan for the distribution of the vaccine communication, queuing or scheduling, uh, and logistics. Again, this is, you know, project management 1 0 1. I'm gonna get back to the main problem in a minute, uh, because the, the new plan doesn't seem to address the, the, the main problem, either, uh, the plan or, so let's go back to the existing plan.

Uh, the plan relies on a distribution, mostly at the state level with CD, c guidelines on who should receive it first. Get the limited production of the vaccine in the arms of those who need it most frontline workers, our elderly population, and those at the greatest risk. Uh, guidelines were not as clear as, as everyone would've liked, uh, but they were close enough for government work as they used to say.

Um, you know, there was some ambiguity. People had to make decisions, but hey, we're, we're all adults here, especially in, in the healthcare trade, we could figure out how to do this effectively. Right? So they gave us the guidelines, um, contracts to organizations that can handle mass distribution for long-term care facilities, like, uh, the CVS agreement we talked about on yesterday's show.

Uh, my, you know, my only issue with the CVS agreement to be honest with you, is, you know, if they're gonna receive 6 million new customers, you might want to as, as, as the, uh, entity that's giving them the contract, you might want to extract an agreement to participate in, in any and all HHS interoperability efforts.

I mean, that was an opportunity, not that I want them to use, uh, the pandemic as an opportunity, but it was an opportunity and it's probably a missed opportunity if I, uh, uh, if we dig in far enough. Okay, so finally, uh, you, you, you get the vaccine to the health systems locally. These, these health systems are responsible for getting it, uh, to the appropriate people in their community.

Again, this is while the vaccine is in limited supply. Once it ramps up, it will expand to new outlets, like additional hospitals, clinics, uh, CVS, Walmart, Walgreens, uh, potentially healthcare workers like, like dentists can be used to administer the vaccine. Uh, this was always part of the plan. Now, here's where you change leadership in the program.

All right, so we, today, in inauguration day, we change the, the leadership. This is just like every other project you have going on in your health system, and you say, all right, it's time for a leadership change. We bring in a new project manager, we bring in new, uh, we fire the CEO, you know, we, we fire everybody, C-E-O-C-I-O.

Project manager. That's one of the distinctions about the government. So they got rid of everybody. Um, alright, so new teams in place, they have a choice resource, the existing plan or change direction. I. , you always have to come back to the organizing principle. This is, you know, project management 1 0 1.

Our organizing principle is vaccines don't save people. Vaccinations do. It's about shots in arms. A change in project direction always comes at a cost changing course. Mid-project is disruptive. As someone who has managed hundreds of projects personally and thousands under my leadership, you, you only change course if it will dramatically change the outcome.

Our outcome is more shots in arms, right? So the new plan is laid out, uh, in this article. It's essentially more sites, more resources, and more production. Uh, you know, we're already on the path for more sites and more resources. Uh, putting the vaccine, uh, in the hands of CVS and Walmart alone will put the vaccine in the most advantageous locations in our community.

The, you know, the free market took care of that. Every time they built a new CVS or a Walmart, they did a, an extensive market study and placed those buildings in the right location so that the po they were close to the populations that were gonna buy from them. And conversely, that means the populations that need the vaccine, right?

Um, they also have the staff to administer the vaccine either through contract or through employment. Uh, and, and you're talking about over 95% of the US population is within 10 miles of ACVS or Walmart. So with two distribution points, we've taken care of sites and staff, right? So sites check, staff check, you know, mobilizing fema if you can mobilize FEMA if you want, but it won't get more shots into the arms.

And remember, that's our organizing principle. Are we gonna get more shots in arms? Does it make sense to invest that money in that spot? Is it going to improve our outcome? Okay, so we get back to vaccine production. Does anyone think that Pfizer and Moderna can't produce drugs at scale? If they have the raw materials?

Uh, you know, do we think that the government is going to make them move faster than profit, motive faster than shareholders are asking them to move? I don't think so. Um, you know, the federal government may want to address the real problem. So this is where we get back to if the goal is shots in arms, what is going to be the real problem And we are making progress and we have a plan that is going to make progress in and of itself a sizable.

Here's the main problem. A sizable portion of the population doesn't want the vaccine. And some won't come in like our homeless and our home bound populations. This seems obvious to me. I, I'm really kind of, uh, almost annoyed that, you know, we're, we're, we're playing around with this without addressing the real problem.

You know, I, I see different studies and it's, it seems like 30 to 40% of the people in our population don't want the vaccine. And then there's a whole host of people that never get counted. Because they are, they're just uncounted in our society. They're disenfranchised, they're disconnected from our society, and we have to go out to those populations.

Project management 1 0 1, identify the right problem, assign the resources to that problem. You have to go to them. You have to figure out a way to make everyone want the vaccine. Uh, you know, I'm, I'm sorry to be all professorial on you on this episode, but, uh, and, and also, you know, any relation to a political statement is unintentional.

I'm apolitical on vaccine distribution. Shots in arms will save lives. I believe if you want to score political points on your side, uh, for your side on this topic, you have a problem and it's time for some self-reflection. We've gotta get shots in arms, address the main problem. And the, the thing I'm gonna be looking for is how are we going to address the fact that a majority of the population, not a majority, but a significant portion of the population, does not want the vaccine.

And how are we gonna get shots in arms of those people who are homeless, home bound, and not coming in? All right. That's all for today. If you know of someone that might benefit from our channel, please forward them a note. They can subscribe on the website this week, health.com, or wherever you listen to podcast Apple, Google Overcast, Spotify, Stitcher, you get the picture.

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