The following post is part of a year-long online campaign highlighting #WomenofPenn. The campaign, developed by FOCUS on Women’s Health and Leadership and Penn Medicine Communications, promotes the work being done by women at Penn Medicine and aims to inspire early-career women in academic medicine through the examples of successful women role models.
If you asked Ann Huffenberger to thrive during nearly any point in history, not only it is highly likely that she would, but chances are she’d build a top-rate team to excel along with her. She’s not only the head of teams running Penn Medicine’s cutting-edge, telemedicine efforts, but she’s also an experienced mariner who captained a three-masted, 177-foot rigged ship that navigated to foreign ports through the use of the sun, moon and stars.
Huffenberger, DBA, RN, NEA-BC, a nurse with over 30 years of experience alongside her 10 years as captain of the Gazela, now serves as director of Penn Center for Connected Care, Penn’s centralized hub overseeing the PENN E-LERT® telemedicine ICU program, the telehealth remote patient monitoring initiatives, plus, FirstCall, the on-demand virtual urgent care practice for Penn Medicine employees and their adult dependents.
Beth Mooney, MSN, CRNP, in Medical Oncology for Gastrointestinal Cancer, has been dipping her toes into the telemedicine realm. She’s serving on a team in the Center for Health Care Innovation developing chatbot technology, an augmented intelligence program called Penny, which helps Penn’s cancer patients navigate often-confusing at-home chemotherapy regimens.
Earlier this month, Mooney sat down with Huffenberger to hear how her maritime career has helped inform her day-to-day decisions and how she views the future of health care.
Q (Mooney): Can you tell me a little bit about your history prior to nursing?
A (Huffenberger): Yes. Early in my career, I took a somewhat atypical path: A couple years after college, I had my first nursing job, was working full-time, and had set goals for myself to travel and explore new places. I moved from a full-time position to a per-diem position after receiving an invitation to volunteer as a medical officer aboard the Gazela, which is a sail training ship from Philadelphia. At the time, she was one of about sixty Class A tall ships in the world. Sailing this traditionally rigged ship was an incredible experience that changed my life.
Thereafter, in parallel with my work as a nurse, I trained and received my captain’s license as a professional merchant mariner under the United States Coast Guard. I spent roughly the next 10 years sailing. Every chance I could, I’d try to go to sea. I took trips for three or four months, then came back to my nursing career. I think that explains why it took me so long to complete my graduate studies.
Sailing provided remarkable insight into personal accountability and, as a captain, I coupled that realization with my responsibly for oversight. When you’re on these ships, you don’t have the safety net of resources ashore, like 911, for example.
We trained to manage all types of emergencies — firefighting, illness, rescue, weather — we ensured our success by building the team’s core competencies. Everyone aboard played a part. We had to; the ship becomes your universe. It’s similar in health care: There’s genuine concern for safety. I used to say it all the time and I still believe it: My decision–making skills as a captain weren’t anything unique; they were simply my nursing skills at work.
When I finally settled ashore, we moved to upstate New York and I worked at the VA. Management was a nice fit for me as I felt confident in building and working with teams. Ultimately, I took on the responsibility of executing plans: Getting from Point A to Point B. Truth be told, that’s really what I like best about my job today. Changing processes to be more efficient is super exciting for me.
Working at the VA was a turning point, and it was also about the time the Institute of Medicine had published the “Future of Nursing,” which was very powerful to me. They set aggressive goals to increase the number of nurses working with doctorate degrees, amongst other metrics, and I thought, “I’m committed, I want to play my part.” I worked to receive my MBA and thereafter to receive my DBA — doctorate in business administration.
Q: I think it’s clear that your efficiency and ability to triage has made you a really good manager. What continues to motivate you to push forward and break boundaries in your current role?
A: The diversity of working inside and outside of health care has helped me considerably, along with studying principles of business administration.
After all these years as a nurse, I know what clinicians will tolerate and I know what they won’t. You probably feel the same. You might hear, “We’re going to have them do this,” but, in the background, you’re thinking, “Clinicians are never going to do that.” So the question is always, “How far can you push the boundaries and what’s necessary to manage the change?”
For my team, I try to motivate them, every opportunity I get, by emphasizing that we have to be agile and responsive. Technologies are always changing. Reimbursement models are always changing. Every year we’re working to be in a better position than the year prior. We are always looking to support enterprise initiatives that provide value.
Q: I think that adaptability goes a long way. Telemedicine is a whole new form of care that we didn’t anticipate 10 years ago. Was telemedicine always an interest of yours, or shaped particularly by this role?
A: Before I became the director, I spent five years at Good Shepherd Penn Partners where we implemented PENN E-LERT. I was a clinical coordinator at the time, was recruited to help open the post-acute operations on Penn’s Rittenhouse campus. I remember distinctly when we admitted our first patient, it was a relief to know that we had the telemedicine team supporting us. I guess you can say that I was sold on telemedicine then.
A 1993 Philadelphia Inquirer article about Ann Huffenberger (identified by her maiden name) captaining her ship,Gazela, back to home port.
Q: Tell me about some of the major hurdles you’ve faced in your current position.
A: I wonder if my hurdles are similar to yours with Penny?
For me, I think the biggest hurdle was establishing trust. For PENN E-LERT, for example, when we were preparing to expand operations across all ICU beds downtown, I knew if we couldn’t establish trust with our [on-site] ICU teams, then we weren’t going to be an integrated and optimized solution.
There are still areas where I think we could do more, but it’s always about striking a balance and, again, knowing how far to push and when to throttle back. We have such high regard for our on-site ICU teams in their day-to-day work, they are so incredibly busy, caring for some of the sickest patients in the nation. It’s truly remarkable.
Q: That certainly hits home with my project. And I’ve found that, with what I’m doing, there are no issues establishing trust with patients. Did you ever find that to be an issue with telemedicine?
A: No. I’ve found patients and families absolutely embrace our telemedicine solutions. I think it’s comforting for them for a multitude of reasons. Whether it be remote surveillance, clinical decision-support, or simply the convenience the technology offers to connect with providers in real time.
Q: A lot of roles within health systems can be regimented and specialized, sometimes creating obstructive barriers to change. Have you faced that in implementing telemedicine?
A: Penn Medicine is a complex organization, so it’s more about figuring out how we all play on the same field and coordinating our efforts to achieve wins.
For my colleagues who are regimented, as a first pass, I pick up the phone and say, “Can you help me? I’m kind of struggling to solve this one.” Sometimes that goes well and I gain support, and other times it’s not the outcome I had hoped.
In the latter cases, I’m forced to re-examine. I tend to use the 80/20 principle. I never lose sight of the 80 percent who are willing, able, and receptive. For the 20 percent who aren’t, I try to be patient, always waiting for the opportunity to re-assert the value we might add.
Q: I think the outcomes that you’ve had really speak to the value of your work. What are some of your key accomplishments in your role as director? And where do you see things heading?
A: Yes, I’m proud of the teams we’ve built. They’re very capable, both clinically and operationally. They’re a diverse group of clinicians with vast experience, they are calm and supportive. Because of them, we’ve been able to accomplish so much, we’ve leveraged the team to successfully integrate new initiatives on top of the existing infrastructure.
For example, FirstCall has been a big success. The clinicians are proud of their accomplishments and I’m proud of them. We’ve successfully established Penn’s first 24/7 virtual care practice using technology embedded within the envelope of our electronic medical records. We’re at the 18-month mark and we’ve seen close to 5,000 patients. The feedback has been very positive.
As models of reimbursement continue to evolve, and patients begin to expect the technology, we will continue to press forward with these contemporary solutions.
Q: We talked a little bit about barriers and that supplementing a nursing degree with a business degree can be a driver that helps one implement change. Did you have a particular experience that motivated you to pursue business in your advanced degree?
A: Yes. So, something you mentioned before we met today, wondering whether it’s harder to make changes because I’m a woman, I want to touch on that briefly. I’m not confident that it is any harder to make changes because of gender. But I do think it can be harder for nurses. I think people tend to think of nurses as the worker bees — the doers, not the strategists.
I tend to think that perception is wrong. Nurses intuitively do, we take care of people, we make things happen, we overcome challenges every shift. All of that requires due diligence in planning and a lot of strategizing for the clinical outcomes we all desire.
Q: Since I’ve been a part of Penn, I’ve seen that level of respect is starting to shift. Nurses have a key insight into different structural issues that we can change—to improve costs even.
A: That’s right and great to hear.
Let me say, I think it’s imperative we all take time to reflect the future of health care in our nation. I mean that sincerely. Who are tomorrow’s caregivers? It doesn’t take much to recognize that we all play a part.
I have a fire in my belly about the future. I think we have to understand the business. Nurses have to be full partners leading—with physicians and others—the redesign of health care. Nurses should be prepared to run hospitals and health systems, we should be on boards, and in operations and other executive positions.
I’m humbled and delighted when I think about Regina Cunningham, a nurse who is the CEO of HUP, and Janet Ready, a nurse and president of Princeton Medical Center. Plus, so many others around us at Penn Medicine. The literature suggests we have room to move the needle more. The New England Medical Journal just last month published the results of a survey showing that two-thirds of participants estimate that less than one-fourth of the leadership roles in their organizations are filled by nurses. There’s an opportunity to make a change, I believe nurses need to learn the business and help drive that change.