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One-on-One With Seattle Children's Hospital CIO Drex DeFord, Part III

November 17, 2008
by root
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In this part of our interview, DeFord talks about the importance of laying the groundwork before implementation begins.

Seattle Children’s Hospital serves as the pediatric referral center for Washington, Alaska, Montana and Idaho. The organization’s facilities include 250 inpatient beds, a Level IV Infant Intensive Care Unit, Surgical Unit, Pediatric Intensive Care Unit, Inpatient Psychiatric Unit, and Rehabilitation/Complex Care Unit. HCI Editor-in-Chief Anthony Guerra recently had a chance to chat with CIO Drex DeFord about his work at hospital and industry trends.

Part II

AG: Your career path came up through the IT side?

DD: Yes. My career path is pretty interesting. I enlisted in the Air Force and was a data center operator help desk guy. I went to school at night. My education was commissioned as a Medical Service Corps Officer, a hospital administrator, where I did everything from supply chain to CFO to human resources in smaller facilities. I eventually tied my IT background into my job in the Air Force, as a hospital administrator and became a CIO at the Air Force School; a WCIO at the Air Force School, healthcare sciences. Then the Air Force offered the opportunity for me to go back and get a Masters in Health Informatics. I had a Masters in Public Administration already, and I went and did that for two years and was a regional CIO in the Air Force Medical Service, and then finally was a Chief Technology Officer for Air Force Health Worldwide Operations.

And, in 20 years, I said, “Really, I’m not kidding this time, I’m getting out of the Air Force.” Military healthcare, Air Force healthcare, actually, is incredibly similar, almost identical to the issues that we face in civilian healthcare. So the transition from that job at the Pentagon to Scripps Health, as the corporate vice president and CIO there, was really pretty easy. Then the transition from there to here, obviously, has also been a very smooth transition. So I come from an IT background, but I have done healthcare administration over a lot of different areas; I have a pretty broad background as far as that goes.

AG: Assuming that most CIOs, like yourself, have come up through the IT side, one of the skills they would have to add is around budgeting and finance. Do you think, one, that budgeting is something CIOs have had to learn along the way, and is there any advice you can give your colleagues who may not feel they’re as strong in this area as they should be?

DD: It would be more difficult for me to believe that someone could get to the position of CIO without some skill and background in budgeting. So I guess I would start there. But if I were a manager in IS, or a director in IS and I was aspiring to be a CIO somewhere down the road, I would take the, “I don’t know everything about everything, I need to learn as much as I can” approach to life and my career. That is, if I know that I’m weak in numbers, I have to school myself in that, and that may mean I have to spend a little extra time and take somebody from the finance department out for dinner, and have them explain some things to me, and do some one-on-one education on the side, or find a mentor in that area that can help.

In many of my past positions, I realized that there was no way I could have universal knowledge, so the best thing I could do was figure out my weaknesses, try to make myself as strong as I could in those areas, but then also hire teammates that can cover those areas that were strong there, but maybe weak in what I can do well. I’m always telling the team, all of us are smarter than any one of us, and that’s really how I think a good team has to be built. You’ve got to figure out how to cover yourself, and that’s why I’ve always had a financial analyst on the staff, because while I’m okay with numbers and budgets, I’m not great. I can explain where I want to go, I know what I want to do, I know how to negotiate contracts. Maybe I’m better than I think, but I’m always skeptical about how much I know and, if I can get help, I get help, I ask for it.

AG: In good times, people can probably get by with basic knowledge, but in lean times, when your budget’s really going under the microscope, it helps, it’s important to be savvy on understanding those numbers and how those spreadsheets lay out. Is that correct?

DD: Yes. I agree with you completely and, again, I think if you did a really good job in building a budget in the first place, and you had to defend it in the original process, and you had to aggressively defend it in the original budgeting process, then it becomes much easier to defend in lean times.