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At Health IT Summit, CIO David Chou Challenges Leaders to Think Digital Transformation

October 19, 2017
by Mark Hagland
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David Chou, CIO of Children’s Mercy Hospital in Kansas City, told attendees at the Health IT Summit in Raleigh that they need to be change agents, helping to lead healthcare into the digital age

In the morning keynote session at the Health IT Summit in Raleigh, sponsored by Healthcare Informatics, and being held at the Sheraton Downtown Raleigh (Raleigh, N.C.), David Chou, CIO of Children’s Mercy Hospital (Kansas City, Mo.), challenged his audience to “think digital” in a big way, in the face of an emerging healthcare economy filled with challenges and opportunities.

Chou’s full title is vice president / chief information and digital officer at Children’s Mercy Kansas City, the only freestanding children’s hospital between St. Louis and Denver. He has served in numerous different executive roles in healthcare, from CIO at AHMC Healthcare in California, to senior director of IT operations at Cleveland Clinic Abu Dhabi (where he led the creation of a hospital in Abu Dhabi from scratch).

In his keynote address, entitled “Health IT Leadership in the Era of Digital health Innovation: Stories from the Field,” Chou told his audience that “We hear the buzzword all the time: digital transformation. In fact,” he said, “it’s one of the most overused terms in the last few years. But what are we talking about when we talk about digital transformation? Who leads it? And where is it going?”


David Chou

Chou broke the concept of digital transformation down into four areas. “Think of digital as using four core technologies,” he said. Those are mobile computing, cloud computing, data, and the social media space. “In terms of mobile, that is the platform of choice now in terms of rolling out solutions. Meanwhile, when it comes to cloud, are you thinking of cloud-based solutions? And if you are, will you be using a private cloud, a hybrid cloud, or a public cloud? Then there’s data. Every one of you is trying to be a data-driven organization; and data and analytics will be a big part of digital. Meanwhile, the last area of consideration is the social space. How many of you took Uber from the airport to get here?” he asked the audience. “You’ve probably rated your driver. And maybe you’re rating your doctor as well.” Social media interaction will become increasingly important going forward, he said.

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Chou then broadened out the conceptual framework around digital transformation. He noted to his audience that 52 percent of the U.S. corporations on the Fortune 500 list in 2000 are now gone—“acquired, merged, or bankrupt. Meanwhile, 55 percent of Fortunate 500 companies were losing money in 2015. And,” he said, healthcare organizations are all being disrupted by digital.” He told an anecdote about showing some twentysomethings a photographic image of a floppy disk—and having them believe that it was the photo of something created via 3D printing. That, he says, shows how quickly things are changing now in the world.

One very important element in all this, Chou told his audience, is for CIOs to understand that digital strategy and IT strategy are not the same thing. “Start thinking about digital and digital strategy. That’s a lot different from an IT strategy,” he emphasized. “It’s really about creating new business processes, or redesigning existing processes using technology. And that’s a very different role from the traditional CIO role. I remember years ago when I was in data processing,” he recalled, “and people didn’t even know what a CIO was. Now, we’re asked to create new business models. That’s a very different thought process. I would challenge you guys to think about that.”

So, he said, “How do we use information technology to help us win? That’s the current CIO role. But now, think about how our business might survive and thrive in a digital world? I call that the CIO 2.0” role. “And where do you start? You’ve got to understand your organizational DNA. Without understanding that, you really don’t know how fast your org can move. Are you considered a market leader?”

Citing research, Chou said that, across industries, experts see only 5 percent as “market leaders” in their fields. “Apple, Google, Microsoft, they want to be the first movers on everything,” he said, with regard to the 5 percent of business organizations normally considered “market leaders.” The next category, composed of 15 percent of business organizations, is comprised of the “’fast followers’—they’re closely watching the market leaders. That’s a good place to be as well.” Still, he continued, “If I had to guess, I would guess that every one of you here would fall into the third or fourth buckets, most into the third. The third group is ‘cautious adopters,’ and they compromise 50 percent of the business organizations in the world. They’re looking carefully at solutions, making sure they’re OK. When they feel safe, they roll out those solutions,” he said, speaking of strategies and technological adoption.

Meanwhile, the fourth and final group, “laggards,” makes up a full 30 percent of business organizations. “Are you the last organization in your region, or nationally, to roll out a regional telehealth solution, for example?” he asked. “That’s a very dangerous space to be in.”

Chou challenged his audience to think about these dynamics. “So how do you start on this digital journey?” he asked. “First, ask what kind of organization you are. And what are you focused on, if not innovation? Cost? Most are business organizations are focused on cost. And how do you innovate in a digital world, if you’re mostly focused on cost? And who should lead the innovation? Gartner did a survey where they found that the CEO should lead the digital transformation, followed by the CIO. But that’s changing now, some people believe the CIO should be leading it.”

By way of illustrating the challenges today, Chou reported that “I spoke recently with a CEO who was looking for his CIO to be a digital transformation leader, and his CIO wasn’t that. Think about that in terms of your role. Are you merely keeping the lights on, or really thinking about the digital world?”

Meanwhile, Chou said, “Consider the ‘I’ in ‘CIO.’ My job is to influence.” In other words, “CIO” should really stand for “chief influence officer,” in the context of leading one’s organization forward into digital transformation. “So, aspiring CIOs, you need to think about what that means for you, since you can’t control everything. And, for my part, I want to be the chief influence officer.”

Emerging issues

When it comes to what areas he thinks CIOs should really focus on in the next year or two, Chou says, “I see four issues for this coming year. First is building digital capability for the coming healthcare [system]. Second is IT security. Third is creating a digital experience for internal stakeholders. In that regard, everyone hates IT help desks. We simply have to create a new experience. And, in that context, are there possibilities in terms of social collaboration, where people could post a problem to the community for suggestions? And how do we staff the help desk? Do we know how to staff it correctly for fluctuating levels of demand? And the fourth one is [optimizing] our contact center—the first point of contact.”

Meanwhile, Chou noted, surveys have found that 90 percent of CEOs believe that the forward evolution of the digital economy will have a major impact on their industry; yet only 25 percent say they have a strategic plan in place to address that evolution, and fewer than 15 percent are currently funding and executing a digital transformation plan. CIOs and other healthcare IT leaders, he concluded, need to shape their future. “You have to create the change,” he told his audience. “You have to move forward into the new healthcare economy.”


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The Modern Healthcare CIO, CMO, and CTO

December 10, 2018
by Lori Williams, Industry Voice, vice president of fulfillment, Gigster
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Disruption in the healthcare space comes primarily from the expansion of data’s role in the industry, and the healthcare C-suite’s familiarity with that expansion will help drive company and industry success

For the healthcare C-suite executive, the industry has never been more complex—nor has it ever contained so much potential. Emerging technologies mixed with political uncertainty has created an environment where incredible amounts of healthcare data are revolutionizing how patient care is handled, but patients remain uncertain about the future of their own health. With better data and the means to draw insights from it, healthcare CIOs, CMOs and CTOs are in a position to help address patients’ uncertainties and make hospitals and clinics more accessible and effective than ever before.

Here’s a look at how the role of the modern healthcare CIO, CMO and CTO is changing:

The Modern Healthcare CIO
The modern healthcare CIO’s role has evolved to become more innovative. No longer a title reserved strictly for engineers and IT professionals, today’s healthcare CIOs are focused on information science instead of simply setting up network infrastructure or providing back-end support. The trend towards a more data-centric role began as hospitals rolled out electronic health records, equipping individuals with better access to healthcare provider data. Through enterprise data warehousing, CIOs are becoming masters of data management, governance and predictive analytics, and passing along the many benefits of those knowledge bases to patients.

The Modern Healthcare CMO
The confusing healthcare landscape makes the role of a healthcare CMO more necessary than ever before. Thanks to ongoing regulatory changes, uncertainty surrounding the Affordable Care Act, and shifting consumer expectations for on-demand services, healthcare CMOs are responsible for helping patients navigate their way through a complex and opaque industry. As patients continue to assume the role of consumers, carrying out comparison shopping as they would for any other industry, CMOs must be adept in crafting a healthcare provider’s brand and messaging.

At the same time, CMOs must also ensure that healthcare providers offer a modern online experience, ensuring websites are mobile-optimized and social media accounts are generating engagement. This also means CMOs need to help move marketing efforts into the 21st century, transitioning away from direct mail or billboards towards digital marketing and CRM tools. Because if they don’t, there are plenty of med tech startups that will promptly eat into their market share.

The Modern Healthcare CTO
Unlike healthcare CTOs of the past who remained siloed off from the rest of the organization, today’s modern healthcare CTO is fully engaged with healthcare providers and their technology stacks, utilizing new software and hardware to improve daily workflows. The CTO is enabling the transition to patient-oriented self-service operations, enabling patients to carry out administrative tasks like scheduling appointments or refilling prescriptions over the internet. Because medical data is often stored in a variety of different sources, it’s critical for the CTO to be able to keep these systems interoperable with one another. For hospitals riddled with legacy software, CTOs should expect to continue employing middleware solutions to bridge the gap between old and new.

Members of the healthcare industry C-suite have the power to transform lives, and the CIO, CMO and CTO have roles that directly affect a provider’s ability to carry out positive change. With better data from the CTO’s tech stack, the CIO can use better analytics to help providers determine the best solutions for their patients, marketed to consumers by the CMO through modern platforms in clear, easy-to-understand language.

Lori Williams currently serves as Gigster’s vice president of fulfillment. Prior to joining Gigster, Lori was the general manager for Appririo.


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What Does Your Magnum Opus Look Like? A Few Operatic Thoughts

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I was given the privilege and pleasure recently of presenting, for the second year in a row, a lecture on Richard Wagner’s “Ring” cycle, as the leading opera company in my city, a world-class opera house, has been putting on, in yearly succession, the four operas of the “Ring of the Nibelung” cycle by German composer Richard Wagner (1813-1883). Last year, the second opera in the tetratology, “Die Walküre,” was performed; this year, the third opera, “Siegfried.” After the concluding opera, “Götterdämmerung,” is performed, the entire cycle will be presented in festival format, always a major cultural event. I spoke on “Siegfried.”

I’ve been fortunate to have seen six complete “Ring” cycles in live opera houses in different cities, and I can tell you, it’s a life-changing experience, as this four-opera work (16 hours of music altogether), sits at the absolute summit of western art. Richard Wagner was a hideous human being himself, but spent numerous years working on something that changed the course of classical music and redefined opera.

What’s more, from the summer of 1848, when Wagner wrote a first sketch of the libretti, or texts, of the operas, until their true compositional completion in 1871, more than 23 years were to pass; and it would be another five years before the tetralogy was fully presented, in a purpose-built new opera house in the Bavarian town of Bayreuth. It was a herculean feat to create the entire text of these four long operas, and compose 16 hours of music that would completely redefine the concept of opera. Indeed, when the crowned heads of Europe, the great living composers, and the 19th-century European intelligentsia and glitterati, gathered at the new Festspielhaus in Bayreuth in 1876, many were so overwhelmed by what they saw and heard, that they were rendered speechless. Even now, 142 years later, first time Ring-goers are overwhelmed by the breadth and sweep, the musical and dramatic audacity, and uniqueness of the “Ring” operas, with their story of gods, giants, dwarves, flying Valkyries, Rhinemaidens, one huge dragon, humans, gold mined from a river, magic swords and spears, and of course, a gold ring whose possessor can control the world and its fate.

Even just looking at the third opera, “Siegfried,” Wagner struggled mightily. For one thing, being essentially a grifter and a cad, Wagner borrowed/took money from everyone who would lend/give it, and often had affairs with the wives of the patrons bankrolling his compositional work, leaving his life in constant chaos, as he fled from one city to the next. One such wife, Mathilde Wesendonck, inspired the opera “Tristan und Isolde,” groundbreaking operas that Wagner wrote during a 12-year hiatus in his composition of “Siegfried.” And “Tristan” itself changed the entirety of classical music, its tonality-challenging chromaticism.

Well, no one is expecting anyone to match the unique creativity of Wagner’s “Ring” cycle. But the leaders of U.S. patient care organizations are doing a lot of important things these days, including using formal continuous improvement methodologies to rework core patient care delivery processes in order to transition into value-based healthcare. What’s more, as our Special Report on Leadership outlines, the entire role of the CIO is being rethought now, as the demands for leadership and strategic capabilities are catapulting that role forward; and patient care organizations are beginning to make real headway in advancing equality for women and people of color among the ranks of healthcare IT leaders and managers.

So while no one is expecting anyone to create an operatic tetralogy that will change the face of music, there are plenty of heroic endeavors open to anyone willing to envision the healthcare system of the future. The opportunities are as limitless as the imagination.

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Using Performance Management to Scale

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Performance management is so much more than just a year-end performance review
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Performance management and goal setting have always been part of my DNA. It’s like a compass that tells us we are steering the ship in the right direction or gives us a chance to course correct if we wander off track. It’s hard for any organization to determine how they are doing unless there are clear measurable objectives. CIOs and their leaders need monthly, quarterly and annual goals to measure how you and your team are doing against the plan. I also firmly believe they should be S.M.A.R.T. goals: Specific, Measurable, Achievable, Relevant and Time-based.

Once the goals have been established, you need a written plan. I like three-year rolling plans so you can look into the future and describe your vision of what your organization will look like 36 months out. Then you can work back to the second year, and eventually the first year, to give you the framework for what you need to accomplish in the next 12 months. I suggest you do it with your managers. It makes them accountable to the organization since they are involved in the formation of the plan.

Your plan must be a living document to be used frequently during team meetings throughout the year to see how you are performing as a team and individually. This is not a process you invest in to review at year-end to see how you performed. By then it’s too late. It must be reviewed on a consistent basis to make sure everyone is on track. Performance management is so much more than just a year-end performance review. If there are individuals who are not performing against the plan, you can use the plan as a tool to performance manage them to re-engage as an important member of the team. 

I just returned from the Scale-up Conference in Denver and learned so much about taking goal setting and performance management to a whole new level by adopting the "Rockefeller Habits," as written by Verne Harnish. After reading the book, everything changed for me in the way we will be doing our planning, goal setting and performance management forever. It’s so brilliant and easy to understand. Here they are:

Rockefeller Habit #1: The executive team is healthy and aligned

Rockefeller Habit #2: Everyone is aligned with the #1 thing that needs to be accomplished this quarter to move the organization forward

Rockefeller Habit #3: Communication rhythm is established and information moves through the organization accurately and quickly

Rockefeller Habit #4: Every facet of the organization has a person assigned with accountability for ensuring goals are met

Rockefeller Habit #5: Ongoing employee input is collected to identify obstacles and opportunities

Rockefeller Habit #6: Reporting and analysis of customer feedback data is as frequent and accurate as financial data

Rockefeller Habit #7: Core values and purpose are “alive” in the organization

Rockefeller Habit #8: Employees can articulate the key components of the company’s strategy accurately

Rockefeller Habit #9: All employees can answer quantitatively whether they had a good day or week

Rockefeller Habit #10: The company’s plans and performance are visible to everyone

Accountability is no longer hard to measure since the entire plan is visible to everyone throughout the organization. Each part of your team should have key people accountable for every functional part of your organization. No more guessing is required. I’ve read countless books about leadership, performance management and goal setting, as I’ve been an avid student on the subject for decades.

These ten habits, once adopted and measured regularly, can change any organization that wants to grow and scale, and keep everyone accountable along the way.

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