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Steve Lieber Reflects on his Retirement, the Future of HIMSS, and the Future of Healthcare

December 21, 2016
by Mark Hagland
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Steve Lieber reflects on his 16-plus years at the helm of HIMSS, and on the future

H. Stephen (Steve) Lieber has served as president and CEO of the Chicago-based Healthcare Information and Management Systems Society (HIMSS) since April 2000. On Dec. 19, HIMSS announced that Lieber is planning to retire during 2017, and that a search for his replacement will begin immediately.

According to the news announcement that HIMSS released on Monday afternoon on its website, “Lieber, 63, assumed this role in April 2000 and has led HIMSS through a period of significant change in healthcare and information technology. During his tenure, HIMSS has become an influential association voice, thought leader, resource and advisor driving global transformation of health and healthcare through the best use of IT. Lieber has been a significant figure within HIMSS, the American healthcare community and globally as governments, care delivery organizations, clinicians and others have embraced health IT as a primary asset in addressing problems associated with the cost, quality and access of health and care. Under his leadership,” the announcement stated, “HIMSS has built a global operation annually reaching hundreds of thousands of engaged healthcare professionals in more than 35 countries through its educational programs, public policy leadership, strategic advisory and assessment services, membership and community networks, and other services.”

On Tuesday, the day after the HIMSS announcement, Lieber spoke with Healthcare Informatics Editor-in-Chief Mark Hagland about his impending retirement, the evolution of HIMSS as an organization, and the current moment in healthcare and healthcare IT. Below are excerpts from that interview.

You’ve been at the helm of HIMSS for sixteen-and-half years now. How might you summarize the arc of those years, both in terms of your tenure, and in terms of how HIMSS has evolved forward as an organization?

What has happened is that HIMSS has evolved from a membership organization that ran a trade show, into something very different. And in all honesty, I’m trying to be very kind to the people before me, and all—but HIMSS was not an influential voice, was not at the table in Washington, talking about changes in legislation or regulation, when I came on board. And over the last 16-plus years, we certainly have changed that dynamic. And we’ve become recognized as the largest voice of multiple stakeholders—we’re not just the voice of vendors, of clinicians, of providers, of IT folks—and of government as well. So as a result, we’ve achieved a level of credibility and independence of voice that really has made a significant difference in healthcare and in the use of technology in healthcare. That’s how I’d summarize what we’ve done. We can look at what we’ve done and really see a valued contribution to the worlds of healthcare delivery and healthcare policy.

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H. Stephen Lieber

Do you have any regrets about anything that has happened? And in any case, what do you view as your most important achievements during your tenure?

No, I have no regrets at all. Honestly, when this job opened up in the fall of 1999, I was running a division of the American Hospital Association, and I knew that this was a job I wanted; and I knew it was a job that had very significant potential and opportunity in healthcare. I’m incredibly fortunate to have been put in this position, so I have absolutely no regrets. I’ve also been incredibly fortunate to have an unbroken string of extremely supportive volunteer leaders. We have our disagreements like everyone else, but at the end of the day, we always find a good path forward together.

Meanwhile, in terms of achievements, I look at HIMSS Analytics and their having created a global standard for IT evolution that is accepted [with regard to the HIMSS Analytics EMRAM schematic for electronic health record and clinical IT adoption]. It’s the ability to bring everybody to a common place in looking at a problem and searching for common solutions; you can see how you are compared to everyone else. So that’s one example. And beyond that, it’s been our ability to work in so many countries. We now operate in, on average, 35 to 38 countries, every year. And we’re bringing a considerable difference in helping people understand the barriers and how to overcome them. And, as an example, using the EMRAM as a tool; and the biggest accomplishment is in what we’ve been able to do in helping clinicians, providers, IT, and government, in various places. I really feel we’ve accomplished a lot.

How many people were on staff when you started back in the spring of 2000?

There were 32 employees when I started, and today we have 400. And those people were sitting on one floor in a building on East Ohio, and today, those people are scattered across the globe. Our operating budget that first year was about $11 million; and this year, it will be about $90-92 million.

You’re deriving tens of millions from the HIMSS Annual Conference, correct?

That’s correct.

That leads to a question I was going to ask about the one negative critique I hear consistently about HIMSS as an organization. And that is that some people believe that HIMSS as an organization is too much about the numbers, about the revenues.

We always try to balance everything out. So for example, HIMSS Media is designed to drive revenues. That business unit is really focused on business numbers, in terms of what they’re able to drive. Meanwhile, HIMSS North America is strongly separated into two pieces. And when it comes to the piece of HIMSS North America that is focused on professional development, and the folks there have no requirement to focus on the financial numbers at all. Yes, they do have a budget every year, and they have to bring their costs in, so they are paying to numbers in that sense, but they’re not driving revenue at all. So the professional development is strictly member- and subject matter-focused.

And then there’s the annual conference. The annual conference has two purposes. One is to educate, and that side is focused on just breaking even. The educational program charges a fraction of what a for-profit company would charge. We don’t design that to make money; if we break even, I’m happy. But yes, we are focused on driving net income. That’s where I feel that our critics aren’t recognizing what the purpose is of why we do some of the things we do that drive profit. I’m not doing things in Turkey, Latvia, other parts of the world, if I don’t create profits that I generate in other places. So the work we do in many places is designed solely to break even, because the work in those places we do requires a much bigger investment. So I make no apologies for making money in some places, so that we can spend those profits and truly bring about a better way of life in those other places.

What will happen to the organization in the next couple of years ahead?

Every year, we develop a set of strategic statements that really drive us in terms of our internal thinking and planning. And I’m glad to share one of them with you, because it very much is a telling statement about the organization of the future; it’s to expand the impact on policies, content and communities around the world. So it’s an expression of our intent that we started just about 10 years ago when we went to Geneva with the first conference that HIMSS produced outside the United States. It’s recognizing the reputation, the brand, our convening ability, and the thought leadership and voice that HIMSS can bring to all parts of the world in helping everyone move positively down this journey. That’s what I see for the future—an absolute commitment to that by this organization. That’s not a “Steve agenda”; it’s ingrained in the culture of the organization. So I think what you’ll see of HIMSS in the future is that, if I do my job right in the next 12 months, the strategic thinking and the resources for those who follow to continue to build on that.

And what do you see happening in healthcare more generally, in the next few years?

Healthcare is getting smarter, and it will do so using technological tools. We’re going to understand disease better, genetic makeup better, what works and what doesn’t work. So the key comment, the key prediction, is that healthcare will get smarter by using technological tools. And that’s exactly the thinking I had 16-plus years ago; I wasn’t able to articulate it quite the way I can now. But it really was the view I had when I applied for and received this ob. I knew what the opportunity was for what information systems could bring to healthcare. And looking forward, what healthcare will come to realize that most other industries already have, is the value of smartness. I think it’s going to become even more of a technology-driven and information-driven sector, and therefore, very much where HIMSS is positioned, and in terms of what we’re continuing to try to do to anticipate how those tools will be used. And that influences how we develop our next round of tools.

People really are using healthcare IT to create transformational change in healthcare. The pioneers are doing it, as I just blogged today. Meanwhile, there are an awful lot of “Debbie Downers” out there these days; but the pioneers are proving them wrong.

My view is that the pioneer or innovator will never be a “downer.” These are the people that at times you have to watch out that they’re not overly optimistic or over-promising or leading you off the cliff. But there is far more upside potential from an innovator, from a pioneer. I certainly am an admirer and an advocate for pioneers, and I like to provide the platform for them to talk about and show what they are doing, because I really do believe that they provide probably the best avenue to the future. If you only follow the doubters or the negative voices, it will lead you back and not forward.

Do you have any other thoughts that you’d like to add?

As I joked with my staff yesterday as I was making the announcement, I’ve got two years’ worth of agenda that I’ve got to cram into one year, so I’m very engaged. I’m very excited about the year ahead. But yes, I will feel a great loss when I walk through the door the next time. There will be a next chapter and a future Steve; I’m not sure what it is yet. I’m not going to do it full-time or the exact same thing I’ve done for 17 years. But I’m very excited about what we’ve done, and am excited about what’s next. And I honestly don’t know what will happen; that’s kind of liberating, actually!

I honestly don’t picture you sitting in front of the fireplace knitting, in your retirement.

No! I have to be engaged. I’ll be contemplating what the best things I can do.

 


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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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