Catholic Health Initiatives is a nonprofit organization headquartered in Denver. The faith-based system operates in 20 states and includes 77 hospitals, 40 long-term care, assisted- and residential-living facilities, and two community health services organizations. With approximately 70,000 employees and annual revenues of $8.2 billion, CHI ranks as the nation’s second-largest Catholic healthcare system. Last month, O’Rourke was promoted to full-time CIO after an 18-month interim stint, during which he helped restructure the entire IT organization. Recently, HCI Associate Editor Kate Gamble spoke with O’Rourke about what it takes to transform 40 autonomous operations into a single enterprise, as well as his vision for the organization.
KG: So by pushing forward with plans and being upfront, you were able to gain the respect of the staff as well as the senior leaders.
MO: I would say it was identifying the outcomes and the journey we were on, and being clear. One of the key successes, and I think this is important in any work you do, especially transformation, is to have really extraordinarily clear communications and to manage expectations; to define expectations and then to manage them with your audience. When I came into the organization, the one thing I was emphatic about was that I said I need communications people — Mike Romano and Peg O’Keefe — to help me with this. Because I can do all the right things and it can be interpreted all the wrong ways. I would say the communication was done extraordinarily well, and I think that without it, there would be a lot of misunderstandings and misgivings. It was so clear what our objectives were and how we were going to do it, and information was sent out in advance. If someone asked me what I was paying for this or how much consultants cost, it was all transparent. You could put it right there on the table. And I think that put people back a bit and made them say, well, this is not Attila the Hun. This is really just good, sound business.
But it was a shocker for myself and others, I think, in the end, that we did achieve this degree of acceptance. There was credibility there.
KG: You mentioned that governance was one of the key components of CHI’s restructuring. How was it set up?
MO: The way that the governance structure works is we have representatives from our MBO as well as our corporate office. Most are senior executives, but there are people from clinical and other different areas who sit as a group now that really represents different constituents and stakeholders throughout the organization. We still have smaller steering committees in the MBOs that do work locally, so that we can pull that work together and bring it up to this national governance group, which is very important. This way, we still have alignment. But the national group is actually responsible for looking across the organization as we bring all this information forward. An example would be, as we go into a budget year, we’re looking at all the different types of requests for IT for different things. It’s part of this governance that we look to in working with IT to make recommendations and say, ‘We can’t do 15 different of these various different things. We’re going to do three, and they’re all going to be with the same vendor.” So they are now empowered to help us move that standardization model forward.
And we feed into that governance model through this whole EPMO (enterprise project management organization), which puts all this structure and rigor to what project requests are, how much they are, what are the benefits, when will we see the benefits, are others doing the same thing, and can we leverage some of the applications we are already have in the organization. So there is a very large funnel that happens through the EPMO into that governance structure, which basically provides the information for making good decisions.
KG: I would imagine that with such a large organization, it has to be structured so there are regional CIOs to help manage and funnel the requests and other IT issues.