San Luis Valley Regional Medical Center (SLVRMC) — located in South Central Colorado — is an 85-bed facility, operating a level III trauma center, with valley-wide ambulance service. The organization is the largest medical facility in the valley, and works closely with two large clinics; one dedicated to specialists and the other to family practice and outreach. Recently, HCI I had a chance to talk with CIO Spencer Hamons about what it takes to be an effective IT leader.
AG: It sounds like when you have a staff of 18-20 you can’t afford to have someone that just wants their head down behind the computer, no matter how good they are.
SH: Right. There is always going to be that exception, and there are always going to be those folks who don’t want to go out and do that, because that’s not something that interests them. But you need to make it clear that it’s important — and that’s the thing about being a leader. Too many people in leadership positions expect to come in every day, manage their budget, watch their salaries, watch their overtime, look at project plans to make to sure they're meeting their goals, but that doesn’t fit the definition of what a leader truly is. A leader is someone who leads people. And you have to take people out of their comfortable situations and sometimes put them into uncomfortable situations to do it. I think in healthcare we have forgotten that. We try to come in every day and manage our budgets, manage our bottom line, manage our projects, and we don’t manage our people.
AG: Our conversation has drifted towards staff — and I’m very okay with that — is that something that is on your mind, or is that something you think may be an overlooked part of the CIO job?
SH: I think that that is something that’s overlooked in most management jobs in healthcare. I just think in healthcare we have gotten past the point of hiring people who understand what leadership truly is. In most management jobs, I firmly believe they come to work every day thinking that they are doing the best job that they can do. And if you look at the different management training methodologies that are very popular in today’s society, a lot of those trainings talk about how do you sell more, how do you manage budgets, how do you manage projects, Leans, 6-Sigmas, all of these data-driven analysis things, but we have forgotten about leading people.
I have a military background and that’s something that’s very personal to me, very strong in the way that I was brought into managing was about managing people. As many faults as people think that the military has, they have great leadership training. And I wish that we, as a culture in healthcare, would look at how we can do that and bring that back into something that is popular.
AG: That’s very, very interesting, because two other individuals that I know (both consultants), and one of them is writing an article for us and they both have military experience. They both have said that being in the military was invaluable in shaping not only who they are, but the way they approach leadership and project management. It seems like with that military experience or training have a unique perspective.
SH: It really does define it. You learn, first off, that taking people out of their comfort zone is not necessarily a bad thing. In the military, you may take what you would consider to be your weakest link and you put them into leadership roles to see how they perform. It will oftentimes amaze you whenever somebody really steps up and they do things that you can't believe. You start to learn about what that individual brings to the table.
In the military, there are a lot of measurements. Everybody has a physical fitness test score. Everyone has an aptitude score. Everybody has their marksmanship scores. I can look at an individual on paper, and I can say this guy is a great soldier on paper, but that doesn’t tell me anything about the person. That is really where the military really teaches us, as a leader, those numbers are important. They're important for the mission of the military to do its job, but when it comes to interactions with people and leading others into doing the right thing, the infantry motto is ‘follow me.’ That is one of the big things that they teach in leadership skills.
For example, one of the first things you learn in any leadership training in the military is the different types of power. Let’s talk about reward power. Reward power is my ability to reward you for doing something good. People do things for me so that they will get rewarded. People do things so that they don’t get punished. You have what they call authoritative or legitimate power, which is just by your rank, and you outranking somebody, they do it because of that. But what you really strive for is reverent power. Reverent power is the power that you have, the authority that you have because people want to please you. They want to do the right thing for you. Whenever you have folks that work for you because you have that type of power, there is nothing you can't really accomplish. It takes two-way respect to pull that off. I’ll tell you, I don’t have reverent power with everybody in my organization, but I know who I do have it with. I know who in the organization has coercive power. I know who in the organization responds best to reward power. And so you have to know how to use those things. But most people in leadership positions don’t even grasp those concepts.
AG: What is the hardest relationship for a CIO? Is it dealing with, for example, a chief of cardiology who has no interest in the system that you're rolling out? What if you don’t have any type of power over that person?
SH: Those situations are very tough to deal with. What a CIO has to rely on in those types of situations is the authority and respect that the CIO has with the remainder of the executive team. And what I have found is most of the time, when those situations come up where you have a difficult physician that you're trying to deal with, that physician has something that motivates them. It might be their ability to see more patients. A lot of times, it’s their ability to do what in their mind equates to the most quality that they can get or the best care that they can get, and they are going to do whatever they can to meet that motivating need. And that’s where it’s really important for the CIO to have every one else on the executive team on the same sheet of music in understanding what is going on.
If I have a physician who goes to my CEO and says, “You know what, this system that you're putting in is terrible. It’s not going to meet my needs. It’s going do this, it’s going to do that … ” What I want to hear from my CEO is I understand your concerns, but I know that Spencer has gone through this process, and he has looked at that, and these are things that if it was actually going to do that, he would not be considering it.
AG: So you need to be backed up and supported.