It is quite possible that Tim Stettheimer is one of the busiest hospital executives — or people, for that matter — in the country. In addition to serving as senior vice president and CIO at St. Vincent’s Health System in Birmingham, Ala., Stettheimer is also regional CIO for Ascension Health System in St. Louis, Mo., where he works as national advisor for clinical information systems development for the 20-hospital network. In addition to that, he is an active member of the CHIME board; still, he found the time to speak with HCI Associate Editor Kate Huvane about how he manages his time while balancing so many roles, and about the importance of leveraging CIO relationships.
KH: One thing that’s amazed me since I started at HCI is how many CIOs seem to know each other.
TS: It is actually a pretty small and tight community. I serve as a board member for CHIME; I just started a term this past January, and it’s one of the greatest deals, just having the opportunity to make even more connections and learn about some of the behind-the-scenes stuff on the professional organization side. But it is a small community, and if you don’t know somebody, you absolutely know you’re only one degree of separation there, at most. If you get into this industry, particularly at CIO level, somebody knows you — you never burn your bridges, because there are not that many bridges around. But it’s a great opportunity, just in terms of where we’re at in healthcare right now, and the needs and challenges.
KH: You have not one, but three professional titles — how on earth are you able to split your time among these three positions?
TS: I do have three hats, and that is in addition to my other professional hat as a CHIME board member. The CHIME board is a working board; for example, with CHIME, my unique responsibility on the board is to head up the educational efforts, which involves the fall forum, the spring forum, the regional lead forums, which are online — about 20-30 presentations or webinars each year, and to also deal with the CIO boot camp, the vendor or foundation firm boot camp, and a few other things.
KH: So your role with CHIME is obviously a very involved board position.
TS: Oh yeah, it’s pretty busy, but fortunately we have great staff there, so it makes a world of difference.
So aside from that, the professional contribution hat, which is actually pretty darn fun, I have three hats that I’m actually paid for. One is my role of senior vice president at CIO for St. Vincent’s Health System here in Birmingham, which is really four acute facilities and one pretty large non-acute. This is my home base; it’s where I’m sitting in my office right now. That was actually the job I was hired to into about five and a half years ago when I moved to Birmingham.
My other two roles have come about because of the evolution of our larger health system in terms of its IS structure, organization and capacity. About a year after I got here, I got a phone call asking me if we wanted to participate in some efforts that were going on at the system to try to look at how we wanted to restructure and redesign; because in the past, historically, we hadn’t done a huge amount across what we call our ministries. Our ministries are essentially our local health systems. Ascension Health is in 20 states and the District of Columbia, and Birmingham is one of its ministries. St. Vincent’s in Indianapolis is one that has even more acute facilities that we have down here. We have about 28 ministries, but there are about 72 hospitals. I’m not sure what the exact count is, sometimes it evolves and changes — like the ones in Birmingham (we actually acquired last year three of them). We’ve been going through some pretty significant growth here.
My other hat is regional CIO, which means I take care of southeast region for Ascension Health, which really encompasses Florida and Alabama. So I’ve got Mobile and Birmingham in Alabama, and in Florida, I’ve got Jacksonville, Pensacola and then we have some related facilities a little further out. We actually had a facility in Georgia that I was responsible for, but we divested that one. So I take care of the region, meaning that the CIOs at those ministries report up to me, and I go out and work with the executive teams and support the staff. Those are usually quarterly visits, sometimes more frequent; like in Jacksonville, I was out there every month, pretty much, over the last year, because we were acquiring the facility from Mayo, so I wanted to make sure I had a presence for that.
That happened in April.
And then my third hat is nationally for Ascension. I, along with one of my peers — Mary Paul (vice president and CIO at Columbia St. Mary’s in Milwaukee), are charged to basically oversee all the clinical system efforts from the IS perspective across the entire health system. So we are responsible for the clinical information systems team; we work with our clinical excellence organizations, our physicians and nurses, at the national level across Ascension in terms of trying to match up the IS work with the clinical priorities. We are executive sponsors for that national work on the IS side.
KH: In having that role, I would imagine that entails a great deal of communication and collaboration with clinicians. How does that work impact your role as a CIO and help you to better understand the needs of clinicians?
TS: It’s critical. We do have different customers and constituents. We have operations people, administrative, finance and supply chain — all of these are groups that we support, but the clinicians are key and critical, because without them none of those groups would need to exist. It’s interesting, if you look at most healthcare entities today, the IS organization is one that has to span every part and corner and area of the healthcare entity, because frankly, we’re who every part of the entity looks to for support for their initiatives these days.
Three years ago, when Ascension was putting together its 20-20 vision and strategy, I was at that meeting with about 105 people in St. Louis, and what impressed, scared and otherwise amazed me was that as we laid out that vision for long-term direction and strategy, I couldn’t pin any item on our map that didn’t involve some degree of significant IS support and work. And that’s just, I believe, common now across most HC entities; the reality is that the IS organizations have become a critical component for success, not just from a pure plumbing or operational perspective, but really to support the strategy and direction that organizations want to take, whether that has to do with being able to be consumer-centric or bringing clinical excellence and high-reliability healthcare presence to deal with outcomes, to deal with process — all these things are touched by what we support and do. Our job has become even more critical over the last many years because of that.
KH: In your work as a national advisor, who are you dealing with primarily? Is it super user groups of clinicians?
TS: This is somewhat unique to the Ascension structure, but we do have a clinical excellence group at our national level. We have a vice president of clinical excellence, we have a nurse and physician who deal with informatics, we have a chief medical officer, and a chief nursing officer.
So we — Mary and myself — have relationships with those people that we’ve worked to form, because they’re the ones working more with all of the individuals at the ministries than we are, because that’s their primary job. What we do is, we make sure we form relationships with them and support them. We have on a national clinical excellence team which is primarily clinicians (physicians, nurses, pharmacists, etc) from our ministries. Mary and I sit on that committee to be resources available and provide input; but we’re not viewed as purely technical participants. That is actually a change that’s occurred over time, not just with Ascension, but with many entities. In fact, I think that’s why over the last 5-7 years, there has been turnover in many of the CIO ranks in places, because the expectation has started to change that the CIO is not just a technical expert but they are really a participant in the executive discussions. They need to be well-versed in clinical discussions, operational discussions and strategic discussions, and that creates a higher expectation.
I think that everyone brings unique experiences and backgrounds to that, and I think that on a team, they can complement each other. My background is different from my co-executive’s background in this area, and we complement each other very well. But you have to bring more than a technical hat to play in this area.
KH: I’m sure a lot of people would agree with that. I’ve spoken to many CIOs who say that their role is constantly evolving, and it seems like communication and collaboration are becoming more and important in maintaining an edge.
TS: Absolutely. In fact, the regional educational sessions that CHIME has hosted this year have focused exactly on that. I was just at one in Boston and basically the topic was CIO 2.0, the idea being that we’re beyond the first generation of what a CIO is and we are now into that space where it is well-recognized that CIOs are different than they were and will continue to be different. We talk a lot about the characteristics of what that is, how to get there, and what that looks like.
It’s a very timely discussion and topic.
You almost have to think of a curve — every healthcare entity is at a different place on that curve in regard to what the CIO does in that entity, how they view the CIO and how integrated that CIO role is in relation to the executive workings of the organization. Some are very far ahead; for example, here at Birmingham, I report directly to the CEO and the senior executive, and I attend all system-level board meetings. It’s very advanced compared to some other organizations where the CIO looks more like what they looked like 20 years ago, with just pure technical contributions.
But the curve is shifting and the curve has been shifting and I think it’s a big shift in accelerating, and frankly those organizations that haven’t leveraged greater involvement of the IS organizations in support of their entire business operations are going to be left behind in terms of their ability to sustain themselves.