In opening addresses to the CHIME Boston event, cosponsored by the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME) and the Institute for Health Technology Transformation (iHT2—a sister organization to HCI under our Vendome Group LLC corporate umbrella), two nationally recognized healthcare IT leaders spoke Monday morning, May 18, of the challenges facing patient care organization CIOs today and going into the next few years.
Speaking at the CHIME LEAD Forum, being held at the Hyatt Regency Cambridge in Cambridge (Boston), Massachusetts, John Halamka, M.D., CIO of Beth Israel Deaconess Medical Center in Boston, and Russell P. Branzell, president and CEO of CHIME, spoke passionately about the need for CIOs to help shape the futures of their organizations—and their own futures. At a time when technology is advancing rapidly, when the U.S. healthcare system is going through a fundamental shift from volume-based to value-based payment, and when CIOs are facing ever-growing “to-do” lists, both Halamka and Branzell, both among the best-known healthcare IT leaders in the U.S., urged CHIME LEAD Forum attendees to focus on strategy and the future, and to keep their eyes on the bigger picture of healthcare system change.
Halamka, whose organization continues to pioneer in so many areas of healthcare IT, noted the difficulty for CIOs of helping to lead change even as their own organizations undergo regular management and other organizational disruptions. “It’s really hard as CIO when things are constantly changing,” he told the audience of healthcare IT leaders. “I’ve had seven CEOs in my term at Beth Israel Deaconess. So I as a healthcare IT leader try to be as open and consistent as possible. I’ve not ever had a situation that I’ve suddenly changed course in such a way that people are confused,” he said, noting that a certain type of management constancy, allied to perpetual flexibility, will be key for CIO success going forward.
It is particularly difficult now that CIOs are pelted daily with new requests and demands from inside and outside their organizations, Halamka said. “People say, ‘OK, I get it, we need to be prepared for the accountable care future, we need to prepare for care management and care in the home, and even though there’s this cool project that some stakeholder wants, we really don’t have the bandwidth for that.’ And so what not to do” as a CIO “is as important as what to do, because each of us gets this laundry list of hundreds of things that stakeholders wants.”
He said with a bit of humor, “The technique I usually use is not to say ‘no’; ‘no’ is such a negative word, so loaded with emotion. So, I say, ‘not now.’” Meanwhile, he added, “My role on the resource side is not to create fear, uncertainty and doubt, but to explain to the board what we need to do.”
Focusing on the strategic and being a strategic leader, Halamka said, has really helped him help to guide his colleagues forward at BIDMC, where that organization’s culture of innovation has been moving forward continuously. For example, his team has just created a new app that interfaces with the smartphones of BIDMC patients and allows the organization to upload data from their smartphones. The organization went live with that app, BIDMC At Home, about a month ago, beginning with the uploading of patient body weight; glucometer data from diabetics will come next. What is important, Halamka emphasized, is to create an environment of transparency, accountability, and true leadership, in which CIOs can be assured that the other senior leaders, and all the organization’s stakeholders, will follow their lead in pursuing innovation.
He also shared his perspective that CIOs need to constantly engage with “VUCA”: the volatility, uncertainty, complexity, and ambiguity inherent in their operating environment.
Branzell, whose address came immediately after Halamka’s, shared a slide that he used to help frame what he called the journey to the “CIO 3.0.” The evolution of the CIO role has been thus, he said: pre-CIO, IT operations directors were technical managers, and their role was advisory. The “CIO 1.0” was a supportive role, focused on being an application purveyor. The “CIO 1.5” is an enabler role as a knowledge purveyor. The “CIO 2.0” role is a driver role, with the CIO functioning as a service broker, project advisor, and venture capitalist. Most patient care organization CIOs, he noted, are struggling to move into and through the “2.0” role phase; his view is that only 10-15 percent of CIOs are”2.0s,” in his view, while 40 percent each are “1.0s” or “1.5s.” What does the “3.0” CIO look like? The handful of true 3.0 CIOs are truly driving change and transforming their organizations, he said.
Towards the end of his address, Branzell shared his “Rules of the Revolutionary CIO” for his audience. Those five “rules” are: “Don’t ever accept the status quo; ‘Semper Gumby’—always be flexible; plagiarism [in operating innovations] is a skill, not a crime; don’t evolve, revolt!”—and, finally, “Make somebody mad today!!!!” (all four exclamation points his).
He closed his address by stating firmly that “Radical change is what will save this industry. And that’s a tough one for us, because we don’t want to stick our necks out.” And he added that John Glaser, formerly the CIO of Partners HealthCare once told him, “Russ, don’t be afraid to get fired. Because,” he quoted Glaser as saying, “Your fear of being fired will keep you from doing what is right and what is important.”
Tuesday, the Health IT Summit in Boston will begin in the same location. HCI will provide coverage of that event as well.
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