For Robert Slepin, health information technology has never been an end in its own right, but rather a tool that can be used to improve individual and population health. In this interview, Slepin discusses his organization’s goal of getting its hospitals and physician network on Epic in 2012, best practices for disengaging with vendors, how disease management can help improve patient outcomes, and why ICD-10 should be postponed. He also talks about the importance of transparency within an organization, how to effectively delegate tasks, and why it’s okay to say, ‘I don’t know.’
Chapter 4
- On leadership
- The importance of continuing education and professional development
- “The pressure that is on CIOs today is just tremendous”
- Measuring yourself against the best performers
- Reaching out to CIO colleagues
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It’s about helping them see and appreciate a picture of the strategic vision and direction of your business organization and how IT supports that—why IT exists and what you need to do as an IT organization and as a team, and charting a course with them to get from where you are to where you collectively need to go.
It’s really challenging—the pressures around CIOs and healthcare executives in general are just tremendous now. It really stretches you and it really tests your character and it probably brings out the very best in you, but it can also bring out the worst in you.
You realize that you don’t have all the answers and that it is perfectly okay to say, ‘I don’t know’. In fact, it’s a great thing because when you say it, you’re opening yourself up to possibilities for solving problems and making decisions in helping you in your organization that otherwise you would be closed to.
It’s one of the great things about Epic as a vendor to work with—they really encourage you to learn from their experiences working with clients. I’m a big, big believer in that.
You need to be selective about picking your spots. Determine what are your biggest problem areas, what is the root cause that’s driving your challenges, and what are your biggest opportunities for gains that are going to improve quality of care, patient safety or efficiency or customer service and patient satisfaction, and focus on those things first.
Guerra: You said the number one skill of a CIO is leadership which I certainly wouldn’t argue with. When you think of leadership or when you think of the leader that you try to be, what does that mean to you?
Slepin: It’s a great question. I’ve been thinking a lot about that lately. I’m always working to develop myself professionally as a leader, and so I’m always seeking to learn. I think I would sum it up by saying that you need to really know yourself well and be available to others. I know that sounds pretty simple, but I think it’s about knowing yourself—who you are, what your values are, and what’s important to you, and knowing where you’re at and where you want to go. Knowing your vision for the future and making yourself available and really wanting to be there—being open and transparent, direct, candid, honest and having the support of your management and your staff and helping them deeply understand and really see the reality of what the current state situation is in your organization, from a business and technical perspective. It’s about helping them see and appreciate a picture of the strategic vision and direction of your business organization and how IT supports that—why IT exists and what you need to do as an IT organization and as a team, and charting a course with them to get from where you are to where you collectively need to go, engaging the team in that. I think that’s a key part of the core responsibility of an effective leader, whether it’s a CEO, COO, or CIO. But I’m translating it here into IT terms. I think it’s the same kind of stuff you need to do regardless of what your discipline or your domain is.
Guerra: You may or may not have heard me chuckle when you said ‘know yourself’. I just wrote tomorrow’s edit memo this morning, and it’s exactly about that—specifically, how important it is to know yourself, and to be able to make choices and put yourself in situations where you can thrive and be successful.
Slepin: I completely agree. Amen to that. It really is critical. I’ve been joking lately to folks is that I’m not really the chief information officer; I’m the chief impatience officer. I’ve been saying that because my staff helped me become aware that I sometimes am impatient, and this is a recent learning for me. I suppose I should’ve learned this one a long time ago but I was a little slow to learn that. So recently I’ve learned about myself that I have this huge sense of urgency to do the right thing for my team and our organization, but I need to be more patient with them individually and support them better. And I’m doing that and my staff is telling me that I am, so I’ve recently gotten to know myself a little better.
It’s really challenging—the pressures around CIOs and healthcare executives in general are just tremendous now. It really stretches you and it really tests your character and it probably brings out the very best in you, but it can also bring out the worst in you. So these are times that really try leaders. And they’re great times to grow and learn and improve yourself and really help you in terms of supporting your organization and your staff—helping them grow and develop as professionals and leaders and helping move the whole team forward to accomplish the goals of the organization. It’s a very, very exciting time—a terrifying time, but also very exciting.
Guerra: Definitely one of the consistent things that I observe and hear from CIOs is humility and a desire to want to learn and to want to improve weaknesses, and a desire to be aware of them. It’s that desire for growth and improvement and that humility that makes a good leader, which is kind of interesting and almost paradoxical.
Slepin: Yeah, it is. It’s almost like one of the statements here. There’s an old saying: The more you know, the more you realize you don’t know. I agree with that, I really do. I certainly feel like a humble student, especially when my staff reminds me of things that I need to be doing better. I think that it’s really important to continue to learn in life, and I think that’s important for everybody, not just for leaders. But to really be the most effective leader that you can be, you really need to be humble. You need to be really listening to your people—whether it’s your staff, your customers, your patients, your physicians or your vendors, and you need to be open-minded about what you’re hearing. You need to empathize and think it through.
You realize that you don’t have all the answers and that it is perfectly okay to say, ‘I don’t know’. In fact, it’s a great thing because when you say it, you’re opening yourself up to possibilities for solving problems and making decisions in helping you in your organization that otherwise you would be closed to.
And there’s tremendous power in the team and looking to others, both within your organization as well as outside, for really good practices. We’ve been doing a lot of looking outside recently. We’re on a continuous improvement journey at John C. Lincoln Health Network, both for the hospitals as well as in IT. And that’s a humbling experience when you benchmark yourself against the best performers, not only in healthcare but across industry, and you see how much better some other organizations are doing in terms of metrics that count. That’s humbling.
Guerra: And it’s probably easy to just do your work, which will take all the hours in your day, and go to sleep and do it again. But you take the time—you’re part of CHIME, you contacted me and you mentioned that you listen to the podcasts, and you take the time to observe what your peers are up to. You don’t let that get blocked out by everything else you have to do. You invest in yourself by absorbing the best practices of others and that’s another sign of leadership and someone who wants to continually grow.
Slepin: I agree with you, thank you. In fact I was talking to Dennis L’ Heureux, CIO of Rockford Health System, who was generous enough to respond to a call for help that I made, and he made 30 minutes of his time available to me on short notice because I wanted to consult with a peer who had a similar challenge that we’re facing in the Epic implementation. He’d already been this through this piece of it and it was great to get on the phone and talk. He was very generous and encouraged me to call back anytime and I offered to help him. I think it makes sense to help each other and I think we can learn from each other.
I think we have a responsibility to what Epic calls, ‘stand on the shoulders of others.’ They’re really big on that. I think it’s one of the great things about Epic as a vendor to work with—they really encourage you to learn from their experiences working with clients. I’m a big, big believer in that. But it doesn’t mean that you blindly follow and accept what you hear from others. What are termed best practices aren’t always best practices, but rather commonly used or known practices that people think are best. In reality, best practices, in the moment that you’re aware of them, are probably are becoming less than best because someone else is out there figuring out how to make that practice better.
So I think the key is trying to figure out how to get better every day; how to always improve. If you’re not working on that, then chances are you’re probably not standing still; you’re probably falling behind, and you’re probably headed for trouble. You may or may not know that, but you’re doing a disservice to your team, to your organization, and to your mission and if you’re not striving on a continual basis to advance the ball forward. It doesn’t mean that you have to improve everything every day or that you have to implement every best practice known to man—the entire ITIL infrastructure library in 12 months. That’s craziness. So I think you need to be selective about picking your spots. Determine what are your biggest problem areas, what is the root cause that’s driving your challenges, and what are your biggest opportunities for gains that are going to improve quality of care, patient safety or efficiency or customer service and patient satisfaction, and focus on those things first.
Guerra: Well Robert, that is about all I had to for you today. Is there anything else that we didn’t touch on and you want to discuss?
Slepin: No, I can’t think of anything, Anthony. Thank you for inviting me to join you for the interview. I am a big fan of what you’re doing and certainly learn from hearing what my colleagues are doing, and I’m happy to contribute to the information pool.
Guerra: Well, I appreciate it, Robert. This was a wonderful discussion, and I look forward to speaking with you again soon.
Slepin: Thank you, take care.
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