Daniel Barchi, CIO, Yale New Haven Health System & Yale School of Medicine, Chapter 3

Daniel Barchi, CIO, Yale New Haven HS & Yale School of Medicine

During the six years he spent as an officer in the US Navy, Daniel Barchi endured quite a few “white-knuckle moments” that tested his skills in crisis management and leadership. But without that experience, he might not feel so comfortable guiding Yale New Haven Health System and Yale School of Medicine through a large-scale infrastructure project designed to unify IT operations across the system, facilitate better data management, and reduce costs. In this interview, Barchi talks about rolling out Epic, the importance of clinician buy-in and solid leadership, and how he is leveraging his dual CIO roles to bridge the gap between two organizations. He also discusses the value of IT rounding, the challenges of working in academics, and why he wouldn’t trade his job for anything.

Chapter 1

Chapter 2

Chapter 3

  • Using feedback to improve the IT rounding program
  • Learning crisis management as a naval officer
  • Going from biomed to IT
  • “It’s not about bits and bytes; it’s about working to create solutions to problems”
  • Dealing with the challenges of an academic environment
  • Making the move from VA to CT
  • “I wouldn’t trade it for the world”

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Bold Statements

We get feedback from the team about what was good and what was not good. We’ve actually changed it slightly every time that we’ve done it. So I think we’ll keep doing it, and as we have new people join our IT team, we’ll want them to do it.

When things go bad in a healthcare environment — there are times when a key piece of equipment is down or there’s an immediate need for a tool or a piece of data — it really does impact patient care. And having been through a lot scarier moments in the military, I find that I tend to remain calm and try to keep the people around me calm and focus on the mission at hand.

I think any CIO you ask these days would say that their job is not about bits and bytes and equipment; it really is about working with the executives of their academic institution or health system to create solutions to problems. And so I don’t think having been just a technical person will get you where you need to be.

I found that working in the academic arena has its own challenges. So I reached out to the CIOs at Hopkins and UCLA and some other institutions to get more of an academic perspective, and that’s been very helpful. There really is a collegial body of CIOs out there who are willing to work with one another.

Healthcare, after lagging the other parts of the IT industry for many years, really is catching on and getting on the cutting edge in many ways, so it’s an interesting time to be doing what we’re doing. I’m enjoying it.

Gamble:  As far as the feedback people get from the program, is there a process in place for collecting that just to see if anything should be tweaked or to see how this is benefitting people?

Barchi:  Good question. We’ve done this three times in groups of 20 to 30 people. We started with Greenwich Hospital, we’ve done it at Bridgeport Hospital and we’re moving on to Yale New Haven Hospital, and every time afterwards, we get feedback from the team about what was good and what was not good. We’ve actually changed it slightly every time that we’ve done it. So I think we’ll keep doing it, and as we have new people join our IT team, we’ll want them to do it. There’s no harm in doing it several times between different parts of the organization. I got a whole lot of different perspective a few years ago when I spent a day in OR than I had when I spent a day in the ICU, so all of it is valuable.

Gamble:  I’m sure that was a great experience.

Barchi:  Absolutely, you can’t trade it for anything in the world. Before this, I was in the US Navy for several years as a naval officer and then in the telecom industry, and as dynamic as those environments are, nothing really prepares you for healthcare and seeing how healthcare works. And quite frankly, that at the end of the day, it really is about patient care.

Gamble:  Yeah, absolutely. I’m glad you brought that up because I did see on LinkedIn that you were a Naval Officer and I found that to be pretty interesting. I come from a military family and actually I have a brother who was stationed in Norfolk, among other places, and I wanted to talk about how you think that experience does help you prepare for a leadership role down the road, because it’s not something we see with that many healthcare executives.

Barchi:  That’s a great question. You might imagine that serving in the military — no matter what branch of service or what kind of role you had — at times can be stressful. I look back to many white knuckle, scary moments. At the time, they seemed like they were just challenging moments, but I learned later on that they were good teaching moments too. Because when things go bad in a healthcare environment, there are times when a key piece of equipment is down or there’s an immediate need for a tool or a piece of data, it really does impact patient care. And having been through a lot scarier moments in the military, I find that I tend to remain calm and try to keep the people around me calm and focus on the mission at hand.

And so I’d say it was a good experience, both from a managing crisis perspective and also from a leadership perspective. Most people who are in the military find themselves managing large diverse groups of people at a very young age, many of whom have different backgrounds or, in many cases, are older than them. When I started in healthcare, I found that I was working with 200 to 300 people who work for me who know far more than I did than any of the tools, yet they look to me to be their leader and having done that same kind of role in the military allowed me to work smoothly into it.

Gamble:  That’s really an interesting perspective, and like I said, not one that we see a lot. You said you were in a telecom for a few years also before taking on the CIO role at Carilion?

Barchi:  I was. I left the military and started as a project manager for MCI and ended up as the director for Global Project Management and director of Technology and Engineering for MCI and then WorldCom.

Gamble:  Is that what made you think about getting into more of a healthcare type of role?

Barchi:  Interestingly enough, when the telecommunications industry had its challenges, and MCI and WorldCom particularly had financial problems in the late 90s and early part of the last decade, there were a lot of challenging business environments within telecom. I was often the person who was sent in to fix a broken part of the company or sell off a business, and so I gained a lot of turnaround experience. I got into healthcare because I helped turnaround a biomedical institute and that led to the CIO job when the CEO of the health system I was working for called me up and asked me to go from running the biomedical institute to running IT. So it seems like it should be more logical than that, but it was really more about turnaround and fixing broken things than it was a logical progression from telecom technology to healthcare technology.

Gamble:  And all of this helped you prepare for everything you need to do in the CIO role, right?

Barchi:  I would say so. I think any CIO you ask these days would say that their job is not about bits and bytes and equipment; it really is about working with the executives of their academic institution or health system to create solutions to problems. And so I don’t think having been just a technical person will get you where you need to be. Having diverse experiences, whether it’s military or telecom, or quite frankly, a challenging academic environment or a sales environment — any of those are good experiences I think that can help today’s CIO solve problems.

Gamble:  And just in terms of dealing with everything that CIOs have to handle right now, do you find yourself turning to your peers a lot, either through organizations or just reaching out to them to see how they’re dealing with the same issues that your organization might be?

Barchi:  It’s funny, it goes both ways. There are times when I reach out to other CIOs across the US to get insight and then there are other times when you find that you’re such a unique institution, no matter where you’re working, that it’s good to hear other feedback, but essentially you have to plot your own way.

I would tell you that when I went from a large, billion and a half-dollar community health system in Virginia to the Yale New Haven Health System and Yale School of Medicine, I found that working in the academic arena has its own challenges. So I reached out to the CIOs at Hopkins and UCLA and some other institutions to get more of an academic perspective, and that’s been very helpful. There really is a collegial body of CIOs out there who are willing to work with one another.

Gamble:  I can imagine that is really helpful, because from everything I’ve always heard, academic medical centers really are a different ballgame.

Barchi:  They are. We’ve got challenging patients — really sick patients, in many cases, and unique challenges from a clinical environment and also from a funding and research environment that you just can’t see elsewhere.

Gamble:  Now as far as making the move from Virginia to the Connecticut area, was it a tough adjustment for you or did it happen fairly easily? Those are two pretty different areas.

Barchi:  Interestingly, it worked out well for me and family. Even while we were in Virginia, my daughter was training to be a professional ballet dancer, and so she was spending a lot of time in New York to the point where my wife and son were also spending a lot of time in New York. And when the Yale opportunity came up, it was a good opportunity for us to move to this area and spend time both in New York City and Connecticut. And so it’s worked out well for us in a way that I wouldn’t have imagined, even just a couple of years ago.

Gamble:  That did work out nicely. I know that sometimes when you’re dealing with the New York City area, it is very different. It’s very fast-paced and sometimes little too fast-paced for people at first.

Barchi:  We actually get the benefits of New York City but also the slower and nicer lifestyle of the New Haven, Conn. area, so it’s worked that well for our family.

Gamble:  So now when you’re not at work, when you’re not in the CIO role, I saw on LinkedIn that you enjoy marathon running. Do you think that it’s important for CIOs to be able to have some other outlet and just have something else they do to get away from the fast pace of work?

Barchi:  Absolutely, and that’s true for anybody who works hard at their job; CIOs are no different. For me, reading, hanging out with our family, and then running are all things that I really enjoy doing. I was fortunate — I’d never say this, but I had a small break in my ankle running last fall and it slowed me down. But my son and I believe it was really a fortunate thing in that as I was recovering, he started running with me. And so as I was building up my mileage again from zero, he — and he had not been a runner; he’s 12 years old — started running with me. And so every day this year, we’ve run at least a mile together, and we’re training to do a six-mile race together. So I’ve enjoyed the process of getting back into running after an injury and having my son join me as well.

Gamble:  That’s great. That’s a really nice silver lining to come out of something that otherwise could be unpleasant.

Barchi:  Absolutely. I would have thought it was a bad thing at the time, but now I’m really glad it happened in the way that it did.

Gamble:  All right, before we wrap up, I just wanted to see if there’s anything else you wanted to add as far as everything that’s going on in the industry right now. I know that it is such a busy time but it seems to me that it’s such an interesting time and that CIOs and other people in leadership positions really have the potential to guide along these really important initiatives right now. What are your thoughts on being part of healthcare during this time?

Barchi:  Healthcare is such a dynamic and interesting environment; I never imagined that I would be in it. I didn’t grow up in a healthcare or medical-oriented family, and now I wouldn’t trade it for the world. I find it very interesting. I think any challenging environment would be fun to work in, but the added benefit that we get to take care of people is great. I also find that so much is happening in healthcare, whether it’s Meaningful Use or federal stimulus dollars or a national push for health information exchanges. Healthcare, after lagging the other parts of the IT industry for many years, really is catching on and getting on the cutting edge in many ways, so it’s an interesting time to be doing what we’re doing. I’m enjoying it. I think the investments that we as a nation are making in healthcare IT are going to see benefits for us in our overall healthcare, and I’m glad to be part of this.

Gamble:  I agree. I think it is really an interesting time and it is going to be interesting to see what happens in the next year or so.

Barchi:  It will be. As we speak, the Supreme Court is debating the national healthcare law. That will change what we’re doing — in terms of being driven by federal statutes in terms of what we need to do and don’t do, and even the way that we get reimbursed drives how much we’re able to spend, and it really changes what we can do.

Gamble:  Yeah, and we’ll be keeping track of that. So unless there’s anything else you want to touch on, this has been great. I really appreciate your time.

Barchi:  Sure, I enjoyed speaking with you, and it’s always fun to talk about some of the exciting stuff that we’re doing.

Gamble:  Alright. Keep up the great work, and I hope to talk to you again soon.

Barchi:  Great. Thanks so much, and thanks for your time.

Gamble:  Thank you.

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