When people see Norma Tirado’s title, they often do a double take. But while it may seem unusual to serve as VP of both IT and Human Resources, to Tirado, the dual role makes perfect sense in the world, especially in today’s turbulent health IT world, where change management expertise is as good as gold. In this interview, she talks about Lakeland’s “fast and furious” Epic rollout — an initiative that required significant buy-in; how she is able to balance the two roles; what it takes to retain staff and build a high-performing culture; and why achieving Stage 7 means so much to the organization and the community.
Chapter 3
- Lakeland’s volunteer RaDAR team
- “Leading toward the future”
- Significance of stage 7 — “It’s about outcomes.”
- 32 saved lives
- IT’s role in demonstrating value — “We have to do better.”
- Escaping to the golf course
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We try to identify those people that have that special talent, and we try to get those people involved in special projects or committees or have them lead maybe an optimization effort.
If you look at all of the adoption stages, it is at Stage 7 where you actually get evaluated on how you’re using the system and what you’re delivering from the way you use the system. Up to that level, it’s mostly about what you have and what’s connected.
You always have that, ‘okay, we’re not getting enough money in our budgets and we don’t get the attention that we needed.’ What I tell my staff is, ‘we wanted the attention, now we got it. What are we going to do with it?’
As a leader, if you don’t prepare your people to deal with situations when you’re gone, you’ll never be able to take time off.
Gamble: When you talk about things like leadership development, are there ways where you can seek out people who might not necessarily have been on a certain track but you can see that they have talents and kind of pluck them out? Is that something that you try to do?
Tirado: We try to identify those people that have that special talent, and we try to get those people involved in special projects or committees or have them lead maybe an optimization effort. For example, we put together a team that we call RaDAR to attract our key performance indicators. I didn’t have money to offer those people, but I wanted to have really, really talented people. I just asked for volunteers and I told them that it would be a very exciting project with a great deal of visibility doing something that the organization hadn’t done before, and their job was to hold the organization accountable for delivering results on the EHR. I had 14 people volunteer to do that, at a time when I said I cannot reduce your workload and I cannot pay you more to do this. A number of those people got rewarded by going to the HIMSS Conference.
But you take some of those people and now you have to make sure you keep them engaged. We had a number of them lead projects that got us to HIMSS Level 7. We put those people through leadership classes. We have a program called ‘Leading toward the Future.’ In some instances we encourage people to get their master’s degree and we pay for all or part of it with a commitment to the organization in the future.
We are constantly identifying those people that we believe have high potential, and we have to do that both on the technical side and on the leadership side. Not everybody wants to be a leader. One of the top performers in my organization said he had no desire whatsoever to have a leadership position, but he has some incredible skillsets that we need, and we need his leadership in implementing technologies in the area that he’s an expert in. We just have to make sure we involve them when we’re making those decisions, and that he’s an integral part of our leadership team. Even though he is not leading people, he is helping us lead our technology effort.
Gamble: Interesting. And it’s really telling that you had 14 volunteers come forward. It’s a nice validation that you have good people on your team.
Tirado: Absolutely. I have exceptional people on my team.
Gamble: Your organization achieved Stage 7 last year. Is that something where you make an effort to market this type of achievement either inside or outside of the organization, just to have that validation of all the hard work that’s been put in?
Tirado: We do. It was our belief from day one that getting to Stage 7 meant we were using the system the way the system was meant to be used. If you look at all of the adoption stages, it is at Stage 7 where you actually get evaluated on how you’re using the system and what you’re delivering from the way you use the system. Up to that level, it’s mostly about what you have and what’s connected. But with HIMSS 7, it’s a great deal about outcomes. Okay, so you have the system, so what? Did it help the patients in any way?
It was really important for us to get to Stage 7, and we want our patients to know. It gives them assurance that we’re using the system appropriately and we can deliver better outcomes, because we’re there. We’re very proud that there are so few numbers of hospitals in the world and in the country that are Stage 7. In Michigan, we were the first organization to get to HIMSS 7. That’s something that’s exciting for us, and we want our customers to know that. We publicize it a little bit. I don’t think we went over board but we tell the story any chance that we get.
Gamble: Right.
Tirado: To us, I think that helps engagement, because people know that the work that they’re putting in — the sacrifice of time and effort and learning a new technology — is resulting in better outcomes for patients. You saw the presentation; with just one initiative, our sepsis initiative, we can equate that to 32 saved lives. That’s unbelievable. And we did that while maintaining our costs at a lower level, which is exactly what we’re trying to accomplish in healthcare — delivering better care more efficiently and more effectively and more cost effectively. That particular project is the perfect example of that.
And there’s the radiology project, where we’re trying to identify people that have been exposed to higher levels of radiation and not expose them unnecessarily again. It brings value to the patient, and it helps us save money by not doing tests that are both dangerous to the patient and costly to the patient. That’s exactly where we’re trying to go in healthcare — better care more cost effectively.
Gamble: When you can say 32 lives saved, that’s something that obviously brings so much value to patients also who might not be as concerned about costs as they are about safety and lives being saved.
Tirado: Absolutely. And they know that when they come to our hospital we are very, very tuned in to ensure that they don’t acquire something when they come here. They know that we’re using the technology to help them have a good experience and have better outcomes. And so I think it’s important that we share why we’re doing what we’re doing, as well as the results that we have been able to get.
Gamble: For you personally, the time that you entered the health IT world was really an interesting time with so much going on. All and all, have you been happy with the experience you’ve had?
Tirado: Absolutely, I think for a long time when I first started in IT — and even when I came here, which was four years after I started in IT — IT people felt unappreciated, and I think a lot of people in IT felt they weren’t getting the resources that they needed to do their work. Now we are. You can spend a lot of money in IT, and people involved in technology love new gadgets. So you always have that, ‘okay, we’re not getting enough money in our budgets and we don’t get the attention that we needed.’ What I tell my staff is, ‘we wanted the attention, now we got it. What are we going to do with it?’
I was very fortunate in both organizations to have boards of directors, CEOs, and senior leaders that supported the effort. Some a little grudgingly, because there’s always that hesitation about spending a lot of money in technology if you don’t see the value. I think in the past, we in IT haven’t done a great job of showing the value of IT. We have to do better at it. It’s been rewarding for me because I have been able to be in organizations that allow me not just to implement the technology but actually do something with it.
Gamble: Actually, my last point I wanted to ask was just about getting away from work. As we all know, there is so much to do in IT. And with your dual role there’s even more going on. Are you able to kind of get away to take some time away from all of this?
Tirado: I thank technology for that, because I can get away from work and still be connected if I need to be — or not be connected if I don’t want to be. I find time because I have grown children that are out of the house. I think that when my children were smaller, this was much harder to do. I like to golf, so in the summer, I golf. I like to travel. Some people may say that I am never disconnected; to me that’s okay, because it allows me to be away. If I want to go golfing in the middle of the day someday (don’t tell my boss), I feel I can do that, if I need the time to relax. And still, if there was something that required my attention, I could be available.
But as a leader, if you don’t prepare your people to deal with situations when you’re gone, you’ll never be able to take time off. At times I feel like my children have grown up and they don’t need me anymore with some of my departments, and that’s an unsettling feeling sometimes, but it allows me time to get away. I also like to be involved in community organizations like the Symphony Orchestra or the First Tee of Benton Harbor or economic developments. I put time and effort into those endeavors as well.
Gamble: They say that if your staff — and your children — don’t need you all the time, I think that means you’re doing something right.
Tirado: I hope so.
Gamble: Okay, well we’ve definitely covered a lot, and I really appreciate your time. I’ve really enjoyed speaking with you. Unless there’s anything else you wanted to add, I figure I should let you get back to everything.
Tirado: Thank you. It’s been interesting. I hope that you and your listeners get something out of this. Thank you for the opportunity to speak about what we’re doing here at Lakeland.
Gamble: Sure. I hope we can catch up again sometime down the road.
Tirado: Thanks, Kate.
Gamble: All right, thank you.
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