People often like to compare a situation to “drinking from a fire hose,” but when Shane Pilcher started as CIO at Siskin Hospital in the summer of 2015, it really was quite an experience. Not just because he was the first CIO the organization had ever named, but because it was his first exposure to the post-acute care and rehabilitation environment. But although it’s been an adventure, Pilcher has cherished every moment.
In this interview, he talks about the major initiatives on his team’s plate, including selecting a new EHR system — which is “a journey it itself,” replacing legacy systems, and of course, keeping data safe. Pilcher also discusses why he believes “the post-acute space is the next frontier in healthcare,” what he looks for in a vendor partner, how consulting helped prepare him for the CIO role, and what he learned during his time with the Navy.
- Replacing legacy systems
- Security: “If you’re not doing the formal processes, you’ll fail an audit”
- 15 years in consulting
- “You’re that liaison between every business unit”
- 21 years in the Navy – “I treasure those years.”
- Military values: loyalty, commitment & courage
- “Own the position”
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If you’re not doing the formal processes, then you’ll fail an audit anyway — even if you’re doing everything else right. While we were doing everything right from a technical perspective, it’s taken us some time for us to get that formal infrastructure in place as well.
I feel very lucky that I was able to get exposure to numerous healthcare IT shops around the country and be able to identify what works and what doesn’t work. I was exposed to a lot of different processes, and I think that that’s a strength that I was able to bring into this organization.
As a CIO, you’re essentially a consultant in every case. You are that liaison between every business unit, every workflow unit, and technology.
They’ve got to have a passion for doing what they’re doing to go along with the skill that they need for that job. Without passion, they’re not going to be able to drive a solution to resolution and to be able to continually pivot when things change like it does every day.
Gamble: What are some of the other really pressing priorities on your plate right now?
Pilcher: As with everyone, security is huge and equally a top priority. Also, just legacy systems. This organization has done a fantastic job of investing in technology. The fact that they put an EHR in 10 years ago, without Meaningful Use pushing us in that direction, really shows the foresight of the organization in wanting to enable their caregivers and administrative team through technology. But the problem is that when you put a system in, if it’s not maintained, it can really get old and outdated and unsupported very quickly. We had a lot of systems like that.
So while we knew we were going to be replacing our EHR platform, we also had a lot of legacy systems that needed to be replaced. As of this year, we will probably have the final remaining legacy systems that have really been holding us back in some areas out, and either replaced or upgraded so that we can now put in an EHR on top of everything and really move forward. Those are the three big areas that we’ve been focusing on this year.
Gamble: As far as security goes, I would imagine you don’t have a CISO. Do you have someone who is charged with security, or does that fall under your purview?
Pilcher: That falls under me as well. That’s been another area that’s been like drinking from a firehose. While this organization does a fantastic job of doing all the technical pieces to keep their infrastructure hardened and secured, if you’re not doing the formal processes, then you’ll fail an audit anyway — even if you’re doing everything else right. While we were doing everything right from a technical perspective, it’s taken us some time for us to get that formal infrastructure in place as well. One of my team members is actually going for a security certification that I plan on being able to use as our ISO. However, in this organization everybody wears multiple, multiple hats, so it falls on a few of us. It’s been an interesting journey to start getting that program in place as well.
Gamble: For that team member though, it sounds like that’s a great opportunity to build on a field that’s in a lot of demand right now.
Pilcher: It is. It really takes a lot of time and a lot of focus as well to do it right. I’m definitely excited to be able to give them that opportunity and be able to have additional eyes on that than just mine.
Gamble: In terms with the legacy systems that are being replaced, has it been a long-term plan to stagnate them in a certain way?
Pilcher: Yes, from a capital perspective, and from a bandwidth perspective, in terms of the number of FTEs that we can put on it. And two, just the effects that it has on our workflows. It had to be a phased approach since there are also so many dependencies across those legacy systems. As we’ve been able to address systems, we’ll be able to address the systems that are dependent upon them. We’ve eventually come to this place where we’ve been able to address most and hopefully by the end of this fiscal year all of our legacy systems.
Gamble: Prior to coming to Siskin you were a consultant for several years, right?
Pilcher: I was. I spent about 15 years consulting.
Gamble: I imagine that you’ve benefitted from that experience in your current role. Have you found that to be the case?
Pilcher: I do. I feel very lucky that I was able to get exposure to numerous healthcare IT shops around the country and be able to identify what works and what doesn’t work. I was exposed to a lot of different processes, and I think that that’s a strength that I was able to bring into this organization.
In a consulting firm, and in a small organization, you get very nimble and you can move very quickly. As a consultant, you don’t always get pulled into the infrastructure of an organization and have to address different committees and different policies and different procedures. So it was getting used to, again, having to go to different committees to get things done and different processes and procedures that were needed to address certain things. That was a little bit of an area that I had to relearn.
Gamble: I guess that’s something you just kind of learn by doing.
Gamble: Is it a little bit difficult to break out of the consulting mode where you’re somewhere to solve a specific problem and then you move on — is it difficult to break out of that thinking?
Pilcher: I would say no. Because as a CIO, you’re essentially a consultant in every case. You are that liaison between every business unit, every workflow unit, and technology. You have to be able to think broad term as a consultant, depending on the scope of the projects that you’re on, and the tasks that you’re asked to do, you’re expected to think more broadly than just what you’re working on and bring some level of expertise or advice to the client.
I see the thing here. Anytime I’m conversing with any leader of any other department of the hospital I need to be able to understand them enough that I can bring some kind of advice and value to the conversation. I see it very similar. The fact that you’re not fixing a need and then moving onto the next is actually very refreshing to me. Being able to actually see something grow out of what you’re doing and being able to be part of it long-term has been really exciting.
Gamble: You also had quite a bit of experience in the Navy and that’s always interesting to me to speak with people who have been in the military and just how some of that time has influence your career and leadership style you’ve adapted. What have you found?
Pilcher: I truly treasure those years. I spent 21 years in the Navy, 8 of those were active, and then 13 were reserves. A lot of experience. Probably the values that I got from a military career and were able to bring into my current career are loyalty, commitment and courage. I learned to be loyal to the organization, to make sure that you’re protecting them in every way that you should, and be committed to delivering what you need and the courage to do what you need to do. All those pieces factor in. As far as leadership, it’s knowing that you’re responsible for a job and you’re expected to do it. In the military you delivered, and if you didn’t, it could have some dire consequences. You get used to learning how to make quick decisions but not rash decisions, and then learning how to adapt and pivot as the situation changes. I think all those were really kind of key pieces that I can take with me into my current job.
Gamble: As you lead your staff, which, as you alluded to, are people who really have to be able to wear multiple hats and have to be able to pivot, what are the qualities that you really value?
Pilcher: I am very collaborative in how I lead my team. That’s coming from the military way as well. When I put somebody into a position, I look for them to own that position. They’re supposed to understand it, to get their hands dirty to point where they understand everything about that area of responsibility, and own it to the point where they see problems before problems happen. And when they come to me with a problem they also have a solution, which is something that we were taught in the military all the time. You don’t come with a problem, you come with a solution. And it shouldn’t be me deciding what solution it is. It really should be them. And only on the rare occasion do I say no, that might be because of some information that they’re not aware of or some implication that they didn’t see that I do.
Outside of that it’s yea or nay, and they run with the area that they’re in. And that’s something that I look for in any individual on our team, because you have to wear so many hats. They’ve got to have a passion for doing what they’re doing to go along with the skill that they need for that job. Without passion, they’re not going to be able to drive a solution to resolution and to be able to continually pivot when things change like it does every day. A very passionate person that loves what they’re doing, that cares about our patients and what we’re doing as an organization, are critical for my team.
Gamble: Right. Because we know things aren’t going to slow up any time soon.
Pilcher: Not at all. That is a challenge. When you stay in implementation mode, it’s very easy to get burned out. Many organizations have been implementation mode for years and I don’t really see that changing much. So it’s being able to manage that, having ways that your team can get a mental break and step away so that when things are really, really stressed and they need that breather, you and identify that and give them that breather, but then allow them jump back in the fight and keep moving forward with their mission. But no, I don’t see it stopping any time soon.
Gamble: No, especially with your plans for the next few years. Well, thank you so much. It’s been really interesting to speak with you, and I’ll definitely be contacting you again, because I think we’ll have more to talk about in a year or so.
Pilcher: I certainly would love to. I think you guys do a great service, and I’m excited to be a part of it, so thank you very much for the invitation.