When Bill Spooner stepped down as CIO at Sharp Healthcare in 2014 after spending 35 years with the organization, he had mixed feelings. Although he was ready for a change from the frenzied pace of the CIO role, he hesitated to leave because “there were so many exciting things going in healthcare.”
Fortunately, Spooner found a way to remain involved in the industry — and pass on some of the wisdom he gained from his tenure — through his work as an advisor with Next Wave Health Advisors, and as an active participant with CHIME’s advocacy initiatives. In this interview, he offers insights on a number of pertinent issues, including why workflow is still a significant challenge for many organizations, the factor that most slows down the optimization process, and the surprising area in which healthcare is still far behind. Spooner also reflects on his own career, where we stand in terms of interoperability, and why perspective can be the best gift for leaders.
- The slow evolution of patient care models – “I thought we’d be farther along.”
- Emergence of CDOs
- Recognizing the CIO’s value
- “They’re part of the decision process.”
- Chief Experience Officer’s role in increasing engagement
- “I saw what it did for us at Sharp.”
- IT’s unsung role in patient care – “They keep the system running.”
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Most organizations recognize that the CIO needs to be at the table. They may not be involved in some of the strategic decisions, but for the most part, they’re there. They’re not coming in and taking orders and leaving. They’re part of the decision-making process.
The role of the Chief Experience Officer is probably separate from all of those, because it’s about getting the whole organizations to take a much different view of the patients they’re serving.
Clinicians may say that patient scores don’t reflect quality of care that’s being given, but I think satisfaction is what probably drives the tolerance for some of the variations that happen in care.
Communicating everything that contributes to patient care is an important message for clinicians and IT. In many organizations, nurses, respiratory therapists, and other care providers see that the work that they’re doing is a larger contribution than it was when they were only taking care of one patient.
Spooner: The biggest thing that has really exploded in the four years since I left Sharp is cybersecurity. I think I may have gotten out at the right time. It’s fascinating the changes we’ve seen and the sophistication — both of the hacking methods and the methods of defense that are coming into place with the NIST framework. I’m enjoying staying up to speed through those avenues.
Gamble: I’m sure. So, when you’re in the advisor capacity doing IT assessments, I can imagine it’s really interesting doing that from the perspective you have now. I’m sure you’re able to draw a lot from your own experience.
Spooner: What has been really interesting to me, and I guess I didn’t really appreciate it having been in one organization for such a long time, is looking at organizations and seeing the variety of philosophies with patient care models. When I left Sharp, I thought the rest of the country would be farther along in terms of patient-centered medical homes and clinically integrated networks. I’ve seen such a variety from area to area, including one organization that will remain unnamed, where the CEO said, ‘We’ll never have managed care in my town.’ I thought, ‘okay, good luck.’
But just in being able to see the different models and different philosophies that organizations are bringing, and then translate that back to the vendor environment or the consulting organization environment, I appreciate the knowledge that they gain from experiencing and exploring all those different models. That’s something I probably didn’t fully appreciate while I was working in a single organization for a long time.
Gamble: One of the things that comes up in a lot of our discussions is the importance of the relationships between CIOs and other C-suite leaders, particularly as we’re seeing new roles or functions pop up, like the Chief Experience Officer. I would think that been an interesting thing to see from your perspective.
Spooner: It is interesting. There are probably four or five new officers that have emerged in the past few years, including the chief information security officer. There’s a lot of discussion about whether that position should report to the CEO, the CIO, the audit committee, etc. Then there’s the chief health information or health informatics officer, which seems to be an evolution from the CMIO. That’s the physician who’s more into the analytics side than the workflow side.
And there’s the chief digital officer role, which is very interesting. If you look at some organizations, you see the challenges facing the CIO. The world is changing so quickly, and it’s a challenge for the CIO to stay abreast with everything. I’ve seen some organizations that hire a chief digital officer, and then two weeks later, the CIO is gone. It would seem logical that the CIO would have evolved into include the new digital apps under their umbrella; apparently the organization wasn’t satisfied that it was going fast enough. But it really makes it incumbent upon the CIO to be evolving with the organization.
I’ve talked with a few CIOs over the past couple of years who were at the executive table and suddenly were removed for whatever reason. But I see fewer and fewer cases where the CIO is not at that level. If you go back 20 or 25 years ago and you’re a CIO, you probably asked, ‘why aren’t I at the executive table? How do I get in the room?’ All of that seems to have repeated a few cycles over the years, but it’s pretty well quieted down. Most organizations recognize that the CIO needs to be at the table. Clearly they may not be involved in some of the strategic decisions, but for the most part, they’re there. They’re not coming in and taking orders and leaving. They’re part of the decision-making process. And you see that more and more. You see lots of variations on things like where the CIO reports, but for the most part they are at the table, and I think that’s the important part.
Gamble: You bring up a really important point with digital, because we’re starting to see more CIOs who are making sure that they understand it and are making digital part of their strategy, especially as we see its evolution in areas like consumer engagement.
Spooner: Yes. The role of the Chief Experience Officer is probably separate from all of those, because it’s about getting the whole organizations to take a much different view of the patients they’re serving. That was something that we were on to fairly early at Sharp, where we brought in an organization and decided that we wanted to almost change our culture. This started around 2001, and we branded it the Sharp Experience. It’s still labeled the Sharp Experience. We always a got a kick out of it when one of the competing organizations would say, ‘we’re going to do the Sharp Experience next year.’ It almost became a standard label.
It really was about moving the whole organization toward a better perspective on the patient — in the same manner as a customer is expected to be treated in any other capacity. I’m strongly in favor of that Chief Experience Officer role. I saw what it did for us at Sharp. Sometimes I will admit that we sometimes said the person who was leading the role was a pain in the neck, but she pushed us, and it really brought benefits. When we started the journey, our overall Press-Ganey scores were not very high. Our target was to get them in the top percentile, and it was amazing the improvements that we made over a period of years. Some of it was common sense things in terms of training our employees to understand what they needed to do for the patients. It was simple things that made a world of difference with employee satisfaction surveys in helping us really understand what was going on within a particular work team, and then giving them the tools that help change those things themselves. It made a world of difference.
Gamble: I think things are going to continue to go down that road, particularly when you talk about things like value-based care and wanting patients to be more engaged in their health and take on a more active role, which we’re starting to see can help drive better outcomes.
Spooner: Absolutely. Clinicians may say that patient scores don’t reflect quality of care that’s being given, but I think satisfaction is what probably drives the tolerance for some of the variations that happen in care.
Before I forget, I want to tell you my own story. My first assignment was as interim CIO in an organization that was doing the same patient experience journey we had been doing at Sharp, and so I knew the model. I knew all the buzzwords. And at that time, some people in the organization were not as far along in terms of adopting the model as we had been, and so part of my fun at that organization while I was there was to coach the IT team in terms of their experience. That helped them to overcome some of the skepticism about the likely outcomes of improving patient satisfaction.
Gamble: That’s interesting too, because one thing we’ve heard is that leaders need to make sure people on the IT side have a better understanding of their part in the patient care picture. It’s not about keeping those world separate, but helping them to see the impact they can have. Maybe that’s something hasn’t always been a priority in the past?
Spooner: I would say that maybe the commitment of IT people hasn’t been as appreciated as it might have been in the past. On the technical side, technicians may not have fully appreciated the contributions that they make by keeping the system running, and making sure that the PC is working properly.
And so, communicating everything that contributes to patient care is an important message for clinicians and IT. You’ll find that in many organizations, nurses, respiratory therapists, and other care providers see that the work that they’re doing is a larger contribution than it was when they were only taking care of one patient, because they are putting systems in place that help to take care of all the patients.