Ron Strachan, CIO, Community Health Network
When Ron Strachan accepted the role of CIO at Community Health Network last spring, the organization had just selected a vendor for a major IT implementation — a project that was not going to be led by IT. It’s not exactly the scenario most CIOs envision when starting a new position, but Strachan viewed it as an opportunity. A year later, the rollout has begun at the constantly-expanding 7-hospital system, and Strachan is enjoying every minute of his job. In this interview, he talks about what it’s like to take on a non-traditional CIO role, having to repair IT’s reputation after a failed implementation, and the importance of setting the right expectations and not overcommitting yourself or your team. He also discusses the organization’s big push for business intelligence, what he’s learned from working different roles, and how being a CIO is a constant education.
Chapter 3
- The HIE picture in Indiana
- “We’re not trying to reinvent the wheel”
- Managing expectations and not overcommitting — “it’s not IT on tap”
- Bringing a fresh perspective to an organization
- Avoiding falling into the trap of status quo
- “Risk-taking isn’t about selecting a new technology”
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BOLD STATEMENTS
Instead of doing direct integration between the platforms, we’re looking pretty hard at relying upon the patient level data that’s being exchanged and what’s available through IHIE to essentially get the same type of clinical integration done.
You’ve got to set that expectation because too many of our colleagues and friends have met their professional demise by overextending themselves in their IT organization and trying to be everything to everyone. And in some organizations, that’s a very hard conversation to have where the demand is such that it’s hard to accept no for answer.
We sat down with our partners, our fellow leaders, and said, ‘Look, you’ve got a bunch of people that are frustrated. It doesn’t seem like we can deliver anything because we’re working on everything.’ So we’re not going to get better unless we say, ‘Look, here are the priorities. Here is the focus of the organization. Let’s align the work with the organization’s overall strategic plan.’
I’ve had the luxury of dropping into organizations and being the new kid on the block and bringing a different perspective than what the organization may be used to, and that’s been part of the reason I’ve been hired at the places where I’ve been.
Most of the risk taking, I think, is really standing up and being strong enough to guide the organization through change and to be a catalyst and to get them to a better place, if you will. There is much more risk with that than there is with adopting a new technology.
Gamble: That’s a pretty sizable network — IHIE?
Strachan: Yes, it is. I would have to check the website to see how many members there are, but roughly I think it’s got to be over a hundred, so it is pretty sizable. There are a couple of exchanges that cover the state of Indiana, and it’s really being driven by geography, which is acutely obvious. IHIE is predominant in central Indiana and really covers about two-thirds of the state, and then to the southeast, there’s a lot of activity with an exchange that’s based out of Cincinnati. To the northwest, there’s activity overlap with the Greater Chicago area and then to southwest, there’s activity that I’m not sure if it overlaps with parts of Kentucky or if it’s more toward St. Louis, but I do know there is activity in that part of the state as well.
Gamble: You mentioned that with your organization you have joint ventures with other states, so you really can’t just be statewide with information exchange.
Strachan: Right, exactly. For our locations that are, for example, up in Michigan, we do direct connect for them and we’re not dependent upon information exchanges, but what’s interesting is as we’re either acquiring or doing new joint ventures, in terms of the connectivity for sharing patient information, we are really trying to defer to using IHIE as opposed to reinventing the wheel. And in fact, we have two hospitals, one that we’ll probably acquire if the deal goes through and then the other one is a very strong affiliation, but that’s a part of our strategy. And mostly it’s because those two hospitals have different platforms than what we’re going to, so instead of doing direct integration, if you will, between the platforms, we’re looking pretty hard and relying upon the patient level data that’s being exchanged and what’s available through IHIE to essentially get the same type of clinical integration done.
Gamble: There’s certainly not one tried and true method that’s being done around the country. Everyone has just to customize it based on their needs; based on where they are with their organizations.
Strachan: Yeah, and every part of the country is different. Having previously worked in the state of Georgia, the health information exchange efforts continue to be, I would describe them, in their infancy as opposed to what we have here in Indiana, which is very mature. So it’s quite a bit different to try to solve your problems when you have this whole other tool set available to you that you’re participating in versus having to reinvent the wheel where that type of service is completely void.
Gamble: Right, every CIO that we’ve spoken to has so much going on right now and there are so many challenges with prioritization that the last thing you want to be doing is, like you just said, trying to reinvent the wheel. You are trying to use the tools that you already have at different levels.
Strachan: That’s exactly right.
Gamble: Just in terms of project prioritization, obviously you have a lot going on and you’ve been up to a lot in the first year. How do you deal with the challenges of having so many things going on — having so many burners on the stove, to use the analogy everyone wants to use where you run out of burners at some point?
Strachan: I think part of it, from an organizational leadership standpoint, is really setting the right expectation and not overcommitting to any group or any particular initiative. I know that for my colleagues throughout the country, if you do anything right, you’ve got to set that expectation because too many of our colleagues and friends have met their professional demise by overextending themselves in their IT organization and trying to be everything to everyone. And in some organizations, that’s a very hard conversation to have where the demand is such that it’s hard to accept no for answer, but I think it really takes a very strong leader and a very confident leader to work with the organization and partner with them and get them to understand that it’s not ‘IT on tap,’ as we called it at one place where I used to work. Because the organization hadn’t gone through good governance and it was demand after demand after demand, and the backlog was unsustainable and unmanageable.
Part of what we did there is we sat down with our partners, our fellow leaders, and said, ‘Look, you’ve got a bunch of people that are frustrated. It doesn’t seem like we can deliver anything because we’re working on everything.’ So we’re not going to get better unless we say, ‘Look, here are the priorities. Here is the focus of the organization. Let’s align the work with the organization’s overall strategic plan.’ And if we do that, then what we commit to at that point we will deliver instead of having these missed expectations. So I think that the relationship with every CIO at every IT organization, that you have to have that with the company that you’re working for — because if you don’t, it’s not going to have great outcomes.
Gamble: Right. And I guess if you’re starting out at an organization, you can help yourself out and help the people who work under you by establishing that right from the beginning and saying, we’re not going to try to do a whole bunch of things halfway. We’re going to do this and we’re going to do that.’ But it might be harder for CIOs that have been at a place for 10, 15 or 20 years to try to change the way things have been done.
Strachan: Yeah I would agree, and I’ve had the luxury of dropping into organizations and being the new kid on the block and bringing a different perspective than what the organization may be used to, and that’s been part of the reason I’ve been hired at the places where I’ve been, and especially here. I’ve been at two places where I followed the person that retired. And so the organization really was looking for something different — not business as usual — and fortunately I’ve had that experience. That’s a really good fit for me personally, but for my colleagues that have been at the same place and they have longevity there, they indeed have figured out how to be successful as well.
The best example I can give you off the top of my head is Bill Spooner. Bill Spooner has been at Sharp for I don’t know how many years, but he’s been there for a very good run. I think Bill’s one of those guys where he’s most likely been one of the catalysts of leading the organization through change and not falling into that rhythm — I was going to say, trap but I’ll say rhythm — of business as usual. Because again, it’s not good or bad; every organization is different and some places have that rhythm versus what I’m going through with our organization here at our Community today.
So I think that the real skilled leaders don’t allow themselves to fall into that. They force themselves to bring the rest of the organization along and not accept or fall into the trap of status quo. But like anything else, you have to have the courage to do that too, and I think that when people talk about risk taking, that, at least in my experience, has not been about necessarily picking a new technology that’s new for healthcare and is kind of risky. Most of the risk taking, I think, is really standing up and being strong enough to guide the organization through change and to be a catalyst and to get them to a better place, if you will. There is much more risk with that than there is with adopting a new technology, because if you’re smart about technology adoption, you’re going to pilot it before you go big bang and then if it doesn’t work, you cut your losses and you move on. But it’s a little bit different and I think there are much higher stakes when you’re a change agent for the organization, and especially, as you suggested, if you’ve been there for a while.
Gamble: Yeah, I think that’s a great point.
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