John Kenagy, SVP/CIO, Legacy Health, Chapter 2

When one door closes another door (or window) hopefully opens. And that’s just what happened to John Kenagy when the door he’d been walking through at Providence closed. Just off interim status, Kenagy is now the CIO at Legacy Health, and loving every minute of it. That’s because the Ph.D. with an expertise in CPOE will be able to bring his research to bear right at the point of care. Being closer to the “rugby sport” that is healthcare IT has this veteran charged up again. To learn more about his plans for improving care by implementing clinical systems at Legacy, healthsystemCIO.com caught up with the long time West-coaster.

Chapter 1

Chapter 2

• Vetting a potential CIO position
• Know thy self, then find thy position
• The core part of my job is marketing and communications
• Promoting for success

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BOLD STATEMENTS

I see a lot of parallels between how an organization views its human resources and its information resources …

Providence works with an organization called Personalysis and Legacy does Myers Briggs, so I’ve had the behavioral colonoscopy at both organizations and realized how limited I am in so many ways (laughing) …

Change is difficult, and helping people through it, helping them see the benefits of that new new, the next environment, I think, is a big part of what we do.

Guerra: Do you have any thoughts on what a CIO candidate might ask the CEO and/or the CFO (of an organization they were interviewing with) that would give them some sense as to how the position is viewed at that organization?

Kenagy: Oh God, that’s a great question. I think, one, you answer it yourself in doing your own discoveries. Where does the role report to? How is it viewed? Interestingly, from my own rule of thumb, I look at the peer relationship with the human resources executive, and so the CFOs generally work directly for the CEO. Actually, a lot of CEOs come from the CFO ranks, particularly as healthcare has become more of a business and a financial operation than a healthcare one, but I see a lot of parallels between how an organization views its human resources and its information resources, and so when those jobs are peers either as, in this case, senior vice presidents and both of us work for the CEO, that, to me, is a sign of how information as a resource, information as an asset to the organization is viewed.

I’m just thinking about being in those interview situations. I think asking, just asking a good question, having a conversation about how the CEO views information, what does he or she see as the biggest pressures, the biggest value, to just listen. To ask: do you think that IS is a strategic differentiator for this organization and how? I remember having that conversation with the CEO here, George Brown, who’s a physician and actually not, as I was saying earlier about CEOs who seemed to be more disengaged from IS or worried about looking dumb, that’s not George’s problem at all. He is amazingly insightful about IS, knows it will be at the center of healthcare transformation, and he’s just a pleasure to work for. I remember having great conversations on the topic I just raised in our initial “get to know each other” conversations around the strategic value of IS and how it will differentiate us in the marketplace.

As we started this conversation, Legacy is very strategically an open health system that works, embraces, attracts, supports and engages with affiliated physicians, with community-based doctors who are on a multitude of information systems — all the way from pen and paper to best in class ambulatory suite products, and George and I have a strong view of how we can use information technology in the community to, in the end, provide better patient care because information flows to where it is needed at the point of clinical decision making. George’s eloquence on that just reinforced that I knew I was making a great career move.

Guerra: It’s a big part of the job to manage a big budget and to do budgeting and forecasting and come in on budget or under budget and this kind of thing, but do you think that could be a red flag if maybe that’s all they’re talking about in the interview and it’s basically a “manage the cost” job?

Kenagy: I’d say yes and no. You know, it’s interesting because I think the interview is going to be driven a lot by the pet peeves they didn’t like in the predecessor.

Guerra: That’s true. Yes.

Kenagy: I mean, so they hate to be that blunt, but I’m sure when Laureen was interviewed up at Providence, they said, “So like here’s what we just don’t like about Kenagy,” (laughing) and maybe a little bit less direct but, “Would you be as flip and humorous in all meetings?” So, yes, I think that that would be a red flag. Or it could be someone who is really – there are all types of CIOs and there are all types of organizations. I also look at my skill set. You know, I have been blessed to work for organizations that really look through behavioral guides. Providence works with an organization called Personalysis and Legacy does Myers Briggs, so I’ve had the behavioral colonoscopy at both organizations and realized how limited I am in so many ways (laughing), but I think one of the things that I know that is natural to me, it is part of my makeup, is structure and organization, and I’m not the entrepreneurial CIO. You know, there’s a Personalysis type around that and on Myers Briggs, and I do think the life expectancy, the effectiveness expectancy of a CIO is around seven years. Now, there are phenomenal people who break that rule. You know, it’s not a hard and fast rule because I know some dear friends who’ve been in organizations many years, but I think generally, you know, two years, three years I think is too short. You don’t have time to execute the vision that you’ve set, and much more than that you can become stale, the organizations can become stale.

I actually believe a lot of my job, the core part of my job, is not the technology leadership; it is marketing and communications, celebrating our success, communicating them and marketing them in the purest definition of that term, of understanding what the customer needs and delivering it, and also financial management. I am very big on that. I’m more of a department administrator and a business leader than I am a technology strategist and chief architect. I do think that the skill set I have is what was needed at Providence five years ago and what is needed now at Legacy, but it’s not a perpetual need.

Guerra: Could you even say that beyond marketing, it’s sales?  I mean that you really have to be out there selling the changes that you’re trying to enact to the clinicians that are going to have to buy-in?

Kenagy: I can’t remember all, the five P’s of marketing – price, placement, performance – you know I think a lot of great sales and great marketing is having it dawn on you that you have a need that you didn’t think about or wasn’t top of mind before that ad campaign or whatever. A lot of the role and a lot of really good marketing is around change management. You need to transition to something new, but you don’t know what that new and unknown is and that’s disconcerting, whether you’re an ambulatory physician who’s now moving from an old system or paper into the electronic system or a manager trying to acquire something and using our ERP system. Change is difficult, and helping people through it, helping them see the benefits of that new new, the next environment, I think, is a big part of what we do.

Guerra: It’s so interesting because you have to go to these very educated folks and convince them they must now work in a different way. It’s going to be painful, it’s going to slow you down, and it’s not going to be perfect right off the bat, so work with me and…

Kenagy: And you’re welcome. Yeah, exactly.

Guerra: It takes a lot of people skills to make that happen.

Kenagy: Right. I think one of the big pressures on organizations is adequately compensating the technical people without making them feel they have to go on to management to get either more authority or more pay or just more pleasure in their job, and I’ve seen people who have actually, probably early on in my career, promoted people who were sort of the best technologist into a manager or supervisor role because that was a promotion and they expected that to be the next step. Many of them flamed out as managers because the manager role is more around people management and budgets management and user management and not being the chief architect anymore and, you know, they were saddened that they left that because it was something they loved and now they’re stuck in something that they don’t like. Well, organizations that have had the insight that you actually can pay a senior consultant, a subject matter expert, the same as a manager, will keep those important folks.

Professional development shouldn’t just be the once a year time when we’re doing the perfunctory performance appraisal, but really it’s a continuous look at what we’re doing, where does a person want to be in five years in an organization. We have people leadership and technical leadership and both must be highly respected and appropriately compensated in our organization. That’s something I want to bring to our human resources colleagues here too.

Chapter 3