Carolyn Byerly believes vendor relationships don’t have to be so complicated. During her 11-year tenure as CIO at Stanford Hospital & Clinics, she made it a point to take the high road by being as transparent and honest as possible. The strategy served her well; she helped transform a best-of-breed shop into a Stage 7 Epic enterprise environment. In this interview, the recently “semi-retired” Byerly talks about partnering with Perot to successfully implement Epic, the criteria for selecting the right vendor, and her organization’s five-year data warehouse journey. She also discusses Stanford’s sizeable investment in securing patient data, the creation of an Innovation Council, and the attributes all CIOs should have.
- Stanford’s telehealth vision — patient portal & dermatology clinics
- “You will see Stanford break ground here.”
- Growing the network
- Byerly’s decision to retire
- Advice for CIOs — “It’s okay to fail”
- The importance of humility
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Every organization — especially academic medical centers — is trying to figure out how do we play in this new field, who do we partner with, and what are we going to need to sustain financially and sustain our patients’ journey.
I really believe that our vision around Stanford Health Partners with telehealth and virtualizing our services and e-visits and being able to interact with your doctor and your nurses is really going to be important for growing our network and competing in the next generation of healthcare delivery.
The next 10 years will be very challenging and very exciting, but I believe Amir needs a CIO that can go the distance with him, because he’s young. It’s right for me, and I think it’s right for Stanford as well.
The most important thing a CIO can do is to be honest; to be candid when you need to be candid, and make the tough calls when you have to make the tough calls. If you do that in a way in which everyone knows that you’re very approachable — that your door is open and that you will listen — I think that goes a long way.
One of the most difficult things you learn as you progress through your career is that everyone isn’t going to do it like you might do it. Everyone may not even think of the same solution that you might think of, and it’s okay.
Guerra: You mentioned vision being one part of the CIO’s job, and it looks like one of the visions or strategies for the organization is around treating patients in their homes through telemedicine and online portals, these type of things; basically extending the hospital out into the community — into homes and practices. That’s certainly something where I think the industry understands that keeping them out of the hospital is going to be as financially rewarding, or more so, than having them in with health care reform and things like pay for performance as we move away from fee-for-service. It certainly looks like that’s one of your strategies; one of your top three priorities. Would you say that’s true? And maybe just tell me a little bit more about what you’re doing in that area.
Byerly: That is very true, and I believe in the next five to 10 years, that vision will come to life at Stanford. It starts, obviously, with healthcare reform and the accountable care organizations. Every organization — especially academic medical centers — is trying to figure out how do we play in this new field, who do we partner with, and what are we going to need to sustain financially and sustain our patients’ journey.
From Stanford’s perspective, we’re already doing this very effectively with the MyHealth products from Epic. We have close to 70,000 to 80,000 patients using MyHealth, the patient portal. I think we have 6,000 or 7,000 referring docs using the affiliate link from Epic as a referring doc portal, and we’re also doing telehealth with our corporate partners — and I’ll describe corporate partners in a minute. But we actually have a dermatology telehealth clinic at Cisco and we’re expecting to deploy more throughout Cisco where it’s a telehealth setup and you’re actually talking to and seeing a dermatologist from Stanford. It’s open to all employees.
We believe the virtualization of services to the home, to corporations, and to referring physicians that we have a relationship with will absolutely change the way that we see and care for our patients. Make no mistake — Stanford is an organization where we take care of very sick people. Our vision is changing to where we want to be our patients’ health partner, and that means we need to know everything there is to know about our patient — their family, how many children, etc., and becoming more of a partner and having our patients be a member of Stanford Health Partners where we take care of patients.
With our strategy for network care, we actually have created a medical foundation and we have close to 300 doctors in our market who are affiliated and who now use our EMR. We see the virtualization of care as being very important for us to be able to interact with them, and we see telehealth as being extremely important. You will see Stanford break ground here. I really believe that our vision around Stanford Health Partners with telehealth and virtualizing our services and e-visits and being able to interact — whether it’s through your iPad or any other small tablet — with your doctor and your nurses is really going to be important for growing our network and competing in the next generation of healthcare delivery.
Guerra: You mentioned a little earlier in our talk here that your tenure was coming to an end, and I wanted to discuss that with you. You mentioned being in the business for four decades. We talked about how you became CIO at Stanford in 2002, so you had 10 years as a CIO there, and obviously other stints. You said you’re going to semi-retire, but tell me about the decision making process — what your new status is going to be, and what Stanford’s plan is for the CIO role.
Byerly: I am. I’ve been here 11 years and I feel very good about the decision. It was very, very tough. I am very happy here. I’m very proud of what we all accomplished and what we achieved, but I just feel that at this stage of my life, I need to take some time off and spend a little bit more time on my golf handicap and do things that I haven’t done and just have a little bit less pressure in my life. I’ll put it that way. Stanford’s been great. The announcement went out about a month ago, even though I did tell Amir Rubin, our CEO, in October. It went out, and everybody’s just been so gracious and there have been lots of dinners and parties. It’ll be hard to say goodbye to a lot of people who I’ve known for many, many years, but it’s right for me, and I believe it’s right for Stanford. The timing is right.
The next 10 years will be very challenging and very exciting, but because of my age, I believe Amir needs a CIO that can go the distance with him, because he’s young. It’s right for me, and I think it’s right for Stanford as well. I will take some time off. I know a lot of people in the industry and I still believe that I have some skills and experience that I can share in many different ways. I’m not looking for employment. I know my CIO days are over, but I think there’s ways in which I can help part-time, and I’ll look into those after the first of the year.
Guerra: When you say ‘semi-retiring,’ it means you’re fully retiring from Stanford but possibly doing some contract or consulting work?
Guerra: It’s obviously a big decision. There are probably a lot of emotions involved. So you look back at 40 years on a pretty good career. I would imagine you’re pretty pleased?
Byerly: I’m very pleased. I have had great opportunities, and now you’re going to make me emotional.
Guerra: I’m like Barbara Walters now.
Byerly: I’ve worked for great CEOs. I’ve just been blessed and had great colleagues and tremendous support. I’m very happy about that, and I’ve had people who have worked for me over the years almost in every institution, who work for me today here, who have followed me when I called, and it’s a hard goodbye. But they will be friends forever and we’ll keep in touch.
Guerra: Just as a final question, what would your best advice be — any lessons learned or advice to maybe young CIOs or newly-minted CIOs? Any general advice you can give them on how to be effective and successful?
Byerly: I think the most important thing a CIO can do is to be honest; to be candid when you need to be candid, and make the tough calls when you have to make the tough calls. If you do that in a way in which everyone knows that you’re very approachable — that your door is open and that you will listen — I think that goes a long way. I’ve tried to make myself available and listen and engage at all levels of the organization. I think if you demonstrate those attributes, people will understand why you made the tough call or why you’ve changed your direction or why we might have selected a certain technology over another.
So I think that’s my advice. You have to be approachable, and then you have to put on that list the fact that you can’t win all the battles, and you don’t want to, as a matter of fact. If you think you need to win them all, you’re not going to last long, and you’re in the wrong job. And I think you have to lead; you have to really delegate. You have to delegate responsibility and accountability, and it’s okay to fail. You don’t want to do it repeatedly, but it’s okay to fail because it’s all part of what you’ve learned. But you have to delegate and you have to lead. You have to let people do what they do.
I think probably one of the most difficult things you learn as you progress through your career in each higher position is that everyone isn’t going to do it like you might do it. Everyone may not even think of the same solution that you might think of, and it’s okay. A few years ago I learned that. Twenty years ago, I said I can’t have them do everything the way I would do it because then I’m not leading, I’m managing. I think delegation, giving accountability, and letting people grow is all very important in a leader. And last but not the least, I think humility is very important. I don’t think arrogance or egos play into being a good leader. So that would be my advice.
Guerra: That was wonderful, Carolyn. I really enjoyed our talk. I think a lot of CIOs are going to get a lot of value out of hearing your words. Congratulations on retiring. I’m sure a lot of your colleagues are going to be envious who are stressed out when you talk about your swing. Thank you so much for your time today, and I hope we get to chat again.
Byerly: Anthony, thank you very much. Happy Holidays.
Guerra: You too.