For David Tomlinson, there was perhaps no better prep course for the CIO role at Centegra than serving as VP of Operations for five years. The role enabled him to obtain valuable experience in change management and build the leadership skills he is leveraging to guide Centegra through an “Amazing Race” to implement McKesson’s Paragon and qualify for Meaningful Use within a short window of time. He recently spoke with healthsystemCIO.com about his strategy to make MU a reality, why his organization decided to outsource, how to structure a solid outsourcing agreement, the keys to successful relationships with executive leaders and vendor partners, and why today’s CIOs must be comfortable with taking risks.
Chapter 3
- Getting comfortable with risk
- The difference between pressure and stress
- The beauty of team building
- “I’m only as strong as my weakest link”
- Servant leadership
- Thinking back to the music store
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Bold Statements
You need to have the right relationships, and you need to have the strategy internally, because there are a lot of different tools that can get to the same outcome. The wise decisions are those that can pick the solutions that are going to get you there quicker and perhaps with less resource consumption.
It’s project management, basic and simple, and that pressure or stress can grow. If you have the right team, it’s pressure. If you don’t have the right team, it’s stress, and we all know what happens when we’re stressed; you do not get the outcomes you desire.
There are times where you have to be very objective and straightforward and say, ‘You know what? I just don’t think this is working.’ A leader needs to create a vision and then get the buy-in from those they’re leading. If that doesn’t happen, then you need to say, is the vision wrong or are the people not on their right seat on the bus?
You can buy a best-of-breed system, but if it’s not openly embraced and ownership and accountability aren’t taken on the departmental level to make it better and improve it, it doesn’t matter.
Guerra: Really interesting; as we talk, we see that the journey your health system is on has had bumps in the road. I’m sure everybody’s had bumps in the road. You didn’t come from the technology ranks. You came from operations and then got into technology, and now you’re the CIO. I would imagine it’s very important for someone in your position to not be risk-averse because if you can’t handle risk and you can’t handle going on a road and saying, ‘Oops, this isn’t working out. We need to step back and not throw good money after bad.’ You need to have a certain mentality — a certain temperament or outlook — to do this job, especially in this environment where nothing is certain and things are evolving day by day and no one has a road map. No one knows where things are going. You have to be able to handle that kind of uncertainty. Tell me your thoughts on that.
Tomlinson: I couldn’t agree with you more on that. I actually think that’s why the operations background has been so beneficial to me. You have to make similar types of decisions on an operational standpoint in some respects. We deal in evidence‑based medicine and we call the practice of medicine ‘practice’ for a reason. IT is not much different, other than it just changes so quickly, and so you need to be able to assess. You need to have the right relationships, and then I think the key is you need to have the strategy internally, because there are a lot of different tools that can get to the same outcome. The wise decisions are those that can pick the solutions that are going to get you there quicker and perhaps with less resource consumption, whether it be resources, capital or people — whatever it may be. And a lot of it, I’ve found, is having the right people, because if you have the right people you can make products work. You can have a really good product with the wrong deployment, and it will fail.
There is no silver bullet out there, unfortunately. I think that would be nice, but it’s all about what are you trying to do, what are your business objectives, and then having the right team to pull it together and just get it done, because there are all kinds of products out there. Sometimes I feel like you just need to pick a strategy and move with it and just stick to it. Sometimes that’s hard in IT — look at mobile devices. You wait a couple of months and everybody wants the new one. Look at the iPhone 5 — everyone was excited about that and you can’t even use the same adaptors and it’s just all kinds of different things. But it’s interesting.
I couldn’t agree with you more that it is stressful. What I attempt to do is take stress and turn it into pressure; the difference between the two is your ability to control it. With stress, it’s like William Tell and the arrow and the apple. The guy with the apple on his head is the one feeling the stress, but the guy with the arrow can control it, so he feels pressure. We need to turn things into pressure, and we do that by doing the best due diligence we can, creating the right team, having the right partners, and then sticking to a vision and getting it done. So much in IT is failed projects or lack of great deployments or implementations, just because there’s so much going on and it’s a little bit at a time.
Guerra: That’s a fascinating point. I was just thinking about what you said about stress and pressure. When you’re thinking about all the things you have to do but you’re not in the position to do them — you’re away, it’s the weekend, or you’re doing something else — but for some reason they get in your head, then you feel the stress. But once you sit down and you’re able to work, it goes away because you’re working. Do you know what I mean?
Tomlinson: Yeah, you’re controlling it. That’s the trick.
Guerra: So maybe the key to managing this kind of stress in a work-life balance type of thing, is to be able to shut it off when you’re out. When you’re supposed to be relaxing, when you’re with your family — when you’re doing whatever, you need to be able to shut it off, because you can’t do anything at that point. You’re just eating yourself up.
Tomlinson: Yeah, and I wish I could tell you that I’m the model of balance. I have five children. My first and most important title that I had ever had would be that of a father and a husband, but at times, I struggle with balance. But to your point, I think what’s benefitted me a lot in my career, both in IT and before, is the ability to build teams — people that are just highly functioning and very skilled — and being able to empower them, and even lead people that have more expertise in a given area. I think about when I led surgery or pharmacy; these are clinical pharmacists that have been at this for 20-plus years. They know this in and out. How do you empower them? How do you give them the vision? How do you help them see the direction, and then get out of their way?
And you can feel pressure — not stress, but pressure — because you have the team that is controlling the outcomes. It’s the same thing with IT. It’s project management, basic and simple, and that pressure or stress can grow. If you have the right team, it’s pressure. If you don’t have the right team, it’s stress, and we all know what happens when we’re stressed; you do not get the outcomes you desire. So yeah, one of the things that I’ve been fortunate is to have people around me that are tremendous people that are just awesome, on all sides — the executive team that I’m a part of as well as then those that I get to support.
Guerra: Let’s delve into team-building a little more, because it’s very easy to walk into a place and say, ‘I’ll get the dream team.’ But it never happens, right? That doesn’t happen. What happens is if you go to a place, hopefully you’ll get some good folks, and there are some folks that are either they don’t click with you or your vision, or they don’t like you, or whatever. It just doesn’t work out. They’re not the right people to be on your bus at that time. That’s a great phrase, and a great concept. Team building therefore is either getting those folks to see the world the way you need them to see it and persuading them that this is the way we need to move forward, or removing them from the bus gently and getting your folks on it. And that’s hard; that’s not easy. I think team building is easier; for example, once you get them out, getting the people you want in. That’s not so hard. If you’re a leader, you can build a team. You know what you want. You know it when you see it. You bring them in. I think probably the hardest part is going into a place and having folks where you come to the conclusion that they have to go. Tell me about that.
Tomlinson: That stuff just excites me. That’s what’s pretty exciting. It starts with the leader, first and foremost. You lead by example. You listen and you understand. There are a couple of principles that I found to be true and that I try to live by. I’m only as strong as my weakest link, so when I look at my team, whoever that is, I’m as strong as that weakest link. And so as a leader, once you feel like you’ve got the team and once you’ve got the buy-in, you need to listen to them. I found a practice that I have been blessed to use and have learned from, and that is rounding, where you go roll up your sleeves and spend some time with whoever it is that you’re leading. It’s just remarkable the things that you can learn and the ideas that can be generated. And then you take those ideas, whatever they are, and implement them and give credit to those that gave you the idea.
You can easily build a team. To consider walking into a situation that’s just really struggling, that’s fun, because you can go in and really change it. But you’re right, there are times where you have to be very objective and straightforward and have the conversation where you say, ‘You know what? I just don’t think this is working.’ You have to have a vision. A leader needs to create a vision and then get the buy-in from those they’re leading. If that doesn’t happen, then you need to say, okay, is the vision wrong or are the people not on their right seat on the bus? And then you have to do what you need to do on that end.
I think regardless, every leader comes in and there will be people that will align very well with that leader, but that leader needs to prove himself. But then at some phase, depending upon the culture of the organization, those that are not on board need to make a move, because it can be cancerous for the rest of the department because they may be the unspoken leader. You need to have a high degree of social intelligence, but you need to be in the department enough to kind of get that and see that. And it doesn’t take long to figure it out if you’re adept at it. That’s fun, but our business is driven by people — everyone we’re talking about.
Servant leadership is the style that I align myself most with. I support people. I could say that these people report to me or I’m their direct leader, but I always say, ‘I support them and they know that.’ If they know that I’m out to support them and we’re all working together on a shared vision, what’s great is they get so much done and I can be behind the scenes. In some respects it could be argued that without me being behind the scenes, it may not have happened. But I’d rather let them shine and let them succeed rather than have any accolades thrown my way.
Guerra: I’m looking at the book right now on my desk — Servant Leadership by Robert Greenleaf.
Tomlinson: Yeah, there you go.
Guerra: There are some ones, like the Collins one we referred to. You’re just reading them and you’re like, ‘yeah that makes a lot of sense.’ It just clicks with you.
Tomlinson: Absolutely. But yes, people are what it’s all about. Technology and processes — those tools are all great, but it’s the people that really will make things work. When you’re implementing a new system, you can buy a best-of-breed system, but if it’s not openly embraced and ownership and accountability aren’t taken on the departmental level to make it better and improve it, it doesn’t matter. You can spend as much money as you want and have the best project management team, but if it’s not shared, you’re going to struggle.
Guerra: Did you have a love of technology or a propensity for technology? You have to enjoy it to some degree or be comfortable with it to some degree. What can you tell me about that?
Tomlinson: Well, I love complexity, and I love to learn. I do miss operations, but I love the challenge that I’m in today and being able to learn a whole another language, if you will. And I’ll tell you, I probably have still a learning curve that is great, but yes, I would say I have a propensity to enjoy technology and always try spreadsheets and just anything with data. Tools make things better, so that’s probably inherent in my own DNA. And so yeah, it’s a nice fit, and it’s pretty neat to have a CEO that somehow recognized and kind of handpicked me for this role. The goal is to do the best we can to make things work. So yeah, I’ve taken many IT classes, but I didn’t get a specific information technology degree. I did an MBA and an MHA, so I certainly enjoy learning and I love clinical stuff and this technology stuff is great too.
Guerra: It’s an interesting combination that the position requires — people who enjoy data and working with data and spreadsheets, and yet if you’re going to be a leader at the C-level, you better have high emotional intelligence and social intelligence and the ability to lead. And not a lot of folks have that combination.
Tomlinson: We all are blessed with different strengths and abilities, that’s for sure. But I think the key is aligning people to get the best outcome as possible, and when that happens, you do get outcomes and everyone’s much happier with the life balance and their contribution to the world and to the work place.
Guerra: And certainly if you enjoy complexity, the five kids must give you some of that.
Tomlinson: Yeah, I don’t know what’s more complex — my list of interfaces and our interface engine on a poster here in my office, or the schedule that my dear wife manages with the doings of our children. I think the children are a little more complex, probably.
Guerra: I’ve got two and that’s plenty complex for me.
Tomlinson: Well, that’s great. It’s fun to see them succeed.
Guerra: It’s fun to see them sleep when they’re three.
Tomlinson: That’s true. That’s a good concept.
Guerra: We’re not seeing much of that right now, but we won’t talk about me. Let’s talk about you. Just one more thing I want to touch on; I thought this was great. On your LinkedIn profile it says back in 1998 to 2001 you were sales manager at a music company. Everyone’s got some fun background; some folks have interesting degrees.
Tomlinson: Oh goodness. I need to leave that out.
Guerra: Here’s the question. Tell me how you’re leveraging your work at the music store in your role today?
Tomlinson: Oh man. Again, I need to do a disclaimer for all those that will choose to listen to this podcast or read it. When I was pursuing my undergrad, I had a propensity to be involved and work in positions that were more sales-driven because of the flexibility of hours and the ability for me to provide a living for my young family while I was going to school. And so as luck would have it, I joined a company called Priddis Music and it was actually a Karaoke manufacturing company.
Guerra: Wow.
Tomlinson: I became a sales manager and had worked my way up to that role. I didn’t serve the entire three years in that position, but the last half or so I was the manager of growing that little company. It went from a local small company in all of the trans-world entertainment. That was all the stores like FYE and there were hundreds and thousands of stores throughout the nation. It was great. You leverage any experience in life. You learn to deal with people and you learn to understand what their needs are, whatever they may be, and try to fulfill that need with the product you’re trying to sell. It’s building relationships of trust and learning to lead people and learning to set a goal and achieve it. I learned plenty of that. You learn different leadership styles from those that you work with throughout your life. And so I think I may delete that from my profile after this conversation.
Guerra: All of us have done interesting things. At one point I was doing inventory for a mobile phone store. At one point I was assistant manager of a pool. And like you said, you leverage every experience, and some experiences tell you what you’re not interested in doing.
Tomlinson: Right. I must say that I grew up on an apple orchard and most of everything that I would attribute to maybe future success or current success or past success, I learned on a farm. It’s probably even more entertaining than a Karaoke company, but I’m a self-proclaimed apple bagging champion of the city that I grew up in. There were a couple of ladies down the road that always bagged apples and they were fast, so it was a big day when I beat them as a young teenager. I still remember that moment very vividly.
Guerra: Well, that’s great. And I’m not trying to one-up you here, but I’ve actually, with my family, been thrown out of an apple orchard.
Tomlinson: What were you doing? You must have been really rowdy.
Guerra: I’m going to forward you the column I wrote about it so you’ll get to read that after our interview. But anyone can go on the site and search ‘apple.’ Actually, that might not work; apple would probably bring up too many stories, but ‘orchard’ and things like that. Let’s leave that as a cliffhanger. I will send you that article, but yes, I was told to get out of an apple orchard. It’s a good story.
Tomlinson: That’s funny. I have fond memories from the farm.
Guerra: That’s right. All right, David. This was wonderful, and I appreciate your time today. I think that’s all I had. Is there anything else you wanted to add?
Tomlinson: No, thanks for the opportunity. I appreciate it. It’s certainly fun to chat and share a little bit about Centegra and myself, so thank you.
Guerra: Great, well hopefully we’ll get to work together again soon on something else. I appreciate your time and let’s talk soon. Have a great day.
Tomlinson: Thanks, you too.
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