Tom Bres, VP/CIO, Sparrow Health System, Chapter 4

In 2008, Tom Bres was in his 19th year with IBM, and Sparrow Health System wasn’t heavily focused on health IT. Five years later, Bres is leading the organization through a large-scale Epic implementation as its vice president and CIO. What a difference five years makes. Recently, healthsystemCIO.com spoke to Bres about the organization’s reinvestment in IT, the all-hands-on-deck effort required to go from an environment of paper records and disparate systems to an Epic customer, and the critical role clinicians are playing in Sparrow’s transformation. He also discusses how the organization is leveraging mobile apps to increase patient engagement, Sparrow’s partnership with the Mayo Clinic, and his thoughts on talent management and leadership.

Chapter 1

Chapter 2

Chapter 3

Chapter 4

• Building a results-driven culture
• Learning from the Epic rollout — it’s not always a technical issue
• His pet peeve
• Educating staff on how to use e-mail more efficiently & avoid unnecessary meetings
• How he “disconnects” from work
• Is there ever a right time to schedule a go-live?

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Bold Statements

There are a few things that I emphasized and am still emphasizing; certainly performance accountability and performance management, and results-based management so that we measure our success. We set goals for ourselves and work hard to achieve those goals.

As we’re going through our lessons learned, the areas that we could have performed better in were largely due to a communication or collaboration issue more so than a technology issue.

Most businesses have had email for many years, but how do you use it? Do you really communicate and get things done via collaboration tools like that, or are they just another thing that you have to attend to on a day-to-day basis?

You hold people accountable. You set the goals for them and hold them accountable to achieve the results. And if you stay focused on that, then whether you meet or not or how you get it done becomes less important.

The attitude of our caregivers really helped a lot. So many of them were practicing leading up to the first day, and so many of them were asking and getting extra training. Their attitude of wanting to be really good at this and to learn it and to take advantage of it has helped us tremendously.

Gamble:  I know I asked you about four questions in one so if you wanted to talk just about your perspective on building a culture. But I you’re not really building a culture; there’s already a culture there. So is it a matter of you adjusting to that or did you try to kind of take things in a different direction?

Bres:  No, I definitely did and still am achieving a transformation — really a complete transformation for information technology at Sparrow. So there are a few things that I emphasized and am still emphasizing; certainly performance accountability and performance management, and results-based management so that we measure our success. We set goals for ourselves and work hard to achieve those goals. And then there are the cultural types of things I mentioned a minute ago — a focus on collaboration and communication and breaking down silos between departments, and a team-based approach to leadership and to management are a lot of cultural things that we have moved toward that are different or were things that I’ve emphasized in my time here.

You can tell I’m being careful not to say that we’ve made those changes. We’ve certainly made progress, but we have more that we want to do. Even if you look back at the iSparrow or Epic implementation, as we’re going through our lessons learned, the areas that we could have performed better in were largely due to a communication or collaboration issue more so than a technology issue. It’s really confirmed I guess some of these beliefs that we’re starting to manage and to lead our organization by.

Gamble:  I have to tell you, I read the piece where you were featured in Information Week and they asked you about your business-related pet peeve and you said ‘when people meet instead of act,’ and I can really relate to that because meetings for the sake of having meetings is something that absolutely drives me nuts. What can you do to prevent that? Because I know there are organizations where people just really like to sit down and talk about things instead of doing them.

Bres:  Well, again, I’m very fortunate to have had the terrific experiences that I had at IBM, and so I was forced to be productive in a company where you often were not in the same city with the person that you needed to collaborate with or communicate with. And so for a company like Sparrow where 90 percent of the employees are in the same city or within 20 or 30 miles of each other, they’re very accustomed to getting together and meeting in person. Certainly there’s value in doing that, but some of it is just educating folks on how you can be productive through other means — for example, how to use electronic communication. Certainly most businesses have had email for many years, but how do you use it? Do you really communicate and get things done via collaboration tools like that, or are they just another thing that you have to attend to on a day-to-day basis? Do you use things like instant messaging and other collaboration vehicles like that? Those are some things that I’ve brought to Sparrow.

And some of it is just really leading by example and cancelling meetings when they don’t need to happen; showing people how to run an effective meeting so that when you are together, you do get something done. You talk about meaningful things and you don’t waste time on things that aren’t straight talk. It’s just a lot of little cultural things like you referred to that I think have brought some progress to, but I still keep it as a pet peeve to watch for on a regular basis.

Gamble:  There’s almost like a skill at determining which things can be addressed by email and which things that can be addressed by phone. And of course there are things that you do need to talk about face to face sometimes. But I’m sure the people who work with you appreciate limiting meetings, and then when you have meetings, keeping them focused. Because I think a lot of people feel that way.

Bres:  It goes hand-in-hand with demand — if you’re a results-oriented culture, then that’s what you’re looking for. You’re not looking at whether or not you’re meeting or how you’re communicating. You hold people accountable. You set the goals for them and hold them accountable to achieve the results. And if you stay focused on that, then whether you meet or not or how you get it done becomes less important.

Gamble:  Absolutely. The last thing that I wanted to touch on is that obviously being a hospital or health systems CIO, from everything I’ve heard, is an extremely busy job right now. So I like to ask people what they do to get away from it and if they are able to kind of disconnect sometimes from work.

Bres:  I haven’t disconnected a lot lately. I am back to sleeping more regularly than I was the first two to three weeks after our December 1event.

Gamble:  Sure.

Bres:  I joked with a lot of the physicians that I never was a resident so I never got to learn how to not sleep for multiple days in a row, but I tried to quickly learn. So I haven’t been able to disconnect a lot lately but I do have an awesome family — my wife and four young kids — who keep me very busy whenever I can get time away from Sparrow. So whether it’s watching or coaching their basketball games and football games and soccer games or just spending time with them, that’s pretty much where I try to focus myself when I’m not with Sparrow.

Gamble:  I guess the timing of this question is tough because when you did go through something like you guys in November, it is going to be really difficult, like you said, to disconnect.

Bres:  We were very fortunate though. We didn’t know with it being December 1 what kind of holidays folks would even have, but we were able to get everybody time off. And so with all the analysts and all the people that were working really around the clock for a number of days, things were going so well that we were able to give people time off and so there were holidays and time away for everybody, so that was terrific.

Gamble:  That’s good. I don’t know if there is an ideal time to do a go-live or any big project like that. But I did have a CIO tell me recently that he’s never again going to schedule a go-live for July because they started running into issues with vacations. I can’t imagine that that’s an easy spot to be in.

Bres:  No, you’re right. There isn’t a good time. We studied it quite a bit. We talked to a lot of other health systems. Obviously, you have the holiday conflict like we did. We had hoped that it might be a lower census for us, but that ended up not being the case. Our growth and our market share have just been so positive that we’re full most days, and that was the case. If fact, we had a record birth in our mother-baby unit the night we turned on the system.

Gamble:  Oh my gosh.

Bres:  So the lower census didn’t happen. But people have tried it on holidays, and they’ve tried it in the summer. You’re always going to have challenges, because there’s not just the go-live, but the training. We actually felt like we had the perfect time for training because in September, October and November you don’t experience quite as many vacations and so there are pros and cons across the map. We wouldn’t do it any differently than we did it.

Gamble:  It sounds like things went pretty well — or as well as you can expect, so I’m sure that’s a good feeling.

Bres:  Definitely. And like I said, it’s hard. Even though it went well, there’s still a lot that we’re working through. It was such a huge change for folks, and the attitude of our caregivers really helped a lot. So many of them were practicing leading up to the first day, and so many of them were asking and getting extra training. Their attitude of wanting to be really good at this and to learn it and to take advantage of it has helped us tremendously and still is as we’re working through remaining issues and getting the system to a state where it’s the best that it can be.

Gamble:  Sure, it’s an ongoing process. All right, well we’ve really covered a lot and it sounds like you guys are doing some really great things. I really appreciate you taking the time to speak with us. Unless there’s anything else you wanted to talk about, I realize I have to let you go.

Bres:  Thanks, Kate, I enjoyed doing it. We really are proud of what we’ve accomplished and looking forward to doing more.

Gamble:  Great. Well, I hope to talk to you again in the future.

Bres:  All right, thank you.

Gamble:  Thank you.