When he started as CIO at Flagler in 2010, Bill Rieger found himself in an interesting situation. Not only was it his first CIO role, but it was the first time the hospital had named a CIO. Instead of having big shoes to fill, Rieger had “a blank slate,” and he has leveraged that opportunity to help strengthen Flagler’s IT presence. In this interview, he talks about the challenges in migrating from one major system to another, what it was like to take over a department that was lacking in governance, the importance of having a strong CMIO in place, and why communication is absolutely critical. He also discusses his ACO plans, why he’s avoiding HIEs — for now, his social media strategy, and what he’s doing to keep his staff engaged.
- Qualities of a great leader
- Flagler’s upside-down org chart
- Walking the walk — “You promote your own behavior, like it or not.”
- Partnering with iMethods to improve the culture
- Change management — “It always boils down to leadership.”
- HR is strategic, not tactical
- Embracing social media
LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED
You empower the people around you. I’ve been able to hire some great people here, and I just let them do their thing. Sometimes they fail, and that’s okay. Sometimes I’m going to fail, and that’s got to be okay too.
Your culture is being built around you. You can either be intentional about it or not intentional about it. Either way, it’s being built around you. So take the reins and lead it. Lead that culture building effort, because one way or another, it’s happening.
I still get emails daily saying, ‘We have the perfect resource for you.’ How do you know? How can you possibly send me an email and tell me you have the perfect resource for me? You don’t even know how to spell my last name. That really frustrates me.
I don’t think that hiring anybody is tactical. It think every hire — even a helpdesk person — is a strategic hire, and you have to consider that when you’re looking at your culture.
I don’t know where social media is going to be and what role it’s going to play in healthcare in two years, much less five. But let’s not ignore it. Let’s not pretend it’s not there and just put blocks up through policy. Let’s try to embrace it — at least a little bit.
Gamble: I want to talk a little bit about leadership. You said that you’ve reached out to other CIOs, and from everything I hear, the CIO community is really impressive like that; people are really willing to help out and talk about their own experiences to help others. What do you think are the qualities that really make someone a strong leader?
Rieger: That’s a good question. Obviously, hundreds and thousands of books have been written about that, and everyone has their own perspective and certainly I do, and since you asked, I’ll give you mine. I’ve been going around to different conferences and speaking a little bit about this. I’m very passionate about leadership, and I write different blogs talking about this. I write blogs talking about culture in the workplace and the impact that you have as a leader on your people. And I think there are a couple things. One, you empower the people around you. I’ve been able to hire some great people here, and I just let them do their thing. Sometimes they fail, and that’s okay. Sometimes I’m going to fail, and that’s got to be okay too.
So it’s allowing people to fail and making sure that’s okay with them, and helping them when they do fail. But chances are they’re going to hit it — they almost always do. And it’s hiring good people and empowering them to do their work and taking more of a supportive role. Our organizational chart here is upside down. I’m in the very bottom of our org IS chart. And we give that to every new person that comes in here. I’m on the bottom, and I do whatever I can to support all of those people above me. I think that’s one of the big things.
I think the other thing for me is that a leader has to model. If you cannot model a behavior or character, you cannot expect your people to act or behave that way. A great example is what our pastor says to our church all the time. If you have a church and your pastor smokes cigars even once a month, you’re going to have more smokers in that church than a church which has a leader that doesn’t smoke cigars. Not that smoking a cigar is a bad thing; it’s just that you’re going to promote that behavior. So if, as a leader, I’m going out and partying every night, guess what a lot of my people are going to do? Because that’s the behavior I promote, like it or not. I equate it to an NBA star or an NFL star. Kids so idolize those people. They say, ‘I want to get my Michael Jordan shoes.’ That’s what it was when I was a kid. Everyone wanted to get Michael Jordan shoes and emulate Michael Jordan and be like him, and maybe today it’s Tiger Woods or something like that.
Well, these people sit out here in these cubicles outside my office and while I’m not this great person — I’m just a guy who goes to work every day — I am their leader, and I cannot forget that for even one minute. I’ve sat in that cubicle and thought, ‘I want to be in that role one day. What do I have to do to get there and how can I be like that person? Then you see that person and you look at their character and you say, ‘Okay, maybe that’s not who I want to be like.’ To emulate that behavior that you want them to have and to hire good people and to empower them, I think those are the two biggest things that I try to carry with me every day when I come into this office. I communicate that to anyone who will listen.
Gamble: I think those are really great points. You mentioned culture at the workplace. That’s something I’ve written about because like many people, I’ve been in situations in the past where morale was bad and you could see that leadership isn’t doing anything to help it. That and it’s a situation that all good leaders want to try to avoid. Do you try to take the pulse of the people around you and always make sure you’re not having a situation with bad morale spreading?
Rieger: Yeah, we do. I would say that’s been a significant challenge for us because we’ve had some people that have been here for a long time that should not have been. They were just not able to do their work, and so some of them, through this whole process of all these people we’ve hired to do this project, didn’t make it. That’s a cultural no-no in a lot of different places. So there have been some morale issues that we’ve had to deal with. I came on board here, and within a year of me being on board, we have 30 new people in a department that was only 20 people to begin with. And there’s been a lot of that. We’ve partnered with a great company to help us hire all these people — iMethods, which is a local company here in Jacksonville. They focus on culture. They helped us build a culture and they help us monitor that culture by communicating with the people here — ‘how’s it going? How are you doing? How’s the transition coming along?’
So constant communication is really the key to monitoring that, but we are big believers in building a culture here. We’ve done a lot of good things. We have our own culture building program that the IS leadership team is doing. We’re trying to stay ahead of that as much as possible. I gave a presentation on this a couple of months ago at a CIO conference where I said, your culture is being built around you. You can either be intentional about it or not intentional about it. Either way, it’s being built around you. So take the reins and lead it. Lead that culture building effort, because one way or another, it’s happening.
Gamble: That’s so true.
Rieger: Yeah, it is. Again, with the whole behavior thing, you can focus on it or not, but either way, it’s happening. Those people are looking at you. They are looking at how you live and how you make decisions and how you do all this stuff, and one way or another, you’re in the role. You’re the all-star on the team in some sense. You’re in that role, so nothing is overlooked. I hate to say that, but nothing is overlooked — even your personal life. They are paying attention to that. When you come back with stories of whatever you did over the weekend, they’re paying attention, and their behavior is going to model after that. There’s just no getting around it. Why did we look at Clinton and what he did? What is his presidency going to be remembered for? Moral failure.
Rieger: And it’s no different with any leader in a hospital — CIO, COO, or CEO. People are looking at your life. And it’s not something we want to talk about. We want to talk about technology. We want to talk about putting EMRs in place and big data and all this stuff. It’s funny because I was just listening to a book called The Power of Habits. I listen to this stuff in my car all the time when I’m not listening to healthsystemCIO. I’m listening to this book and it talks about the former CEO of Alcoa — I don’t remember his name. He came into Alcoa at a time where it was doing well and in his first meeting with all the board members and all of the investors, he started talking about safety. He said, ‘We’re not a very safe company. I’m going to work hard to make sure that we’re a safe company and safety will be our priority.’ So he was talking all this talk about safety and everyone’s like, ‘I want to hear about earnings per share. I want to hear about revenue growth. I want to hear about synergy. I want to hear about this.’ He didn’t talk about any of that. He talked about safety, because he knew that if he could focus on one fundamental thing, he could literally change the organization.
Sure enough, if you would have invested $1 million dollars in Alcoa the day that guy took over as CEO, five years later, you’d have five times the money, because he focused on something fundamental. And leadership is the same way. So that’s what I’m going to focus on: leadership and culture. Lack of knowledge has never been the problem in change management. It’s never been the problem. Everyone can read. You can gain knowledge all day long. So lack of knowledge is not the problem; it always boils down to leadership.
Gamble: It really does. There’s a reason why, like you said, there’s been so many books written about it and there are so many conferences on it — because it is something where everyone’s looking for the best way to do it. Leadership is huge. It makes or breaks any kind of company.
Rieger: Yeah, I believe that. One of the reasons why we partnered with iMethods here is because of their absolute focus on culture and leadership and modeling good leadership. There have certainly been a lot of companies who try to get it right. I still get emails daily saying, ‘We have the perfect resource for you.’ How do you know? How can you possibly send me an email and tell me you have the perfect resource for me? You don’t even know how to spell my last name. That really frustrates me because the people that come in your organization are a big part of your culture, so you can’t take that lightly. I think HR is a very strategic department and the whole process of hiring is not tactical at all; it’s very strategic. Each person you bring in is part of your strategy of people sourcing. I really get a little peeved at those emails and I kindly reply, ‘Please remove me from your email list.’
But there are even big companies that come in and they’ll meet with me and they start giving me a list of all of these people that they can bring in here, and I’m just like, ‘you don’t even know where my cafeteria is. You don’t even know what we’re trying to do here. You don’t know my culture. How could you give me this list of people?’ iMethods was the only company who came in and didn’t do that. They said, ‘We want to meet with your supervisors. We want to meet with your team leaders. We want to know your people. We want to know what makes you guys tick. We want to know what you’re all about. Then we’ll start putting people here.’ I’m like yes, okay, finally somebody who’s on the right page here. And we’ve really been able to help their organization obviously financially with this project that we’ve been working on. They have really helped us. It’s been a great partnership.
Gamble: And like you said, it’s actually getting to know your culture before deciding who would fit there. It just makes sense.
Rieger: You hear this about healthcare IT right now — it’s a big bubble, and I don’t think the bubble is going to burst any time soon, just because of the number of people requiring healthcare over the next 20 years. But what’s going to happen is there’s going to be competition for people. You look at all these HR surveys and they’ll tell you that the number one reason why people leave an organization is their relationship with their immediate supervisor. It’s not money. Money is up there, but it’s not it.
And certainly relationships don’t pay the Visa bill, but they sure can give you a happy life, so we focus on that a lot. I’m very intentional about the relationships that I have with my subordinates and the relationships they have with theirs, and I have a relationship with them that I would like them to model with their subordinates. We just focus on that. And again, I don’t think that hiring anybody is tactical. It think every hire — even a helpdesk person — is a strategic hire, and you have to consider that when you’re looking at your culture.
Gamble: Absolutely. When you think about how much time we spend at work, these relationships are really important.
Rieger: No question about it. And social media, to me, is blurring the lines between work and home. Imagine a kid coming out of college right now who’s had a couple of years of analytical experience and he wants to work in your organization. He’s great; he’s on fire, and you want to bring him in, but tell him he can’t have Facebook during the day. Well he’s not only talking to his friends on Facebook; he’s also talking to his past colleagues and getting ideas about different things. You can’t just shut that stream off. So those lines are being blurred between home and work now, and social media is doing that.
We had a reboot event halfway through a project here. We just got finished with the majority of the build and we wanted to have an event to mark that milestone. So we did and we really promoted the use of Twitter. I don’t know where social media is going to be and what role it’s going to play in healthcare in two years, much less five. But let’s not ignore it. Let’s not pretend it’s not there and just put blocks up through policy. Let’s try to embrace it — at least a little bit.
We had an event and we really encouraged everyone to tweet. We had all these fun tweets during this event. It was actually really cool. Some of the clinicians were doing it, obviously a lot of the IT people were doing it, and we had vendor partners there. So I downloaded all those tweets and I put them on a picture board with some other pictures on it so we have a marker of time here. But it’s not something, at least from my perspective, that we can ignore.
We obviously have to do the responsible thing with regard to security, and that’s becoming increasingly challenging, but it’s not something we can ignore. It’s part of the Gen-Y culture coming out of school right now. There are a lot of them coming into the workforce and they’ve got a lot of good energy. You want that kind of energy on your team, but you can’t ignore some of their resources. That’s their peer group.
Gamble: That’s another important component of leadership — knowing that you do have to incorporate social media, like you said. Even though it would be easier to say to ban certain sites, maybe it would be easier at first, but it’s not a long-term solution.
Rieger: You expose some people to it and you never know what kind of idea is going to come out of that. ‘Hey, why don’t we use it for this?’ Oh you say, ‘Oh yeah, I’ve never thought about that. Awesome idea.’ And you support that idea and you help that. The ideas in healthcare are not going to come from outside of healthcare. They’re going to come from people who have been in healthcare. But unless you expose them to some of these things, they’re not going to have the ideas, so that’s the whole creative process that we’re trying to embrace.
Gamble: I think that’s a great perspective. Well I think we’ve definitely covered a lot so I don’t know if there was anything else you wanted to touch on, but I really appreciate you taking the time to talk with us. It’s been great talking with you. You’re very honest and you provide a great perspective.
Rieger: Well, I appreciate that, and I know I may go off on a little bit of a tangent talking about leadership and culture building, but it’s obviously something I’m very passionate about. Every conference I go to, if anyone needs someone to speak about leadership or culture building I volunteer, because it’s something that I feel very strongly about.
Gamble: It’s a cornerstone. It really is.
Rieger: Well, thank you very much. I appreciate it. I appreciate your time too, Kate. Have a great day.
Gamble: You too, and I hope to talk to you again soon.
Rieger: Okay, thanks.
Gamble: All right, thank you.