Matthew Chambers, CIO, Baylor Scott & White Health, Chapter 1

CIOs often say that their experience in consulting played a key role in helping to prepare for an IT leadership position, but perhaps it was never truer than with Matt Chambers, who was called in to assess the IT strategy at Scott & White. That firsthand knowledge came in handy when he stepped in as CIO of Scott & White, then led the organization through a merger with Baylor. In this interview, Chambers talks about what it’s like to guide the IT team through dramatic change, the logistical challenge in leading a system with 40-plus hospitals, the clinical transformation layer cake, and why it’s critical to remember that time is money.

Chapter 1

• About Baylor Scott & White
• The merger with Baylor — “We could unite and form a better entity”
• BSW’s triple aim
• Changes in reporting structure
• His background in consulting
• Merging 2 IT orgs — “Rebooting our strategy to drive us forward.”
• “IT never makes the deal, but it sure can break it.”

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Through scale, you have the ability to attract some of the most talented researchers, clinicians, operators to your organization and just continue to improve. So it’s really about being the best that we can, and we think that this is a step forward in that direction.

I’m very fortunate in that I do have the highest level of visibility and insight into the organization to understand what’s important on a day-to-day and on a strategic basis for the organization.

It’s really been not just how do we cram these two things together and how do we sunset systems. It’s really been about how do we take advantage of this turning point where we can architect our IT strategy to drive us through the next five years.

People are really attached to their systems. There’s a lot of emotional investment in things when you’ve spent years and blood, sweat and tears getting to the optimal state, and so you have to be respectful not only of the bits and bites, but of the human emotion that goes in the systems.

Gamble:  Hi, Matt. Thank you so much for taking the time to speak with us today.

Chambers:  It’s my pleasure. I enjoy it. I’m glad to be here.

Gamble:  Great. To give our readers and listeners an idea, can you just give some background about Baylor Scott & White Health — what you have and the number of hospitals, things like that?

Chambers:  Absolutely. The truth of the matter is we are now the largest not-for-profit healthcare provider in the state of Texas. If you know anything about Texas, it’s a pretty big state, and so to be the largest is pretty large-scale. With Scott & White, we talked about our physical coverage area being about 30,000 square miles before the merger, and after the merger, I think it’s probably double that. If I had to guess, I’d say we have over 34,000 employees, including thousands of employed and affiliated physicians. The number of hospitals is above 40, plus hundreds of different care sites, a health plan, and a four-year med school. We span a continuum of healthcare from ambulatory to acute and post-acute. In terms of geography, we go from McKinney to Marble Falls and College Station to Cedar Park to Waxahachie to Fort Worth. It’s a pretty big area.

Gamble:  Let’s talk a little bit about the merger with Baylor. When was it actually finalized — some time last year?

Chambers:  It was. The merger was official in October of 2013, and it was something that had been contemplated for quite some time. It was really the brainchild, as I understand it, of Joel Allison who was the CEO of Baylor Health Care and now the CEO of the merged entity, and Dr. Robert Pryor who was the CEO of Scott & White Health and now is the president, CMO and COO of the merged entity. Through their collaboration together in various organizations in the state of Texas, the story, as I heard it, is over a cup of coffee one morning at breakfast, they said it’d be great if some of these things that we talk about doing together — things we can’t do because we’re independent — if that wasn’t a barrier, and so to improve healthcare, we could unite and form a better entity. That was really the genesis of the whole thing. There was obviously a lot of planning and prep work that went into it. The official date, as I said earlier, was October 1 of last year, and it’s been a whirlwind of activity ever since.

Gamble:  Sure, I can imagine. So really the goal was to be able to form an organization where you can better meet the changing needs of healthcare reform and everything like that?

Chambers:  Absolutely. The question was, why do you want to be bigger? The answer is, we don’t want to be bigger; we want to be better. I’ll quote Dr. Pryor, he’s fond of saying, “Bigger isn’t better. Better is better.” The goal is to meet the Triple Aim — how do we reduce per capita cost, increase the health of the individual, and very importantly, increase the health of the population. One of the ways that we’ve seen you can do that is through scale. You can do it through scale to manage risk and financing. Then of course, also through scale, you have the ability to attract some of the most talented researchers, clinicians, operators to your organization and just continue to improve. So it’s really about being the best that we can, and we think that this is a step forward in that direction.

Gamble:  So Bob Pryor was the CEO of Scott & White, and you’re still reporting to him. Do you report to both Joel and Bob?

Chambers:  I reported to Bob as the CEO of Scott & White, but the way that the organization is structured now, Baylor Scott & White Health is the parent company, and that has Joel and just a very limited number of executives in that level — our chief of compliance, chief of finance, mission and history, and Dr. Pryor, of course. I’m in the Baylor Scott & White Health Services Company, where most what I consider our back office shared service functions exist, and I report to Dr. Pryor in that capacity.

I sit on our operations council, which Dr. Pryor chairs. There’s a long list of C’s that are in it. From both organizations, you’ve got the CMOs, CNOs, COOs, myself, Dr. Pryor, our chief integration officer, and I believe, our chief financial officer and Joel attends that as CEO. I’m very fortunate in that I do have the highest level of visibility and insight into the organization to understand what’s important on a day-to-day and on a strategic basis for the organization.

Gamble:  You were previously the CIO of Scott & White. As far as what the experience was like for you being part of such a large merger, I can imagine one of the biggest things was what was required to merge these two IT organizations. Can you talk a little bit about what that has been like?

Chambers:  I actually have a pretty unique background that has enabled me to come into this eyes wide open. I don’t know if you know much about my prior work history, but I became the CIO at Scott & White in July 2011. Prior to that, I was a consultant; I did healthcare IT strategy and I also did healthcare IT due diligence in merger and acquisition work. In a very interesting, serendipitous turn of events, one of my largest clients was Baylor. I was based out in Dallas, and so, I did a lot of M&A and due diligence work for Baylor as our history in the northern division is relying on joint ventures to enter care spaces that we didn’t previously, like post-acute therapy and things of that nature.

And so I had really good working knowledge of the leadership team and of the culture of the organizational structure and how they did things, and so, I was able to go into it eyes wide open and understand these are the things that Scott & White can bring to the table. These are the things that Baylor can bring to the table.Specifically with IT, there were really great things going on in both organizations. So the question is how do you take the best of these two mature organizations? Both of these organizations are over 115 years old, each of them individually. How do you pick the best of two really great institutions on a national space and blend them together?

From an IT perspective, it’s really been not just how do we cram these two things together and how do we sunset systems. It’s really been about how do we take advantage of this turning point where we can architect our IT strategy to drive us through the next five years to meet that triple aim. And so, it’s a really, really exciting time. The merger has enabled it. It was something that we needed to do anyway, but it’s just a great confluence of events to give us time to reboot our strategy to drive us forward.

Gamble:  I can imagine it was a tremendous benefit having that knowledge of Baylor. Now, having some experience, as you said, with mergers before you were in this position, were there any particular things that you knew to look out for just as far as some of the challenges that you could run into?

Chambers:  Absolutely. One of the things that I was fond of saying — and I’ll apologize in advance; I’m prone to using very simple metaphors and analogies — but one of the things I’ve always said about mergers and acquisitions is that IT never makes the deal, but it sure can break it. There have been times in my experience where I’ve seen an accounting for the cost and the challenges, and then it used to be that in the eleventh hour, somebody would say “let’s take a look at the IT systems and see if they work together.” And that resulted in some very, very costly expenditures that no one had planned on and in some cases some long delays.

The great news about that is one of the things you hear about IT all the time is you’ve got to have a seat at the table. Well, IT started to get a seat at the table, because like I said, it can break the deal based on the costs. That’s one of the things that we were mindful of going forward. There was a lot of discussion around IT synergies and integration from day one.

The other thing that I’ve learned is people are really attached to their systems. There’s a lot of emotional investment in things when you’ve spent years and blood, sweat and tears getting to the optimal state, and so you have to be respectful not only of the bits and bites, but of the human emotion that goes in the systems. That’s something that we try to bear in mind when we look at the soft skills and the cultural impact of these types of things.

Chapter 2