Chris Belmont, VP & CIO, University of Texas MD Anderson Cancer Center, Chapter 3

Why would a CIO want to lead a major Epic rollout after having recently completed the task at another organization? For Chris Belmont — who was asked this very question by his son — the answer was simple: it was a chance to do it better, using the knowledge gained the first time around. In this interview, Belmont talks about how an implementation is like having a child, the two biggest challenges in a major transformation, and how an organization can benefit from disruption. He also discusses MD Anderson’s Moon Shots program, the work his team is doing with IBM’s Watson, how he hopes to improve the patient experience, and the importance of mentoring.

Chapter 1

Chapter 2

Chapter 3

• Customized engagement — “In cancer care, a lot of people want that personal touch.”
• Networking to help “to avoid the speed bumps”
• Collaborative mentorship — “I’m a big fan of growing the talent you have.”
• The “variety” of being a vendor & consultant
• Vendor management
• “We’re doing good things. The industry as a whole is getting better.”

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Bold Statements

We also have to be aware of what’s going on in the industry generally. We can’t just chase the next shiny object — we have to also keep our eye on the current business.

We’re going to be going through a talent calibration process in the coming months — not to evaluate their performance or their ability to do their job or weed anybody out. It’s about where we can complement the skills and tools they have so that they’re ready for the future and they can serve the organization better.

I learned a lot about strategy, a lot about contracting, a lot about executive relationships. So that was extremely rewarding, and it became invaluable back in the CIO role, because all CIOs want to operate at the executive level, but it’s challenging and it’s a different approach.

One of the things I’m very focused on is how do we leverage our partners better? Instead of vendors coming and selling me what they want, I like to take the approach of, ‘let me tell you everything that we’re doing and you sell me what I need versus what I want.’

Gamble:  Getting patients more active and more engaged is something that a lot of organizations are really focused on. But especially when you have so many repeat patients, I imagine it’s an even bigger priority.

Belmont:  Yeah, and people think of it as patients are diagnosed with cancer and they come here and they have an outcome and they go away. The reality is they don’t. They stick with us. There’s actually a group we call seekers — people that are either in the early stages of diagnosis or are maybe looking at it from a preventive perspective. So there are a lot of people interacting with us way before they actually get here. These are patients that may or may not ever hit Epic, for example. And then there are the survivors — and not only them, but their family members and so on — that are participating in this journey with these patients. We interact with a lot of people, not only our patients.

Gamble:  As far as hitting the patient adoption numbers with the portals, what are you doing in that area?

Belmont:  We’re going to improve obviously with Epic. Our portal is pretty good now. In fact, we won an award for innovation a couple of years back for a process called PreCare — it’s basically a preregistration process, and it’s kind of common now, but it was pretty innovative in its day — where patients can start the MD Anderson experience early. How do they now start exchanging information with us through the portal?

We’re just going to take Epic and the enhancements you get with MyChart and embed them into the mymdanderson.org website and enhance it. Because, again, PreCare will interact with patients before they actually get a medical record number, so we’ll leverage PreCare as it is today or we’ll continue to enhance it. And then how do we drive what’s relevant right to that patient? We want to give people options. There are a lot of folks that still don’t use that. And actually, in cancer care, there are a lot of people that want that personal touch — they don’t want that virtual video conference or telemedicine piece that works in so many other scenarios. A lot of patients actually want come here and look eye-to-eye to their caregivers. So we’ll adopt and we’ll adapt our systems to accommodate all those different scenarios. Bui I think our goal is how can we make it a common experience so that whether you’re in the building, on the phone, on your portal, on your mobile device, you’re getting the same experience? So we’re working a lot in those areas. 

And then with the whole seeking through survivorship, how do we expand our online presence to support that across the board? As we democratize and open up and allow the knowledge we have to be available throughout the world, we’ll obviously leverage those technologies as well to do that.

Gamble:  Okay, so there are really a lot of things you’re looking out for the next year or so. You’re keeping pretty busy. Is there anything else we missed, any other bigger things you’re working on?

Belmont:  No. I think the only other thing is we have to get ready for continuing changes in the industry. It’s not about just the innovative stuff. We also have to watch and adjust as the challenge that has hit our industry begin hitting us. Reimbursement is going to change. The pressures for productivity are going to change as the demographics for competition changes. We also have to be aware of what’s going on in the industry generally. We can’t just chase the next shiny object — we have to also keep our eye on the current business. 

Gamble:  I’m sure that that’s something where it helps a lot to have a network. You said that you speak to a lot of other CIOs; I’m sure that’s pretty helpful to get other people’s perspective on what do we need to be looking at.

Belmont:  Agreed. Because, again, we’re a cancer center, some of the challenges they have they may be experiencing earlier than us. And so learning from them and trying to avoid some of the speed bumps is the best way to go. If nothing else, it’s very supportive and validating, so when you call them they’ll say, ‘Oh yeah, that’s going to happen to you.’

I remember at Ochsner when we had our first go-live with EPIC, it was a little rockier than I thought it should have been. I called one of my colleagues who I trust who has been in the industry and been doing Epic for about six years — he’s a great guy. And I said, ‘the first one doesn’t to be going very well.’ And he said, ‘Oh yeah, Chris, the first one’s pretty bad. In fact, it took us nine months to get out of there.’ I said, okay, that’s something you could have told me last time I saw you.’ Anyway, now I know to ask. We’re always very supportive because we’re kind of all going through it at the same time.

Gamble:  Sure. Now, I noticed in doing a little digging that it looks like MD Anderson has like a pretty big focus on mentoring. I think that’s really fantastic to have within the organization because when people with less experience hear those things from those with more experience and get that validation, I’m sure it’s really valuable.

Belmont:  Yes, and I encourage it. In fact, that’s an area within the IS Division where we’re going to put a great deal of focus and development of our talent. In adding 200 new members to the team with EPIC, we need to identify the talent we have as we go through this transition. The systems we have today will not be the systems we have in place in a couple of years — how do I identify the talent I have and leverage them across the institution versus in their own department? So we’re going to be going through a talent calibration process in the coming months — not to evaluate their performance or their ability to do their job or weed anybody out. It’s about where we can complement the skills and tools they have so that they’re ready for the future and they can serve the organization better.

When we moved some people onto the Epic team it allowed others to step up, and it’s just amazing the talent that’s emerging. I’m wondering how much more in this organization with 900 that we can take advantage of and leverage and even challenge. There are people that want to do more things and additional things, so how do we do that? How do we make them ready and make them service the organization better in the long haul?

Gamble:  Now how does the collaborative mentorship program work? Are there people who are assigned to certain people or is it more like getting people together? How does that work as far as helping people to get developed a little further?

Belmont:  Some of it’s very formal and some of it’s very informal. You can get into certain programs that could be as long as six months. Usually it’s reserved for the management development track. That’s going to our formal profession development team. And then there’s the more informal mentoring. I’m encouraging a lot of my leaders to get involved with that because that’s where you can touch more people and you don’t have to enroll.

For example, if you just need help putting together a resume or practicing your interviews process or if you just want to polish yourself up professionally, some of our leaders can volunteer to be mentors. It’s a more informal, almost big-brother type of thing. I’m really encouraged by that. Frankly, I’ve been so focused on getting accustomed to the organization that I haven’t spent a lot of time in that area, but I’m a big fan of growing the talent you have. So in the coming year, I plan on getting more and more immersed on that.

Gamble:  That’s great. Very beneficial for both sides.

Belmont:  And again, our innovations are probably going to come from the new up and comers — the people that are not so stuck on their ways like us old guys. If I can find this talent and cut them loose, who knows what will pop out on the other end?

Gamble:  Sometimes that’s a good way to find the people who want to be challenged more. If they’re reaching out, it’s usually a pretty good sign.

Belmont:  And they don’t know what they don’t know, so they’re fearless. Before they get too trapped and buried, how do I get what’s in their brain out?

Gamble:  Okay, so you had the CIO role at Ochsner previously, and then before that it looks like you had experience in some different areas like vendor and consulting. I wanted to get your thoughts on what it’s been like to have the CIO role — what the experience has been like for you, and how you’ve been able to draw on the different experiences in your career.

Belmont:  Going back to the early 90s, we didn’t have a CIO because it was a small children’s hospital — I was a director of IS, so I was the top IS guy in the building. It’s a very small shop so it allowed me learn everything. And then I went to the vendor side with the idea that, ‘Okay, all the knowledge I have, I can now cast a wider net and help more organizations.’ That was very fulfilling. And I moved up the ranks into then the management of a software vendor, Siemens, where I learned a lot — I learned a lot about strategy, learned a lot about contracting, learned a lot about executive relationships. So that was extremely rewarding, and it became invaluable back in the CIO role, because all CIOs want to operate at the executive level, but it’s challenging and it’s a different approach. Interacting with those executives when I was an executive at Siemens helped me to understand what’s going on their world.

And then I went to Healthlink, which was eventually acquired by IBM, and did some consulting. That’s kind of where I got deprogrammed, because even as a previous director, I only worked on one type of system, so I only knew the Siemens and the SMS environment. And then I got to Healthlink and I realized that these systems are pretty good. They’re all pretty good, and some of the problems we have are not related to the systems. They’re related to either the organization or change management, like we talked about earlier.

So those experiences really helped. I got to work on almost every system. Interestingly enough, the only system I never worked with was Epic, so I didn’t have any preconceived ideas. I heard good things about it, but I actually never saw it. Ochsner was one of clients when I was with IBM and at SMS, and after Katrina, I got a call from the CEO — and I’m from New Orleans, born and raised — and he said, ‘We’re about to rebuild the city” so I said “I’d be more than happy to.’ And so I dropped everything at IBM. They were very supportive. I went to Ochsner and worked on their Legacy system for a while, and then we made the Epic switch. So I think that variety helped me a lot, and it’s helped my partners.

One of the things I’m very focused on is how do we leverage our partners better? Instead of vendors coming and selling me what they want, I like to take the approach of, ‘let me tell you everything that we’re doing and you sell me what I need versus what I want.’ So I think that variety and that perspective I get from working basically on all angles helps me kind of get through some things — definitely on the contracting side, we can really expedite some contracting because I’ve been there. I’ve written a lot of vendor contracts and now I’m signing them on the other side.
Gamble:  It seems like anytime you have a broader view of an industry, there are going to be times where you can use that to your advantage.

Belmont:  Yes. And the challenge we have in probably every profession is that you have to stay relevant. So while I was bogged down in Epic at Ochsner and I’m not quite bogged down, but in the middle of it here, you have to step out and shake your head above the cloud and say, ‘Okay, what else is going on out there?’ You don’t want to be known as the Epic guy, because that’s finite and I’m here to service the organization. Epic is just a piece of it.

Gamble:  Right. Okay, well, we’ve covered a lot, and I really appreciate your giving us all your time. There’s so much great stuff to talk about. And as things progress with Epic, I’d like to talk to you again down the road to see how it’s going.

Belmont:  I’ll be glad to. I enjoy having these conversations. I know I get longwinded, but I love what I do. We’re going good things here. The industry as a whole is getting better. If there’s anything I can do to help, please let me know.

Gamble:  Definitely. For the CIOs and other leaders, hearing about your experiences is really valuable, so thanks so much for that.

Belmont:  I guess I’m becoming that old seasoned guy, right? It feels like yesterday I was not.

Gamble:  Maybe you can just say seasoned.

Belmont:  Thanks so much.

Gamble:  You too. I hope to talk to you again.

Belmont:  Take care.