James Wellman, CIO, Comanche County Memorial Hospital, Chapter 3

When James Wellman arrived at Comanche County, he was met with a thorough to-do list. The data center and network needed an overhaul, the current EHR system was fading into the sunset, and the hospital had “lost faith” in the IT department. But instead of running away, Wellman rolled up his sleeves and got to work. His first priority was to move IT away from “band-aid patching mode” and provide some much-needed stability, and then it was time to make some changes, which included transitioning to McKesson Paragon, and introducing a new approach to vendor partnerships. In this interview, he talks about selling to vendors like EMC and Brocade (instead of the other way around), what he learned from the job he didn’t get, why it’s wise to line up with large health systems rather than try to compete, and how to make changes without changing everything.

Chapter 1

Chapter 2

Chapter 3

• VNA initiative with Merge
• Building a “mutually beneficial partnership” with Integris Health
• From part-time desktop tech to CIO
• Transitioning to management — “It’s not easy”
• His wake-up call — “I needed to trust the people who were working for me.”
• Change management without demoralizing the staff
• “If you really enjoy it, it’s not drudgery or work.”

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Bold Statements

This is what’s best for the customer. The patients will benefit from this in the long run because we’ll be able to share that data much more efficiently and much quicker than we had in the past, and break down some of those barriers.

There are some specialties and certain things that are just not reasonable for us to maintain here. So we want to send them to somebody that we trust because they’re our patients. They’re our families.

My old CIO asked me, ‘Would you ever want to be a CIO?’ And I said ‘no, I don’t think I’m cut out for that.’ He said, ‘shame on you. Why not?’ He really pushed me to think and change some things.

I knew we needed to make wholesale changes here, but I had no idea what they were. That’s why we had to do the assessment, so that I could sit down and make a good thorough plan with both my staff and with the administration.

Gamble:  It was a similar situation with EMC where you had to sell them on it and obviously it worked out pretty well, but I guess it’s just a matter of trying to get these vendors to think a little bit outside of what they usually do and present your case to them.

Wellman:  Yeah. If you’ve got a retailer, they want to make the sales and their money and a lot of volume and they don’t have to make a year’s profit on one sale. Others have a little bit different tact. So we sold the volume component to people and what they’re doing, and frankly we’re not above playing the card of, this is part of what we’re doing. You can still make a profit here. It may not be the same profit you’re going to make with Chevron in California, but look at who we are and what we are and look at our mission.

These vendors have come in and there’s been a change, I think, in the culture in a lot of places. They’ve embraced that a lot more. The heady days of the dot-com bubbles and some of the stuff that you saw then and living through that, people learned and they matured. The process has matured, and the people did. And so I think some of them see a bigger picture in what they’re doing, and that’s kind of a nice component. I say the fact that we are willing to be the reference site and do the sites and host people and do those types of things have helped set us apart, because that’s extra effort and work on our behalf, but we look at that as payoff for some of the other benefits we’re getting from that as well. If we get some of the newer technology because they want to show that off here, hey, more power to them. That that works for us. That was the concept we sold, and that’s what we’re going to continue to do.

Gamble:  It’s pretty amazing how much work needed to be done. There was also the vendor neutral archive and image viewing sharing piece.

Wellman:  That was one where when I came in, we were trying to find where all the images were. They were kind of scattered between modalities, different servers, backed up on different things. Again, that was the outcome of a lack of continuity. The radiology department at the time thought we had two large storage devices down here. They were under the impression everything was stored here and when I looked at it I say, ‘nope.’ We had to change that and then bring all that in.

Now we’ve embarked on a large vendor neutral archive project with Merge. We did a six-month selection process to look for different vendors and talk to them, brought a lot of people in, and they kind of rose to the top. And again, it was that same concept of what we were selling, they were buying. Here’s what we’re doing, here’s where are, here’s what we represent. And they looked at the possibility and the reality of downstream opportunities with other partner hospitals that we work with, and they’ve had sales — some of them even prior to us because of where we were headed; they reached out to their hospitals in the area and they’ve since sold more product down here. Because we all worked together, our ultimate goal was, ‘we’ve got some sharing utilization. This is what’s best for the customer. The patients will benefit from this in the long run because we’ll be able to share that data much more efficiently and much quicker than we had in the past, and break down some of those barriers.

That meant we had had to initiate some partnerships as well. We have a partnership with a very large health system in Oklahoma City, Integris, and that’s been a very good relationship for us. We’re not totally oblivious to the fact of who they are and what they are. They offer quite a bit. In turn, they see that everything west of them is in our arena and that they can work with us, and so it’s been a very of mutually beneficial partnership with them that will continue to grow and expand. We can take advantage of some of their knowledge and some of the opportunities that they have, and likewise, they benefit from some of the things that we do as well. I’m actually setting up a standing meeting with their CIO to come in so that we can talk about ideas and things going forward. So that’s beneficial for us that instead of being sequestered back here, we get out and get involved.

Gamble:  Right. It’s taking that step to say we can work with these guys and not just see them as the big competitor.

Wellman:  That was one of the things was very refreshing to see and talking with some of them is, what’s best for patient? The reality of it is we are a full-service hospital. There’s very little that we have to send away. Part of our component is we can provide the outstanding care here. You don’t need to drive an hour and a half to the city to get that, but there are some specialties and certain things that are just not reasonable for us to maintain here. So we want to send them to somebody that we trust because they’re our patients. They’re our families. It might be my family. You never know, and that’s what we tell people. Who do you want taking care of your father, your mother, your brother, sister, son, or daughter? We keep that in mind when we’re doing these, and I think that’s been a big, big part of that.

Likewise, when the time is done and if their acuity changes, they can send them back to us and we’ll take our patient back and they’re happier and healthier and they can be closer to family here. That’s a really good component that we do. I think if you look in fear all the time, you’ll find it, but if you’re set up and you have a strong organization, then you don’t have to worry about that.

Gamble:  You mentioned before that you were previously at University of Kentucky Healthcare — you were there for quite a while in a number of different roles, correct?

Wellman:  Yes, 22 years. I literally started out as a temporary, part-time desktop tech when such a thing wasn’t that common. I took a part-time job on a fluke. I had gone back to school with a different career path in mind, totally outside of the realm of anything with IT. But I took a job in the IT department and thought it was interesting, found a niche, and one thing led to another. The full-time position was created and I started working at that; desktops were just becoming more affordable and exploding, and then they were going everywhere. So it just kept growing and growing and I kept working my way up. Suddenly I was a supervisor, then a manager, and then part of a combination of being in the right place at the right time, combined with the fact that I found a love for the job.

People aren’t kidding — if you really enjoy it, it’s not drudgery or work. I went home and played with computers and it was fun to me and it was enjoyable and it was challenging. I went into that, and then along the lines made a transition into full management, which is not an easy transition. I coached sports for quite a period of time, and I told people it’s the same thing as saying that a great person who’s really good in sports doesn’t always mean they’re going to be a good coach, and vice versa.

My initial integration into management was challenging. I had moved up really quickly because I was very successful with a lot of technical components and getting things done, but that doesn’t always equate to being a good leader. I went up for a job; it just seemed like a natural succession. Everybody said, ‘you’ll move up again,’ and I didn’t get that job. Fortunately, I had a really good CIO who recognized that I had potential, but that I needed some seasoning. He allowed me to get over the initial hurt and shock of not getting the job — it went to a peer, and I took a couple of days and did that, and went back and talked to him. I still have a very good relationship with him now, and he was right — I was not the right person for the job at the time. This other person was better suited and deserved the job more than I did, and so rather than taking that and becoming negative about it, I said, ‘what can I do that the next time so it’s very apparent to anybody else that I should be that person.’

I had to do some soul searching. I reached out to my friends and my staff and the people that worked for me and did an assessment of me. It wasn’t very pretty. I really looked at myself, and honestly, I would not have wanted to work for me. I didn’t like myself very much suddenly. I just literally did a wholesale change. It was a professional epiphany that said, if I’m going to do this, I needed to do it. I needed to trust the people who were working for me and put the smartest people that I could find, a lot smarter than me and hire them. I started changing that mentality of how I approach things and how I thought of that, and that in turn paid off and paid off very well for me, because I got more opportunities and then got the opportunity to be where I am right now. I had to leave the university, because even though I was there for 22 years, I wanted to make that next step and again part of that was some very good mentors along the way who took the time and who encouraged me.

My old CIO asked me, ‘Would you ever want to be a CIO?’ And I said ‘no, I don’t think I’m cut out for that.’ He said, ‘shame on you. Why not?’ He really pushed me to think and change some things, and then I got into a mentoring program that the university had for the future leaders of the organization. Here I was working at a university with over 100 credit hours and no degree. She pushed me to go back and finish my degree, which I did, and that boosted my confidence and helped me out a little bit.

Things came together a little bit later in that regard — it was not a traditional route. I learned from the trenches, and so every day when I’m looking at things now, I look back at the different components of where I was, and I’ve always tried to pass that on. I tried to mentor people now, my team, and it’s a very, very rewarding component. I’ve had a lot of people leave to go on to bigger jobs, and I’m proud of that. I don’t look at it as like I’ve got a lot of turnover because actually where I am here, we don’t have a lot of turnover, but there’s been a few people that go on to bigger jobs, and at the university that same thing happened. I’ve also had people that came back and said ‘you know that grass wasn’t all that green.’ I’ve always thought that was a good sign. If they wanted to come back and work for me, maybe I was doing something right.

Gamble:  It seems like the experience you had at the University of Kentucky, especially with the mentors, but then also have to do that soul searching, that it really put you in a good place to step in to the role of Comanche where there had been all this turnover and you knew you had a lot of work to do with the IT staff.

Wellman:  When you come in, you’re evaluating your staff and your staff are evaluating you. And like I said, they had seen a lot of people come in and out. I’ve never understood people that come in and the very first thing that they say is, ‘I’ll come in and I’ll change everything.’ And I’m like, ‘what are you going to change? How do you know?’ It’s one thing if I’ve been in the position for a long period of time and I was very intimately aware of the organization, then I had an opportunity to move up where I could make a more meaningful change. That’s one thing. But to come in completely green to an area and say, I’ll change everything,’ I think sometimes that can have a really negative effect on your staff. I had a staff here who were very, very good, very smart, and cared about what they did. They just didn’t have support. There were a few people that made changes and that maybe this wasn’t the right fit for them, but initially coming in, I didn’t know any of that.

So that’s why I had to sit down and be very cognizant of those people, because I remember over the years being there and having people come in and say, ‘Everything you’re doing is wrong’ and you’re like, ‘wow, that’s really kind of demoralizing, because you’ve been working so hard in doing everything. To have somebody come in who’s never been there and start beating you down even further — that doesn’t win you any influence or friends. I just don’t believe in that type of style to do that. I get change and I knew we needed to make wholesale changes here, but I had no idea what they were. That’s why we had to do the assessment, so that I could sit down and make a good thorough plan with both my staff and with the administration in the organization, something that we could all accomplish correctly.

Chapter 4