James Wellman, CIO, Comanche County Memorial Hospital, Chapter 4

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

Chapter 4

• Managing change with transparency & accountability
• “When it’s your fault, admit it’s your fault.”
• Trusting the staff
• High-level perspective: “A CIO shouldn’t be working on code.”
• CHIME Boot Camp & mentoring
• Learning from a major outage — “We found things to improve.”
• Confident leadership

LISTEN NOW USING THE PLAYER BELOW OR CLICK HERE TO SUBSCRIBE TO OUR iTUNES PODCAST FEED

Podcast: Play in new window | Download (Duration: 16:52 — 15.4MB)

Subscribe: Apple Podcasts | Google Podcasts | Spotify | Android | Pandora | iHeartRadio | Stitcher | Podchaser | Podcast Index | Email | TuneIn | RSS

Bold Statements

When it’s your fault, admit it’s your fault. There’s times I’ve had to go down and say, ‘we messed up. We were trying to do this.’

I’m not going to sit down and tell you how to do the code and how we open the TAC case with Cisco. I’m going to hire really good people that do that or hire really good people who hire really good people, and be an active component in that.

That’s been a big benefit to me because it’s been a very enlightening component that helps me make better decisions from an IT perspective and make better recommendations.

When you lose everything and the only working is the phone system, they recognize that it’s really tough to run a hospital without IT.

The fact that I know I can go on a two week vacation and no one’s going be calling every single day for something, I feel comfortable with that. I want the place to run when I go somewhere. I don’t feel like that makes me less valuable.

Gamble:  Any other takeaways or best practices for other CIOs just in terms a situation where you knew there needed to be a lot of changes, but like you said, not coming in and saying, ‘we need to change everything, you’re doing everything wrong.’ Anything else as far as like how you were able to build that trust?

Wellman:  I think transparency is key. A lot of people say ‘we’re transparent’ or ‘this is going to be transparent,’ — but truly being transparent. Part of that is, when it’s your fault, admit it’s your fault. There’s times I’ve had to go down and say, ‘we messed up. We were trying to do this.’ One, they knew we were making a change and knew we were doing something, because we didn’t do anything without telling them. No system changes were going on, so they were aware there could be a possibly if something happened. Sometimes we’d say, ‘we think this is the best solution based upon the information we have, and we hope that this doesn’t make it worse. Every now and then, a couple times, it did make it worse. We had to go down there and say it didn’t work, but that didn’t happen that often.

We had far more successes because we told them what was going on. If we were really working with the vendors and we all said we just don’t know, then we’d err on the side of caution and we’d plan accordingly. We asked for the input. What’s the best time to take the system down? What’s the best time to take this away? When should we be here? We’ve worked some really strange hours, but I think that transparency is key.

And letting your people work. That’s one thing that I’ve always told them is hire the smartest people and the best people that you can and put them in here. If you’re concerned that that person’s going to get your job, then you’ve got other things you need to be worrying about and focusing on. I’ve got some people — and I’ll tell anybody, and I am not ashamed of it — they’re far smarter than I am technically or ever was. But I feel comfortable in what I do. I think now my job is much more on strategy and leadership and guidance. I’m not in there doing coding. I’m not in working on the switches. That doesn’t mean when there’s a massive event I won’t be there. This past July, we lost our entire data center on a fluke unrelated to us; I was here working on servers and unplugging stuff right there with everybody else, but that was an anomaly, not something that normally happens.

A lot of organizations when they’re hiring CIOs will look at something and I’ve had these people that come out and say, ‘have you put in a Cerner system’ and ‘are you familiar with the product,’ and ‘can you do the coding?’ I’ll say, I’m the CIO. I hate to be the one to break this to you, but if you have me doing your coding, you’ve got a problem.’ I’ve had people ask me that and I’ve sat on a few things and worked with some people on some interview questions, and one organization I was working with was so determined that these people had to put this product in and I’m like, ‘Why?’ They said, ‘Well, they can work on it.’ And I said, ‘You’re a 500-bed hospital. Your CIO should not be working on your code. That’s the wrong message to be sending to somebody. Why are you doing that?’

I’ve worked in some different organizations and have become a little more active in CHIME, which I’ve really gotten behind. I went to their boot camp this past fall and of all the faculty there, I think one of them was technical. One. And these are what I consider the people who are the major league all-stars of our field. I’m looking at some of these people and you’ve got a psychologist, an English lit major, but what they get is they get the strategy. They understand the mission.  They’re leaders; they’re thought leaders. That was one of the things that I didn’t really understand that I was doing when I started stepping away and doing more of that, but it was very nice to have that theory validated for me when I looked at some of the people who I look up to and recognize and want to emulate some of their components. I was like, okay, it’s not too bad I guess, and I’m headed on the right track.

Gamble:  Yeah, it’s very telling to see that.

Wellman:  That’s the thing. Like I said, if I walked into an interview tomorrow and somebody said, ‘What would you do if this switch went out?’ I’d say, ‘I’d call my network guy.’ But prior to that, we’d make sure we had a really good plan and what was our disaster recovery and business continuity if this went out. Those are the things that I want to make sure that we have, but I’m not going to sit down and tell you how to do the code and how we open the TAC case with Cisco. I’m going to hire really good people that do that or hire really good people who hire really good people, and be an active component in that.

Gamble:  That seems much more consistent with what we hear about the CIO role and where it’s going and really where it is.  [TALKING OVER]

Wellman:  We need a seat at the table. I report to the CFO here. In our organization, it works. It’s a small organization. We have a few senior leaders here. And in that regard, I’m part of administration, whereas in a much larger organization, I would not necessarily be worried about it. While you’re worried about the day-to-day and you’re an active part of that, here, I’m actually an on-call administrator every few weeks. I’m talking about things and I’ve had a learning curve on things that aren’t IT related that they’re going to call me about.

Now personally, I think that’s been a big benefit to me because it’s been a very enlightening component that helps me make better decisions from an IT perspective and make better recommendations. So that part I’ve really enjoyed, but open it up and get out there and get involved with your peers. That was one of things I really enjoyed about in University of Kentucky was that mentoring program. I didn’t get mentored by an IT person; I got mentored by hospital operations senior director. She showed me a whole lot of different aspects of the hospital and the organization. I was learning leadership. My IT department and at the time, my CIO, was teaching us the other aspects of that. To this day I talk to him, because I look back and he was a pretty wise man and made some really good decisions. I’ve found people in an organization that I like — you see want you want to emulate and you see who’s successful in what they’re doing. I think that’s how it’s always going to be.

If you’re complacent and you sit there and you sequester yourself, then that’s what you’re going to be. You’re never going to go above and beyond that, but if you challenge yourself and go and try to do some things and maybe get out of your comfort zone a little, it can be very rewarding.

Gamble:  It definitely sounds like you’ve found a home there. It sounds like it’s been a pretty interesting ride.

Wellman:  Yeah, it’s been fun. When I look back now, we smile. But like I said, we physically replace the floor on a data center and ran all our systems hot and never lost a single system. Not a thing went down. But we’ve replaced the entire physical floor. We lost our entire data center this past July. At 3 o’clock in the morning, I get a phone call from my infrastructure manager. She said something’s going on — the systems are going down like crazy, and I said, ‘what?’ And she said, ‘I don’t know, it’s bad. We’re heading in.’ I was the third person on the scene. I had a system administrator here and a desktop tech here and I walked in and the aggregate temperature in my data center was 150 degrees.

Gamble:  Oh my gosh.

Wellman:  Everything was going into thermal overload. The first set of sprinkler heads had popped. They had been doing some work on it literally just before then. They were trying to get some air out of the system and so they had actually turned that component off. It was on a bypass, thank goodness, so I didn’t have water in my data center. We were able to start getting it cooled down, but everything literally was getting so hot, you’d hear an audible snap and switch. We couldn’t shut everything down gracefully in time — hundreds of servers and all those big storage units. We had to go in and we literally started pulling the plugs from the power distribution units and slamming everything shut just so it wouldn’t cook it.

Our claim to fame from that perspective was that happened at 3 a.m. By 4 a.m., the data center was dark. What had happened was our primary air conditioning unit, the condensers, had all blown up. When one went, another one went, and then another one went, and it was just blowing super hot air, and then of course all these systems were pulling in hot air and pushing out hot air. I didn’t know how hot a data center could get without fire in it. Let me tell you, it can get pretty hot.

So we were back up and running. Our fully automated pharmacy system made all of the pharmacy runs by 5 p.m. We had 98 percent of the systems back up by 7 p.m., and were fully functional and then our business continuity and disaster recovery plans worked really well. Everybody knew their role. Nobody attacked anybody. We had great meetings throughout the day. Essentially, from that point on, the CEO came in and we led all the meetings with the organization staff. I led our safety huddle. We went through everything and what we were going to do and responded really well. At the end of the day, the data center went down, and when we got done, the people looked at the IT department as heroes. We weren’t scapegoats.

When you lose everything and the only working is the phone system, they recognize that it’s really tough to run a hospital without IT. And then when you get everything up and running as fast as we did and they’re hearing from colleagues and peers that average time in a situation like that is around 36 hours to 72 hours and they’re sweating, and we get it up in 12, they were ecstatic with us. To suffice, we had been planning to put in the backup air-conditioning systems. Those got funded right away. We now have a fully redundant cooling system as well with everything else. It was a calculated risk that we were all very well aware of. There’s only so much money to spend, so we just kind of sped that up a little bit. But it worked. We look back on that now and say, ‘wow, I don’t ever want to do it again. I’m okay if that never ever, ever, ever happens again.’ There’s oddly a sense of pride in how we responded and what we did with it. So I thought that was pretty good.

Gamble:  I’m sure it’s validating too that you have right people in the right places.

Wellman:  Yeah. And that’s what I told them. They should have pride in what they did, and they do. It kind of fired them up again, because in our after action assessment, we said, what could we have done better? And there are still things we can improve. We did a really good job, but we found things to improve. They were very active in that, and each one of them wanted to lead a segment. So that’s what we did. Each of them reached out and they started doing part of it and they would lead a segment and say, ‘we’re going to go fix this section now. Let’s prevent this from happening. Let’s go do this. Let’s go do that.’

It’s kind of nice to see them take that stand. And the fact that I know I can go on a two week vacation and no one’s going be calling every single day for something, I feel comfortable with that. I want the place to run when I go somewhere. I don’t feel like that makes me less valuable. I think that has the opposite statement.

Gamble:  I definitely agree with that. When people know what needs to be done, I think it shows that a leader has done his or her job.

Wellman:  Yeah, and when I talk to some of my peers, unfortunately you get a fear like, ‘I can’t leave, the place will shut down.’ In a nice way, you say, ‘you need to reevaluate what you’re doing there.’ And I get it. When I first got here, in the first six months that I showed up, that’s kind of how I felt. But that’s because I wanted to be supportive, not because I was physically doing the work. I wanted to be here for them. Because I was essentially training the rest of the hospital, it was, don’t call me constantly. You’re just delaying the process. Call the helpdesk and tell them there’s a problem because you’re calling me and then I’m going to go call the helpdesk, and you’ve just added time to your problem. So like I said, it’s a culture change that we put in here, but it’s been enjoyable to see it happen.

Gamble:  It’s a pretty amazing story. I really enjoyed hearing about it, and I appreciate so much you taking the time to talk about it. I know that I want to check back with down the line because there’s always more to talk about, but I really want to thank you so much for taking the time.

Wellman: No problem. I really enjoyed it, and I’m glad I’m able to talk about it from this perspective and not another one. I’ve talked to colleagues who didn’t have some of that support, but who are probably a lot smarter than me anyway and went in, but they didn’t have the success because they didn’t have the support of their administration or some of the other people. After talking to some of the people who I consider the all-stars of the organization in places that I see and want to emulate and hearing how many times some of them have been let go from positions. So I don’t get my head down. I think that there’s a lot out there and there are great opportunities. It’s kind of fun to be on this side and make a positive change.

Gamble:  That’s a really great respective. I know that our CIO readers and listeners are going to get a lot out of it, so thank you very much, and best of luck. I definitely will hit you up again soon to talk some more.

Wellman:  Yeah, check back anytime.

Gamble:  Alright, great. Thank you so much.

Wellman:  Alright. It was great talking to you.

Gamble:  You too.