For the past few years, health systems across the country have been stuck in constant implementation mode, and Chesapeake Regional Medical Center is no exception. So when the organization made the decision to migrate to Epic, leadership decided to leverage the expertise of a seasoned user, which would enable Chesapeake “focus on innovation instead of just putting in systems.” In this interview, Deans talks about his team’s Epic rollout strategy, their big plans with big data, and their “dynamic” multi-year business plan. He also discusses his leadership style, why it’s important to strive for perfect, and why anyone who isn’t nervous about ICD-10 is either “very impressive or naïve.”
- From graveyard shift computer operator to CIO
- Leading by example — “I wouldn’t expect anyone to do anything I either haven’t done or wouldn’t do.”
- Keys to staff retention
- Ritz-Carlton & the “obligation” to provide excellent service
- “Don’t lead from behind a desk.”
- Good vs great
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I’ve tried to remain current with the technology piece, even through the years as I’ve moved more into the business realm. Because I know that’s important to those who are in the day to day configuring routers, building database scripts, etc.
Either a person is driven or a person is not. That’s not something that you can influence and it’s not something that you can change. And so if you hire driven folks, irrespective of their current technical acumen, they will probably be able to achieve anything you ask of them, because that’s who they are inside.
We want every outcome to be perfect, but you’ve got to have the right team for that. Once you have that team, you become one of the team members. Everything we do is about we, it’s not about I, and that’s the difference between good teams and not-so-great teams.
The higher you escalate in roles and positions in your career, folks are going to look, listen, and perceive you differently, and there’s not a whole lot you can do about that. Every word you say has a little more power and effect for each higher level position you attain in an organization. As a leader, you’ve got to be mindful of that.
Gamble: I wanted to talk about your strategy when it comes to leadership and keeping the staff engaged, and what leaders do or can do to get people to reach their full potential. I just wanted some of your thoughts in that area.
Deans: I’d say first and foremost, I’ll start with me and then we can talk about the broader staffing and drive and all of that. I came up the ranks working in information technology, first in the Department of Defense arena and then ultimately in healthcare. I graduated to leadership roles starting in the trenches, if you will. My first job was graveyard shift computer operator during my freshman year of college. At that time, it was Honeywell mini mainframes that I worked on, so we’ve advanced quite a ways since that time in the technology space.
So I’ve seen both sides, both management and non-management, and I think my personal style or what I’ve strived for is the simple model that I wouldn’t expect anyone to do anything that I either haven’t done or wouldn’t myself do. I think for me it’s a different way of trying to say the model that I subscribe to is leadership by example. I think that’s the top level.
And then I would tell you that throughout my career there are dozens of observations that I’ve made, mantras that I’ve had. And I don’t know why — it was not something it was instructed to me. I think it was probably natural, but I’ve just observed people most of my life. I remember lessons back from even my grade school with the greatest teachers that I had. I’ve always tried to watch and see what people do, observe them, replicate the things that they’ve done that I think work or worked for me that I felt was quite successful, and then not replicate those things that did not work or that I did not perceive to be strong and robust. With that initial mindset, I think that’s the first key: lead by example.
And then as you go from there, I think people need someone who understands them. I’ve been in situations where I’ve had leaders coming up through my career that really had no real perspective related to the technology itself even though they were the technology leader at that time, and so I observed that and I remember the frustrations I had during those times. I’ve tried to remain current with the technology piece, even through the years as I’ve moved more into the business realm and the business world. Because I know that’s important to those who are in the day to day configuring routers, building database scripts, etc.
But it’s not as easy as it once was. In the old days, we could have a pretty round sphere of knowledge and know a lot about a lot 25 years ago, but as technology has advanced, you can pick a particular segment of technology and serve in the capacity of a database administrator for an entire career these days. Back in the early days, we had to know a little bit of programming. We had to understand infrastructure. We had to understand network processes and protocols, and you can’t really do that so much today. That said, I do try to keep a round knowledge of a little bit about everything; that way, I’m at least somewhat versed on the various capacities.
So I think that’s the ‘me’ part, but honestly, most of leadership is not about the ‘me’ part. I would tell you it’s really about the collective we. I think you have to start by hiring good people. Probably 8-10 years ago, at one of our formal conferences that we have each year, I had the opportunity to meet a leader from the Ritz-Carlton. They gave a presentation and I chatted with the gentleman a little bit afterwards. They talked about how the Ritz-Carlton has a mystique of what they do, and that’s with some intention. Every employee in that organization is empowered to provide excellent service. In fact, they have an obligation to it.
I don’t know if you’ve ever stayed in a Ritz-Carlton. I have not. But I’ve talked to folks who have, and what I’m told is for example, when you check into Ritz-Carlton, there’s a bowl of fruit. While you’re there on your first day or your first visit, you might eat more bananas than you do apples or vice versa. Well, the Ritz-Carlton apparently keeps a database of most of your activity, which sounds a little bit spooky, but it’s all service-oriented in nature. What will happen is the next day when your room is reset or even that afternoon when they refresh that bowl of fruit, there will be more bananas than there are apples. They knew that’s what your preference was, and so they keep track of that, and the next time you check in, same thing. They won’t completely remove the apples because you might change. On one trip it might be you, next trip your family is with you.
I found that fascinating and the point is it also relates to the individuals within that organization. If someone who is passing you by in the hallway that works in food services notices or observes or you indicate that you have an issue with your HVAC for example, that person is now the owner of that issue, even though they themselves don’t have the technical capability to improve your air conditioning system. Cradle to grave, they have responsibility to make sure that’s taken care of for you. I really found that interesting.
In the Q&A, we said to the leader from the Ritz-Carlton, ‘well that’s great, but how do you ensure that every employee works to achieve that same outcome, no matter where they’re at within your organization? The response — and that has always stuck with me — is, ‘we don’t believe that we can put into you would God didn’t,’ and I don’t think they meant that from a perspective of a religious context. What they meant is either a person is driven or a person is not.
So going back to the leadership model, it’s incumbent upon us as leaders to hire the right candidates to begin with, because either a person is driven or a person is not. That’s not something that you can influence and it’s not something that you can change. And so if you hire driven folks, irrespective of their current technical acumen, they will probably be able to achieve anything you ask of them because that’s who they are inside.
On the leadership side, we have to try to hire those similar-type folks out of the gate. Once we do that, we lead by example. We set clear concise goals. Driven people are going to want to achieve great things. I heard a coach of a football team once say that we aim for perfect. You strive for perfection; even if you fall a little bit short, you might still achieve greatness. That’s what we are all after, because in healthcare we want every outcome to be perfect, but you’ve got to have the right team for that. Once you have that team, you become one of the team members. Everything we do is about we, it’s not about I, and that’s the difference between good teams and not-so-great teams. And so you’ve got to put a lot of focus there.
We do other fun stuff. We have a pretty tough world that we’re living in. We work in healthcare. If you think of healthcare as a whole, patients are actually customers, and so if you think of yourself as a customer, when you go buy a new car or you go to Best Buy and buy that new big-screen TV, you’re excited when you go in. You’re excited when you come out — maybe except until you get that first car payment and then sometimes you’ve got a little bit of remorse, but in general you’re happy making those purchases or being a customer. With few exceptions, maybe labor and delivery and maternity, people don’t come to healthcare for happy reasons. We have to be cognizant of that, and so a lot of times as caregivers or care providers, no matter our profession within the healthcare model, we carry a lot of that with us, because we’re around it and we see it every day. And so you have to recognize that it’s a special type of people who attempt to work in healthcare irrespective of their discipline.
One of the other things I try to do is inject a little bit of ‘fun’ in the workplace and humor. There’s a time to take care of business, and then there’s a time to decompress and have a little fun here and there when it’s appropriate and possible. I deploy little small techniques like that, and I think folks appreciate that and they reciprocate. But it’s not an easy business model to be in, and so I think it’s important as a leadership tactic to always remain mindful of that and try and ease that burden and stress a little bit if you can.
In IT in general, whether you’re in healthcare or outside of healthcare, you’re also strapped to a pager. In the modern era of cell phones/smart phone these days, it’s 24/7. I think we also have to be mindful that our staff are strapped to devices 24/7 and we’re always on call. We’re always waiting and ready to be available for the next need. And so you have to find ways to compensate for that. But I think at the end of the day, there’s change done to me versus change done by me, and that’s really kind of digging over into change management, but I think it applies to staff across the organization as well. You’ve got to be mindful of that and navigate accordingly to compensate for that.
And so I’d say lead by example, aim for perfection, and all the aspects that come along with that. Make sure you’ve got the right team in place that are there for the right reasons. We want folks who want to achieve things — not just to be there for the position. And really, to some degree, seem real and seem human to your staff. The reality of it is, the higher you escalate in roles and positions in your career, no matter what it is, folks are going to look, listen, and perceive you differently, and there’s not a whole lot you can do about that. Every word you say has a little more power and effect for each higher level position you attain in an organization. As a leader, you’ve got to be mindful of that. But I think you need to make sure you don’t lead from behind the desk. You need to lead with the folks in the trenches. At least that’s my style, and I think that’s been an effective style. But that’s my mental model in a quick nutshell.
Gamble: It’s really interesting. You’ve observed so much over the years and incorporate pieces here and there, and like many things, it is this ever changing kind of model. But it seems like you found a combination that works so that’s always important.
Deans: I feel like one of the luckiest people alive, genuinely. I’ve had some really great mentors throughout most of my life, obviously starting with my parents and seen some of the things they’ve done, but even going into grade school — I have things that I still carry with me from the fourth grade. I had a high school band director that once asked the question: what’s the difference between a good musician and a great musician, to which all of us had various answers. He went on to explain that the difference is that a good musician practices it until they get it right, whereas a great musician practices until they can’t get it wrong. I’ve carried things like that with me. It applies. Shouldn’t we all strive to be great musicians in everything that we do? Back to even elementary school and all the way through my professional career, I’ve been very fortunate to have a lot of what I perceived to be incredible leaders, and I think there’s no shame in the face that I’ve stolen a lot from all of them. It’s just kind of been my way.
Gamble: Yeah. I think that’s what we’re meant do to; to keep passing that along.
Deans: For sure.
Gamble: Well, I could talk to you for longer, but I know I’ve already taken up a lot of your time and I really want to thank you. I know that there’s always more to talk about, so I’d love to catch up with again down the road. Thank you so much for taking some time to talk about everything you’re working on and giving your insights. It’s really appreciated.
Deans: Thanks for asking. It’s a community effort for sure in healthcare. We’re big, but we’re not that big. It’s always good to talk to others that are doing the same. I appreciate your time as well.
Gamble: Thank you, and I look forward to catching up with you again. Enjoy your week and good luck with everything.
Deans: Yes, thank you too. I appreciate it.
Gamble: Okay, thank you.
Deans: Alright. Talk to you later.