Patty Lavely, SVP & CIO, Gwinnett Health System, Chapter 3

When Patty Lavely stepped into the CIO role at Gwinnett two years ago, one of her top priorities was to build a strong relationship with the CNO. It was something she had admittedly struggled with in the past, but one of the many lessons she learned during her time in consulting was that relationship management is an essential skill for today’s CIOs. In this interview, she shares more takeaways from her time in consulting, including how to build trust, and how to avoid the common trop of hiding behind bureaucracy. Lavely also discusses leading a major EHR selection process, how the organization revamped the security process by reassigning responsibilities, and the “daily challenge” CIOs face with prioritization.

Chapter 1

Chapter 2

Chapter 3

• Interim CIO
• Guardrails for demand management — “It was quite eye-opening.”
• Consulting experience in her back pocket
• Introverts managing relationships
• Building trust
• Evolving CIO role — “We have to understand the business.”
• “Innovation isn’t easy.”

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Bold Statements

I don’t want to use bureaucracy for a demand management strategy. I’d rather get back to this idea that, yes, we have a budget, yes, we have processes, but we need to be doing what’s right for the organization in a timely manner.

I’m very open to people bringing me issues. I will take it and then assign it to someone, but make sure there’s follow-up regardless of who it is. Rather than to say, ‘call the help desk, or, ‘you need to call so and so,’ I facilitate that process.

In years past, we could get away with just knowing the technology. That’s not the case anymore; we have to understand the business.

One of the most important skills, other than identifying innovative technologies that would be a good fit, is identifying the right people and building those relationships.

We weren’t usually not the brightest personality in the room in days past. I think that’s changing now and I think it will continue to change, because it does require a personality to develop those relationships and to bring people together.

Lavely:  One of things I did discover while consulting is, I still like the leadership positions. I really enjoyed going in as an interim leader. I did some other consulting that was more project based and that wasn’t as appealing to me. One of the nice things about being a consultant that is different from when you’re an employed CIO, which was quite an awakening for me, is when you’re employed, there’s a lot of obligations that you have as an executive of the organization or as part of the management team that take a lot of time. Whether that be management team meetings, mandatory education, or social events, there are a lot of different things that you have to do and when you’re an interim leader, you don’t have to do any of that. You just go in and get the job done, and I found that very rewarding. It really sort of clears away all of the corporate, I want to say, busy work. And I don’t mean to minimize it because it’s really all necessary, but most of it doesn’t contribute to the work at hand — it’s in addition to. And so, it really helped me to take a look at where I spend my time and what I prioritize.

The other thing that became very clear to me is that corporate organizations — Gwinnett and all of the ones I’ve been a part of — have this bureaucracy that you work within. It’s pretty much the same, although there are nuances to each organization, whether it be your board committee structure, your management committee structure, how you get approvals, how you do budgets, all that stuff. And when you’re a consultant, that’s all there, it’s happening in the background, but you don’t really have to deal with it. What I found when I was consulting is when I was an employed CIO, I hid behind that, if that makes sense. I used it as my demand management strategy. And when you don’t have them anymore and whoever your executive sponsor is says ‘we need you to do X, Y and Z,’ you just need to do it. You need to help clear the way and you need to get it done. You can’t use the layers of bureaucracy, because someone has already cleared the way for you. You just need to get it done.

And so it really helped me to see how, without even realizing it, I had built that stuff in as my guardrails for demand management — ‘it’s not budgeted,’ or ‘we have to go through the finance committee.’ In today’s world, when something has to go the board, that’s an easy month delay before I need to make a decision or act on it. It’s almost like I can just put it out of my mind. As a consultant, you don’t have any of that. You’re just there. You have something to do. You have to get it done. As an interim CIO, you do work within some of it, but not nearly as the same when you’re employed. And it really depends on the scope of your interim role.

I found that very enlightening for me, and I brought that into my role here at Gwinnett and I really looked at how I do things and I don’t want to use bureaucracy for a demand management strategy. I’d rather get back to this idea that, yes, we have a budget, yes, we have processes, but we need to be doing what’s right for the organization in a timely manner. And so it just sort of helped me get back to that way of operating. It was really quite eye-opening.

Gamble:  Sure. Did you have any hesitation about going back to the full-time CIO role?

Lavely:  I did, because there’s some freedom to not being bound to all of that. In some cases, it depends on the role. I spent a lot of time on relationship management, which is not one of my comfort areas by the way. I’m an introvert — not 100 percent introvert — but I’m far enough across the line that that doesn’t come naturally to me as it does to others, and so that was another ‘a ha’ moment with the interim role. Depending on the scenario, sometimes you don’t have to be terribly concerned about that.

In one engagement I had, I was there for a while and I had to work on relationship management. It’s funny because my executive sponsor didn’t think so because it was, ‘you’re here to get this done, just get it done. And what I realized is I need to back up and develop some relationships, because the people here need to help me get this done. They’re the ones doing it. And so I ended up having to do it, but not nearly like I do here today.

It was definitely an eye-opener and I think all of those lessons make me a better CIO today. I’m very glad I had the opportunity. The other nice thing is I know I can do it if I need to go back, I could. I’d probably do some things a little differently, but I definitely could go back. And our roles are so volatile at times that it’s nice to know that that’s out there.

Gamble:  When you started the role at Gwinnett, did you find it was something you definitely approached differently than your previous CIO roles as far as things like building relationships? Did you have a different strategy this time around?

Lavely:  I did. I immediately put things in place to build personal relationships, because that’s really what they are. One of the areas that quite honestly that I’ve struggled with in the past is my relationship with the chief nurse of the organization. So that was one of the first things I addressed when I got here. And actually through the interview process when I met her, I realized it wasn’t going to be a problem and that we hit it off really well in the interview process. But I still wanted to take care of that and not allow it to not be nurtured, and not leave it to chance. So I immediately set up monthly lunch meetings with the CNO so that I could make sure that we always had that scheduled time. We obviously meet in a lot of different committee meetings and things like that, but I did definitely want to make sure that I was developing that relationship, because that has been a problem for me in the past.

I had the opportunity of couple of years ago to sit on a CHIME Association of Nursing Executives event. It was a CIO-CNO work group where the two organizations came together to write a white paper on that relationship, and was very happy to know that I’m not the only one that struggles with that. It’s about our roles and our responsibilities and how they may clash at times, and our language is so different. I learned a lot from that work group that I also applied here and then I think the consulting helped with that a lot as well.

The other challenging relationship is that of the medical staff, and so I try to be very visible and I attend as many physician-specific meetings as I can. I think the more important thing is I’m very open to people bringing me issues. I will take it and then assign it to someone, but make sure there’s follow-up regardless of who it is. Rather than to say, ‘call the help desk, or, ‘you need to call so and so,’ I facilitate that process, which some days I wish I wouldn’t do, quite honestly, because it can add a lot of to do’s to my list. But I realize that it helps people to learn to trust me when they think if they give me something that’s going to be handled. And a lot of it’s very simple; it just requires an action. That was another technique and I learned that from consulting. Because when you’re in a consulting role, you do that. When people bring you issues, you resolve it. You don’t have people to go to necessarily. So I really learned that from the consulting roles.

Gamble:  It’s really interesting to me seeing how the CIO role has evolved and how so much of it really does revolve around relationship building. It’s funny because that probably wouldn’t be how people would have described it years ago, and so I guess it really makes it necessary to build those skills.

Lavely:  It does. I’m a member of CHIME and I have been participating in a CHIME committee on CIO professional development. One of the exercises we did is to look at the skills of the future CIO, which really are not that much different from the necessary skills for today, but it is evolving, with leadership in terms of being a part of the health system and knowing the business, not just knowing the technology. I think that’s where the difference is, because in years past, we could get away with just knowing the technology. That’s not the case anymore; we have to understand the business. And I don’t think we have to be clinicians — although I have some colleagues that are and it serves them well in their role as CIO. In my succession plan here, the person I’m developing to replace me is a nurse, and I think when and if we get to that, she will serve this organization very well and her clinical background will certainly add to her ability to do that. But in cases like me where I don’t have a clinical background, it becomes imperative that I partner with the right people so that I add that clinical influence to my decision making.

The other outstanding characteristic that came up in those discussions is the ability to innovate. You would think for CIOs, ‘that’s what they do, they can innovate.’ Well, it’s really not that easy. It requires a lot of, I want to say team-building. You’ve got to bring people together, you’ve got to persuade them that this new technology can add value. You’ve got to be willing to get in there or try it out, and stop it if it’s not working, and move on. You’ve got to bring people together and you got to help them through it, because sometimes innovation isn’t easy. You’ve got to understand the right places in the organization where you can do that. There are a lot of skills that go with that. I think one of the most important skills, other than identifying innovative technologies that would be a good fit, is identifying the right people and building those relationships. So it really just keeps coming back to that relationship management.

Gamble:  That’s very interesting. And it’s interesting to see how this role is going to continue to evolve and change. You talked about being somewhat introverted and I think that that’s a really common thing, and a focus of a lot of people to make the effort to try to get outside of the box a little bit and get outside of the comfort zone.

Lavely:  Yes, I would agree. If you stereotyped CIOs, kind of like accountants or CFOs, we weren’t usually not the brightest personality in the room in days past. I think that’s changing now and I think it will continue to change, because it does require a personality to develop those relationships and to bring people together. It could be somebody like me who can do it. I have matured in my career and I can do it, but it takes a lot of energy for me to do it. I have some of my colleagues that it comes very natural to them and it’s energizing for them to do it, so you see the two different types of personalities. But I think you’re right, I think all of us are coming to the conclusion that we just have to get out there and can get out of our comfort zones.

Gamble:  Definitely. Well, I’ve really enjoyed speaking with you. There was a lot of really great stuff, and I think that our listeners are really going to benefit from this and from hearing about the work you’re doing at your organization, as well as the lessons you’ve learned along the way. This is the stuff that people really appreciate, so thank you so much.

Lavely:  Thank you, and I appreciate all the other podcasts. I listen to them whenever I get a chance. It is good to hear other people’s experience.

Gamble:  That’s great, thanks. We like to hear that. All right, well thank you. Best of luck with the selection process, and I’d definitely like to catch up with you down the road to see how everything went with that.

Lavely:  Great, that sounds good.

Gamble:  Alright, thank you, and enjoy your day. I hope to talk to you soon.

Lavely:  You too.