George Hickman, EVP & CIO, Albany Medical Center, Chapter 3

Whenever an organization’s core vendor is acquired, there’s going to be some trepidation. But when a CIO has the opportunity to sit down with leaders and talk about the intended roadmap, those fears can be quickly assuaged. In this interview, veteran CIO George Hickman discusses his feelings on the Siemens-Cerner merger, why his organization serves as a reference site, and what has helped NY’s HIE remain successful. He also talks about the prioritization challenges facing CIOs (which he handles using a Ouija board), the “Henry Kissinger skills” he picked up as a consultant, and the road that took him to Albany.

Chapter 1

Chapter 2

Chapter 3

• Prioritization challenges — “I use a Ouija board most days.”
• Medicaid reform, MU & expansion
• Early career influencers
• 12 years in consulting — “It made me a better CIO in the long run.”
• “Henry Kissinger skills”
• Pride in Albany’s progress

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Bold Statements

Whether you’re CIO or you’re sitting at any other seat in the C-suite, the list is very long, and it’s changing.

If you talk to a CIO, we’re going to talk about how it is that we integrate all those things, how it is that we make decisions to buy versus expand or to collapse infrastructures for economies versus when there are causes to keep those infrastructures separate.

I got to work with really bright people, I got to work in some really challenging circumstances sometimes and I got to meet a ton of people along the way, all of which made me a better consultant, but it also made me a better CIO in the long run.

Working in-house in a CIO job while I was consultant, I really missed the sense of community where you’re camped out at one place for a long period of time and/or the sense of seeing something really accomplished, where it’s not ‘go in, drop, get it done and get out.’

I could tell by the fact that I wasn’t being told too much that it probably was going to be very challenging. It certainly was. And yet again, I can look back over the 11-plus years, and see just how far we’ve evolved things.

Gamble:  So obviously you have a lot going on. When we talk about that with CIOs, something that comes up a lot is the prioritization challenge. Sometimes you can just hear in people’s voices or see it on their faces if you’re talking to them in person, that it is so challenging having to juggle so much. Can you give just some thoughts on what it takes to kind of decide what needs to be done now and what can wait?

Hickman:  I use an Ouija board most days. If that doesn’t work, I have one of those magic 8 balls.

Gamble:  That’s a good strategy.

Hickman:  This is one of the questions — what’s the answer to life and the universe and everything. The challenge of priority reminds me of a boss I once had who, as we would meet, I’d be going through a list of things with him and he would say, ‘When you leave here, that is your number one priority.’ I’d go to the next thing on the list, we’d talk about it, and he’d say, ‘When you leave, that’s going to be your number one priority.’ And when we’d get to the end of the list, I’d say, ‘Joe, you just gave me five number one priorities for the day.’ And he said, “That’s exactly right.”

And that’s what it is these days, whether you’re CIO or you’re sitting at any other seat in the C-suite, the list is very long, and it’s changing. We have the whole challenge in New York State of reforming the Medicaid system and our government and DOH here leading the charge and describing, certainly with incentives, but describing all the way to conceptual process and conceptual technology, here are the things you’re going to have to put in place to reform how it is you treat your Medicaid patient population to assure that they are getting the care that they need, but doing it in a way that decreases hospitalization and manages clinical utilization more than you ever did. That’s becoming a very big priority right now.

At the same time, there’s MU. There’s the things that we need to do to continue to grow our business. We’re out buying practices, we’ll have a new hospital as a family member hopefully by the end of the year. We’re talking with yet another hospital about being a family member right now. We’re opening emergent care practices. In fact, we opened two new ones last year, we’ll open two new ones this year, and I’m sure we’ll open two more next year, and so on.

All of that requires the efforts of the whole C-suite. And if you talk to a CIO, we’re going to talk about how it is that we integrate all those things, how it is that we make decisions to buy versus expand or to collapse infrastructures for economies versus when there are causes to keep those infrastructures separate, are and so on. And I can’t say that there’s necessarily a lot of opportunity to push things to the back burner. More so, I find I think a lot, and I coach my direct reports a lot, about how it is that we create leverage by continuing to add to our talent pool. Then we are able to delegate to others if we coach them well so that we don’t have to have everything residing on our plates alone. That’s the best way, I think, at least for now, that I’ve figured out how to manage through the many things that we’re facing that are all number one priorities.

Gamble:  Right. There is definitely no easy answer or no single answer, but it’s something that everybody faces, so it’s good to get that perspective. And you said you’ve been at Albany since 2003?

Hickman:  Yes, I came here right at the end of the year.

Gamble:  And then before that, I noticed that you had CIO experience and then also had some time with Ernst & Young, so I can imagine gave you kind of a good diverse background for coming into this role?

Hickman:  In terms of my education, I have a Bachelor’s and I have a Master’s degree, both in engineering — but engineering where I opted to steer my electives and/or, in the case of grad school, my graduate school concentration toward computer science. When I came out of school, I went to work in a healthcare provider setting, a hospital system, St. Mary’s Health System in Knoxville, Tennessee, which was near my hometown. I was very fortunate because I worked for a guy, Joe McDonald, who is the CEO at Catholic Health Services in Buffalo now. He was a very young chief operating officer. Joe gave me way more lead than he should’ve probably ever given a guy that’s 22 to 25 years old. But he had me do all kinds of stuff all over the organization that led to me having an understanding of supporting applications, but a lot of process understanding about how things worked in a healthcare delivery organization. That positioned me uniquely for consulting at a young age. At 25 years of age, I went to Pricewaterhouse. So I spent four years at Price and another eight years at Ernst, with a CIO stop in between.

In my consulting years, I might have been focused on regional provider work. But I can tell you in the early days at Price, while I was doing work in Western Pennsylvania, upstate New York, Ohio, and West Virginia, for one year my number one billable client was in Scottsdale, Arizona, another year was in Portland, Oregon. I did work for the Ministry of Health in England in the early days of privatization, and I did work for the Ministry of Health in Singapore. All of those opportunities, all those engagements early on certainly shaped and influenced me and gave me experiences that I think I’m just much better for having had them.

I did have a CIO stop after Price with a very large healthcare delivery system. It was an early job in terms of my age and experience, but thankfully because of client and other consulting firm relationships, the organization pulled me in, and that was a great kind of opportunity along the way.

I spend eight years at Ernst, was eventually a partner at Ernst before I left. There’s no doubt that having had the ability to work in many, many, many organizations, and see all of the different cultural and behavioral things that can go on organization to organization, executive to executive, and the sorts of problems I got pulled in to work on usually were problems where the organization knew that they needed to augment who they had there for the sake of doing something and doing it better. I got to work with really bright people, I got to work in some really challenging circumstances sometimes and I got to meet a ton of people along the way, all of which made me a better consultant, but it also made me a better CIO in the long run.

So yes, my 12 years along the way in consulting probably gifted me in some ways to a) know I had to get things done based on metrics, but (b) also taught me a few Henry Kissinger skills as to when those might be needed too, and a host of other things.

On the other side of it, working in-house in a CIO job while I was consultant, and I did that for a while, I really missed the sense of community where you’re camped out at one place for a long period of time and/or the sense of seeing something really accomplished, where it’s not ‘go in, drop, get it done and get out.’ In the case of Albany Medical Center, I’ve been very fortunate to have an executive team here and team of people around me and a board that’s put a lot of faith and trust in the things that we’ve done, and continues to invest and we’ve been able to shape something very fine here over a period of time. And so I can compare and contrast the two. I can assure you that also both working in the hospital setting and in the consulting setting shaped me as to who I am and have benefited me in my role here.

Gamble:  Right. Did you have any idea what you were walking into, coming to Albany when it was just about ready to get into the electronic world?

Hickman:  Things were not very evolved here. There were some real challenges at that time of what was going on with Soarian. I could tell by the fact that I wasn’t being told too much that it probably was going to be very challenging. It certainly was. And yet again, I can look back over the 11-plus years, and see just how far we’ve evolved things. I know others can feel what I feel, but I definitely feel a sense of some personal pride in seeing how this organization has come along.

Gamble:  Right. Well, I know I’ve taken a lot of your time, but I really appreciate it. We got to cover a lot and I definitely appreciate hearing your insights and just talking about some of your experiences. So, thank you so much for that.

Hickman:  Sure thing, Gamble. I’ve enjoyed doing it. Is there anything else you need?

Gamble:  Not just yet, maybe I’ll ring you up again in a little bit to see how things are going. But I really appreciate it, and I look forward to seeing you in person at the next event.

Hickman:  That’d be super. Very much appreciated, and I look forward to running into you soon.

Gamble:  Sure, thank you so much. Have a good one.