To say that security has gained traction as a priority is quite an understatement. In fact, Ken Lawonn gets more questions about security from his CEO and board than any other topic. And so it should come as no surprise that Sharp has changed its entire approach, creating an IT risk management department and recruiting its first CISO. In this interview, Lawonn talks about the rapid evolution of Sharp’s security strategy, how the organization looks to leverage its managed care expertise to thrive in the population health world, and his thoughts on integration — including what his team is currently doing to provide a unified view of data, and how this plan may change in the future. He also discusses what it was like to go from being the acquiring party at Alegent Health to being acquired, why he made the move to San Diego, and what it’s been like to fill Bill Spooner’s shoes.
- 13 years with Alegent Health
- Epic selection process
- Learning the business during M&A — “It helped me to be better leader.”
- National standardization vs local integration
- Filling Bill Spooner’s shoes — “Could I really continue to build on the legacy?”
- Learn and understand first
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We went through an evaluation there and decided to move Epic, so I had the chance to evaluate and move down the path of trying to build out something with one partner and then having to make the difficult decision to switch and go to an integrated solution.
It was really helpful to understand the strategy and business perspectives, and to try to balance the need for controls that IT was always trying to put in place, and standardization, along with the need to be innovative and to provide services.
As we look at the continued consolidation in the healthcare space, you always have to look at what’s in the best interest of trying to leverage scale and efficiencies versus what’s in the best interest of providing a good integrated service and solution as we become more and more judged in a consumerized model.
My style when I went to Alegent and when I was coming here was these are great organizations that are doing some great things. Your objective is to come in and learn, and before you start making decisions, make sure you really understand the implications.
You have these initiatives you want to move along, but you have to be patient enough to make sure you work through the cultures. I think it’s always a challenge to understand how are decisions made — who do you need to engage? You could have the greatest idea in the world, but how do you make sure you’re talking to right people?
Gamble: You’ve been with Sharp since early 2014, correct?
Lawonn: Yes, about 22 months.
Gamble: So then before that, you spent awhile at what was then Alegent Health?
Lawonn: I spent 13 years at what was Alegent Health, which became Alegent Creighton Health when we acquired Creighton Medical Associates and Creighton University Medical Center. And then as I was leaving, it was acquired by CHI and now it’s called actually CHI Health. But it was an integrated delivery system in Omaha, Nebraska. I spent 13 years there.
Gamble: And that covered a really interesting period as far as the changes in going to electronic, I’m guessing.
Lawonn: It really did. We went through some pretty significant strategies and different changes. When I got to Alegent, it had been formed through a joint operating agreement of two small systems in Omaha and had continued to grow, and had been a big customer of Siemens for years. They used Siemens’ Invision. But when I got there, one of the first things we had to do is determine how we were going to proceed relative to building out the whole EHR, physician order entry, and clinical strategy. And so we actually evaluated our options and decided to become an early adopter of the Siemens Soarian product. We implemented that first in 2004 and really worked closely with Siemens in building that platform out and implementing things early on. We had some really good success in implementing clinical documentation systems, but they didn’t have an ambulatory system so we had to go out and look at something there. So we went to NextGen and then we were really struggling with CPOE.
After a number of years, we actually went through an evaluation there and decided to move Epic, so I had the chance to evaluate and move down the path of trying to build out something with one partner and then having to make the difficult decision to switch and go to an integrated solution. I got an appreciation of the value of that integration, and went through the process of selecting and then beginning the implementation of Epic. And then right as we were in the early stages of that, CHI acquired full interest in Alegent — they were one of our sponsors. As I said, we were a joint operating agreement. And we ended up having to merge our implementation of Epic with the group that was doing the implementation of Epic up in Tacoma. So we went through the process of forming an enterprise Epic team and supporting implementations in two locations and at the same time I was working on helping support the transition off of some of some of our other systems moving from PeopleSoft to Lawson.
One of my biggest learning just as a CIO there is I got a chance to do some strategy and business development work and also had responsibility for some support areas like marketing and communications, facilities, and things like that. It was really helpful to understand the strategy and business perspectives, and to try to balance the need for controls that IT was always trying to put in place, and standardization, along with the need to be innovative and to provide services. For example, when our marketing communications wanted to get into social media very strongly, it was really learning how to help put the people together to balance that to say, what are the things we really want to do to be more competitive and provide a better service, and then what are the kinds of controls or standardization we need to put in place. It helped me I think be a better leader and a better organizational CIO, because I got to understand the business side of it as well.
And then within the course of like two to three years, going from being an acquirer when we acquired Creighton University Medical Center and Creighton Medical Associates, I led that actual acquisition — as I said, I was running strategy so I got to negotiate the acquisition, and then lead the team that was putting the whole implementation together, and the transition of them from one system under Alegent. To then turn around and then be acquired and then have to lead the process of integrating into a larger organization, it gave me a real appreciation of being on both ends of that spectrum, being both the acquirer and the acquiree. It really did give me a good perspective.
I think in the end, I felt like being part of an integrated system in more of a single market was something that I preferred versus being part of a national system, and that’s what led me to start to look at opportunities and what brought me here to Sharp. I just think it’s there’s so much that occurs locally, and if you’re always having to balance the national standardization versus the local integration, it can be a challenge. With the big systems it’s really difficult, because they’re trying to leverage their scale, and yet they’re trying to provide an integrated approach locally, so it’s a particular challenge.
Gamble: Yeah. I’m sure it was valuable getting insight into something that would always have to be dealt with that type of system.
Lawonn: With any type of acquisition, you want to take out the variation and try to get to some standardization. So if it’s just two systems coming together or you’re acquiring a small hospital or if you’re being acquired by a large system, you have to understand that part of the objective is to drive some consistency and leverage that scale. And then how do you balance that, maybe on some of the back end systems, with the need to have an integrated system and an integrated experience for the customers at the local level? That’s the kind of balance you’re always playing off.
At CHI, we were looking at was there opportunity to leverage homecare nationally, to build a national homecare program where we drove consistent practice and consistent standards the same on medical group management. But you had to make sure that for the sake of standardization on a national level, you did not jeopardize the integration on a local level. We were struggling with whether we put in Epic for homecare or do we put in a different system that they’re going to use nationally so that they can drive some things.
It’s a balance. It’s a tough thing. As we look at the continued consolidation in the healthcare space, you always have to look at what’s in the best interest of trying to leverage scale and efficiencies versus what’s in the best interest of providing a good integrated service and solution as we become more and more judged in a consumerized model. We’re looking more at this from consumers and retail than the operational control model that we’ve had in the past where people just came to us.
Gamble: When you made this decision to go to Sharp, that’s a big transition, not just moving to a completely different area, but moving to this type of health system. Did you have any hesitancies or was it something where after having the experience you had, you wanted to try this?
Lawonn: I’d say there’s always a little hesitancy when you’re following a legend like Bill Spooner. You’re coming into fill some big shoes. For me, I was more interested in the type of organization that had a real opportunity to be at the forefront of transforming healthcare delivery, and I knew that that would force me to have to take on some challenges that would be unique or big. But if you can get in with the right organization, the right kind of people, and have a chance to help lead transformation, that was really drove me.
And yes, there were hesitancies. There were concerns. It’s a big move. They had a health plan here and they had a history of some really innovative things — could I really come in and make a difference? Could I really come in and continue to build on the legacy? I had some good conversations with the organization. I had known Bill for a long time, and I just felt like it was going to be a good transition and good fit for me.
Gamble: And how did you approach that? It’s a pretty unique thing for somebody to be in the position as long as he was and of course to be really influential. How did you approach the taking over his position?
Lawonn: I think my style fit okay because I’m not the kind of person that comes in and immediately looks to make change. My style when I went to Alegent and when I was coming here was these are great organizations that are doing some great things. Your objective is to come in and learn, and before you start making decisions, make sure you really understand the implications. Sometimes on the surface something might look like this doesn’t make any sense, but as you dig into it, you see that it does. I wasn’t looking to go into an organization and have to make a lot of change and transform a lot of things. I was looking to build on something that was strong and solid and figure out how we could take it to the next level or leverage it to help transform where healthcare was going. My style fit pretty well because I was able to come in and say, ‘Hey, I know things are working great here. I know you guys have a great organization. Bill is a great leader. You’ve done some wonderful things. Help me understand that and let me talk about where I think things need to go, and then let’s talk about how we can leverage things that we’re already doing and how we build off of that. Or if there are things that we need to change, help make sure that I understand the implications of those changes before making them, because the last thing we want to do is do something that’s going result in some unexpected consequences.’ I just think it fit my style.
Bill was here for about a month after I got here, and we would meet and we’d talk about things and I’d say, ‘I want to understand the things that might on the surface look like why would you do this — help me understand where those points are that I’ve got to really be cautious of. Where do you think there are opportunities? If you were staying, what would you try to do?’ So it wasn’t like I had to come in and create my own identity. I wasn’t concerned about that. I have enough confidence in my capabilities and that we would be successful, that I could just come in and learn and leverage off what they already had in place.
And so I didn’t see it as a big negative that I would be following someone with strong relationships and strong performances who was not only a legend in San Diego and at Sharp, but in the industry. To me it was that I don’t have to create my own identity. That will happen over time and we’ll do fine.
Gamble: Now looking at almost two years, do you feel that it was the right move? That it definitely feels like the right decision?
Lawonn: I would definitely say so. As I said, the organization is just fantastic. It’s all about people, and to have the kind of reputation and deliver the experience that Sharp’s been able to do and be as successful says a lot. It’s about having good strong people.
One of the things that really drew me to the organization was the leadership and the strong team that was in place at the executive level that had worked together for a fair amount of time. They had some new people, but they had a strong core that was planning to stay here. I didn’t want to come in and be part of something that was going to go through a tremendous amount of upheaval. So it’s been good. Sometimes you want to make more progress than you do. You have these initiatives you want to move along, but you have to be patient enough to make sure you work through the cultures. I think it’s always a challenge to understand how are decisions made — who do you need to engage? You could have the greatest idea in the world, but how do you make sure you’re talking to right people? There’s been a bit of learning there, but as I said, it wasn’t like I had a list of five or ten things I felt like I had to accomplish in the first two years. It’s been great. The organization has a lot of strength. It has a lot of potential. I think we really like our presence in the market. And it’s hard not to like San Diego. So, it’s been a great move.
Gamble: Well, we’ve definitely covered a lot. I want to thank you so much for your time and I certainly would like to catch up with you in the future to talk about how some of these big decisions have weighed out. Hopefully, we can talk a little bit down the line.
Lawonn: I would love to. I think it’s really interesting to watch how this whole healthcare system and industry is changing. I was thinking it, and it’s like we’ve always been in this business when somebody felt like they needed something, needed a service, or got sick, they came to see us and that was our interaction and that’s what automated and that’s what we kind of maximized, was how could we be efficient at that?
And now we’re shifting to a world in which it’s no longer about that kind of environment, but it’s about how do we establish ongoing meaningful relationships that help people improve their health, whether that’s moving from a sick model to a wellness model, or whether that’s just trying to keep people healthy. It’s all about continued engagement and communication with individuals. It’s not about maximizing efficiencies when someone schedules an appointment and comes to see. It’s a real transition and it’s really going to be fun to be part of. So, I look forward to having more conversations.
Gamble: Yeah, definitely. It’s really interesting to watch this evolution in the industry. I’ll definitely want to get more thoughts from you in the future. Thank you so much for your time. It’s really appreciated.
Lawonn: Alright. You’re welcome.