Chris Paravate, CIO, Northeast Georgia Health System, Chapter 2

If you’re going to be a successful CIO, you need to learn how to do one simple thing: let go, says Chris Paravate. Yes, CIOs need to be aware of what’s going on throughout the organization, but he believes their purpose is to educate, set clear expectations and provide guidance. In this interview, Paravate talks about the groundwork his team is laying to prepare to roll out Epic across the system, why he’s all about workflow training but cautions against overusing consultants, and how NGHS worked to achieve operational engagement. He also talks about the concept of humble leadership, what he learned from Allana Cummings, and what it takes to build a culture inside the IT division.

Chapter 1

Chapter 2

• The CIO’s delicate balance — “You have to be willing to let go of some control.”
• Educate, set clear expectations & provide guidance
• The moment when “all the hard work paid off”
• Operational engagement
• Go-live — “It’s just the beginning”
• Chasing optimization
• From Chief Applications Officer to CIO — “There’s no safety net.”
• Humble leadership: “Take care of your staff.”

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

Podcast: Play in new window | Download (Duration: 13:28 — 12.3MB)

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

Bold Statements

You could shepherd the process, but if you want operations to own it, you’re going to have to educate them, set clear expectations, and give them guidance on how to be successful. But you’re going to have to take your hand off the steering wheel a little bit, and that’s a delicate balance.

With this type of scale and magnitude, IT alone can’t make this a successful implementation. It’s going to take every aspect of the organization engaged and being transparent and leaning into the problems and being decisive, recognizing when we make mistakes and correcting them, and approaching the overall project with purpose and conviction.

Most people think, ‘It’s go-live; we’re done.’ Well, you’re not done, it’s just the beginning of the next phase. For just one moment, you’re like, ‘we’re up to date, we have the current release, the design is fresh and everything is good,’ and that’s gone in about 15 minutes. Then you’re chasing it optimization.

When you move from being a leader in the IT department to being the leader of the IT department, there’s no safety net. You are ultimately responsible for the outcome and the success of the department. Those few months — it was tough. It was frightening, and I had to really work through that.

Part of developing that IT strategy was building those relationships with each of my peers, each of the senior leaders, and understanding what their challenges and problems were, and then starting to shape that strategy into something that the organization could identify with.

Paravate:  I think a lot of times CIOs can see solutions and they can see the vision and the strategy for technology, but you can’t outstrip the pace of operation’s ability to make some of those decisions, and you have to be willing to let go of some of that control. And it doesn’t mean you can’t influence and it doesn’t mean you don’t steer the ship, but it does mean that you may be at the back of the room.

When we did demos, I didn’t open a single session. The operational directors opened every session; they managed the selection. I wasn’t at the front of the room saying, ‘hey guys, we’re going to look at an IT system today.’ I was in the back of the room actually, just making sure that the sound quality was good and the visibility was good and that people had what they needed. What I learned from that is you could shepherd the process, but if you want operations to own it, you’re going to have to educate them way in advance, set clear expectations, and give them guidance on how to be successful. But you’re going to have to take your hand off the steering wheel a little bit, and that’s a delicate balance. It certainly has been for me, but it’s also been very rewarding as you see people step up.

When we finished our system selection, it was right around Paravatetmas. There was a treasury meeting and the Gainesville president and the CFO were in that meeting. I wasn’t at the treasury meeting, and the CFO stopped by my desk and said, ‘hey, we had a treasury meeting today and I just got to tell you a story. They started asking questions like ‘who is Epic,’ ‘what was our selection criteria,’ ‘who was involved in the demos,’ ‘how much is this thing going to cost,’ and ‘how long will it take to implement?’ And he said, ‘I was so proud I could answer every single one of those questions.’ I realized at that moment that all the hard work to make sure that everybody was on board and knew the process had paid off, because they could stand on their own and answer those questions. They didn’t need the CIO to stand up and say, ‘Let me tell you about the KLAS reports’ or ‘Let me tell you about Judy’s methodology.’ They had gone firsthand and met Judy, and so they knew it. And that, for me, is pretty exciting. I think it also sets such a strong precedent for the implementation, so now as we start our design sessions, all of the vice presidents are expected to go to some of those design sessions and participate, while others are expected to be visible so that the staff see that this is important and that this is a huge investment.

So I don’t think any of these things guarantee success, but you really have to just plant the seeds early on and continue to water the garden and take care of the problems. Those things all lead toward a strong implementation. I think that with this type of scale and magnitude, IT alone can’t make this a successful implementation. It’s going to take every aspect of the organization engaged and being transparent and leaning into the problems and being decisive, recognizing when we make mistakes and correcting them, and approaching the overall project with purpose and conviction, but also a sense of humility to say, let’s have a respect for how big this is going to be and how much we all have to learn.

I think that’s what we’re trying to really build within our implementation because most people think, ‘It’s go-live; we’re done.’ Well, you’re not done, it’s just the beginning of the next phase. For just one moment, you’re like, ‘we’re up to date, we have the current release, the design is fresh and everything is good,’ and that’s gone in about 15 minutes. Then you’re chasing it; you’re chasing that optimization. So that’s a little bit about kind of where we’re at and where we’ve been and I think the way that we’re approaching the implementation is really exciting, and because everybody feels like they’re part of it there’s so much energy around, and that in itself builds momentum.

Gamble:  Right. And once you start getting into the training and you get closer to go-live, I’m sure the hope is that you’ll see that buy-in from the users early on because this hasn’t been viewed as an IT project, but instead there’s been so much involvement the whole time from all aspects of the organization.

Paravate:  Yeah, and I think the fact that we’re discussing training being mandatory and there must be a competency assessment now, and that that decision has been made, by the time we get to training, that won’t even be a question any longer. It will be, is the training of good enough quality? And that’s really where we should be focused. Each of these things are building blocks.

I had someone ask me the other day, ‘what’s your goal for the implementation?’ And my response was, ‘well, it depends on which phase we’re talking about.’ And they said, ‘What?’ I said, my goal is that we have the highest quality training and that people are proficient to do their jobs. And they said, ‘Well, that’s an interesting goal.’ I said, ‘well, that’s in my training phase.’ My point is, you don’t just set out an implementation goal like, ‘we’re going to have a successful go-live’ without definitions around what a successful go-live is. You have to have measures of success throughout the implementation that yield that outcome. That’s what we’re leaning into right now and trying to figure out how do we build those stepping stones.

Gamble:  Right. Is this the way that projects have been approached before in the organization or is this something that’s a little different because it’s such a large scale initiative?

Paravate:  We’ve been a McKesson customer for decades and I’ve been here for six years, and in the past, whether it was supporting McKesson and the implementation of Paragon or implementing Allscripts in the ambulatory setting, it was predominantly driven and directed by IT. I think operations tried to be engaged and tried to take some ownership, but I think the key gap was that they didn’t really understand what that meant, and they weren’t necessarily educated on what that might look like and how they could plug in. I think that’s the fundamental difference that we’re trying to establish — let’s just assume everybody’s trying to do the right thing. What makes you think that they know what being a champion for a product looks like, or being a subject matter expert? You’ve got to give them some education and training and coaching on how to serve in that role.

A lot of times we’re implementing a product maybe for a department director but we haven’t spent the time coaching that operational director on what they’ll need to do in order to be successful — to be that leader and to be effective. And so from that perspective, I think we sometimes expect a little bit too much and we haven’t spent the time to really help that leader be successful.

Gamble:  That’s interesting. You said you’ve been there six years. How long have you been in the CIO role?

Paravate:  I’ve been in the CIO role since October of 2014, so about a year and a half.

Gamble:  And previously you were chief applications officer?

Paravate:  That’s correct.

Gamble:  In terms of making that transition, it’s one that certainly makes sense given the responsibilities that you have, but what was it like to make that move? Did you find it to be challenging?

Paravate:  It was very challenging. When you move from being a leader in the IT department to being the leader of the IT department, there’s no safety net. You are ultimately responsible for the outcome and the success of the department. Those few months — it was tough. It was frightening, and I had to really work through that. Part of where I spent a lot of time focusing is on my core team, on my direct reports, in building the strength and the capabilities of that team. I’ve always carried some key values with me that I think have made me successful and certainly I’ve applied over the years, one of which is to take care of your staff; to invest the time in your staff and your team. I use the analogy of nobody ever remembers where you were in the third shift to the second week of that go-live, but everybody remembers how they felt and if you got them lunch or maybe if you checked on them or helped them work through a problem. They remember that and it’s the relationships that you have that strengthen the team and give us purpose. I’ve always carried that with me and I think that’s really served me well. I’ve got such an incredibly strong team, and as I stepped into this role, I was very confident in in their capabilities and in their support.

Another aspect I touched on is that I approach everything with a certain level of humility. It doesn’t mean I can’t be decisive or purposeful, but I don’t pretend to know all the answers, and I don’t pretend I’m smarter than I am.  I think humility can be your friend and keep you grounded and keeps you listening, and that’s something that I’ve carried with me. As I stepped into this role initially as the interim, I had a very high degree of confidence that we had the right team to support IT and to keep operations running well in IT. Where we really needed to focus was on our strategy, and part of developing that IT strategy was building those relationships with each of my peers, each of the senior leaders, and understanding what their challenges and problems were, and then starting to shape that strategy into something that the organization could identify with and that would move us in the right direction.  And everybody who ultimately reviewed that IT strategy could see something that they had contributed and that they had shared with me in those conversations about what the IT strategy should be.

It was a very collaborative approach. It was something that everybody could identify with and I think at the end of the day, there was a point where I sat down with my wife and we talked about the things that were stressing me, and I realized that you can’t walk around being worried about what you’re not doing. You have to do what you know is right and know where your convictions are. For me, that was a little bit of a growth to step into that CIO role and to know that there isn’t always a safety net — there isn’t a CIO who’s going to say, ‘what are you doing? Why are you working on that? You need to be over here.’ But it also means you can leverage your team in a new way and use your team to really be that voice and to help you shape where things are going.

Chapter 3