Bobbie Byrne, MD, EVP & CIO, Edward Elmhurst Health, Chapter 3

If you’re going to lead an organization through a merger, the one thing you can’t be afraid to do is step on few landmines, says Bobbie Byrne, who encountered several during the union that created Edward-Elmhurst Health three years ago. What leaders can do is to be sensitive of the differences that exist between cultures, and keep the lines of communication open. In this interview, she talks about how to navigate partnerships with competing organizations, how her own experience as a pediatrician factors into her rollout strategy, how getting people to think “Epic first can be both a blessing and a curse.” Byrne also discusses her new role, which is a reflection on the organization’s strong focus on consumer driven health, her thoughts on managing expectations, and what she considers to be the “most fun part” of her job.

Chapter 1

Chapter 2

Chapter 3

• Delaying Epic at Elmhurst — “We just didn’t have the money.”
• Post-M&A adjustment period
• Merging cultures — “Using humor is helpful.”
• Value of giving specific feedback
• Personal coaching — “It’s the most fun part of my job.”
• Coaching millennials vs older generations, and women vs men
• “There’s definitely a difference.”

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Bold Statements

I’m really pleased with the people who stayed. I’m proud of them for adjusting to a whole bunch of new processes and totally new systems. I know it really took a lot of courage for them to learn everything new, because it is a big difference.

Is there any history that I should know about? Is this reasonable? Who should I really go to for this question? Because sometimes the person you really need to go to is maybe not the same person on the org chart, so just keep asking.

It’s probably the thing that’s the most fun part of the job, especially when you’ve identified somebody at a more junior level who you think just has talent — maybe they’ve shown some calm under stress or they were able to get consensus amongst a difficult group in a very small setting.

I would give a presentation and say, ‘how did that go?’ And people would say, ‘it was great.’ That doesn’t help me. I was always looking for something like, ‘you started a little slow, but then you picked up and your ending was good.’ That would be helpful to me, but I never got that. So I really try to give that specific feedback whenever I can.

On the whole, I see a difference. I have to push women really hard. With the men, I give them a little shove and they tend to be off to the races.

Gamble:  How was it for coming to terms with the fact that Epic was going to have to wait for Elmhurst? Was it a difficult thing or was it something where you said, okay, I guess this is what’s best, so that’s what we’ll do?

Byrne:  Well, we made the decision based on the fact that we just didn’t have the money. So we needed to do some other things in order to fund this Epic implementation. We did put the physicians, as I mentioned, all on Epic first, because there’s just a lot of efficiencies related to referrals and care. Let’s face it, most of the care is outpatient, so let’s make sure that we prioritize that. We did that. We did all of our ERP solutions and we consolidated on the Lawson Infor system, which we had used on the Edward campus for quite a while and had been really pleased with, so to get things like materials management, HR, and GL all onto a single system was really helpful, and I think ended up giving some efficiencies that then allowed us to fund the Epic implementation.

My thought was I’d like to get started, but I understand there’s some prep work we need to do and some other things that are probably just higher priority. So we took care of those things, and then we were able to move onto Epic. Time goes fast — I’m thinking, it’s three years, but it seems like yesterday.

Gamble:  Definitely. And then did it take some time for the IT staff to shake out? There’s going to be some turnover, so I imagine that can be difficult as you’re going through this phase, kind of seeing who’s going to stay, who’s going to go, and making those decisions.

Byrne:  There is some staff turnover. There definitely was staff turnover of IT staff on the Elmhurst side. I think that it is almost inevitable when you have a CIO who’s coming from one campus and then is now over both. I’m really, really pleased with the people who stayed. I’m proud of them for adjusting to a whole bunch of new processes and totally new systems. I know it really took a lot of courage for them to learn everything new, because it is a big difference. We’ve sort of changed every system on the Elmhurst campus, so that’s a lot of adjustment for them to make.

Thankfully things settled out pretty quickly within our merger as to who was staying and who was going. I just wouldn’t recommend implementing a system while you’re in the middle of that shakeout where you don’t quite know who’s staying and who’s going. It just was extra stress.

Gamble:  Right. And then you also have this big thing on your plate to try to merge different cultures. I’m sure that that’s something where you can’t really follow a blueprint because people are so different and organizations are different. Was that something where you just had to learn as you go?

Byrne:  You try and be sensitive and you try and communicate as much as you can and talk about the differences — even things like the dress code at Elmhurst was more prescriptive and specific than the dress code at Edward. Edward has a jeans on Friday policy, Elmhurst is coat and tie for manager and above. They’re very different in that way, so it’s trying just to be respectful of it and saying, please dress appropriate to the site that you’re going to be working at on that day. It has happened where we had an unexpected event at Elmhurst on a Friday and my team is in jeans and driving over to the Elmhurst campus. Those types of things happen, but you have to just go with it as much as you can.

Using humor about things when you do have misses I think is really helpful. We had a scenario early on with something you would never expect to be an issue, but at the Edward side, the way we do our go-lives and the way we run our command center — and it’s relatively small — is that every seat has a name on it. The CIO has a chair in the command center, and it’s my chair. The administrator of the day has a chair. People really want to be in the command center, and we can’t have everybody in the command center that we want to have in there. It’s just a quirky, weird Edward culture thing.

On the Elmhurst culture, the command center was only people who were answering the phones. This was considered to be more of a help desk type function. So when we first went live we started assigning our leaders, our IT managers to be in the command center. On the Edward side they were very used to this, but on the Elmhurst side they thought that we were somehow telling our highly technical managers that they now had to be first line answering the phones. It was just a miss. Nobody intended to insult anybody else, but it was a miss. You try and just laugh at it, and say, ‘no, we’re not going to be taking our director of technology and having him reset passwords. That doesn’t make sense, we’re not going to do that.’

Gamble:  There are just no many nuances.

Byrne:  Right. So many land mines. I think I stepped in them all.

Gamble:  I guess that’s how you learn, though.

Byrne:  Absolutely. There are the things that you know to ask about, like dress code, and then there are all these things that never would have occurred to me to ask about, like what’s their culture of their command center. That never would have occurred to me, so of course we made a mistake on it.

Gamble:  I guess the key thing is, like you said, having a sense of humor and then just keeping the lines of communication open. I imagine that that’s a big thing as far as conveying that we’re all learning.

Byrne:  Absolutely. It’s trying to ask, is there any history that I should know about? Is this reasonable? Who should I really go to for this question? Because sometimes the person you really need to go to is maybe not the same person on the org chart, so just keep asking.

Gamble:  Did you have a moment where you said, ‘okay, it feels like things are coming together?’ Or was it one of those things that happened so subtly that you didn’t really notice it?

Byrne:  I think it’s very subtle. I think it’s only when you realize, ‘I don’t have to ask who to go to anymore, I know who to go to now,’ and only when you really pause to think about it that you realize how much it has improved. I don’t think that for us, or for me at least, there really wasn’t any sentinel event that said, okay, now we’re merged. And I think there are still very big differences between the cultures, even though we’re 17 miles apart. There are very big differences in the cultures. That probably won’t change, or it will change very, very gradually.

Gamble:  Right, and that doesn’t have to be a bad thing either.

Byrne:  No, not at all. There are definite advantages and disadvantages to both.

Gamble:  Okay, I know we’ve touched on a lot of things. I think the last thing I wanted to ask was the idea of growing leaders. It’s an interesting concept to me. I heard somebody say that one of your most important jobs is to grow leaders. How do you think CIOs can do this? What do you think you’re really looking for in someone you would consider a leader or a future leader?

Byrne:  It’s interesting; I’ve spent a lot of time thinking about this and a lot of time talking with my colleagues about this. It’s probably the thing that’s the most fun part of the job, especially when you’ve identified somebody at a more junior level who you think just has talent — maybe they’ve shown some calm under stress or they were able to get consensus amongst a difficult group in a very small setting. And so you identify them and you try and bring them through the leadership tracks, and try and find additional opportunities for them to step up, to gain experience.

We have a whole system of looking at how do you identify someone, especially a new manager or somebody who’s in their first supervisory role, and the training that you send them through and the additional pieces. I think every organization has something like that. There’s the whole formal piece around how do you promote somebody and how do you get them to the next step and what sort of education do you ask them.

But the thing I like the best is really more the personal coaching, and I think it’s because it’s really hard to get. I would give a presentation and say, ‘how did that go?’ And people would say, ‘it was great.’ That doesn’t help me. I was always looking for something like, ‘you started a little slow, but then you picked up and your ending was good.’ That would be helpful to me, but I never got that. So I really try to give that specific feedback whenever I can. Sometime it’s, ‘Hey, you sent this email and the way that you said this really upset the person. I get what you were trying to say. If you’d used this language then maybe it would have gone over well.’ I try and do that really individual piece. I have a couple of books that I really like, so sometimes I’ll give a book to somebody who I think is maybe struggling. There are a few that I enjoy, so sometimes I prescribe that book for them.

I definitely really value presentation skills, so I do try and give feedback for people when they give good presentations or things that they could improve on their presentations. I’m not perfect at this. I think every leader should be doing more. It’s the type of work that I think is the most labor intensive and takes the most time, but I think it’s the most valuable.

Gamble:  That’s great, because I can attest that when somebody who is in a leadership position does pull you aside and give you feedback, it may not register right away, but eventually it sticks in their head, and sometimes they go back to those pieces of advice years later. I know I do. Those types of things really do help people along the way.

Byrne:  I had a conversation with somebody on my team who has young children at home and is not ready to take a bigger job right now and really wants to maintain the balance. I said, ‘When you are ready, please come to me, because I really want to get you on the track. I think you have all the potential.’ I could tell from the look on her face that she was just shocked that I was saying that. I was like, ‘you’ve got to start thinking of yourself as a leader, because you are a leader.’ This is somebody that I may not be able to help for several years because of the way that her personal life is going. But I was like, ‘I’m coming for you. You have too much skill to just sit in your cube and do what you’re told. You are somebody that I see as sort of that next generation.’

Gamble:  That’s a big confidence booster, and you probably took her by surprise quite a bit with that.

Byrne:  I did. And you know, there is a difference in generations and how I think you coach millennial generation versus older generations. There is definitely a male-female difference. Now, the individual is paramount, so if you know how to reach a particular individual then that’s obviously most important, regardless of the age or gender. But on the whole, I see a difference. I have to push women really hard. With the men, I give them a little shove and they tend to be off to the races.

Now, there are exceptions, of course. The amount of feedback that our younger employees prefer is higher. Our older employees don’t really crave it as much. Or maybe they’re just not used to it; maybe they crave it as much, but they just have never gotten it so they don’t ask. But there’s definitely a difference.

Gamble:  Yeah. I know that that’s been the case for me, too, as far as having the skills but really needing a little bit more of a push. That’s why it’s so great to hear you say that. Hopefully more women and men are doing that, and making sure that they’re giving kind of the right types of encouragement to different people, whether it’s by age or gender. It’s true, at least what I found, that women sometimes do need a little bit more of a push, but sometimes once you get that push, it is a big confidence booster and it can make a huge difference.

Byrne:  Absolutely. I’ll keep pushing them.

Gamble:  That’s good. It’s what’s needed sometimes. Well, this has been great. I’ve really enjoyed speaking with you. I always do, and I hope we can do it again. Thank you so much for your time, I really appreciate it.

Byrne:  My pleasure. Thank you so much.

Gamble:  There’s always more happening and more to talk about, so I’m sure I’ll be hitting you up again.

Byrne:  I think so. Some of the next things that we’re really working on around pricing and price transparency and selective discounting. I think we’re still in the planning phases on that but I think that’s going to be pretty exciting.

Gamble:  All right, great.  I’m going to take you up on that.

Byrne:  Okay. Thank you so much.