Timing is everything. When the Hospital for Special Surgery was beginning its EHR selection process, Epic released its orthopedic module and announced plans to offer remote hosting. For a hospital that specializes in musculoskeletal health and is located in New York – a city where real estate is at a premium, the decision was easy. Selecting a vendor, however, is just the beginning. In this interview, CIO Jamie Nelson talks about the strategy she used to build an Epic team, why she believes education is the key to data security, and how HSS has made innovation part of its DNA. Nelson also discusses the “boardroom skills” necessary for CIOs, why work/life balance doesn’t truly exist, and the next big frontier for her organization.
- “Things are changing very rapidly and we need to keep apace.”
- The next frontier after go-live
- “CIOs have to keep educating themselves.”
- Having a background in administration & finance
- HSS’ mentoring program
- Eyeing analytics to support innovation
- Work/life balance — “When you’re a CIO, you’re always on call.”
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When you’ve spent a couple of years worrying about putting an EMR in, these things are all suddenly new. And now they are the next frontier, so CIOs have to really keep educating themselves to be able to contribute in a meaningful way.
With the Epic implementation, I was less a technical lead than an organizational change lead, helping to make sure the right governance was in place, the right parties were involved, and we handled the issues in a manner that helped us expedite getting to resolution.
Having that type of background and understanding the operation and environment of a hospital is also important for a CIO. It really allows you to understand what your constituents are trying to do, and it helps you better guide them to getting there.
The most important projects are the ones around analytics, around supporting innovation and value, and around optimizing the system that we put in, and helping to change practices here through the use of the system we’ve put in, and really transform the way we deliver healthcare.
For me, there’s no separation of work and life. When you’re a CIO, you’re always working, you’re always on call. There’s always something that could come up on the weekends. I can never just say, ‘okay, I’m done working.’
Gamble: I guess you have to trust your instincts when you’re talking about when to push forward with something, and when to hold off. It’s going with your gut instinct and what experience has told you.
Nelson: Yes, and you don’t want to be seen as being in the way and slowing things down. These are different times. Things are changing very rapidly, so we need to keep apace. I’m training my own self this year. Obviously I’ve been a fan of cyber security for quite a few years, but now they’re asking us, ‘What’s Blockchain? How’s that going to impact what we do?’ ‘What is analytics? How are we going to take all of this data that we have with Epic and other systems and have that help foster innovation and creativity?
So it’s learning these new areas and really coming up to speed. And they’re not new areas, but when you’ve spent a couple of years worrying about putting an EMR in, these things are all suddenly new. And now they are the next frontier, so CIOs have to really keep educating themselves to be able to contribute in a meaningful way to these new frontiers that the hospital is pushing through.
Gamble: Right. That segues nicely into another area, which is looking at some of the biggest ways in which the CIO role has evolved, from more of a technical leader to somebody who sits at that table and is involved in strategic decision-making. I’m sure it’s been interesting to see, particularly in the last 5 to 10 years.
Nelson: You have to be seen as a business partner and as a change agent in an organization. I think that’s the most important thing. With the Epic implementation, I was less a technical lead than an organizational change lead, helping to make sure the right governance was in place, the right parties were involved, and we handled the issues in a manner that helped us expedite getting to resolution. That was a lot of my role.
I think that throughout IT leadership and management, that’s important — having those boardroom-level skills and being able to take complex things and put them in a way that the finance committee, the audit committee, or the general board can understand. Those are important skills. I think we’re long past the days of the IT director that used to run operations being necessarily the one who’s going to lead the IT organization in the future. I think very different skill sets are needed moving forward in this environment.
Gamble: A lot of that is focused around being able to communicate in the appropriate way to people in different positions.
Nelson: Right. I started in hospital administration — not in IT, and I’ve also worked in finance. I’ve worked in ambulatory care. I’ve run ancillary departments. I’ve run lean organizations. And so having that type of background and understanding the operation and environment of a hospital is also important for a CIO. It really allows you to understand what your constituents are trying to do, and it helps you better guide them to getting there. So having operational background and experience I think is very important for today’s CIO.
Gamble: Now, in your role, do you do any formal or informal mentoring?
Nelson: The hospital has a mentoring program that I’m part of where they will match executives with the rising stars of the organization to mentor them. My mentee right now is a young administrator in the department of medicine, so it could be from anywhere. I do a lot of informal mentoring because of this idea that having an IT background and becoming an IT leader is not the only path. I often speak with people who have different types of healthcare background who are interested in moving up through their careers, and help them figure out how their skills and experiences can be used in lots of different places within the healthcare environment.
I think that’s important because it is a role that needs many different types of skills, and we need to remind younger people how important it is to build skills in different areas. I often say I’m thrilled when somebody in my department moves to another department in the hospital in terms of their growth path, or when we take somebody from outside of the department and bring them into IT, because I think moving back and forth in an organization and learning a lot of different aspects of it can help with anybody’s career growth in terms of administrative positions within the hospital. So I do a combination of formal and informal mentoring.
Gamble: And I’m sure it’s interesting from your perspective to be able to speak to people who are of different stages of their careers.
Nelson: I was chatting recently with a young gentleman who’s a senior at my alma mater, and then I’ll speak to people I’ve worked with 20 years ago and are now looking for a career change. So it’s all over the place.
Gamble: Sure. Are there any other projects or anything you’re working on that we didn’t cover? I want to make sure I give you a chance to cover everything.
Nelson: We’re doing a lot of things. We’re doing a lot of things with cybersecurity. We have another data center that we’re trying to move out of Manhattan to an offsite location. We have two ambulatory surgery centers that are going to be stood up and we’ll be putting systems in there. But I think the most important projects are the ones around analytics, around supporting innovation and value, and around optimizing the system that we put in, and helping to change practices here through the use of the system we’ve put in, and really transform the way we deliver healthcare. Those, I think, are the most exciting things we’re working on.
Gamble: Now that you’ve been on the new system for a year or so, I’m sure you’re moving to the point where you are able to make changes, and make sure the people using the system are getting the most they can out of it.
Nelson: I was chatting with one of our physicians the other day outside an elevator bank, and she said she now wants to go back to look at all the initial training and the tip sheets, as we call them. Because now that she’s been on this system for a year, she wants to go back and revisit what the training was and how to do things. I think people are at that point where they’re ready to take that next step and re-educate themselves or have us help with that. So it’s exciting to see that happen.
Gamble: Yeah, I’m sure it’s nice to see, too, from your perspective to see that interest.
Gamble: And you said you’ve been there for five years?
Nelson: April will be five years, yes.
Gamble: Do you live in the city?
Nelson: I live in suburban New York, about 20 miles from the office.
Gamble: When we spoke last time, you were excited about getting back to the city and it seems like you still really like working in New York
Nelson: There’s amazing energy here. I’m a life-long New Yorker, so I love being here, especially on the Upper East. We are next to New York Presbyterian Hospital. We are across the way from Memorial Sloan Kettering. We’re up the street from Rockefeller University Hospital. NYU is a couple miles down, and Mount Sinai is a couple of miles up. So we’re in this wonderful academic corridor — there’s a lot of energy, and a lot of excitement. These hospitals are doing really wonderful things for patients. It’s nice to be in the middle of all of this in such a fantastic institution. So yes, I love being here in the city.
Gamble: And hopefully, you’re able to get away to or get some time off on the weekends.
Nelson: I was thinking about that. For me, there’s no separation of work and life. When you’re a CIO, you’re always working, you’re always on call. There’s always something that could come up on the weekends. I can never just say, ‘okay, I’m done working.’ Fortunately, I love where I am and I love what I do and I love my team, so I don’t see that as a burden at all. It’s just part of life and understanding that you can’t control everything, and that often, how you react to things is more important than what may have happened. That’s a great way to ground yourself, but also remembering that work is just a part of life and it’s a continuum, and so you make sure you’re doing something that you love. It’s just part of your overall satisfaction in your life. To me, it makes work-life balance almost immaterial. It’s one continuum, and this is coming from a woman who’s raised three children while working.
Gamble: That’s a very honest take on it. It’s true that they never really are separate, especially at the C-level.
Nelson: It’s one big slow.
Gamble: Are your kids out of the house at this point?
Nelson: One is a sophomore in college, one is graduating in May, and the other is going to be going back to law school. So I think I have a bunch of perpetual students, but that’s okay.
Gamble: All right, well that was what I want to talk about, so thank you so much for your time. It has been really great hearing about all the incredible work that your team is doing.
Nelson: Well, I’m so fortunate. It’s funny because I was with our CEO the other day and he was thanking me for my particular performance last year. And my response was, ‘thank you for allowing me to put the team around me I have,’ because I’ve always believed that you are only as good as the team around you. So having the ability to hire what I consider the best around me is what makes us all successful.
Gamble: Thanks again, and I hope to catch up with you maybe at one of these local events.
Nelson: Yes. Local events I’ll go to.
Gamble: Okay, thank you again. I appreciate it.
Nelson: You’re welcome. Take care.