Brian Thomas, VP & CIO, Swope Health Services, Chapter 2

When an opportunity presents itself, smart people jump on it. For Brian Thomas, that moment came a few years ago when Swope Health Services was restructuring its executive team. Seeking to learn more about the business, Thomas asked to take on a 90-day assignment as interim VP of operations, and in doing so, impressed the board enough to earn a new title. In this interview, Thomas talks about what he believes it takes to become a successful CIO, why leaders must “get in the trenches” to better understand user needs, and his philosophy when it comes to innovation. He also talks about how his team is preparing for the ACO world, the dangers of over-customization, and the strong foundation he was able to build during his time with the Marines.

Chapter 1

Chapter 2

• Building an EDW to support accountable care
• Interim role as VP of operations — “It helped me to understand the business even more.”
• Need for agility with long-term plans
• His innovation philosophy
• “Sometimes the big shiny object comes with a big price.”
• Assessing contracts
• “We need to treat vendors as strategic partners.”

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Bold Statements

It was certainly something new for me. It was a challenge, and it definitely pushed me to some limits at some points, but there was great growth there. And because of that, I’m where I am today.

If you really want to be a successful CIO, you’ve got to get in and learn your customer’s business, and this has given me that opportunity to learn so much more about the business. Just stretching yourself really gives you that growth you need from a leadership perspective.

Technology touches everything, and in order to be more successful as a CIO, you need to understand the business inside and out. You can’t just rely on your CEO or your COO or your CFO to say, ‘we’re going to make these widgets for the next six years.’

You have to look at what’s available today that won’t break the bank. In some cases, it’s just a matter of redesigning your workflow, not necessarily a technology. But what we found is that to stay innovative, we’ve got to be looking outside the organization a lot of times just to see what is available.

I have a fiscal responsibility to the organization to review them, and so I went through all the contracts, starting with the largest ones. I wanted to ensure that we were getting the best value for our dollar. In a lot of cases, I was able to renegotiate several of these contracts for multi-year savings.

Gamble:  What about accountable care — are you involved in any ACOs right now or is that something that you’re looking at?

Thomas:  Yes. We are part of an ACO here in Missouri. Around the time we had joined the ACO, population health was in our strategic plan. We had started to build an enterprise data warehouse so we could better support the ACO and our strategy going forward for managing our population’s health. So that has been a great learning experience for me, obviously, but it has truly helped our patients and the overall quality of care that’s provided. It’s really been an eye-opener, so I’m pretty excited about it. We’re still in the middle of it, but we’ve come a long way.

Gamble:  How long has the enterprise data warehouse been in the works?

Thomas:  Two years now. We’ve gleaned a lot of information and data out of that system in meaningful reports. What’s exciting for me is we had a bottleneck with a report writer providing pivot tables and Excel spreadsheets, and now we’re able to push this data out in real-time to all of our customers and they can pick and choose what they want in a visualized form. We use a product called Tableau here that’s been just amazing.

Gamble:  Right. And I’m sure that’s an ongoing thing as far as being able to get that information and translate it in different ways.

Thomas:  Absolutely.

Gamble:  All right. Now, going into your background a little bit, you’ve been at Swope for about four years?

Thomas:  Yes, four and a half years.

Gamble:  What role were you originally hired for?

Thomas:  I was hired for the chief information officer role here. I was in talks with them going on five years, but that’s what I was originally hired for. Of course, my role has changed since then.

Gamble:  And there was a period where you were in an interim role? How did that work?

Thomas:  A few months into my career here at Swope, the CEO came to me and said, ‘do you mind managing our call center?’ And I said, ‘sure, whatever I can do to help the organization.’ Then subsequently, a few months later as we were restructuring our executive team, I was asked if I could be the vice president of operations on an interim basis while that restructuring was completed, so I did that for about 90 days. It was certainly something new for me. It was a challenge, and it definitely pushed me to some limits at some points, but there was great growth there. And because of that, I’m where I am today. I’m still the CIO, but I’m also the vice president of support services, managing those several other departments.

Gamble:  That seems like a pretty unique experience. It’s like a trial, in a way. How did you approach that having this type of role?

Thomas:  I think it’s attributed to really some great support from my boss and my peers, but it goes back to leadership abilities. Certainly, it was an opportunity of growth. It was a time where I could actually push myself professionally, but I took it as a learning experience, and I think it’s only made me a better leader. So yes, very unique for sure. I know CIOs do more than what they were hired to do, but this case was very unique for sure.

Gamble:  Was there anything that stood out as a real lesson learned or takeaway from that experience?

Thomas:  I think it really helped to understand the business even more. As I’ve said before — and I blog about this — if you really want to be a successful CIO, you’ve got to get in and learn your customer’s business, and this has given me that opportunity to learn so much more about the business. Just stretching yourself really gives you that growth you need from a leadership perspective.

Gamble:  Right. Now, what about the role you played in developing and implementing the strategic plan with the organization going through changes — can you talk about what that experience was like, and how you were able to work with different people to get an agreed upon plan?

Thomas:  Absolutely. About two and a half years ago, we started working on a six-year strategic plan. As you know, technology touches just about everything in a healthcare system — or any business for that matter. There were several initiatives planned for each of the six years, and many of those had required that technology provide a supporting role or some type of integration to the business. One example I’d mentioned earlier was our data mining strategy for population health.

One thing I’d like to add is that this was a unique opportunity the first time being on the executive team and participating in a strategic planning cycle. It was unique, for sure, and eye-opening. Having the background I had in project management and leadership over the years allowed me to help provide resources, timelines, and budgets, on a larger, more organizational scale.

So again, a very unique experience, but something I would hope that anyone sitting at the executive team would have the opportunity to participate in.

Gamble:  Right. When you’re looking at health care, especially healthcare IT, I can imagine it can be a bit tricky to look six years out, especially when, as you said, technology is evolving so quickly. How does that get worked into the plan as far as being able to plan for what we don’t know yet?

Thomas:  Sure. I mentioned earlier that technology touches everything, and in order to be more successful as a CIO, you need to understand the business inside and out. You can’t just rely on your CEO or your COO or your CFO to say, ‘we’re going to make these widgets for the next six years.’ The industry can change, and so what’s been really good for me is being out there and reading about newer technologies and what works — not just in health care, but across the industries.

I see it with the emergence of Blockchain, for example, and how that can be applied to health care now — those types of things. And so as our executive team looks at the plan going forward, one of the initiatives being telehealth, for example, I need to be able to be agile in providing a solution to the business. We can’t be the last ones here or we’ll be out of business. That’s just how it works in any business.

Gamble:  That’s interesting you bring up Blockchain, which is pretty cutting edge but is really finding its way into health care very slowly. For you and the organization, how do you view things like this when it comes to innovation? Everybody can’t be bleeding edge, but what is the philosophy that you use with considering newer or different technologies?

Thomas:  I look out there at what others have tried and trialed. People are going to want to go after that big, shiny object. Well, sometimes the big shiny object hasn’t been tested, or it may come with a big price. So what I’ve learned is be patient but be very agile. BYOD (bring your own device) is constantly emerging. We had some archaic signature pads for some of our social workers, for example. It was a piece of hardware that was attached to a device, but it doesn’t always work in the field. So we started looking at iPads or Surface Pros where you can just take your finger and sign your name on the pad and it’s integrated right into the EMR, versus signature pad that doesn’t work, and you have to get a paper record signed.

You have to look at what’s available today that won’t break the bank. In some cases, it’s just a matter of redesigning your workflow, not necessarily a technology. But what we found is that to stay innovative, we’ve got to be looking outside the organization a lot of times just to see what is available.

Gamble:  Right. Now, I had read that you had some experience in renegotiating vendor contracts. This is an area I find really interesting, especially because we always hear that this has to be a partnership that works for both sides, and that’s not the easiest thing to do. I wanted to get your thoughts on what strategy you use with renegotiating contracts and if you have some takeaways for others as far as how to approach it?

Thomas:  Sure, and I know a lot of times, no matter what industry you’re in, the word ‘vendor’ has a bad connotation to it, because people have been burned by bad experiences. In order to be more successful at your technology strategy, it’s important that you assess all your vendor contracts and build the right relationship with those vendors. That’ll help ensure success, either for your project or your organization.

Many times, vendor contracts are just left in place, never looked at. They auto-renew every three years, or there’s a certain fee increase that happens, whether it’s every three years or they tell you on the fly, ‘we’re going to increase your software maintenance by 6 percent this year.’ That can be challenging, so you’ve got to always stay on top of that.

What really helped me drive some of the changes with our vendors here is the simple fact that we’re not-for-profit and community health. I have a fiscal responsibility to the organization to review them, and so I went through all the contracts, starting with the largest ones. I wanted to ensure that we were getting the best value for our dollar. In a lot of cases, I was able to renegotiate several of these contracts for multi-year savings, totaling well over a million dollars to date.

It’s not all about saving money, but obviously where I work, it’s important. But it’s twofold. You want to make sure that your vendors are being honest, but also make sure that you are doing the right thing for your organization.

The thing I’d like to share, Kate, is to treat the vendors as strategic partners. If you treat them that way, they will come to the table and they’ll work with you. It’s a give and take relationship, absolutely. It’s not one-sided. But you’ve got to do the right thing. They need to step up and do the right thing, but if they can’t, then it’s time to look at a new partnership.

Gamble:  Right. And it’s important to be willing to have that conversation and at least try to see what can be done to help lower the costs.

Thomas:  Absolutely.

Chapter 3 Coming Soon…