When most people are asked to name to top traits of a leader, the same responses often come to mind — adaptability, vision, and communication skills, to name a few. But one that is often overlooked, especially in health IT, is the ability to “make sound decisions based on the needs of users and patients,” says Mike Mistretta.
In this interview, he talks about why listening and knowing your team is so critical for leaders. He also discusses his team’s strategy in rolling out Epic, why he didn’t hesitate to join an organization that was headed for a transformation, how Virginia Hospital Center has worked to develop (and retain) in-house expertise, and the surprising factor that’s become a recruiting tool for the organization.
- Facilitating teamwork with ‘huddle rooms’
- “Overlooked” leadership qualities
- Focusing on growing from within, not recruiting – “Most of our directors are homegrown.”
- Leading through change: “This is the type of work I like to do.”
- Key attributes of successful CIOs
- The “underground network” of Epic users
- Social media as a recruiting tool
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The key is in setting clear objectives, giving them the tools and the resources they need, and creating an environment where they want to work and are able to be successful. It goes a long way.
From a leadership perspective, we’ve done more internal building from within than outside recruiting. We did bring in a few managers, but most of the directors we’ve had here are homegrown.
It’s important to at least have an idea in the back of your mind what direction you might go, and get a feel for who the key decision holders are so that you can build the appropriate relationship when the time comes.
Any CIO in any organization is required to be collaborative in nature. That’s where you need to focus to be successful in the long term. If you can build the relationships.
Gamble: You talked before about being a community hospital. I imagine there’s a lot of emphasis on that community perspective, especially when you’re surrounded by some of the larger systems. Is that something that’s a big part of the organization’s philosophy?
Mistretta: It is. We actually have a Patient Experience Director that a lot of things go through. When they’re there, we do patient groups for various topics, whatever it happens to be at the time. So we focus quite a bit on that. Every week when we have our CEO staff meeting, we review our HCAHPS scores by nursing unit to see where we might need to do something different in a particular area. We take that patient piece very seriously.
Gamble: Right. Now, with the Epic go-live happening, I’m sure a lot of the focus has had to be on that. Once things are somewhat stabilized, are there other priorities that need to move up the list?
Mistretta: It’s interesting. We’re working on a deal with Spok to upgrade our communication systems and integrate back to the Epic module now so that we can get some clinical workflows for STEMIs and things like that running through there. It also gives us an app to be able to do some secure communications internally.
We’re looking at integrating nurse scheduling and incorporating acuity, which we can pull out of Epic, and upgrading that with the Kronos modules. So yes, there’s a whole suite of projects on the docket now we’ll start on once we get stabilized.
Gamble: And you said population health is not a priority right now, but is that something you’re looking at down the road?
Mistretta: It is. We’re not part of an ACO or anything like that, but we do have some risk sharing contracts with CareFirst, our big carrier here. So we’re going to be looking at some of that from a quality perspective. I believe we get more from that regard than we do a true ‘population health’ initiative as most people would define it, but Epic’s Healthy Planet has a campaigns module which we’re looking to implement here probably in the next six months. That way, we’ll be able to start doing things for routine screenings and things of that nature, which dovetail into those types of initiatives.
Gamble: In terms of the IT staff, approximately how many people do you have?
Mistretta: Post-implementation, we have just over 100 on our staff.
Gamble: And when you go through a go-live, there really needs to be a strong level of teamwork. What do you believe are the keys to building a team that works well together?
Mistretta: One of the things we did is we made sure that we co-located as many as we could in the same vicinity prior to the implementation. We were kind of spread out across different facilities in different areas. Now we really only have two sites: the technology group, which is around the data center, and our main site, which is a couple miles down the road. We leased it for the project, but it’s more of a long-term lease so we can keep people there afterwards. I think co-locating them where they have an environment that’s conducive to sharing has been critical.
In that facility, we made sure to have a lot of ‘huddle rooms’ where small groups could meet. We outfitted everyone with laptops to upgrade their ability to work, and we put large screen TVs in each of the conference rooms and huddle rooms. There are three or four large training rooms that are fully electronically equipped.
I think the key is in setting clear objectives, giving them the tools and the resources they need, and creating an environment where they want to work and are able to be successful. It goes a long way. One thing that’s been remarkable is we actually raised our employee engagement and satisfaction scores and won an award during in the middle of a major implementation. That’s pretty remarkable.
Gamble: It is. So, when you think about people who have the potential to be a leader, what are the qualities you find to be most valuable?
Mistretta: The main thing is kind of an intangible, which is, do they listen to the problems that need to be solved, and do they exercise sound judgment? There’s definitely a level you need to have from an industry knowledge perspective; being able to take those and make sound decisions that meet the needs of our users and patients, that’s something I believe is overlooked many times.
Gamble: Has it been a challenge to recruit or are you able to take advantage of being in the D.C. area?
Mistretta: From a leadership perspective, we’ve done more internal building from within than outside recruiting. We did bring in a few managers, but most of the directors we’ve had here are homegrown. We have a pretty good two-phase leadership development program in the organization, and it’s been pretty successful for us.
Gamble: In terms of your role, you’ve been at Virginia Hospital Center for about three years?
Mistretta: Yes, just under three.
Gamble: I imagine that when you were interested in the role, there was some awareness that there was going to be a transformation. Was that something you knew going in?
Mistretta: It wasn’t explicitly stated, but I had a pretty good idea, knowing that they were running Soarian and the contract was coming up for renewal in the next five years. I knew it wasn’t going to be a tenable position over the long term, so it was a matter of when we decided to make the transition. It was a little bit sooner than I would have anticipated, but I knew there was a pretty good chance of that happening.
Gamble: And it wasn’t something that scared you away?
Mistretta: Actually, this is the type of work that I like to do. Maybe I’m a little bit of a masochist, but it’s the type of implementation work that I’ve done through my career that I’m pretty good at, I think — that’s what I enjoy doing.
Gamble: That’s definitely important. Even if it wasn’t expressly stated that there was going to be a transformation, you could sense it, so I’m sure it’s important to have the right mindset going in.
Mistretta: Absolutely. It’s important to at least have an idea in the back of your mind what direction you might go, and get a feel for who the key decision holders are so that you can build the appropriate relationship when the time comes. It’s definitely part of what you need to do to make it work.
Gamble: This, of course, is not your first CIO role, but every organization is different and I’m sure that there were some lessons learned from past roles that you’ve been able to bring to this experience.
Mistretta: Absolutely. I think any CIO in any organization is required to be collaborative in nature. That’s where you need to focus to be successful in the long term. If you can build the relationships that you need within your peer group, you can work through almost anything that comes up.
Gamble: And what about the experience you had on the vendor side? I imagine that’s a useful thing to have in your back pocket.
Mistretta: It is to some degree, but I will tell you, this is the first Epic account I’ve had to work with; I had no prior experience with Epic, and so it’s a whole new set of vendors and a whole new set of relationships to be built. There was some overlap and some people who I’ve worked with in the past in at different stops, but that was the minority. The ability to work with vendors, build relationships with them, and hold them accountable for the delivery of things — that doesn’t change regardless of who the vendors are. Having that type of experience under your belt certainly is helpful.
Gamble: Did you find yourself reaching out to colleagues? How did you approach working with Epic for the first time? From everything I’ve heard very different from working with other vendors.
Mistretta: It’s extremely different. A lot of peer interaction is about references. The thing about Epic is pinning them down. A lot of the conversation is asking them who has done what you’re trying to do and then building relationships so you can use them multiple times down the road. There’s a pretty good underground network with Epic customers out there for sure.
Gamble: I’m sure that was an education. The last thing I wanted to talk about was the updates you were posting on LinkedIn leading up to the Epic go-live. From my perspective, it was so interesting to be able to follow along. Why did you choose to do that? We don’t often see that level of transparency in these situations.
Mistretta: It’s interesting, when we talk about recruitment and trying to attract people and build a team, one thing we’re really learning in this market — and it’s something I’ve had to adjust to, to be honest — is the level of social media presence. It’s off the charts compared with some organizations. The ability to be able to post things and have people see the successes and challenges we’re having, and to be able to provide recognition, it becomes an incredible recruitment tool when you’re working in a competitive environment. That’s one of the big drivers for it, but it’s also fun, to be honest, when you put stuff out there.
Gamble: Sure. And from the staff point of view, I’m sure seeing that recognition is good for morale.
Mistretta: It is. A lot of the feedback from staff on those things, especially when you can be inclusive of them and recognize their achievements as a part of it, has been really positive. It goes a long way in building the employee engagement we need to get where we want to go.
Gamble: Yeah, Well, I think that wraps things up. Thank you so much for taking the time to speak with us. We really appreciate it!
Mistretta: My pleasure, Kate. Anytime.