Being an interim CIO comes with an enormous amount of pressure. You’re trying to prove your worth as a leader and develop a strong rapport with the team, often while carrying out a strategic plan that predates your tenure. In Heather Nelson’s case, it also meant competing with external candidates boasting impressive resumes.
So she did the only thing that made sense: treating the job like it was already hers. The strategy paid off, as Nelson officially took on the CIO role this past spring, and is thrilled to be leading the IT team through a period of tremendous growth.
Recently, she spoke with healthsystemCIO.com the organization’s plans to become a “digitally enabled health system,” and the many pieces that are being put into place to make that a reality. Nelson also discusses why vendor management needs to be a collaborative effort, the critical role governance plays in prioritizing projects, why it’s important to be willing to ask for help, and the evolution IT has gone through in recent years.
- Vendor relationships – “You need the business at the table with you.”
- From interim to permanent CIO – “I was going to do the job like I had it.”
- Being a “humble and vulnerable” leader
- IT’s ultimate goal
- Value of honesty, consistency & the ability to partner
- “We have to be okay with asking for help”
- Volunteer work with AHA and GoSTEM
It’s just as important for my business and clinical partners to have a relationship with these vendors so that when we’re negotiating or we’re thinking about strategies or doing roadmaps, they too have a voice, because they’re the ones that own it. It’s their tool.
For me to step in, I knew there were some big shoes to fill. But more importantly, I knew I needed to keep the team focused. I had to make my mark, because while my predecessor had been there for some time, I wasn’t him. I needed to be myself.
There’s a lot of technology out there; our role in IT is to make sure we’re enhancing the workflows that we support. Our role is to make things more efficient — not to add a burden to the care team.
The complexities and the external pressures that we’re all facing often force us to go a million miles an hour, and we can’t do it all ourselves. And so when I’m coaching my direct reports, I always tell them, ‘don’t be afraid to ask for help, and it’s okay if you don’t have the answer.’
Gamble: Let’s talk about vendor relationships. What’s your strategy when it comes to managing those relationships and making sure you’re getting what you need from the investment? I imagine it can get difficult.
Nelson: It can. Traditionally, it was IT managing vendors. But the way I see it, you need the business at the table with you managing that relationship, because I don’t use Epic every day. I don’t log in every day and take care of patients or do coding or do claims. And so it’s just as important for my business and clinical partners to have a relationship with these vendors so that when we’re negotiating or we’re thinking about strategies or doing roadmaps, they too have a voice, because they’re the ones that own it. It’s their tool. We need to make sure the vendor is delivering on their contractual obligations, and more importantly, that we’re getting benefits out of the spend. I always like to bring my partners to the table with me when we’re talking to the vendors about what’s coming up next and what should we be thinking about, because they need to be part of the discussion.
Gamble: Right. Now, in terms of your role, you’ve been CIO role since April, and prior to that you were interim CIO, correct?
Nelson: Yes. I was in the interim role for seven months, but I’ve been with University of Chicago Medicine for four years. I joined the organization in 2014 as executive director of Applications.
Gamble: I’m sure that was an interesting experience being interim CIO. How did you approach the role?
Nelson: My approach going in was to do the job like I already had it. I didn’t know how to do it any other way. It was a time of transition; my predecessor had been with the organization for 16 years and was a highly valued, trusted, and respected colleague in the organization. For me to step in, I knew there were some big shoes to fill. But more importantly, I knew I needed to keep the team focused. I had to make my mark, because while my predecessor had been there for some time, I wasn’t him. I needed to be myself, and I know he wouldn’t want it any other way.
And so I really had to think about getting the job done. We were right into our new fiscal year, so we already had our budgets done. We had our projects teed up, and we had to get the work done. So I just did the job like I had it. I knew they were going to recruit externally for candidates, and I let them know that I was very much interested in becoming a permanent CIO. I knew that I would need to be part of the recruitment process and I was fine with it.
While I was in the interim role, I reported to the president, and I still do now. I worked with her and I solicited feedback from her and from my new peers to make sure that I was meeting objectives and expectations. Fortunately, I beat out the external candidates and got the job.
Gamble: I would guess that in some ways it was an advantage having already been part of the organization, but in some ways, maybe it was a disadvantage.
Nelson: Definitely. I had previously been in an interim role, and I know that when you’re in that position, people approach you differently. It’s interesting, and honestly, it’s stressful. It was a stressful seven months, because when you really want something and you’re doing the best job you can and you’re just hoping that the right people are seeing that, it’s tough. And I didn’t want my teams to see that I was stressed out, but at the same time, being a humble and vulnerable leader sometimes is just as important. We did this together, and I’m very lucky that those individuals that were once my peers and now my direct reports, still report to me. I was able to hire a CTO during my interim period, and when I moved into the role fulltime, these folks have stayed onboard. So I feel very lucky and blessed to have the team that I do.
Gamble: I’m sure it’s validating that the team has stayed in place.
Nelson: It is. There has been some movement, as you can imagine, which happens anytime there’s a leadership change. We had some folks leave, but we’ve had a lot of new people join. So it’s been a transition, and we’re still working through it. What makes the difference is having the right people on board. And now we have the IT team at Ingalls Hospital, which is another outstanding group.
Gamble: Before coming to University of Chicago, you held a few other roles, including applications director. How have you benefited from that experience?
Nelson: Part of being an applications manager or director is to really know the business of healthcare. I think what’s been critical for me is making sure I’m able to build the relationships with the business, and really take time to understand the workflows, the business needs, and the use cases. There’s a lot of technology out there; our role in IT is to make sure we’re enhancing the workflows that we support. Our role is to make things more efficient — not to add a burden to the care team. And so understanding that, building relationships, and listening are all critical, and I’ve been able to hone those skills throughout my career. That’s a credit to the teams I’ve worked with, built, and been part of along the way; they’ve made me who I am. I’ve learned a lot, and I’m never afraid to ask questions.
Gamble: That’s important, both in building your own knowledge, and in demonstrating to others that we’re all still learning, no matter what our title might be.
Nelson: Absolutely. I learn every day. I make mistakes every day, and I learn from those mistakes.
Gamble: As a leader, what qualities or attributes do you think our most important in today’s health IT environment?
Nelson: I would say honesty, consistency, and the ability to partner are very important qualities in any leader, along with doing what you say you’re going to do, and not being afraid to ask for help. As we move up the leadership chain, whether it’s in an executive role or C-suite role, we still have to be willing to ask for help, because the healthcare environment — and specifically, the healthcare IT environment — is very complex.
When you’re an academic medical center or a large IDN, those complexities and the external pressures that we’re all facing often force us to go a million miles an hour, and we can’t do it all ourselves. And so when I’m coaching my direct reports, I always tell them, ‘don’t be afraid to ask for help, and it’s okay if you don’t have the answer.’ There are a lot of smart people on our team — how do we bring people together to find a solution or find the answer? That’s what I’ve done with my career, and that’s what I hope I’ve imparted on the teams I‘ve worked in the past, and my team now.
Gamble: Right. So, the last area I want to touch on is volunteering. In doing some research, I saw that you’re active with a few different organizations. How does that help you, as an individual and as a leader?
Nelson: It reenergizes me. When you’re in any leadership role, it’s very much a ‘go, go, go’ mentality. By volunteering with the American Heart Association here in the Chicagoland area, specifically with the GoSTEM Initiative, I’m able to work with juniors and seniors in high school who are preparing for college and thinking about what they want to study, and offer them some guidance. I’m able to mentor these young women and get them thinking a little bit differently, and it’s so rewarding. I wish I would’ve someone guiding me when I was that age.
In addition to that, being able to help be part of the clinical research that’s being done around heart disease and stroke—which is a core part of what University of Chicago Medicine does—and work with a system that believes in it and is passionate about it is truly energizing. I’m very proud to be an advocate for that.
Gamble: That’s great to hear, very inspiring. Well, that’s all I have for now. I want to thank you so much for your time, and I hope we can catch up again in the future.
Nelson: Absolutely. I appreciate your time as well.