One of the most common pieces of advice offered by those in leadership positions is to take risks. Get out of your comfort zone. It’s solid guidance, and for the most part, isn’t difficult to follow — unless, of course, you’ve been on the losing end of a big gamble. In 2015, Aaron Miri accepted a leadership role with an organization that aimed to make patient care a luxury experience. But after just a few years, Walnut Hill Medical Center closed its doors due to financial troubles. For most, the experience would be enough to scare them away from risky moves.
Fortunately, Aaron Miri isn’t most people. Last summer, he assumed the CIO role at Dell Medical School at UT Health Austin, a cutting-edge organization that places a high value on value-based care, innovation, and using social determinants to improve care. For Miri, the opportunity to return to his home state of Texas and work alongside some of the brightest people in the industry was too good to pass up.
In this interview, he talks about why he was willing to take another leap of faith, why he’s a strong believer in ‘open-door leadership,’ and the importance of building a solid professional network.
Chapter 3
- Reflecting on Walnut Hill’s closing – “There are positive lessons in everything I’ve done.”
- Stepping out of the comfort zone
- “Elasticity is the key to success.”
- Value of a solid network
- “You have to go through trials and tribulations.”
- Comparing leadership to parenthood
- Advocacy – “It’s something you have to make time for.”
- Learning from Pamela McNutt
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Bold Statements
I understand what it takes to build something from scratch. I understand the ‘roll up your sleeves and get it done’ mentality where you’re not just a CIO who speaks from a stage and is able to articulate something; you’re a CIO who can actually develop a working product.
I’m going to learn and I’m going to lean on my network, and lean on my peers, and lean on folks I can trust to fill in the gaps and teach me what I don’t know. And it’s okay to not know everything. If you can do that, you can be successful with anything. That elasticity is the key to success.
A lot of these world-class institutions are just beginning to dip their toe in the water. We’re all in on it — the good, bad, and ugly — and we’re sharing that at a federal level with great partners that are willing to learn, listen, take notes, help maybe articulate policy that helps deal with the deficiency. That’s been priceless.
If you don’t help at the rule-making, law-making, policy-making level, you’re leaving a key thing out of the entire mix, which is teaching the next generation how to get things to goal.
Gamble: You’ve had experience being with new organizations, and I imagine there’s always lessons learned — for example, with Walnut Hill Medical Center. What were able to take from that experience?
Miri: Absolutely. Starting a brand-new hospital in Dallas from scratch with phenomenal world-class physicians was a dream shop, but it wasn’t tethered to an academic R1 university, and it didn’t have that infrastructure behind it to help propel it. But the Walnut Hill healthcare team was amazing — they now operate at a couple of major facilities in Dallas. They’re doing well. That team was going to be successful no matter what it did. And I’m proud of them. I’m proud to know them.
But yes, that experience has absolutely played a role here, because I understand what it takes to build something from scratch. I understand the ‘roll up your sleeves and get it done’ mentality where you’re not just a CIO who speaks from a stage and is able to articulate something; you’re a CIO who can actually develop a working product.
Throughout my entire career, from pediatrics, to adult care, to building products and partnering with an outstanding global team at Imprivata, I’ve found that there are positive lessons in everything I’ve done. It’s funny; when you look at your career linearly, you might say, ‘I never would have expected this.’ It’s amazing in retrospect what you actually learn at each experience that you’re now bringing forward to your next role. When you look back, you can see how much you actually did learn and grow from your prior lives, and how it all comes together in various roles to say, ‘All of that plays together to help me here.’
And so in my case, I believe everything I’ve done, from Walnut Hill to all of the opportunities and all the mentorship I’ve done as a world-class CIO, has built me up for this. Now, I’m able to bring it all together to help a top-tier university put something together with a flagship university for the entire system.
Gamble: Right. Sometimes it’s those experiences where you did something out of your wheelhouse where you end up learning so much. It’s really interesting how that works out.
Miri: It is. The other dynamic as a CIO, or any leader or health IT individual, is you have to be willing to step out of your comfort zone, and you have to be willing to take on projects and things that seem risky. And that’s a tough proposition. There’s a certain security and safety in doing things that are known; that are comfortable and feel good. That’s a beautiful thing and I give a lot of credit to it, but it’s important to have the ability to stretch yourself and see beyond the horizon and say, I can tackle that. And if I can’t, we’ll deal with it then, but I’m going to learn and I’m going to lean on my network, and lean on my peers, and lean on folks I can trust to fill in the gaps and teach me what I don’t know. And it’s okay to not know everything. If you can do that, you can be successful with anything. That elasticity is the key to success.
Gamble: I agree that it’s important to be willing to take risks in your career. There are always lessons to be learned, and it seems that organizations find that to be a valuable quality.
Miri: Absolutely. There’s an adage that my father used to tell me all the time — I guess that’s why I became an engineer, and eventually a CIO. He’d say, ‘Son, no pain, no gain.’ And to a degree, you have to be willing to learn and go through the trials and tribulations so you can come out on the other side. And so I make it a point to keep in touch with my prior mentors. When I see them at events like CHIME or HIMSS, I can’t even begin to express to you how proud and how happy they are for me, and how grateful I am to them.
We were talking earlier about our young children. At some point, your children get to a phase in life where they maybe don’t appreciate you as much, and then they come back around, and they’re like, ‘You’re the wisest person in the world.’ It’s almost like that as you go through your career. You look at your mentors, and think, ‘Maybe I didn’t appreciate that little nugget of information at the time as much as I should’ve but, boy do I appreciate it now looking back at it many years later.’ It’s the same concept.
Gamble: It makes so much sense. I had a stint where I worked for a pharmacy publication — it wasn’t something I had intended to do in my career, but I learned so much from it and have this whole different perspective about healthcare. It’s funny how that happens sometimes.
Miri: It is, and I credit to you for being willing to do that. As I said, sometimes it’s a very risky proposition, but I think that elasticity is what’s going to drive things forward. I would also say making sure you keep good communication with those from your prior lives, whether it’s people you worked with or who worked for you, having that network to reach back to, ask questions, and learn from — because they’re growing and they’re evolving even if you’re not there — that’s important. That’s the reason why I haven’t changed my cellphone number in 20 years; I keep in contact with people, because it’s important. It’s important to make a difference in their lives and keep in touch with them, even when you move on.
Gamble: That’s true. It’s natural when you land your dream job to think, ‘I don’t need to keep in touch with people.’ But nothing is a sure thing. And not just that, but you continue to learn from people.
Miri: I think the best room to be in is one where you’re not the smartest person, and the same goes for your job. I love learning from folks, being humbled, listening, and realizing that the people around you are triple PhDs and MDs, and just being amazed and in awe at some of the things they’re able to pull off that you can learn from them.
I think one of the key traits of a good CIO is knowing that and being okay with it. I don’t want to be the smartest person in the room. I want to be learning from you and enabling you. I want to understand your business. I am not a neurologist. I am not a brain surgeon. I’m not a cardiologist. I don’t open up pediatric hearts and make these children become vivacious, growing young adults. I’m not an MD. I want to understand that discipline and I want to help that cardiologist or neurologist provide better care, quality care, exceptional care, world-class care, leveraging technology. That means I’m going to partner with them side-by-side and basically become a pretend MD and understand their business, because that’s where I’m able to leverage and interject technology that’s effective in their workflow.
Gamble: Well said. It’s really interesting hearing about the unique things you’re doing at Dell Medical School. I’ll be really fascinated to see if it’s something that becomes a care model as far as what you talked about with the waiting rooms. I think it’s going to be a really interesting few years.
Miri: It is. The other dimension this has really helped is I was congressionally appointed to the HITAC Committee that was established as part of the 21st Century Cures Act. As part of HITAC, I’m able to really lend a lot of the experience we’re learning here, boots on the ground, at the federal level. And so as we look at things like information blocking, value-based care, and all the dimensions that are 21st Century Cures, which was a fantastic bill that was signed into law, we’re leveraging the experience of what’s being learned at UT and giving it back at a national level. And that’s been priceless, because a lot of these world-class institutions are just beginning to dip their toe in the water. We’re all in on it — the good, bad, and ugly — and we’re sharing that at a federal level with great partners that are willing to learn, listen, take notes, help maybe articulate policy that helps deal with the deficiency. That’s been priceless.
Gamble: I’m glad you mentioned that. I know that you’ve done a lot of policy work, and I did want to check in about that. It’s so important to get the CIO’s perspective when policy decisions are being made.
Miri: I would agree with that, and I know we’ve talked about it many times before, but advocating — whether that means getting with your state or federal government, teaching, learning, or partnering with HIMSS and CHIME and their federal and congressional advisory committees — that has got to be a discipline and something you make the time for. If you’re not doing it, you’re not helping to leave the world a better place. I have two young daughters, and at the end of the day, and it’s incumbent on me to make healthcare better for them as they become adults. That’s why I do this. If you don’t help with rule-making, law-making, policy-making level, you’re leaving a key thing out of the entire mix, which is teaching the next generation how to get things to goal.
Gamble: It’s so important. Are you planning to attend the CHIME Advocacy Summit in June?
Miri: I do plan on being there, absolutely. I’m helping them on a number of dimensions, one of which, as I mentioned, is by serving on HITAC. There’s only a handful of CIOs on that committee, and so I try to give back as much as I can to CHIME and HIMSS. My hat’s off to both of those organizations to learn from those of us in the field what’s going on and how we can give back.
Gamble: That’s great. I was at the inaugural summit last fall, and it was so refreshing to see two days all focused solely on policy. It can’t just be part of a larger meeting — these issues are too important. I’ll look forward to seeing you there.
Miri: I look forward to seeing you there too. Hopefully as all of us go forward in our careers and the next generation of CIOs comes up, they listen, they learn, and they grow in their careers to do the same thing. The reason I got into policy making and engaging in federal government was one of my early mentors — a world-renowned CIO who’s been at her organization for a long time. She would let me listen in when she was speaking to HHS about Meaningful Use and educating them about what they should consider. I remember thinking, ‘One day when I’m a CIO, I want to do what she’s doing.’ And sure enough, I am.
Gamble: And who was that?
Miri: Pam McNutt, the longtime CIO at Methodist Health. She is one of the people who wrote the book on advocacy. I’m in awe. One of her many wonderful dimensions is working with the federal and state government, and education.
Gamble: Right. Well, I could talk to you longer, but I should probably let you go. Thank you so much. This has really been great, and I know that our readers and listeners will enjoy hearing about the work you guys are doing.
Miri: I appreciate that. Anybody with any questions, please give me a call or shoot me a note — I’m always happy to help answer.
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