Pamela McNutt, SVP & CIO, Methodist Health System
For many CIOs, there are about a million reasons not to get involved in advocacy. The most commonly cited, of course, is time. But to Pamela McNutt, who was instrumental in developing CHIME’s policy committee and has long been a champion for health IT legislation, those reasons are far outweighed by the positives. Not only does it help leaders stay educated on key issues, but by sharing “boots-on-the-ground experiences” with political leaders, CIOs are forging a better path for the entire industry.
Recently, healthsystemCIO spoke with McNutt about the enormous transformation healthcare has undergone in the past three decades – the vast majority of which she has spent with the same organization – and how she has evolved her leadership strategy. She also discusses the critical lessons she has learned about vendor management, the keys to working for a new CEO, and what excites and scares her most about the future.
Chapter 3
- 28 years of CIO experience
- Working with a new CEO – “Listen, explore, and get to know their priorities.”
- The power of “trusting relationships”
- Navigating “turf wars”
- Methodist’s core mission & values
- Overcoming rough first impressions – “You realize you have more allies than adversaries.”
- Hope for the future of health IT
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Bold Statements
You need to ask, ‘What does this person expect of me?’ The previous CEO may not have wanted a formal IT strategic plan, but maybe this CEO does. You need to listen, explore, and learn what the expectations are.
With the evolution of all these new disciplines involving IT, whether it’s telemedicine, digital patient health, informatics, or reporting, it’s ripe for a lot of turf battles. As a leader, you have to be able to navigate that.
That’s probably what excites me the most — the hope that patients will want to take control of their data and to use it to better their health. I fundamentally believe the data does belong to the patient, and I think it’s exciting that we keep moving down that path.
It’s natural to see shifts in the balance of power in Washington. When that occurs, there’s often dramatic change, and you have to gear up and perhaps change some of your strategies or priorities.
Gamble: When did you assume the CIO role?
McNutt: Before I came to Methodist, I was at Hermann before it was Memorial Hermann and was still a standalone. At the time they didn’t have a formal CIO role; I was director of IT, which was considered the CIO, for two years. And so I’ve been in a CIO role for 28 years.
Gamble: During that time, I’m sure you’ve seen a lot of changes to the C-suite. What do you think are the keys to navigating difficult situations, like when there’s a new CEO?
McNutt: The way it works is, you have to act like you’re in a new job when you get a new CEO, or even if you’re shuffled within the organization from one boss to another. When you’ve been with an organization for 26 years, you already know the people, but when you get a new CEO, you have to act like you’re in a new place. Just like the CEO coming in, you have to seek first to understand and listen. You have to get into that mode and really listen to the CEO and get to know their priorities. Hopefully they’re also meeting with you and trying to understand your challenges and your experiences. So you really have to think of it as a new position.
You need to ask, ‘What does this person expect of me?’ The previous CEO may not have wanted a formal IT strategic plan, but maybe this CEO does. You need to listen, explore, and learn what the expectations are.
Gamble: I like the idea of approaching it like a new job, because in many ways it is.
McNutt: And it can be hard. You have to be very stoic because some of your peers who you’ve worked with and really admire might not make the transition, and you have to be able to move through that.
Gamble: Along those lines, what advice would you offer for those who are going into a new organization on how to handle what is certainly a tricky situation?
McNutt: Number one is you have to establish trusting relationships. I’ve seen it cost people their jobs, or at least prevent them from being successful, when they’re not able to survey the landscape and decide who’s really important. Of course, you need to develop trusted relationships with everyone, but some in this role are more important than others.
You have to work very effectively in this new world where there are chief digital officers, CMIOs, and informatics departments taking on more and more responsibility with the EHR. You have to have excellent relationships with those folks. You have to work very hard not to have adversarial relationships, because with the evolution of all these new disciplines involving IT, whether it’s telemedicine, digital patient health, informatics, or reporting, it’s ripe for a lot of turf battles. As a leader, you have to be able to navigate that, but sometimes those situations can be very difficult to navigate for various reasons.
The thing that has kept me — and so many other people — at Methodist is the core mission and values. As long as you’re able to drop down to that level and decide what’s right for the organization, you can navigate through those turf battles and other challenges that come up. It’s all about being able to fall back on the mission. Where things sometimes go off track — whether it’s dealing with new leadership coming in or if you are the new leadership — is everybody not being on the same page with those core values. That’s where you’re going to come across an insurmountable conflict.
Gamble: True. So it’s really important to get off on the right foot where that’s concerned.
McNutt: And if you don’t, you need to quickly apologize for the misunderstanding and find that common ground.
Gamble: It really is true what people say about first impressions; it’s hard to change a negative impression.
McNutt: It is, but even that is surmountable. Most of us have stories where the first six months or year working with someone was rocky, but then something happens, maybe a project or some sort of crisis that occurs in the organization, and you realize you’re more allies than adversaries. I’ve seen it happen time and time again. Even first impressions can be overcome.
Gamble: Right. That last area I wanted to touch on is the future of healthcare IT. When you look at where the industry is going, what gives you the most hope?
McNutt: I’ve always been an advocate for patient control of their data. That’s probably what excites me the most — the hope that patients will want to take control of their data and to use it to better their health. I fundamentally believe the data does belong to the patient, and I think it’s exciting that we keep moving down that path. I also think the digital transformation, in all aspects, is going to help streamline healthcare and improve patient outcomes. Those are probably the two things I’m most excited about for the future.
Gamble: It’s exciting to think about how far things have come, especially in the past few years.
McNutt: What scares me — and not just me, but other CIOs — and exhausts everyone in healthcare administration, whether it’s IT, or some aspect of revenue cycle, or how to operate a hospital or physician group, is fear. Fear of whiplash in the overall regulations — not just IT, but overall, and the constant back and forth: are we going in the direction of value-based care? Are we doing bundled payments? And what will happen in a few years if there’s a shift, which there always is? It’s natural to see shifts in the balance of power in Washington. When that occurs, there’s often dramatic change, and you have to gear up and perhaps change some of your strategies or priorities. So there’s fear about the continuing seesawing back and forth with regulations.
We hear people touting the benefits of Medicare for all — that would have huge impact on everything that we do. And there’s the push toward more managed Medicare and Medicaid, and what that means to us. We’re marching down these paths and it gets scary; first we’re going left, now we’re going right. It’s hard to manage.
All of have to have a foot in each canoe. You have to be prepared in case it goes in one direction, and you have to be prepared in case it goes another way. Every three or four years, we get some major changes that could change our course. What would be better are subtle changes; working our way into these things instead of the some knee-jerk reactions we sometimes see in Washington where we’re going completely this way or that way instead of figuring out a nice clear sequential path to the future.
Gamble: It sounds logical to me.
McNutt: It would be too logical, right?
Gamble: Exactly. Well, that should wrap this up. Thank you so much for your today, I really appreciate it.
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