For CIOs, especially those who are new to an organization, there’s a lot of focus on the to-do list, and understandably so. But what’s just as important, according to Craig Richardville, is the ‘not to-do’ list. What often happens, he has found, is that individuals can become stuck “spinning their wheels on certain functions or features that aren’t a priority” — and in some cases, won’t ever be.
This is where leaders need to set realistic expectations, communicate them effectively, and have a defined ‘no-bucket,’ he said. Recently, healthsystemCIO spoke with Richardville about his first six months at SCL Health, which has included a major restructuring to ensure that the right people are on the bus, and that IT priorities are aligned with the organization’s newly released strategic plan.
He also discusses his approach to change management, what he learned during a year-long CIO sabbatical about the enormous potential of innovative startups, and why it’s time to retire the ATM comparisons, once and for all.
Chapter 2
- SCL’s Mission 2025 – “All of our work needs to tie into it.”
- First 1-2 months as CIO: “You have to take a step back and just listen and learn.”
- The “no bucket”
- His goal to “create a world around digital”
- The leader’s role in “coordinating events”
- Keys to successful change management
- Breaking down silos with accountable executives
- Anticipating change 3-4 years out – “That’s part of my job.”
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Bold Statements
We work as one service unit or division. Everyone has their own tool belt and their own subject matter experts they bring to the table, but we’re looking for unification to support the single strategy.
It’s creating a world around digital or a world around data, and making sure we understand what work is being done now and where, so we can make sure there’s alignment and consistency.
Part of going through and managing these changes is in truly understanding the impact you’re going to have upon the organization, the patients, and the providers, and making sure this all done in a very thoughtful way.
When you know what your vision is and how you want to get there, you can make decisions immediately. We’ve made plenty of decisions over the past six months that support what the vision and direction is going to be — we didn’t have to wait for the whole thing to be built out. It’s our way of being agile.
Things that are here today weren’t here a year ago, and some things will happen in a year that are unexpected, and we have to be prepared to be able to take a little bit of a left or a little bit of a right.
Gamble: You mentioned that the organization’s strategic plan was announced in January. Was there an understanding from the beginning that you were going to put together the pieces you felt were necessary to carry out?
Richardville: Exactly, to carry out the corporate strategy. We needed to develop what I call a roadmap, which consists of 10 programs. Those programs support the strategic plan of the organization. And so it’s important for me and for all of our associates to understand that there is one strategy, and all of our work needs to tie into that strategy. When we do things around digital, technology, CRM, or any one of those 10 major programs, those programs are viewed more as a product. We’re moving into a product-type format, where they’re viewed as products and programs versus projects; those tie directly into Mission 2025, which is SCL Health’s brand for our strategic plan.
Gamble: Right. As far as what did to reorganize and repurpose some of those roles, you first had a discovery period where you were focused on observing everything. Then you recruited for a dedicated CTO and VPs of applications and digital services, who I imagine are going to be working together quite a bit.
Richardville: Absolutely. All of these programs have their own leads and their own governance, but they’re all tied together, and it’s the same across the organization. The way it’s designed, we work as one service unit or division. Everyone has their own tool belt and their own subject matter experts they bring to the table, but we’re looking for unification to support the single strategy that the company develops.
All of these are done in unison with each other so we can ensure that when someone new comes into the organization, they don’t come with preconceived notions of ‘this is what we’re going to be doing.’ You really have to take a step back and be quiet for the first 30 to 45 days. You have to listen and learn about what the current state is and what some of the history is. You have talk to the leadership in place about what their vision is and where they want to go in the next three to five years, and develop that gap analysis and do an assessment. Where do I need to repurpose certain roles? How can I find the right people for those roles, put programming around the initiatives, and feed into the company’s strategic plan, which is all supported obviously by the CEO, the board, all the way down to all associates, and make sure the effort and the direction we’re taking is fully in line with supporting and achieving the strategic imperatives that have been shared with us.
Gamble: It definitely makes sense to have a dedicated VP for Digital Services. Before that was in place, I imagine digital responsibilities were shared across different positions? Can you talk about why you felt like you needed one person who was sitting over that?
Richardville: That’s the key with data, and it’s the key with digital and a couple of other areas. In many cases, the chief digital officer or chief data officer is that person who helps coordinate and collaborate with the rest of the organization around those services. It’s not a direct line responsibility. In many cases, what they’re doing is taking an inventory of all our digital work that’s going on today, which is happening in multiple areas, to make sure we don’t duplicate it. We’re inventorying it to make sure that when new things happen, we’re asking first if we can leverage an existing project or program that’s already in place.
And then it’s creating new work; things that we haven’t done or want to expand or extend farther, and I think it’s just as important to understand what you’re not doing. That you’re not going to be looking at blockchain, for example, at this moment, and so you have to put it in the ‘no list.’ It really is creating a world around digital or a world around data, and making sure we understand what work is being done now and where, so we can make sure there’s alignment and consistency. It’s looking at creating the work we want to do in order to accelerate or to achieve some of the strategic priorities and expectations of the company and of our patients, then also creating a bucket of work that is on hold or in the ‘no bucket’ at the moment. That way we know we’re making an intentional decision, and people aren’t spinning their wheels on certain functions or features that just aren’t a priority at this point. They may be a priority in the near or far future, or possibly never, but we want to make sure it’s intentional. When we say no to something, we realize it’s then going into that third bucket of work. Digital is that way, data’s that way, and the IT risk is that way.
A lot of these initiatives are around coordinating events that are happening across the organization — not necessarily a direct line responsibility, as opposed to what you see with the chief technology officer or the chief applications officer, where much of their work is within their span of control. They’re expected to deliver the technology for the applications, but it’s different with digital, data, CRM, and IT risk. They’re expected to coordinate the effort, but not necessarily have that via a direct line responsibility.
There will still be a lot of work happening in innovation, in marketing, and in our medical group, acute care operations, and business services. They’re going to be coordinating that work and making sure it aligns with where we want to go to support the strategic vision of the company.
Gamble: That’s a lot for your first six months in the role. I’m sure your goal was to hit the ground running and get the pieces in place that are needed for the organization to move forward. And even if you take the time to get to know the people and get to know how things are done, I imagine there’s still an art to making changes and doing it in a way that’s respectful. I’m sure that’s not easy to do, especially when there’s a short timeline.
Richardville: It is. Part of going through and managing these changes is in truly understanding the impact you’re going to have upon the organization, the patients, and the providers, and making sure this all done in a very thoughtful way. A lot of that happens with the partnerships and relationships you have with other service departments at all the care delivery sites and locations, and making sure you’re taking a full 360-view of these types of decisions, and the direction you’re taking.
For example, as you start moving through the process of defining what the right C-suite will look like — and you need to retain or recruit the right people in those seats in order to provide the level of service and success that’s expected — a tight partnership with human resources is certainly important to make sure things are done in a thoughtful manner as you start making a lot of these changes.
On the process side, it’s certainly about developing relationships. One of our next initiatives is to develop what I call ‘accountable executives.’ Every executive within the organization will have an IT counterpart who serves as the account manager for them in their area of their services. Part of their responsibility, as this continues to grow, is to encourage people to look more broadly outside of silos or even break down silos across the organization. When they meet with their counterparts, they’ll bring everything that we’re doing to them. For example, we might say, ‘Here are the major initiatives happening within ITDS. Here are the initiatives that are generated by you, here are some of the initiatives happening that might affect you, and here are some of the things we decided not to do at this time.’
They get a full representation of all the services. So if we’re talking to somebody in one of the clinical service lines or somebody in one of the systems support or corporate areas, they’re getting a 360-view of all of our work, and then there’s obviously more of a drill-down into the work that either they’re leading or that’s impacting them but that they’re impacting others. There’s also the intent to make sure they understand what’s happening in other areas of the organization so that they’re aware of all the activity. It can even spur the additional conversation of, ‘maybe that’s something that I want to learn more about or be part of.’ Or, ‘now I understand why there’s attention being given to some area outside of mine,’ because that’s something the company has prioritized.
That’s the next level of maturity; that by the end of the year, we have all these programs built out, shared, and approved by the appropriate members of the senior team — including the CEO and the board — and really be able to start putting forth the progress of working the plan. We’re working over a multiyear investment strategy that has very defined measurements of success so that as we continue to mature and learn, we’ll figure out what we’ve done well and where we can do better.
Gamble: Right. It seems like the key focus for you has been getting the pieces into place to be able to move forward with core objectives and make sure the infrastructure and support are there.
Richardville: That’s exactly right. In the meantime, when you do know what your vision is and how you want to get there, you can make some decisions immediately. We’ve made plenty of decisions over the past six months that still support what the vision and direction is going to be — we didn’t have to wait for the whole thing to be built out. It’s our way of being agile with the work we’re doing and how we want to deliver services out to the organization.
And so, as things do come up, we’ll go ahead and be very flexible and intentional, while still maintaining those guard rails of ensuring we’re progressing forward with any of these decisions or any of these investments toward the larger picture. We’re not waiting for the whole design to be completed, but we’re actually starting to achieve successes as we speak in order to be prepared for some of these larger investments and larger programs as they start to appear over the next several months.
Gamble: I imagine it’s all a work in progress.
Richardville: That’s exactly right. Over the last couple of decades, people have learned that’s where having automation and being in a digital world makes it a lot easier. Things are very dynamic. Things can change very quickly; things arise that are unplanned. And so that ability to be able to maneuver as appropriate and still move the organization and support its work or the achievement of its strategies and initiatives, is important. Because things that are here today weren’t here a year ago, and some things will happen in a year that are unexpected, and we have to be prepared to be able to take a little bit of a left or a little bit of a right. In majority of the cases, it’s not a really sharp turn or a complete stop, because you’ve thought about what the future is going to look like. That’s part of my job; to make sure we’re ahead of the actual execution by two or three years, and we can be prepared for when those things start to come up.
For example, knowing that voice technologies will continue to grow, we’re building platforms to prepare to embrace it. If you look at things like contact centers, you need to think about how you want to relate back to your providers, employers, or patients, as we move more and more toward a consumer digital world. Amazon, one of the largest retailers, doesn’t have a contact or call center. It’s all done through a very intuitive method. It’s all done through AI. It all done through a self-service model, and yet consumers achieve high levels of satisfaction and efficiency. We prefer to do it on our time and our schedule. And so we continue to mature, we need to prepare ourselves for a world or a community that expects us to be able to provide service in an efficient, quick, easy way, and enable patients and consumers to be able to access those services, versus having them come to us.
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