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 3
- His year-long CIO sabbatical
- The “bridge strategy” offered by small organizations
- 80/20 rule
- “If you can delegate responsibilities, it’ll free up time to focus on other areas.”
- Healthcare’s digital journey
- Changing consumer expectations – “They don’t have the same guard rail.”
- The flawed ATM comparison
- “It’s the most exciting time for many of us who have been industry.”
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Bold Statements
I believe a lot of change is going to come from smaller, innovative, entrepreneurial types of organizations that have very low investments of either time or money, but offer huge returns.
It’s important to make sure you can understand where you want to go with that original platform, versus finding what we’ve defined as a bridge strategy. Your primary vendor may not be able to have that module completed or work its way toward it until two or three years from now, so we’ll partner with somebody who can fill that gap.
If you do it right and partner and create a network both in and outside of healthcare, it will allow you to grasp a lot of those little pieces, those nuggets, and bring that back to your organization to truly make a difference.
The CIO role really isn’t as centric to the vertical industry as it is to moving things toward the new technology era and the digital era, regardless of the industry that you’re serving.
How they’re going to want to create that over the next decade or two and how the next generation will be served by the healthcare industry is going to be so dramatically different, because they have different expectations. They don’t have the same guard rail that we’ve had.
Gamble: What was it about SCL that appealed to you?
Richardville: That’s an easy question. When I came and talked to the senior team, it was a very dynamic, purposeful, caring, thoughtful environment, with thought leaders in their own areas as well as a larger visionary of where we want to go. So it was the people that drew me here — the CEO, down to the rest of the C-suite and other members I had spoken to — and their vision of how they see the industry maturing into a digital industry that delivers healthcare. It was also the compassion and the mission of this organization and the values it believes in; it’s all about the people and the vision.
I was fortunate enough to be able to get access to their strategic plan of where they’re going over the next five to six years, and that aligned very quickly with where I thought the industry was going. It aligns with what I thought were the services we could partner with and how we could support the team in order to achieve those success — all of that fell into line. It was a very open, collaborative team approach. That, as well as the value system of the team leaders, is what sold me into coming to SCL Health.
Gamble: Before this, you were away from the CIO role for about a year. Can you talk about how that time changed your thinking, and how you’re applying that in your current role?
Richardville: Sure. During that year, I spent a lot of time talking and learning with several smaller organizations that provided products and services. I went to about 60 companies and spent a lot of time with their CEOs, their board members, and other investors to learn how they were approaching different markets and how they were moving forward with their product or service. Some of them were healthcare-specific, but many were just technology companies. Having served as a CIO for many years, and being fortunate enough to have great teams that have gotten lot of accolades and awards and have achieved a lot of success, I believe a lot of change is going to come from smaller, innovative, entrepreneurial types of organizations that have very low investments of either time, money or capital, but offer huge returns back to the organization.
I became very enlightened about this new workforce coming in, having three sons in their 20s, as well as the new ways of how we’re going to achieve success. It isn’t always going to be the large companies that differentiate themselves. It’s not going to be Epic or Cerner, per se. It’s not going to be the ServiceNow. It’s not going to be your major ERP vendors. It’s going to be those things around it and how we take advantage of the investments made in those platforms. It’s playing with a bunch of little niche applications or vendors that can add a lot of value back to an organization that may be undeveloped or underdeveloped with these larger platforms.
And so I think it’s important to have that base. But it’s also important to make sure you can understand where you want to go with that original platform, versus finding what we’ve defined as kind of a bridge strategy. Your primary vendor may not be able to have that module completed or work its way toward it until two or three years from now, so we’ll partner with somebody who can fill that gap and provide a return on that investment, then allow us to transition to the larger platform in the future. Or in some cases, they may ride it out for a bit longer, not necessarily as a bridge, but part of the solution that connects everything together.
But we still are very much mitigating and minimizing the number of partners that we have. We’re standardizing across all of our care site locations, or all of our clinics, or all of our system services areas so that we have a single solution that everybody is partnering with and is utilizing as part of their processes.
Gamble: So you were able gain a new whole perspective during this time, and see things you may not have seen if you had stayed in the CIO role.
Richardville: That’s right. It’s almost like a little sabbatical, because when you’re a CIO with a major system, a lot of your time is spent trying to tie into the large vendors, because that’s where you’re spending a lot of your money. It’s a lot of investment. You want to try and get the most out of it. It’s the 80-20 rule where 80 percent of your time is with the big vendor, but I think you’ll find that if you can open your eyes and allow other people to manage parts of those relationships, that’ll free up your time to focus on some of these other successes. They may, at some point, be a really big success; however, at least for the moment, for a small investment of your time and of your capital, you can get a larger return with some of these smaller partners. I think that opened my eyes to the face there’s a lot of neat, innovative work happening in Silicon Valley, Silicon Alley, and everywhere in between, and you’ve got to keep yourself open to that.
Gamble: When you look at healthcare’s transition to a digital industry, what are some things that need to happen to help guide that transition?
Richardville: One of the things I did back in Charlotte — and hopefully I’ll have the opportunity to do here in the Denver area, because they’re more ripe for the large urban markets — is to look outside of healthcare and into other industries, and capture the things that are successful and apply those to healthcare. People have the tendency to say healthcare might be a little bit behind. And yes, you can recruit outside of healthcare to bring in people with other ideas and fresh thoughts. But if you do it right and partner and create a network both in and outside of healthcare, it will allow you to grasp a lot of those little pieces, those nuggets, and bring that back to your organization to truly make a difference. I think the more we can continue to leverage each other across multiple industries, and through it, transition ourselves to be consumer-based, the more it will allow us to move toward a digital industry.
What I mean by that is, some people are proud to say, ‘I haven’t been into a bank in the last three or five years. I haven’t walked into a mall or a store in the last X amount of years.’ They’re still gaining all those services; they’re just doing it in a digital arena, in a whole different environment. As people continue to utilize those, that’s the expectation we’re creating, and the expectation we have an obligation to deliver within healthcare.
That’s why when you look at typical healthcare hours a decade ago, it was 8 am to 5 pm, or 7 am to 4 pm, because that was convenient for the healthcare system and for the provider network. For me personally, I need healthcare 24/7 and the time that I have access is typically outside of the normal day because I’m working as well, so I can’t see my provider very easily between 8 and 5. I have to see them during off hours or on the weekends, because that’s when I’m available.
That’s where you start to see a lot of extended hours, the rise of urgent care centers, and the rise of EDs being used for primary care services, but you also start seeing a rise of telehealth and doing virtual video visits or e-visits, with patients doing a little more self-diagnosis. You start seeing a lot of that rise as well, because that I can do 24/7. If a provider allows that kind of access, it allows us to be able to meet those demands of the consumer versus the patient. That will allow us to continue to migrate toward, and hopefully in many cases, accelerate that movement.
At some point, somebody who’s healthy and well may be like that person today who hasn’t been to bank or seen their financial advisor for several years, and go several years without seeing a healthcare provider. They might say, ‘I’m healthy, I’m well, I’m being taken care of, I’m being monitored, I’m being managed. I don’t have that physical presence because it’s all happening around me in the whole digital space.’ I think we will continue to evolve and accelerate that.
In many cases, I would argue that we’ve surpassed a lot of the complexity that happens in other industries. For example, people like to compare financial services and healthcare and say, ‘I can go to any ATM in the world and get cash.’ The reality is you don’t have access to all your financial services. You have access to your savings and your checking, and maybe a credit card, but if you’re talking about all your investments and stocks, you can’t go to kiosks and bring that up, nor can you easily put all of that into one portfolio.
Yet there’s an expectation in healthcare, which has all that data and more, to be able to have all that together. There’s a lot to be done still, but I can get access to my problem list, my medications, my allergies, and my procedures. I have access to that anywhere in the world through my phone, and so I could say that’s similar to what’s happening within financial services. Do I have access to every single transaction that has happened? No. And do I have access to all of that within healthcare? No. So I think there are situations where actually we could make an argument that we’ve surpassed some of the other industries.
However, I think as a consumer, they’re all leveling out and becoming very close, and we’re seeing a mixture. You’re seeing some people who still like the bricks and mortar; the physical presence. They still go to the physical stores, banks, or an advisor. Then you have some who are using robo investors and things like that. In healthcare it’s similar. There are people who are into managing and taking care of things automatically, and some still like that physical presence. I think the reality is there’s some kind of a hybrid in between.
As we continue to grow and lean toward digital, I think healthcare will continue to mature at an accelerated rate and catch up to some of these other industries that have been doing this for a few decades, but we’ll catch up fairly quickly. In some cases, like I said, I believe we’ve actually started to surpass them.
And so, the CIO role really isn’t as centric to the vertical industry as it is to moving things toward the new technology era and the digital era, regardless of the industry that you’re serving.
Gamble: You make a lot of great points, especially with comparison we hear so much. It’s really an exciting time. Granted, there is still so much to do, but I think it’s important to sit back and look at how much is being accomplished.
Richardville: Definitely, and it will continue. I think it’s the most exciting time for many of us who have been industry, but it’s even more exciting for those who are coming up. With my children, for example, one is a physician, one works in patient access, and the other works in financial services, and the future for them is yet to be defined. How they’re going to want to create that over the next decade or two and how the next generation will be served by the healthcare industry is going to be so dramatically different, because they have different expectations. They don’t have the same guard rail that we’ve had, and I think you’ll start seeing a lot of the financing around healthcare support the move into that direction. And as that continues to turn and move with clinically-integrated networks, fewer fee-for-service models and more value-based care, you’ll see these different ways of delivering service on the care side and the maintenance of health continue to accelerate and be adopted by our consumers.
Gamble: It seems like you were doing some really interesting work, but that it was the right move to come back to the CIO role.
Richardville: Definitely. Again, it’s an amazing organization made up of tremendous leaders. That was certainly a big key component of the decision, and when you look at how we’re positioning ourselves to lead and exceed, it’s really a fun time. And it’s great to be with an organization that’s in the top quartile or top decile of healthcare systems that are truly meeting a lot of those challenges.
Gamble: Sure. Well, I can always talk to you for longer but I figure I should probably let you go. There’s so much exciting stuff going on, and you’ve had a heck of a first few months on the job. I’d definitely like to catch up down the road.
Richardville: You bet. I’d definitely like to stay in touch.
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