“You can’t understand someone until you’ve walked a mile in their shoes.”
It’s a saying that’s been quoted and revised so many times that it’s not attributable anymore. It is, however, applicable, particularly in healthcare.
For John Henderson, it wasn’t a particular individual, but rather an entire department that drew criticism from him until he achieved a better understanding of what they did. “I was tough on infrastructure teams when I didn’t have responsibility for them,” he said during a recent interview. Once he had the opportunity to run the team, Henderson developed “a completely different appreciation for what they do and how challenging and difficult it is.”
That humility and awareness has served Henderson well during his career, particularly since he assumed the CIO role at CHOC Children’s more than three years ago. In this interview, he talks about how his team is working to deliver the “Disneyland experience” across the enterprise, how they’ve adjusted to the challenges stemming from Covid-19, what he learned from Myra Davis, and the question leaders should constantly be asking.
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- Although CHOC Children’s had no prior experience with remote work prior to the pandemic, the organization was able to transition 1,100 workers because of the work that had been done to modernize the data center.
- To accommodate the large number of individuals working remotely for the first time, leadership has held virtual learning sessions and provided ongoing support.
- For the past few years, IT has been working on modernizing the data center and refreshing equipment as part of an effort to improve user experience.
- Providing a digital experience has become an essential part of the CHOC Children’s strategy. “It’s how everyone wants to interact with us, and so we’re trying to make sure we have the right capabilities for that engagement.
Q&A with John Henderson
Gamble: Let’s start with some background information. Can you provide an overview of CHOC Children’s?
Henderson: We’re a two-hospital system. One main campus which is our CHOC Orange Campus, but we’re a two-hospital health system with more than 25 primary care locations and another 30-plus specialty clinics.
We serve the entire Orange County region, and a little bit beyond. If you think about it from a population perspective, we have a reach of around 4 million.
Gamble: In terms of the pandemic and how it impacted your strategy, where you with remote work versus onsite?
Henderson: In IT, we’re about 90 percent fully remote. The only folks on site are field support and some of our network engineers who have been on projects, and then our communication center. We have about 1,300 people across CHOC who have been remote since the pandemic. We were not a remote work organization prior to the pandemic; there was a big cultural issue around remote work.
Gamble: That’s a common thread we’ve heard. Can you talk about how your team was able to make that adjustment?
Henderson: I think we were in a really good position to make the switch. I’ve been at CHOC for three and a half years; one things we’ve been focused on in the past three years is modernizing our data center. We had completed phase 2 of that right before the pandemic, meaning we had moved everything off premise to a co-located facility with a brand new infrastructure and architecture. We had migrated all of our applications and we had begun moving everyone from Skype for Business over to Teams.
Once the pandemic hit, we needed to push everyone to remote. We were able to do that over a three-week time frame. We were positioned well because of all the work that had been done with the data center. We didn’t have to buy any new capacity. It was really more around education and providing the tools that are needed to connect remotely.
We set up what we call a walk-in remote enablement center. We were open from 7 a.m. to 7 p.m.; anyone could come in and we would configure their corporate device for VPN connectivity, and they went home and were able to start working remotely.
Gamble: Was there a big adjustment in getting used to communicating in different ways?
Henderson: It was a big adjustment. One thing we did was to hold a lot of virtual learning sessions. Our organizational development group, which includes one of our managers over clinical training, created some virtual learning modules on how to leverage Teams — for example, here are the 101 foundational aspects of it and what each type of communication vehicle within Teams is best suited for.
We did a lot of education and awareness. As part of our overarching organizational communication, every day we sent out what we call our source of truth information — anything we wanted people in the organization to know. On Tuesdays, there was a tech section within that where we could communicate anything new or anything we want to reinforce to the folks working remotely.
We started putting together a library of best practices for staying connected. For those who normally have coffee with co-workers in the morning, we suggested doing it over a video conference. For leaders who walk around to check in on their team and see how things are doing, maybe do that via a chat message, or set up office hours where folks can come in and connect with you. We’re promoting those types of activities.
Gamble: That goes a long way with people who aren’t used to the remote world.
Henderson: From our perspective, we feel like folks have really settled in to the remote environment. There are obvious challenges particularly for our associates who have kids at home doing remote learning and having to manage that environment while also doing their work. We’ve been promoting extreme flexibility; do what you have to do to support your families, and if you are working different hours than you normally would, that’s fine.
Gamble: In terms of modernizing the data center, have you been able to stay on track with that? How was it affected by the pandemic?
Henderson: We’ve actually been able to stay on track. We’re in the final of our three phases, which is around IT/DR and rebuilding our full IT/DR capabilities based on our business continuity plan. The other element is layering in some more advanced monitoring of the end-user experience, all the way back to the data center. Those things haven’t been delayed; we’ve been able to continue to move those forward.
We did have a bit of a delay in a couple of our lifecycle refresh programs because we were so focused on moving everyone remote and on some of the other things we were doing to support clinical operations, and so we took a pause with our network. We have some core network gear we had to replace, as well as some of our devices that were end-of-life in the clinical setting.
We got off schedule for about six weeks; we picked back up and were able to wrap that up in July this summer. That project got closed out with a slight delay, but we think the impact of that delay wasn’t as important as some of the other things that the organization needed. And our physicians who were receiving the benefits of the new equipment were sympathetic about the delay because they understood what was going on.
Gamble: Right. And I would imagine this is part of a larger strategy?
Henderson: Yes. It’s not just about modernizing our data center, but also building out infrastructure and a resilience with the infrastructure. And part of it is we’re a growing organization; we need to have that level of resilience and the ability to scale up as we grow.
The other key part of the strategy really has been around what we call delivering a Disneyland experience. That’s the model we’re striving for, and so everything we’re doing is to deliver that type of experience, whether it’s for our physicians, our nurses, our administrative workforce, or our patients and their families. That strategy hasn’t changed. Actually, I’d say it’s more amplified with Covid.
We did delay the launch of our digital-based experience for about two months. The focus was on ambulatory outpatient settings; specifically the transition plans for our specialty clinics and primary care. We launched in May, and the goal has been to improve outreach. We already do appointment reminders and confirmations, but we’re now consolidating to one platform. We want to create the ability for pre-visit questionnaires to be completed prior to coming in, and for multiple check-ins through a smartphone. We’ll also have some iPad-based kiosks in the clinics for those types of check-ins as well. We’re looking at the ability to do more on-demand messaging, whether it’s tied to a specific practice or related to health maintenance activities like immunizations. We want to be able to send out targeted communications.
We’re also baking in the ability for bill pay from a mobile device, really focusing on everything being mobile. Based on our research and what our marketing group provides to us, that’s how everyone wants to interact with us, and so we’re trying to make sure we have the right capabilities for that engagement.
We’re moving that forward now. We’re working on our first release of those capabilities. We’ll continue to expand and introduce more and more capabilities with it.
Gamble: Do you have a patient family advisory group or anything like that to keep a pulse on what families want out of the experience?
Henderson: We do have a patient advisory group. We do tap into that. One of the members of our executive product steering team sits over customer experience. They are our conduit to our patient advisory group. We definitely get their input on the things that they’re looking for; that drives some of the things we’re introducing.
Gamble: Switching gears a bit, this is your first CIO role, previously having spent quite a while at Texas Children’s. What was it that appealed to you about this specific organization?
Henderson: I’ve been in pediatric health for the majority of my career, and so it was important that the organization was in that area of healthcare. The number one thing that struck me about Children’s Orange County was the vision. Our CEO, Kimberly Chavalas Cripe, has a vision to be the leading destination for children’s health, and she didn’t put a geography on it. Obviously we’re in Orange County, but she didn’t put that any limitations on our reach, and I really liked that.
I think the other element was the leadership team and the physicians — they made it feel like home. I felt everyone had this overwhelming desire to deliver the highest quality care and they were really committed to that. That’s really important.
The last thing is that it’s not Los Angeles, but the community they’re trying to serve and how they’re trying to do it — that was really appealing to me. They were doing population health before I joined, but I didn’t feel like it was the traditional population health model. They were focused on population health for the entire region, not just the patients that were already consuming the services of CHOC. I thought it was really forward-thinking for them to be looking at it and actually doing it that way, even before I decided to join. That’s really exciting, and it’s what really caught my attention.