When Myra Davis was first approached by her CEO about changing her title of Chief Information Officer – one she had held for eight years at Texas Children’s Hospital – to Chief Information Innovation Officer, she was intrigued. But there was a critical question she needed answered, and so she asked her fellow senior leaders, physicians, and board members, ‘What does innovation mean to you?’
The reason was simple: Davis didn’t want any unrealistic expectations, and she wanted clarity on what the title did (and did not) mean. What she learned is that innovation is about creating change, and that most CIOs – chief information officers, that is – are already there, if not headed in that direction. The challenge comes in some of the other aspects, including the governance piece.
Recently, Davis spoke with healthsystemCIO about what it takes to foster innovation, how leaders can build support for innovative solutions, and how innovation can help CIOs tell a more compelling story.
Gamble: Let’s talk about how Texas Children’s responded to Covid. What stood out most to you?
Davis: We’ve done a great job with testing and screening. I’m really proud of how the organization has responded in terms of testing and clinically preparing to care for patients. We even took on adults at one point, which speaks to what we’re able to do as an organization.
From a technical standpoint, we haven’t missed a beat, whether it was the rapid increase in telehealth visits from around 100 a day to 4,000, or the EMR upgrades that were done remotely. We continue to move forward, and I’m very proud of that.
We’ve been focused on leveraging the tools we have to improve the patient experience; one way is by creating a digital touchless environment. Using our existing portal, families can get answers to their questions, make a co-pay, and notify us that they’re on the way. We’ve also implemented digital consent. By taking these steps, we’re minimizing the need to sign anything, touch anything, or wait for a long period of time.
Gamble: You mentioned EMR upgrades. Did those have to be delayed? And what were some of the other projects that were pushed back?
Davis: We were scheduled to go live with our six-month Epic upgrade in March; when Covid hit, we solicited feedback and made the decision to defer to June. Everyone agreed that was the right thing to do, because we didn’t want it to be a distraction.
With Epic, however, you can’t wait too long before the next one, or it will become a mammoth upgrade. We were also scheduled to go live with Cupid, which we went ahead with, and we had deployed Beaker a few months earlier. In addition to that, we were in the process of executing Tapestry, our health plan solution, which will replace quite a few applications. We decided to delay that; our targeted go-live is now set for summer 2021.
Finally, we’re going forward with our ERP solution, Oracle Cloud, which is scheduled to go live in the fall. It’s been a fast-paced eight months, and I’m really proud of the team. It’s a testament to the trust we’ve built throughout the organization and to their ability to continue to produce. We’re doing what we can to transform the organization, and we’re excited about it.”
Gamble: Your team was able to do a lot despite being remote; what did you find to be the biggest challenges?
Davis: When we deployed our teams to work remotely, it was really important for me to impress up on my team that when you’re not onsite, you still need to have the pulse of what’s happening onsite, because things are changing so quickly. The ability to engage in dialogue and to have conversations that speak to your awareness of what’s happening in the environment was significant. It really mattered.
Of course, we have had some missteps, because we’re still learning to work remotely. What we were able to see in body language during a meeting we can’t see anymore. We can’t have that inference because we’re not having in-person dialogue. And so, when a mistake is made, we use it as a learning opportunity. We dive in and try to quickly understand what we could’ve done differently to achieve a better outcome, and adopt that going forward.
Gamble: In light of what you’ve learned from Covid, will you tweak your disaster preparation strategy? And if so, how?
Davis: We have an engineering team that reports into our risk management group. That team has worked very closely on all things around disaster preparation. And in fact, six months out of the year is hurricane season for us, so we’ve had a lot of practice; we already have a command center. That benefited us quite a bit. The team does a great job making sure we follow the right practices around any disaster-type event, whether it’s Covid or any significant event that requires us to pivot and make fast decisions.
Gamble: Your title recently changed from Chief Information Officer to Chief Information Innovation Officer. What was the impetus for this, and how has it altered your strategy?
Davis: Actually it was my CEO, Mark Wallace, who approached me. He said, ‘I think we need to change your title to something more than information officer.’ Interestingly, when I acquired the new title, I received a diverse, wide range of responses as to what it entailed. And so I started on a journey to figure that out. I asked my peers, senior leaders, physicians, and board members one question: ‘What does innovation mean to you?’ I needed to make sure there weren’t going to be false expectations based on the responses I received, and I wanted to provide clarity on what the title meant — and most importantly, what it didn’t mean.
Going on that journey enabled me to define what innovation meant for the organization. What I learned is that it wasn’t anything different than what we were already doing, which was creating change in the environment. That change could mean creating a new product or simply leveraging what you had and changing how you use it.
Once I was able to define and understand it, I discovered that there’s a big ‘I’ in terms of innovation and a little ‘I.’ The little ‘I’ is really adopting technology and accelerating it in a focused way. That’s what we’ve been doing for the past eight months. The root of the word innovation means to change. It doesn’t mean create a new product or start your own company; that’s the big ‘I.’ And that takes time. It’s not going to happen overnight. It takes investments and it takes energy. We want to do that; we want to create a portfolio and explore opportunities. But if that’s all we do, and we’re not focused on making changes to enable the organization to use technology in more effective ways, shame on us. At the end of the day, all CIOs are innovation officers. I can’t think of one peer who isn’t focused on those things, whether or not they have an ‘I’ in their title.
Gamble: As you know, a lot of organizations have both a chief information officer and a chief innovation officer. What are the drawbacks to doing that? Does it make either job more difficult?
Davis: I would think that in those cases, the chief information officer can get really frustrated, because the innovation officer gets to do the fun projects, and the information officers have to figure out how to get it done. That can become demoralizing to the team. By me having the two ‘I’s’ in my title, it’s the same team that gets to see themselves as part of the change and innovation that’s being introduced in the organization, while also doing the background work.
That’s how I interpret the role. I’ve created my own version of it as a part of the journey.
Gamble: Do the two I’s require different skillsets? And if so, how can you bring those together into one role?
Davis: Actually, I have an executive of innovation and she has a director. They work very closely with my other executives in clinical and business, and the executive who sits over infrastructure and security. I’ve told them, it’s important that you share your strategy, share your portfolio, and align with other leaders so it can be achieved.
Now, if the innovation group makes promises and doesn’t partner with the other groups that’s a problem, because there’s only one infrastructure. There is no segmented network. You have to use the same one. We can’t afford to create another one; that would be an LLC, and we haven’t done that. You have to use that foundation to build your ideas upon, and the same foundation is being leveraged by the rest of the organization. And so you have to bring them on the journey and make them a part of it as well.
Gamble: What do you think is the key to building a culture of innovation?
Davis: We have an innovation advisory group consisting of senior executives and physician leaders whom we leverage to introduce and promote new ideas. We’ve created an innovation hub with a limited amount of internal resources; the spokes are identifying people in the organization who can be the voice for ideas and proposals from their respective areas. The more we keep those spokes, the more we’re able to spread the conversation around innovation and where to go if you have a new idea.
It’s important to remember that innovation is an iterative process. First is the discovery phase; if the discovery doesn’t work, we scrap it. If it works, we define it, and if we like the way it’s defined, we see what it takes to deliver it. We use the ‘discover, define, delivery’ methodology. If it doesn’t get through the discovery or define phase, we end it immediately.
Gamble: Do think that title combining the two I’s is something we’ll start to see more often? Is it a reflection of the evolving chief information officer role?
Davis: Absolutely. I’ve told my peers, ‘you guys are doing the same thing. I just have the extra ‘I’ in my title.’ You can call yourself whatever you want, but the modern CIO must be doing this.
Some of the ones who come to mind are David Chou, Kisha Hawthorne, Dan Nigrin, Theresa Meadows, and Marianne James; everything I’m talking about, they’re doing. I just happen to have ‘innovation’ in my title.
But I know that in some cases, dealing with the chief innovation officer can be challenging for CIOs. With the model that we’ve adopted, you’re not fighting with somebody. You’re not having to educate your team on demand versus supply. You’re not having to constantly tell them that in order to get out of ‘define and discovery mode’ and be able to truly deliver, they have to keep us front and center.
Gamble: Finally, although you’re somewhat new to the CIIO role, you’ve held the CIO title for a while. Based on what you’re seeing in the industry, what do you think are the most important qualities leaders should have going forward?
Davis: Having an open mind is key. We’re often challenged with so much demand and a very limited set of resources to get it done. That can bog you down, and in some cases, it can demoralize you and your team, and zap your energy.
If you put the formula on paper, there will always be more demand than the supply available. And so my advice is to try to be optimistic. When you do that, it forces a different level of conversation with your colleagues and with the organization. Be as transparent as possible, without sounding like you’re making excuses. Engage in possibilities of what solutions can do, and create a level of inspiration to where your colleagues will want to advocate for you, and get what you need to make that vision a reality. The more you advocate for your department, the better position you’ll be in.
The other part is, it’s not just about delivery. The stories CIOs tell shouldn’t be limited to, ‘we went live on this data. We had this many upgrades. We kept the environment safe.’ The story CIOs tell should be about quality of care, patient satisfaction, access to care, and safety. Why should the CIO’s story be any different than that of an administrator? It shouldn’t be.
The more you engage in that level of a conversation — which, let’s face it, is much more entertaining and intriguing than a go-live or a patch environment — the more you’ll be able to accept the reality of that demand and supply equation. But you will never have enough supply to match the demand. It’s just not realistic.
Lastly, you need to be constantly learning. I don’t pretend to know it all because I don’t know it all. It’s important to talk to others, ask questions, and read — anything you can do to learn is critical.