With any major project, establishing guiding principles is an absolutely critical step, but it’s one that doesn’t come without a healthy dose of dissidence. In fact, Laishy Williams-Carlson believes “there are some things you should argue about,” especially with a major EHR rollout. For CIOs, what’s most important is being able to establish a consensus, even where there is disagreement, and use those principles “as your north star.”
During a recent interview, Williams-Carlson talked about the Epic project she’s taking on in her new role as CIO at Roper St. Francis, and how she hopes to leverage some of the many lessons learned during the pandemic to ensure a (relatively) smooth implementation. She also talks about how she has navigated the transition from Bon Secours Mercy to Roper St. Francis — a move she made “with eyes wide open,” the difficult balance leaders face in sticking to a proven formula while also remaining “tried and true,” and how her thoughts on work-life balance have evolved.
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- Having different departments and stakeholders aligned on a common initiative, rather than arguing about priorities, was perhaps the biggest factor in what IT teams achieved during Covid.
- As Roper St. Francis moves forward with its Epic rollout, Williams-Carlson’s top priority is “structuring the right governance and oversight.”
- A critical aspect in any major initiative is to develop strong guiding principles, which means wading through some difficult conversations. “These are things you should argue about.”
- Part of being a female leader in a traditionally male-dominated field is in recognizing the challenges it presents, and embracing the opportunities.
Q&A with Laishy Williams-Carlson, Part 2 [Click here to view Part 1]
Gamble: During the past year, we saw a recognition of what IT teams can do and how hard they worked, especially during the early days of Covid, and I think for a lot of organizations, the thinking has been, how can we capitalize on that?
Williams-Carlson: I could not agree with you more. Recalling that I’ve just been with Roper St. Francis since mid-January, having spent all of 2020 with Bon Secours Mercy, I think it was eye-opening how quickly we stood up capabilities for virtual visits. We were the health system that [Epic CEO] Judy Faulkner quoted about going from 50 virtual visits pre-pandemic across our entire health system, to having more than 8,000 virtual visits in a single day; and that happened within a month.
The capability was there, just not that burning platform of both providers and patients feeling like they wanted to do virtual visits. And so it was an immense source of pride for me that our team was able to step up and build on that infrastructure that was already there. We also made many changes in our Epic system to accommodate new workflows for Covid units and new dashboards — just a lot of great work.
The power of alignment
I’ve done some reflecting on why were we able to get so much done, so much more quickly during the pandemic than in a typical business year, and I think there were a couple of key things. Actually, I wish I could bottle that — without a pandemic, of course. But I do hope to use some those lessons learned with our Epic implementation.
The first thing that was obvious to me is the power of having the entire organization align on a common objective. In a typical business year, the CIO and his or her team are trying to meet a variety of agendas and needs. Just because one region has XYZ as their top priority, it doesn’t mean it’s shared across the organization. When you’re left to juggle multiple priorities and there’s just not one number 1, but 10 of them, the effort isn’t as intense as when everyone from the top down — now just in IT, but operations — is pulling in the same direction. Whereas, with the pandemic, we could say, ‘we’re setting these five other major goals to the side right now because we’re focused on this,’ and got zero arguments, in any other business year there would be multiple stakeholders with different initiatives.
The power of being aligned on a common initiative from the top down, with operations, technology, etc., is huge. To me, that was the biggest lesson. Obviously, another lesson was to not squander a crisis. There are always positives or glass half full aspects of a crisis, and some of the things we were able to do or leverage to respond to those needs will continue to serve us well.
Gamble: You mentioned revenue cycle earlier. Is that another objective on your list?
Williams-Carlson: Absolutely. We’re going to be working with Ensemble on our Epic implementation; they’re very good at what they do. I worked with them at Bon Secours Mercy, and so look forward to leveraging their expertise in our implementation.
Gamble: You mentioned that governance stands out as being particularly important with any major implementation. In your role now, how do you think you’ll approach that and make sure solid governance is there from the get-go?
Williams-Carlson: What a good question. And in fact, the area that’s taking the biggest chunk of my time right now is structuring the right governance for the implementation and oversight. We have a really robust IT steering committee that we will parlay into a major role with the implementation as well as spinning off other teams.
I’m a big believer in establishing guiding principles. Once you do that hard work upfront of getting everyone aligned and making tough decisions around guiding principles, you only have to answer that question once. Every time you reach a pivotal point in the design and ask, are we going to make it easier for caregivers even though it’s a little clunky for patients, or vice versa? If you’ve already said the number one overarching design principle is to do what’s best for the patient, you just flip to that guiding principle and you have your answer.
“Making Tough Decisions”
I believe in spending a lot of time upfront on making tough decisions around guiding principles. We’re in the midst of that, even as we speak. It will be about 18 months while we continue to use the systems that are currently in place in our organization. You don’t just want to tread water for 18 months, and so we need to be really thoughtful about where we continue to invest and improve in those systems; let’s not invest a lot of money and throw away work. We have some guiding principles that we’ve developed around that as well.
I love guiding principles because if you do them right, they’re not motherhood and apple pie. There are things you should argue about. One of the principles we proposed for review is around getting it right for the patient. That trumps all other design considerations. Another is doing what’s best for the overall needs of the health system, versus one specialty or site. We’ll see how that works outs; that could lead to some robust discussions.
Gamble: Right. Like so many aspects of leadership, it’s not the easy way, but it has long-term benefits. And so, even if you have ‘robust discussions,’ you’re keeping an eye on the end goal.
Williams-Carlson: I think probably the most important step to getting it right, is to articulate those, and — even when people aren’t in love with them — to have consensus and use those as your north star.
Gamble: Now, in terms of your workforce, are you mostly remote at this point or are you using a hybrid model?
Williams-Carlson: I’m hybrid, and actually, I probably spend more time in the office with the executive team, which I love. Thankfully we’re starting to really progress with vaccinations and are really enjoying being back together in person. Typically, at least 3 days of my work week are spend in an office, in one location or another.
I’m really enjoying that; I thrive on being with people. I also love working remotely, because there are days in which you can be totally selfish and check off things on your work-to-do list versus everybody else’s. But then you realize that as a leader, your job is to make sure you’re meeting all those other needs as well. So right now it’s hybrid model.
Gamble: So certainly pros and cons with all models.
Williams-Carlson: Absolutely. It’s interesting. With Bon Secours Mercy, the pandemic happened more than a year after the merger; the team had been together for more than 18 months and was able to form personal relationships so that the pivot to remote work sustained us. We had already built those high trust relationships. I always was grateful for that. If it had happened earlier in the merger and we were working remotely without having established those relationships, that wouldn’t have been a good thing.
I’m thankful that we already had built a lot of these relationships at Roper St. Francis and I arrived at a time when it was okay to start being more present with the rest of the team because I think building personal relationship over a computer screen only goes so far.
Gamble: Sure. The last thing I wanted to discuss is your leadership philosophy. I’m sure it has evolved over the years. Is there anything that stands out to you in terms of how it has changed?
Williams-Carlson: I would absolutely say it has evolved. I’ll share a couple of thoughts. One thing that evolved is my sense of what the role of being a female executive means. I was just talking to a colleague about this the other day. Early in my career, I started in that environment where there was a sense that women had to work twice as hard to get half the credit that men did.
In started my career in finance in the early 80s, and I can remember senior partners of our auditing firm walking in to the room, seeing me, and asking me to go fetch them coffee. I would do it; I’d hand it to them and sit down, and then I’d let them know I’m the one they’re meeting with. Of course, they’d be mortified; thankfully, that as evolved quite a bit.
Being a female leader
Early in my career, if you had asked me about being a female leader, my answer would have been, ‘I don’t look at gender, I just want to be the best CFO or the best CIO, irrespective of gender.’ I really believed that.
But in the last 10 years, my thoughts around that have evolved. First, when I became the CIO for Bon Secours Health System, I had other females walk up to me, including some of the sisters of Bon Secours, and talk about how proud they were that their CIO was a female. That made me pause and say, ‘Okay, I may be discounting this aspect of being a female leader, but others aren’t.’ And so I started to pay attention to the responsibilities I have as a female leader in helping others, and not of discounting some of the challenges and opportunities that I have as a female leader. That’s something that definitely evolved over my career — embracing those nuances of female leadership.
Fortunately, in healthcare, and especially Catholic healthcare, which is led by sisters, I’ve always seen great examples of female leaders all around me — not necessarily in IT, but across the healthcare system.
“I work to live, not the other way around”
Another thing that has evolved for me is I have a different appreciation of work-life balance now; I will readily say that I work to live, not the other way around. I still work very hard, but I’d like to think that I’ve learned to stop and smell the roses a little bit more.
I think I’m more appreciative now of the value in recharging one’s batteries and lifting your head up from the work environment. And quite frankly, even if the only thing you care about is work performance, there’s even value in unplugging for a while and revisiting work with more information from outside of your bubble, and having a chance to recharge your batteries and be more innovative and creative. I think those are definitely two ways in which I’ve evolved over the duration of my career.
Gamble: Those are great examples of evolving. I can understand why you would have taken that viewpoint being a woman in a leadership role, but it’s so important to keep an open mind and be willing to look at things differently. That’s growth, to me.
Williams-Carlson: Thank you for saying that. I think the way we think about diversity of all kinds — race, gender, and ethnicity — has evolved a lot during my work career. Early on, it was ‘we’re all the same. We all have the same agenda. We all want the same things in the end.’ There was a sense that differences should be minimized instead of celebrated and used as a source of strength. Now, we tend to see things differently.
Gamble: I agree. I like what you said about work-life balance. Some have said that term is on its way out, but it’s all about trying to achieve some sort of balance and how it can make someone better as a leader and as a person.
Williams-Carlson: I’m not sure why that term would be on its way out. During the really intense phase of the pandemic, I saw a joke that said we shouldn’t call it ‘working from home’; we should be using the term, ‘sleeping at work.’ Because there are some long, long days, and you’re not attached to your team in the same way you had always been. There are a lot of groundhog days, and so it’s nice to see it swaying back to a more healthy balance.
Gamble: Definitely. Well, we’ve covered a lot. I really appreciate you taking the time to speak with me. I hope we can connect again down the road.
Williams-Carlson: Thanks, Kate. It’s always great to speak with you as well.