Perhaps no industry has been hit harder by the great resignation than healthcare. And if qualified technology and clinical people aren’t quitting altogether, they’re being lured elsewhere by bigger paychecks and more flexibility.
That being considered, it may seem surprising that Hospital Sisters Health System, a 15-hospital network spanning multiple states, has made it a goal to grow 70 percent of leaders from inside the organization. If you look at the facts, however, it makes perfect sense. According to Ray Gensinger, MD, the IT team boasts the lowest turnover rate in the company, and the second-highest engagement scores.
Clearly, they’re doing something right, and it’s all about the people. HSHS prides itself on choosing individuals who are “compassionate” about patient care and willing to do hard work, said Gensinger. In a recent interview, he talked about what makes the organization unique (both in its makeup and vision), how he transitioned from CMIO to CIO, why support is such a critical part of implementations, and his thoughts on remote versus in-person work models.
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- Although there are myriad benefits to being a CIO, having “a high level of control” isn’t one of them. “You still have a lot of governance to work with and hurdles to go through from a budgetary perspective.”
- “When you’re a CMIO, you’re pitching clinical and safety.” Being a CIO means doing that while also being “able to give the very detailed financial value points.”
- The most important attributes in a future leader? Compassion and a willingness to listen. “If you’re talking, you’re not learning.”
- One way in which HSHS is battling the great resignation (which hit the organization hard last fall) is by growing leaders from within, starting with internships.
Q&A with Ray Gensinger, MD, Part 2 [Click here to view Part 1.]
Gamble: So you were a CMIO prior to becoming a CIO. What was it like to make that transition?
Gensinger: I’ll start with the short story. It really was a fantasy that there would be a higher level of control than in previous roles. I changed organizations in order to pursue that. And there are many things make me happier in the position I’m in, but the idea that there’s any more control is a fallacy. You still have governance to work with and hurdles to go through from a budgetary perspective. For example, you want to replace your secretary; well, it’s been a tough year, so you can’t. Or, you have 10 analysts — can’t you get the work done with 8 analysts and start cross-training them?
Interestingly, I went from being a CMIO reporting to the CIO, to, at my current organization, a CIO reporting to the chief financial officer. It’s not totally uncommon, but it took Mike Cottrell and I two years to have a level of confidence and trust where if I came in and said I needed something, he would back me up. I also had to learn how to pitch things to him.
When you’re the CMIO, you’re pitching clinical and safety. As CIO, you have to pitch clinical and safety while also giving a detailed picture of the financial value. In many ways, it improved my skillset tremendously. I’m definitely glad I did it.
Gamble: What did it take to build that rapport with your CFO?
Gensinger: You have to be able to pitch; and by that multimillion-dollar-initiatives. Our Epic initiative was $113 million; I had to convince people that not only could we implement it, but we could do it in a fiscally sound way. That wasn’t necessarily the expertise of my predecessor. When I arrived, the departmental budget for IT was climbing somewhere between 8 and 13 percent; we now have it down to 3 percent. That says a lot. We used to have huge capital consumption—that has markedly diminished. Part of it is because things have shifted from capital to operating expenses, but are operating expenses are actually on a lower trajectory than they were before.
Gamble: Really interesting. Your focus on that really speaks to how the CIO role is evolving; both in terms of the relationships formed and the skillset. Have you found that to be the case?
Gensinger: Honestly, I haven’t been doing it long enough to be able to compare it to how it was in the 90s. But I was very close with my chief information officer at my previous organization, and so, I’ve been familiar with the role for 22 years.
At first, IT was about being successful at implementations. Get things done and don’t break everything. Keep everything humming. Now, you can’t run a hospital without your clinical infrastructure. You need to take those tools and services and, on one hand, make them transparent so that people see them as essential and valuable tools in getting their jobs done, to on the other hand, being resources that people want to use.
That’s the optimization side of things. For example, I collect pens. Why? Because during the first part of my career, I had to write all my notes and orders; I spent a lot of time writing. Now it’s about providing voice recognition. How do we use ambient voice, whether it’s Alexa, Google, Epic or the next iteration, to improve care?
A big focus for us is on empowering consumers. If you want to go online and figure out which doctor you want to see and when they’re available, and you want to schedule an appointment, and we can push a note out to you asking you to fill out your paperwork online, that’s great. We need to do everything we can to make it easy for consumers to do these things. It takes a lot off our staff.
And, importantly, people want to do it. Of course, a 90-year-old patient might not be comfortable going onto a computer or smartphone to make an appointment. They need to be able to pick up the phone and have a caring individual answer the phone and walk them through the steps to make sure they’re successful. On the other hand, if you’re a busy mom who’s trying to juggle two kids and a job and a family, they might want to be able to have a browser open while they’re doing something else.
Gamble: Right. In terms of your leadership philosophy, what do you consider to be the most important attributes in team members? What do you value most?
Gensinger: You have to listen; that’s the first thing. If you’re talking, you’re not learning. Another is that if you’re in healthcare, you need to be compassionate. I always preach to my staff that their job with the organization is to help save lives. I try to make sure everybody understands that job number one, regardless of what I’m hiring you do, is to make peoples’ lives better. You have to have the vision to see that. We hold our core values — respect, care, competence, and joy — very highly. We look for and expect those core values to be expressed in the folks that are here.
For us, it’s a caring mission. We have a responsibility to the people in the community and the impoverished individuals who we serve. And so, we’re looking for people who are more selfless than anything else. Those are the characteristics we’re looking for.
I’ve been truly blessed. Within my leadership team, I haven’t had to replace anyone except for the chief technology officer, who we had to replace twice (the first was an external hire and the second one was a promotion of someone internal).
I’m fortunate in that I’ve been able to handpick almost all of the people in leadership roles. As an organization, our goal is to grow 70 percent of our leaders from inside, and to hire less than 30 percent externally.
Gamble: I would imagine a big part of that is having a strong culture.
Gensinger: It is. The other thing we do — and this is something I took from my last organization — is to start with internships. I bring in about 30 interns a year. Part of the reason is to give undergrads an opportunity to be exposed to healthcare. They’re able to get a foot in the door, and we can get them started on the helpdesk, for instance. And then, after they’ve been there for a while, they might become an analyst. It helps us build our team.
The other day, I spoke to a woman at one of our parties who has been with the organization for 35 years. It’s not uncommon to have people on my team that have been here 40-plus years. It’s incredible.
Gamble: What’s the secret to holding onto people? That’s something a lot of leaders struggle with.
Gensinger: We actually have the lowest turnover throughout the organization and the second highest engagement scores. We got hit with the great resignation last fall when a number of individuals left our team. It was bad enough that some leaders felt like the ship was sinking. But we held tight and rode it out. Now we’re back at a turnover rate of about 7 percent.
I don’t blame anyone who leaves the organization. They need to make the decisions that are important to them, whether it’s money, flexibility, or something else. It’s my job to help them to be successful, whether it’s with my organization or somewhere else.