Q&A with HSS CIO Jamie Nelson, Part 2: “Digital Encompasses So Much of What We’re Doing.”

It’s quite a paradox.

During the first wave of the Covid-19 pandemic, the streets of New York City were deserted — even in the middle of the day. Specialized since 1863, Hospital for Special Surgery proactively paused 95 percent of procedures and transformed to provide multi-specialty support to the city’s overburdened healthcare system.

“There was so much break-fix work to do,” said Jamie Nelson, now in her 11^th year as CIO at HSS. In the few days of transition before and after HSS pivoted to support the surge, “our teams were so busy with day-to-day projects that it didn’t feel like anything slowed down.”

As a result, once her team was given the green light to move forward with projects such as selecting a new ERP solution, they were ready, said Nelson. During a recent interview, she talked about how HSS survived the lockdown – and why she made it a point to show up every day, and her team’s big plans to continue to digitize as much as possible. She also discussed the “new paradigm” leaders face in the wake of Covid, and what worries her most as a female leader.

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Key Takeaways

• “There’s so much focus on digital in terms of the consumer, with apps and things like that, but it’s much broader than that. It’s digitizing the back office, digitizing human resources, and digitizing pathology.”
• Another benefit of digitization? Being able to use cutting-edge technologies “helps motivate staff and keep them moving in the right direction.”
• Implementing a plan for bringing staff back to the office doesn’t happen overnight — and perhaps it shouldn’t. “It’s okay to take a few months to put this together, because hopefully you’re getting real-time feedback from the staff on what’s good, what’s not good, and what they want to change.”
• As some workers — particularly women — choose to remain remote, Nelson is concerned it may “cause us to slip backwards in terms of equality in the workplace. And that scares me.”

Q&A with Jamie Nelson, SVP & CIO, HSS, Part 2 [Click here to view Part 1]

Gamble:  I read an interview you did where you talked about the work HSS is doing with digital pathology. That seems really exciting.

Nelson:  We actually brought that live during Covid.

 

Gamble:  That’s really impressive.

Nelson:  We were very lucky. We’ve been looking at that probably for five years. It had to get FDA clearance, and so we needed to clear three pieces: Sectra, the Leica scanner, and Epic Beaker. They were all cleared, and we brought that live more than a year and ago. In the middle of Covid, we did that.

It’s interesting; there’s so much focus on digital in terms of the consumer, with apps and things like that, but it’s much broader than that. It’s digitizing the back office, digitizing human resources, and digitizing pathology. Now, pathologists can bring up images of the bone using PACS and view the pathology underneath it, and put the two together. Surgeons are doing the same thing, and now they’re interested in pathology again because it’s easy and interesting and they can move things around just like they do with digital imaging systems.

And they’re finding things they didn’t expect, which is helping to improve patient care and improve collaboration. Now our pathologists can work remotely if they need to, which means that if something needs to be looked at during the night, they don’t have to get dressed and come to the office. They can do that from home.

The percentage of slides diagnosed digitally versus using microscopes is in the 90s. According to our chair of pathology, the reason some are done physically is either because of clinical criteria, or because an individual doesn’t want to wait for it to be scanned, and so they do it the old-fashioned way. That’s a critical step forward in terms of digitization.

 

Gamble:  I like the point you made about digital and how it needs to be looked at in a more holistic way. Can you talk more about that?

Nelson:  We have a digital team housed outside of IT that works very closely with us. They’re basically rewriting MyHSS, our MyChart app, to improve functionality with tools like wayfinding. And so, they’re adding a lot of nice pieces, but that’s just one component of digital. Digital encompasses so many things that we’re doing.

It’s also important for staff. You want your core IT staffers to understand that they are using cutting-edge technologies and that their work is valued. I think having that understanding helps motivate staff and keep them moving in the right direction.

I was speaking with someone about our ERP system, and he said, ‘I bet your staff is excited to do this,’ and I said, ‘absolutely.’ They’ve been slogging along with the old ERP system, and so it’s very exciting for a team that has done such great work. Now the challenge extends into the cloud world — it’s exciting for them and us, and it’s very energizing for our leadership team.

 

“We had just cleared the hurdle”

Gamble:  That gets into the issue of retaining good people, which is a challenge for so many organizations right now. I’m sure that’s top of mind for you.

Nelson:  It is. Obviously, we sent people home to work. When we planned to bring people back, we did it with varying timetables. As an organization, we wanted each leader — whether it was finance, IT marketing — to work with their teams to decide what that looks like. And so, we brought them back, and within 10 days we had to send them all home because the building that houses many of those functions had a major flood. Our offices were literally under water. People were home for two more months; it was a big flood and we needed to do a lot of remediation to make sure it was safe and there was no mold. That certainly was tough, because we had just cleared the hurdle. We went to the other side, and now we’re going back.

 

“It’s a whole new paradigm”

It’s interesting because people have different needs and wants. It used to be that people could work from home one day a week, or if they needed to be home to let the plumber in, for example. Now there’s a lot more variety. We’ve learned that some people love being in the office, some would be perfectly happy if they never saw an office again, and some are in the middle. There’s a lot we don’t know, because we’ve been doing it the same way for so long. It’s really a whole new paradigm.

In fact, one of my team leaders is defining what remote work should look like — and it’s been happening since March. But I told them that’s actually okay, because I want your teams to first experience what it’s like coming back. You’re going to learn things, and you can use that to inform and make modifications based on what you’re hearing. It’s okay to take a few months to put this together, because hopefully you’re getting real-time feedback from the staff on what’s good, what’s not good, and what they want to change. A perfect example is somebody coming in on a Thursday and saying, ‘I’m here but my team isn’t here.’ That’s what happens when people choose different days, but we don’t think about that in the beginning. It’s just a very different, very interesting time.

 

Gamble:  It is. When the pandemic first hit, my kids were in second grade, and I had to help them with schoolwork while doing my job, which was very difficult. Once schools started back up it made a tremendous difference. But I definitely felt for those who couldn’t – or didn’t – send their kids back to school or daycare, and I think it’s so important for leaders to stay cognizant of that and make sure people who work remotely don’t get lost in the shuffle.

Nelson:  It’s going to be interesting because as we give people choices, there are going to be unintended consequences. If you’re onsite, you can be seen by leaders and you can have water cooler conversations that are more private. We really haven’t figured out on how to replicate that on Teams, because everybody can hear. And so, if I ask Maria how her kid is doing in college, everyone can hear the conversation. It’s not that quiet sidebar you can have in person. It’s a whole different feeling.

If you’re not in the office, you can become disenfranchised — that’s my worry. As a female leader, I’ve spent nearly 40 years making sure that women are placed in technical roles, and that women are being heard and understood.

 

“Leaders need to be deliberate”

Because we still bear the brunt of the burden with home, child and elder responsibilities, a lot of women are staying home. I’m concerned this may cause us to slip backwards in terms of women’s progress and equality in the workplace. And that scares me; I don’t know that we’ve really thought that through. And I don’t think we know what the ramifications will be going forward.

I think this year is as much of a sea change as the early COVID years, because it really is a new paradigm. We’re figuring out what’s going to work and how people can have the most effective work/life balance, while also progressing in the organization. And so, leaders need to be deliberate, as you indicated, and thoughtful about the people who elect to work from home and how we can make sure they don’t get left behind. It’s probably the toughest thing I’ve dealt with in my career.

 

Gamble:  It is tough. There’s no right answer and there’s so much we don’t know. But I will say that for working parents, getting that commute back is a beautiful thing.

Nelson:  I used to sit in my driveway to finish the chapter of the book on tape I was listening to before I would go into the house. Even for couples who don’t have kids, having that break is important.

But being onsite has so many benefits, especially in building those relationships with both men and women. I wouldn’t have had a lot of my male friends if I hadn’t been in an office, because outside of work, we tend to cohort with our own. So I think there’s a lot of value there.

Also, working at home isn’t as easy as it sounds. Yes, you don’t have to commute. And yes, you can run a load of laundry or do a quick errand that normally would have to wait until Saturday, but it’s hard. There are a lot of distractions, and I think people have to adjust to that as well.

My preference is to separate home and work; I’m sort of black and white in that way. Plus, I’m an extrovert; I love being around people. I love the intellectual stimulation, and I love the chance encounters. But that’s my preference. And I know that what’s important to me is not necessarily important to others. It’s going to be very interesting.

 

Gamble:  It definitely is. The phrase ‘new normal’ is so overused, but the normal really does keep changing. Or maybe there is no normal.

Nelson:  There really hasn’t been a ‘normal.’ Life is always changing. This just happened to be a bit more seismic than what we expected, but we’ll get through it.

 

Gamble:  True. Well, I want to thank you so much for your time. I always enjoy speaking with you.

Nelson:  It was nice catching up.