Taking on a new role, with a new industry, in the thick of a pandemic isn’t for everyone. But for Luke Olenoski, CIO at Main Line Health, the opportunity to be part of “the sector that was literally on the frontline” was too great to pass up. And so, he seized it, approaching it with an open mind and, more importantly, open ears. “The first thing for me was getting to know the people, getting to know the systems, and getting to know the environment,” he said during a recent interview with Kate Gamble, Managing Editor at healthsystemCIO.
Of course, while that was happening, Olensoki was also working with his team to craft a digital health strategy that provides an “omnichannel experience,” while ensuring enough time and resources are devoted to cybersecurity. He also talked about what he considers to be the biggest challenge for healthcare leaders, which is striking a balance between “keeping the plates spinning” and “trying to expand into different areas of growth in digital innovation.”
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- When Olenoski joined Main Line in June of 2020 – marking his first foray into healthcare – the top priority was “getting to know the people, getting to know the systems, and getting to know the environment.”
- In addition to a digital health steering committee, Main Line as a sub-committee with representation from HR, finance, and IT, among others. “We’ve done a nice job threading the needle in terms of making sure it’s inclusive enough but also nimble enough to make decisions.”
- Olenoski’s team seeks to provide an “omnichannel” digital experience by speaking with different constituents within patient groups” to reach people the way they want to be reached.
- There’s no better way to gauge the needs of users than putting yourself in their shoes – even if you have a diverse background. “You don’t get that full appreciation until you’re on their side of the curtain.”
- “Leadership and IT are ever-changing. Some things in IT change faster than others, but there’s always the need to think about what’s the new technology skill, what’s the new project management skill, what new things are emerging.”
Q&A with Luke Olenoski, SVP & CIO, Main Line Health
Gamble: To start, can you just give some high-level information about Main Line Health — what you guys have in terms of hospitals, where you’re located, things like that?
Olenoski: Main Line Health is a community system in the western suburbs of Philadelphia. We’re six hospitals if you include both rehab and our treatment center, with around 1,400 total licensed beds. We have a bunch of ambulatory locations as well. Main Line has been serving the Philadelphia community since 1985.
Gamble: You joined the organization in June of 2020, and it was your first healthcare role. Tell me a little bit about that.
Olenoski: Absolutely. I spent about almost 20 years in financial services and IT before jumping into healthcare in June of 2020, in the middle of the pandemic. And I’d absolutely do it again. It was a fantastic time to do so.
I think the big draw for me was the opportunity to go from one mission-driven organization like Vanguard to another in Main Line. My tongue-in-cheek anecdotal saying is I’ve worked for two great companies, and I’ve never had to apologize. It’s not to say that we get everything right. There are certainly things that we get wrong, and we make mistakes. But I think from a mission and impact standpoint, we’ve done pretty well.
Gamble: That’s always a good thing. So in June of 2020, healthcare was going through a digital revolution. Was that one of the drivers for you — to see what the industry and your organization could do?
Olenoski: Honestly, the first thing, to steal a healthcare phrase, was to do no harm. In came in about 3 months into the pandemic. And I have to say, IT organizations across industries showed up in a fantastic way during Covid. We got people home. We did a tremendous amount in the first 6 months. And so, coming on board, the first thing was to make sure things keep going.
The shock for me coming into healthcare was that this was an industry on the frontline of the pandemic. This wasn’t an organization that was just trying to figure out how to work from home — not to trivialize the impact there, but this was an industry and a sector that was literally on the frontline.
For me, the first thing was getting to know the people, getting to know the systems, getting to know the environment, and then to your point, trying to capitalize on some of the momentum from COVID as it pertains to digital transformation.
Gamble: How did you go about getting to know the people and the organization?
Olenoski: It was an unintended benefit of the fact that in healthcare, not everyone was home. We were going out to the hospitals and going out to the outpatient sites. We had a lot of people in the office, which was advantageous because it allowed me to get out and meet people. I am blessed to have an incredibly strong partnership with our chief medical informatics officer as well as other key leaders in the organization.
To your comment earlier around digital transformation, I have a couple partners in crime and one of them is our chief strategy officer. She’s actually in charge of strategy, digital, marketing, and government affairs and is a co-chair for our digital health steering group.
That group has three workstreams: the consumer side, clinical care, and business process and automation. What I’m really excited about is that we’ve started to layer in equity almost horizontally across those three workstreams. We’re looking at equity across the consumer side, the care side, and then the internal business process and automation side.
Gamble: Does the digital steering group have representation from around the organization?
Olenoski: It does. Candidly, one of the biggest challenges has been that everyone wants to be a part of it. It touches so many pieces — how do you keep it to the right size where it’s small enough where you feel like it’s a decision-making body that can have strong debates but also be inclusive at the same time.
We’ve actually formed a digital health sub-committee which helps to bring together recommendations to take to the steering group. We’re trying to find that balance; so many people are impacted by digital, but we also want to keep the steering group as more than just a weather report which has been a key area of focus for us. I feel like we’ve got the right clinical representation. We have senior leadership from HR and finance. I think we’ve done a nice job threading the needle in terms of making sure that it’s inclusive enough but also nimble enough to make decisions.
Gamble: That’s always a challenge with digital technologies. You want to make the experience better for patients, but without burdening providers. You need to be cognizant of how it affects workflow, right?
Olenoski: When you jump from financial services, where we did not have any bricks and mortar, to healthcare, one of the big things on the digital side was to make sure we think about the end-to-end process. It might be great for patients, but what’s the impact to our clinicians? Or it might be great for the clinicians, but what’s the impact for payers?
Even with something like SMS text messaging, we’ve been thinking about how to make sure we have the right engagement on the patient side because they love it, but also partner with our operational leaders to make sure they also have a good experience — that it’s effective and productive. That’s also been a key area of focus for us as well.
Gamble: One of the examples I’ve heard was open scheduling. That’s a slam dunk for patients, but not necessarily for others.
Olenoski: Right. The cliché is to think about healthcare the way you think about booking airline tickets or restaurant reservations. But it’s not always quite as straightforward. We also want to make sure we provide an omnichannel experience. We want to make sure that we’re thinking about all the different constituents within our patient groups and that we have the right opportunities for everybody whether it’s online, by phone, or by text. We know that families get involved in these conversations as well, and so we’re trying to make sure we’re the omnichannel provider of choice for our community.
Gamble: When you first stepped in as CIO, were there aspects of the role that were more difficult than others? How did you manage that?
Olenoski: I would say the easy piece was the technology. If you follow the standard 80-20 rule, 80 percent is the technology, whether it was email, HR systems, or finance systems. That 20 percent is where it gets challenging.
A few things stand out. One is having a strong partnership with the CMIO, and the other is getting out to the frontline. I’ll never forget one time. It was January of 2021 and I went to one of our medical centers, Lankenau Medical Center, which is right outside of Philadelphia, and I spent a day and a half following people around in the hospital, putting the bunny suit on, going to the Cath Lab, following around hospitalists, and talking to residents and nurse managers. I would encourage any CIO to make sure that they’re getting out to the frontline, because that’s also where you draw a little bit of energy. For those who are new to healthcare or to Main Line, it’s one thing I recommend. It’s a little bit cliché, but this really is brain surgery. We truly are impacting peoples’ lives, so get out there.
Gamble: Being from a different industry, how were you embraced by people in the organization?
Olenoski: It was about 80 percent positive. I think people were interested in the ideas. But I think regardless of whether you’re coming from a new industry or the same industry but a different company, it’s always really important to listen. Even if you have an idea of where you want to go or a change you’re looking to implement, it’s always important to listen. It’s always important for people to feel heard. It’s always important to understand where things are, whether it’s an area of strength or a potential opportunity.
We all tend to comment and rush to judgment. I got some really good advice from our CEO to take time to listen. He said something like, if you have an idea of where you want to go, it’s really important to understand how you got to where you are so that when you think about change, you have that perspective.
Gamble: So it’s more about the attitude and the mindset, and not about coming from a different industry or organization.
Olenoski: Yes. That’s something I learned in my 20 years before coming to Main Line. I spent time in website development, cybersecurity, IT operations, and research and development. Even inside the same organization moving around within teams, you don’t get that full appreciation until you’re on their side of the curtain. It’s taking that time to understand.
One thing I’ve seen is that we’ve had a lot of success with people with a clinical background coming into the IT organization, whether it’s our clinical informatics team or our Epic team. The business knowledge and the business credibility that they bring with them has been absolutely valuable. We consistently hear, ‘Wow, I didn’t know that IT did X, Y and Z.’ And so I think that even when you’re moving within a single organization, asking questions and striving to understand is always a good thing.
Gamble: Very interesting. Let’s talk about the workforce shortage, which has been really difficult. What are you doing to keep people engaged and avoid burnout?
Olenoski: It’s tough. These are definitely unprecedented times. I feel like we went through several phases of the pandemic especially within healthcare. For that first 6 to 8 months, it was very new. It was all hands-on deck and we thought we were through it, and then it came back again, then we thought that we were through it.
I think whenever you go through something like that, especially within IT and healthcare, keeping people connected to the mission is really important. Whether it’s bringing patient stories and patients themselves into our IT town halls, bringing in guest speakers, encouraging folks to get out there to the frontline, one of the big things has been keeping people connected to the mission because I think in IT there’s a natural tendency to sometimes feel like you’re not there with the end user.
Also, if you’re now in a hybrid model, it can feel even more challenging. You need to double down to try to keep people connected to the mission and make sure we’re focused on people’s development as well. Because I also think with change comes opportunity. That can be different working models, new technologies that we’re rolling out, and if someone does happen to transition, what sort of opportunities does that create for others. It’s really working with the team to view change as an opportunity as well.
Gamble: That’s not always easy to do.
Olenoski: It’s not. One of the big things has been being really purposeful with our time. One thing we’ve come to quote within Main Line is, ‘we meet with the people on our calendars about things on our calendars.’ How do we create some of those opportunities? The CMIO and I did a roundtable and met with every single leader within IT over the span of a couple of months in small groups. They also met with their peers in person over lunch. It was a light informal session, but that wasn’t going to happen organically in the environment that we’re in.
I always say there’s going to be dozens and dozens of case studies written about this time, and I think the organizations that will ring true are those that were the most purposeful. It doesn’t mean that they’re going to make every correct decision, but they had an idea, they had an intent, they had an approach, and they thought through it. Those were important things to anchor through when you’re in times of uncertainty and change.
Gamble: So it seems like your leadership philosophy is always evolving, and that you’re very passionate about connecting with people.
Olenoski: Leadership and IT are ever changing. Some things in IT change faster than others but there’s always the need to think about what’s the new technology skill, what’s the new project management skill, what new things are emerging. If we go back in a time machine 10 years ago, and we think about where cybersecurity and data analytics were then and where they are now, it’s amazing. I always say, if you are concerned about changing, don’t be in IT. It could be challenging to be a leader as well. It doesn’t make it easy, but it is kind of fun.
Gamble: You mentioned cyber before. Does that fall under you as well?
Olenoski: It does. And it is cliché, but it definitely keeps us up at night. Healthcare is in an interesting spot where we’re large enough to attract attention and we have a really complicated environment in both the physical and the virtual environment, whether it’s the hospital side, the biomedical side, or the different third-party systems that we leverage.
It’s definitely one of the things that keeps us up at night. At the end of the day, we try and turn it into a business conversation and an internal risk conversation, because you can never drive things down to zero in that space. You just try to make sure you have the right common-sense controls in place.
We’re spending a lot of time on two things: end-user education, because we feel that’s a key frontline for us, and the other is legacy systems. It’s boring, but it’s so important to try to stay up to date whether it’s patching, the OS version, or the server. Keeping that up to date and educating our end users is the foundation to me for a strong cybersecurity program.
Gamble: I imagine it’s tough trying to push user education when there’s so much that people are focused on right now.
Olenoski: And you’re trying to balance the message of burnout as well as best practices and hygiene. To me, that gets back to the strong partnerships that you build. That’s when it comes in handy, whether it’s with the CMIO office, with our other clinical leaders or different folks on the C-suite, or even those on our board of directors to try and let them know that we’re making the best of the investment in cybersecurity.
Gamble: It’s not easy. Everyone knows that cybersecurity dangers are out there, but sometimes you have to paint the picture of what happens when you’re offline for a few hours or a few days.
Olenoski: Unfortunately, when you look at most of the attacks that are out there, it’s been quite a bit of time, it’s been very disruptive. That is what keeps me up at night the most. That business disruption, that potential impact to patient care — that’s the number one thing. Not that any of the other impacts are good, whether it’s on the brand side, the financial side, or the data privacy side. I don’t mean to marginalize those by any stretch, but I think the business disruption and the impact to patient care is clearly the number one concern as it pertains to cyber.
Gamble: It seems every few years there’s one that just dominates the headlines and it’s scary.
Olenoski: Unfortunately, I think it’s more than every few years now. We’re almost numb to certain things. We’re numb to getting those emails that say XYZ had a data privacy incident whether it’s at work or outside of work. It’s definitely a concern.
Gamble: For sure. So I know this a big question to end with, but what do you consider to be your biggest objectives for this year and beyond?
Olenoski: There is an unprecedented amount of change in the industry. I think the biggest objectives for a lot of health systems, MainLine included, is balancing that while also trying to innovate on the consumer side. It’s optimizing the day to day and keeping all the plates spinning, while trying to expand into different areas of growth and digital innovation.
I think one of the big things is not to view them as mutually exclusive, but to think about how they play together, because it’s very easy to be super focused on just the new shiny objects or on how to everybody get through the day to day. And so, I think for CIOs, one of the biggest challenge is how to make sure I’m wearing both those hats and not always separately. It’s how I’m bringing them together to make sure that the overall focus is matching what the system needs.
That’s one of the biggest challenges, and one of the most exciting things about where we are. If you look over the last 10 years, IT organizations have gone from the engine room to the board room in a lot of healthcare services and systems. There’s a recognition that technology is not just a necessary evil, as it was viewed 10 or 15 years ago. Now, I think people are starting to view it as a strategic differentiator, and that’s really exciting.
Gamble: I like what you said earlier about recognizing everything that healthcare organizations were doing during Covid. That’s big, and I feel like you have no regrets about jumping in during that time.
Olenoski: It has been really exciting. And I think for me, it’s definitely true that you grow the most when you’re uncomfortable. For those who are thinking about making a change and doing something new, I always encourage that. Because again, it is very cliché, but you do learn the most when you’re uncomfortable.