Effective Strategies to Engage Internal and External IT Teams: A Thought Leadership Roundtable

Introduction

Much of the focus on digital health in the COVID-19 era has been on healthcare organizations’ ability to quickly build out quality platforms to support telehealth and remote work. Behind those success stories is an equally impressive result: senior healthcare executives swiftly adjusting their management approaches to help their IT teams perform at a high level, whether working on site or at home. The workload has only increased as these teams deal with the backlog of projects put on hold during surges, coupled with the growing demand for digital solutions. Moving their organizations forward under these circumstances will require continued creative leadership as CIOs must engage employees – both theirs and their partners’ – in the journey.

Hyland Healthcare invited five members of the College of Healthcare Information Management Executives (CHIME) in mid-October of 2020 to talk about the impact of COVID-19 on their IT operations and their expectations of the businesses that support them in a virtual thought leadership roundtable. CHIME President and CEO Russell Branzell moderated the discussion. Participants included:

• George Hickman, Executive Vice President, CIO and Chief Analytics Officer, Albany Medical Center
• John Kravitz, Corporate CIO, Geisinger Health System
• Randy McCleese, Interim CIO, Twin Lakes Medical Center
• Theresa Meadows, Senior Vice President and CIO, Cook Children’s Health Care System
• David Young, Service Area CIO, Kaiser Permanente

Adapting to the Times

Agile. Flexible. Versatile. Innovative. Robust. Resilient. Tireless. Those are a few of the words digital healthcare leaders use to describe their teams and organizations in the early days of the COVID-19 epidemic. COVID-19 created opportunities to expand on or adapt existing technologies and create or implement new tools to help protect patients, physicians and other healthcare employees from the disease. The urgent need for quick solutions meant rapid-fire rollouts of telehealth and telework systems as well as numerous other technologies to monitor supplies, workflow and outcomes. Behind the scenes, technicians, software developers, programmers, applications specialists, analysts, security officers, managers, directors and others stepped up to the plate, working long hours week after week to meet their customers’ needs.

Even when the urgency lessened, the work did not. Platforms stood up in days and weeks needed to be revised and refined, often multiple times with incremental improvements. The day-to-day operations that keep a healthcare organization functioning still required staffing while calls for new digital tools continued to pour in. Projects that were temporarily put on hold to address the COVID-19 crisis clamored for attention. For some healthcare systems, that meant an upgrade or EHR go-live. For others, it was fulfilling requirements for a merger or acquisition, or a new hospital or other major capital expense. All the while some, if not most, IT employees were working remotely.   

That many healthcare organizations’ IT departments have been able to handle the pandemic’s evolving challenges while also staying on course with short- and long-term plans is testament to their leadership. CIOs representing a spectrum of organizations – multistate integrated healthcare systems, rural hospitals, academic medical complexes and children’s networks – recognized they needed to adapt their approaches as leaders to accommodate this changing work environment.  

Managing People Remotely

The pandemic has shown some employees can effectively work off site, with benefits that include:

• Keeping staff safe from potential COVID-19 exposure in the workplace
• Freeing up space in bricks-and-mortar facilities for other uses
• For leased office space, saving costs from canceled leases
• No commutes
• For some, increased productivity
• Greater flexibility for employees

But telework requires a different way of managing IT teams, according to the senior digital executives. Of Geisinger Health’s roughly 900-member IT department, a large percentage of the staff will work permanently from home or in a hybrid model, according to Kravitz. He calls the new order a leadership challenge that requires frequent communication and virtual meetings ranging from all-staff townhall-style video gatherings every two weeks to small-group conversations at the team level.

“It’s so important that you understand how your people are reacting and how well they’re doing,” Kravitz said. For instance, some of his employees thrive on in-person interaction; they will be among the on-site staff working along with those who are required to be physically present for certain projects. Others get immersed in their projects as they work from home. “Productivity has never been better. The focus has never been better. People working from home are working more hours per day and accomplishing more than we did before, because they don’t have to commute and get ready for work. … As leaders, it gives us the opportunity to step up our game, too.”

Of Young’s team at Kaiser, many are on site while some project managers work from home. He emphasized the need for frequent communications, updates and sharing. “We started within the IT organization having a daily huddle, and that helped us immensely,” Young said. “Checking in, seeing who’s assigned where, doing a mood check and having the flexibility to adapt to children at home and other situations. Those daily huddles helped us stay connected and offer support to each other.”

Given the fluidity of the COVID-19 pandemic and other stresses on the healthcare system, Cook Children’s IS added a weekly priority check to their communications strategy. “We’ve started at least once a week asking. ‘Are these our priorities?’” Meadows said. “Because they may ask for something today, and it sounds really important, but six things change between today and tomorrow, and something else becomes a priority.”

Staying Focused

As the executives charged with setting the digital health vision for their organizations, CIOs need to concentrate on guiding their organizations through short-term priorities while keeping a strategic focus on long-term goals. The COVID-19 pandemic forced a pause in some of those plans, with many organizations resuming where they left off after a surge. Their IT teams withstood the stress test of the early COVID-19 days, and with strong communication channels in place, many are having productive careers working from home or on site. As they pick up non-COVID projects again, the CIOs carefully are monitoring their teams’ bandwidth for signs of overload.

Albany Med established an enterprise PMO to manage progress on specific goals set through 2022 and across most business units. This method focuses leader and improvement team decision making, Hickman said. Weekly two-hour report-outs track progress in an accountable forum and with priority and discipline. The approach has positioned Albany Med to continue its progress while also managing its COVID-19 response in parallel. “We’re running our day-to-day operation, managing COVID incident command needs, and we’re still introducing and managing new portfolio projects,” Hickman said. “And yet, we’re able to figure out on account of that dialogue that occurred in those settings, how to manage our resource bandwidth through it. It does take a team. There’s no magical answers coming from the CIO alone. The CIO was one more voice in that mix of talented people working together.” 

Kaiser had to put several infrastructure projects and upgrades on hold to handle two different surges, Young recounted. Setting priorities, managing resources, and monitoring through a dashboard have helped keep non-COVID projects on track once they were reactivated. “We created a dashboard that shows us all the projects, assignments and the resources required so we can track that,” he said. “We can make sure that we have adequate resources without overloading people and keep things moving forward, because we have a lot of work to do to catch up.”

The overarching digital health strategies vary by the organization and its circumstances. Twin Lakes Medical Center, for instance, is undergoing a merger that requires McCleese to inventory their IT assets and programs. “We are getting calls, or emails or texts what seems like every hour or two about where’s this, where’s that?” he said. “I’ve been involved in a merger before, but nothing to the detail that this one’s going through. This one’s far more thorough from a technology standpoint than I’ve seen in the past.”

Texas Children’s is concentrating on developing an experience that is mobile with connectivity across care settings and the home. “Our patients and families are millennials, Gen Z, Gen Y, Gen X,” Meadows noted. “Those are our customers; that’s who we see day in and day out. Their expectation is that everything is in the palm of their hand, and they can take it anywhere they go.” As an integrated healthcare system, Geisinger also is taking a customer-first approach by creating a frictionless, easy-to-use experience for patients, clinicians, physicians, students and subscribers. “Migrating my data centers to the cloud is very, very important for me,” Kravitz said. “Rationalizing our application heap, reducing our expenses, simplifying IT, making things better – all those things are on my list. Will they get done in a year? No. Some of them will take three or four years, and migration to the cloud will take me probably four years. It’s huge. But it’s something I’ve got to stay focused on.”

Engaging Business Partners

The skills and focus that make CIOs effective managers of their IT teams also come to play in other relationships. “It seems like the more I can engage the individual that’s sitting across from me in that vendor partner role, if they’re responsive and actually want to engage in a different place than transaction to transaction, then I have an opportunity,” said Hickman. “So the question for CIOs is, do we look to create a circumstance with our vendors in that way so that a partner response can be possible?” 

Some CIOs make an effort to educate vendors about their clinical environments, workflows and the disruption that occurs when a technology fails. Young recommends including partners in the planning stage of large projects, while Hickman has invited vendor leaders and delivery teams to walk the floors of the neonatal and vascular ICUs, talk with nurse managers about their routines and the effects that technology and a technology outage have on patient care. “My closest vendors are those that really have gotten to know us, understand our missions, understand why I’m doing what I’m doing, why people around me are doing what they chose to do, and finding themselves desiring to be mission supporting,” Hickman said. “In a mature state, that’s when we refer to those vendors as our trusted business advisers.”    

At that level, the partner is aligned with the healthcare organization, working in tandem to solve business problems, Kravitz added. “A trusted vendor relationship is a two-way street; it’s not a one-way street,” he said. “They’re not just selling me. It can’t be transactional. It has to be a business-solving, problem-solving type of relationship.” Valued partners anticipate their customers’ needs, as one company did by voluntarily increasing two-factor authentication licenses for Cook Children’s to support remote work, another by doubling Twin Lakes Medical Center’s Webex capability, and others by offering technicians and resources to support Kaiser’s printers. “That to me signifies a true partner, where it’s a friend who’s looking out for you, who knows your organization, knows your environment, and proactively did that,” Meadows said.

The exceptional partners are open and transparent, McCleese added, citing an EMR vendor that provided references to all its clients when asked for three. “That, to me, was totally different,” he said. “It helped me to rely upon them. Not only did they want me to hear the good things that were going on, but they wanted me to call a couple of the ones that they hadn’t done very well, because they wanted me to learn how they recovered from the bad situations.”

Building a foundation of trust may pave the way for deeper relationships like managed service agreements with strategically aligned partners that understand the importance of reliable, responsive and accountable service with 24/7 support. “I tell people we’re in healthcare, but we’re also in IT,” Young offered. “We take the two most complex industries and put them together, and it gets complicated real fast. Then we have to communicate that to our business partners.” But ultimately, he added, for the business partner “it better be up all the time.”

Conclusion

Strong and effective leadership by digital healthcare executives who adapted their management strategies during the early days of the pandemic and after has helped their IT teams succeed. Now, with some team members working remotely and the resumption of non-COVID projects, CIOs are making an effort to communicate frequently and closely monitor employees’ workload and bandwidth. By keeping a focus on their digital health strategies, CIOs are moving their organizations forward and helping them meet short- and long-term goals. Some of these leaders are applying their internal leadership skills to guide the engagement of external vendors, positioning those who respond to become trusted business partners.