During the AI and Machine Learning Forum that took place on August 9 in the Bandol Ballroom of the Wynn Resort, across the street from the Sands Convention Center, one of the sessions, during the first day of the HIMSS21 Conference, focused on the advances taking place at Seattle Children’s Hospital, and on the relations between the IT team and the data analytics team in that organization.
Zafar Chaudry, M.D., the CIO of Seattle Children’s, and Ryan Sousa, the organization’s chief data officer, sat down with James Gaston, senior director in the Healthcare Advisory Services Group at HIMSS Analytics, a division of the Chicago-based Healthcare Information & Management Systems Society, which is sponsoring HIMSS21. They sat on the stage together in a session entitled “AI and Machine Learning and AI at Seattle Children’s.”
Gaston began by asking Dr. Chaudry and Sousa to share with the audience about their backgrounds. Chaudry noted that he had been a practicing physician, and that he has worked in “about 20 different healthcare systems around the globe,” and that, in his words, “I’ve been doing this for about 30 years.” Meanwhile, Sousa, who came to Seattle Children’s from Amazon and after a career in data analytics at several different non-healthcare organizations, noted that “Most of my career has been involved in building predictive models.”
The focus of the discussion was on the interaction between Chaudry as CIO and Sousa as CDO, and how their teams interacted with each other and with stakeholders and sponsors from across the Seattle Children’s enterprise. “What I’ve seen from Ryan’s work is that he has more impact at the stakeholder and clinical level, than other teams,” Chaudry stated. “Ryan’s team’s decision-making process is very different from the rest of the team. As a person running an IT group, at first, it struck me as very different. I would say that it’s more of a business function rather than a traditional healthcare function. Traditionally in healthcare, “ he said, “You seek approval and then do things; but Ryan will tell you that his relationship with his peers in IT is more or less a kind of push-or-pull situation. And I often act as a referee. I think that his model is very much worth applying; but not everyone necessarily always thinks so.”
“You do act as a referee, and you do it very well,” Sousa told Chaudry. “In a traditional IT shop, everything starts with a ticket, whereas in analytics, we’ve pretty much eliminated tickets. A lot of the governance can be highly restrictive; we have 17 teams, and each team acts like a business, and acts like a business. Each is chartered, and has a business sponsor. And what you need is a clinician sitting down with a data engineer, data scientist, and data analyst, to solve a problem; so it’s about putting all the people together on a team to achieve a common purpose with a common cause. It’s really more like having entrepreneurs than experts. And from the outside, it can look chaotic. But if you can put a developmental operations team in place, it can work very smoothly.”
“So it’s a distributed model, right?” Gaston asked. “Yes, highly distributed,” Sousa responded.
“So, success involves finding that right balance, right?” Gaston continued. “And to your point, Zafar, helping people to get comfortable with the differences between IT and analytics is important, right?”
“You have to look at the various skill sets,” Chaudry explained. “Learning from what Ryan is doing, we have tried to cross-pollinate teams; we’ve also included a patient advisory group, and we now use that group to help steer things. We actually had one of the [patient] parents on our Epic advisory team. And that’s very interesting. Healthcare IT is interesting in that technologists tend to think they know best. But really, it’s about everyone deciding together what’s best. And that’s what Ryan’s team is all about. And Ryan’s driven a lot of thinking change in relation to moving away from the traditional,” Chaudry said.
“At another children’s hospital we work with, the CIO has made a very concerted effort not to couch analytics as ‘an IT thing,’ rather than as a division of IT. What do you do?” Gaston asked.
“Analytics needs a home,” Chaudry said. “That doesn’t mean that IT has to constrain the function. I think that that’s what Ryan has built. In terms of watering and feeding his group, that sits with IT. But I hardly ever see some of them. It’s really just a housing function. Fundamentally, it’s really up to the CIO to change the freedoms given to that group, to function. Traditionally, you want to control it, but you don’t need to; you’re really there to provide any level of advice needed. I don’t believe I’m managing Ryan and telling him what to do.
“I would agree with that,” Sousa said. “We could easily have been forced to operate the way that the rest of IT does; but we weren’t. One thing that struck me is that when I came into healthcare—you know, when you say ‘IT,’ there’s baggage there. But it can be death to force an analytics person into an IT function. I’ve been in this just six years; but when I met with my team, I listened to them talk a lot about ‘the business, the business, the business’; and in 20 years, prior to healthcare, it never occurred to me that I wasn’t a part of the business. So, to be effective, you’ve got to become part of the business. So how you achieve that is a really important concept. So when someone comes to me and says, ‘Are you IT or are you a part of the business?’ And I say, ‘yes.’ It’s both. And this is where dev ops come in. All the platforms—all of these things were produced by a team of people who report up to me. And I see it sort of split out among different organizations. And there’s a power in being able to look at things in terms of both business and technology. I’ve talked to a lot of people where the CIO comes along and just shuts everything down and says, ‘You’ve got to do it our way.’”
Meanwhile, Chaudry said, “There are many times when Ryan and I disagree. And that’s not to say that CIOs and CDOs always get along. I like to paint a relationship like this: that there are bad times and good times, and we work through it.”
“I think that’s true,” Sousa said. “There are a lot of things that we haven’t agreed on; and some things need to be resolved, and some things can just be left unresolved. And it’s important to know which battles to pick and which not. It’s funny; I listen to a lot of sessions at conferences. And there’s hubris coming from both sides, both from those coming in from the healthcare sides and not. It’s important to be humble. And it’s important for me not to come storming in as an ex-Amazon guy; some of the things we did at Amazon just don’t work in healthcare; it’s important to find a balance.”
“In pediatrics, we have to do everything by analysis-paralysis,” Chaudry said. “When we make a decision as an organization, 99,000 people have to be involved in the decision. And everyone has to have input. Healthcare is really far behind in certain ways. I try to teach that if 80 percent of us can agree on something, let’s just move forward. And that can be difficult, because you’ll get pushback from the remaining 20 percent.”
“You’re dancing around one of the topics I wanted to touch on; we’ve been talking here about people and relationships,” Gaston said. “And at the end of the day, that’s what gets something done. People come to agreement and come to terms.”
Per that, In my first six months at Seattle Children’s, I spent 90 percent of my time in the hospital, with clinicians,” Sousa affirmed.
And, Chaudry added, “As a CIO, I’ve learned that I have to get out of the way; and that’s really difficult for CIOs to do. Initially, it was difficult to accept that no one was asking my opinion of things. Over time, I saw that people would come to me as they needed to. So my recommendation is this: if you’re surrounding yourself with really smart people, then let the really smart people do the work.”
