Why Leadership and Alignment are Crucial to Success in the New Healthcare

Nov. 8, 2016
CIOs at CHIME16 noted the importance of healthcare C-suite leadership and the alignment of business and information technology goals.

It was fascinating to be at the CHIME16 CIO Fall Forum in Phoenix last week, where approximately 850 attendees, of which some 460 CIOs/College of Healthcare Information Management Executives (CHIME) members roamed the conference halls of the JW Marriott Phoenix Desert Ridge Resort, most with a common goal in mind: to share best practices and continue to learn about how to effectively set up their respective patient care organizations to succeed in healthcare’s changing paradigm.

While there were several broad topics at the CIO Fall Forum that were drilled down in thought-provoking breakout education tracks, the one core theme that stuck out to me was around healthcare C-suite leadership and the alignment of business and information technology goals. To this end, I wrote a story from the Forum about how Banner Health is doing exactly that, by creating a business plus IT partnership model that has driven increased organizational success.

Ryan Smith, senior vice president of IT and CIO of Banner Health, gave a few impressive anecdotes on how the health system, due to its streamlined operating model, was able to integrate data from acquired organizations’ business systems and electronic health records (EHRs) in essentially no time at all. During his presentation, Smith recalled Banner Health:

  • Integrating the business systems and EHR of Goldfield Medical Center in Junction Ariz., 30 days post-acquisition, without ever walking into the medical center prior to the merger
  • Integrating the business systems of Casa Grande Medical Center, located 20 miles south of Phoenix, in just one day post-acquisition
  • Integrating the business systems and EHR of Payson Medical Center in Payson, Ariz., both in just one day

As I reported last week, Smith credited these incredibly quick timeframes to Banner’s operating model. When discussing the model, Smith said: “It doesn't matter what EHR or network they put in, because at the end of the day, we recognize that our model requires consistency and allows us to be really fast when we think about M&A integration.” Indeed, he continued by noting that the model: assumes ALL acquisitions will be rapidly integrated; allows for less time spent on deciding whether or not to integrate; and provides a playbook for executing all phases of IT integration efforts.

This type of operational efficiency and organizational alignment at Banner Health, one of the largest integrated health systems in the U.S., can be tied to Banner’s dyad leadership model, which Smith explained partners a business “champion” with an IT “champion” for most things related to IT strategy and execution. “I coach my team to let that business or clinical champion run the meeting, and be the face whenever possible,” Smith said, comparing the relationship to Batman and Robin’s.

The dyad model continues to be a frequently used one in healthcare. Research from the Physician Executive Council in 2015 found that “dyads are a powerful solution to the basic problem of clinical leadership roles that are too big for any one individual—in terms of scope, competencies needed, constituencies represented, and more,” further noting examples of a “physician-administrative dyad pair at the Mayo Clinic standardized care across 22 EDs, and the hospitalist-nurse dyad leadership model that helps make the emerging model of the accountable care unit so effective).” The research also found that 88 percent of physician leaders surveyed in 2014 “agreed that dyads improve leadership performance and accountability.” The core behind the dyad leadership model is centered on: finding the right “champions”; properly defining roles; and demanding accountability, pundits say.

While leadership models can be debated in clinical and organizational circles forever, there is no hiding from the fact that the world is changing, and at CHIME16, there were plenty of conversations among CIOs about how to adapt to these changes, and thus “avoid minefields.” To this end, a panel discussion of two CIOs, a CIO recruiter and a consulting firm CEO discussed four such problem areas: privacy and security; disaster and downtime; troubled projects; and leadership change. In all four instances, the panelists agreed that partnering with the right people and being as transparent as possible are keys to avoid these minefields, or fight through them if they do occur.

One breakout discussion on security particularly piqued my interest. Keith Perry, senior vice president and CIO of Memphis, Tenn.-based St. Jude Children’s Research Hospital, said in the year he has been in that role, he has made effort to reach out to the CISO at the organization to “elevate” that person and that position. Perry said that a lot of people will focus on if the CISO reports to the CIO or elsewhere, but the real focus should be on getting that CISO to be a bigger part of formulating IT strategy. And it was at this time when the recruiter on the panel, Witt/Kieffer’s Chris Wierz, R.N., said that her firm gets flooded with CISO search requests. “So if you don’t have one, I would say hire one quickly. We are seeing these individual salaries go up by $50,000 each month,” Wierz said.

Another example of how leadership and partnership are so important came when Perry spoke about a storage outage at a company he was working with at the time that resulted in clinical systems being disabled, thus affecting patient care. “After we brought it back up in a few days, I talked to my CISO about being transparent about what happened during the downtime and why, and we brought in a company to do a root cause analysis, which we then took to our executive board. That was a good thing; we instilled trust in the process that we're engaged in the conversation and take these things seriously,” Perry said.

Indeed, these narratives do reveal one thing that is abundantly clear: with the way healthcare’s landscape is shifting, leadership and partnership across the healthcare C-suite is more important than ever before. Banner Health’s M&A activity serves as a prime example, and that health system is far from alone. Healthcare Informatics’ Editor-in-Chief Mark Hagland interviewed the Berkery Noyes Investment Bankers firm’s managing director Tom O’Connor this summer, who said, “Especially as you go to value-based, outcomes-based payment models, things are changing. Physicians get paid, or get penalized, for readmissions in 30 days. All this is driving independent physicians to work for hospitals or affiliate with hospitals. They can’t afford to be independent practitioners anymore, or take on risk.”

Another C-suite leadership trend is also noteworthy: healthcare professionals with both medical and business backgrounds are becoming much more desired in this new healthcare. As reported by Healthcare Informatics, Cejka Executive Search and the American Association for Physician Leadership’s 10th biennial Physician Leadership Compensation Survey found that as compared to physician leaders with no post-graduate degrees, a master's in business administration (MBA) earned respondents on average 13 percent more in salary and a certified physician executive (CPE) on average earned 4 percent more in salary.

Meanwhile, that same report found that the greatest increase in C-suite compensation since 2013 was 18 percent for physicians in the CIO and chief medical information officer (CMIO) roles, and the double-digit increase for CMIOs/CIOs is likely due to the roles' shift in focus—from electronic medical records implementation to ensuring the usability of data to support preventative care at the individual provider level and risk-based accountable care at the enterprise-level, according to the survey report authors. "Clearly, there is perceived value in having a physician leader drive these initiatives and facilities are willing to compensate accordingly," Paul Esselman, Cejka Executive Search’s senior executive vice president and managing director, said in a statement.

So what does all this signal? In a broad sense, healthcare’s changing paradigm means that all of these C-suite roles will undoubtedly become more strategic and complex. And drilling down, CEOs, CIOs, CMIOs, CFOs, chief medical officers (CMOs), chief operating officers (COOs) and chief innovation officers (yes, that’s a whole lot of Cs) will all have to work together and align goals to achieve the greater good—a patient-centered healthcare focused on value-based care that lowers costs by keeping patients out of the hospital. At CHIME16, it was refreshing to hear that many of the industry’s top leaders are recognizing how crucial these elements are to the future of healthcare.

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