assemble the digital transformation dream team

Health Care IT Advisor

Assemble the Digital Transformation Dream TeamThe leadership skills, partners, and workforce to succeed

© 2019 Advisory Board • All rights reserved • advisory.com • WF1329471-a 08/06

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Assemble the Digital Transformation Dream TeamThe leadership skills, partners, and workforce to succeed


ROAD MAP6

Digital transformation and the evolving role of CIO1

2 Four leadership questions every CIO should be asking

3 How to prepare your IT workforce for digital transformation

4 Action items



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Leading through changing times

Digital transformation

was invested in digital health in the first half of 2019

$6.8 billion

Digital health funding Shift in IT prioritiesDigital transformation is crucial to an organization’s long-term vision and helps drive IT strategy

Digital innovation is one of the fastest growing areas in the health care industry

How healthcare executives are spending their IT dollars

4%

21%

25%

58%

79%

Other

Electronic healthrecords

IT infrastructure

Analytics and AI

Digital health

It is important for IT leaders to be able to lead through these changing times. There’s always been more work than people and we’ve always had to manage that, but it’s escalating now.”

A Hospital CIO

Sources: July 2019. Startup Health. 2019 Midyear StartUp Health Insights. May 2019. Mergers and Acquisitions. Healthcare’s Must-Have Technologies. TheMiddleMarket.com; Advisory Board interviews and analysis.


https://www.startuphealth.com/2019-q2-insights


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The CIO role is evolvingAs digital health matures and IT leadership evolves, senior leaders emerge

CIO as IT leader

• “I sell the value of IT.”

• “I execute the IT strategy.”

• “I run the IT organization.”

• “I am the captain of the ship.”

Technology can change the way we run health care

CIO as strategic partner

• “I own a large part of operations.”

• “I have a seat at the executive table.”

• “I have responsibilities outside of IT.”

Technology touches every aspect of health care

• “My customers are the captains; I’m a key participant and navigator.”

Source: Advisory Board interviews and analysis.

The role of CIO has moved from implementing products to being in a position now fully leverage the capabilities of those systems, to create more seamless experiences for customers, and create more efficiency for clinicians.”

Laura Smith, VP and CIOUnityPoint Health



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Potential operational gap emerges as IT roles evolveAs CIOs shift focus, IT leaders must step up


Common CIO questions• What skills do I need to meet the changing needs

of the organization towards digital transformation?

• How do I maintain consistency in these fast-moving times?

• How much time should I spend on leading the organization and my teams?

• How do I inspire my team to take ownership of running the business?

• How do I know if my IT leadership team is keeping the business running?

As CIOs dedicate more time to growing and transforming the business

The IT organization must step up to help run theIT business



10

The world has changed for ITNo-regret leadership and workforce priorities for today’s CIO

The team is changing, your priorities are changing, but a good leader should remain focused on finding really talented people, creating a vision, inspiring passion, and getting out of the way.”

Dana Moore, SVP/CIOChildren’s Hospital Colorado

Four leadership pillars Workforce imperatives

Prepare your IT workforceChange your perspective on IT leadership

• Communication

• Collaboration • Strategy

• Innovation

• Build a unique culture

• Find the right talent• Engage and motivate your teams

CIO




ROAD MAP11




4 Action items



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Your digital transformation has a story


This is what the journey looks like…

This is how it improves the lives of our patients and caregivers…

This is how everyone will feel when it is complete…

This is why our community should care about our digital transformation…

How one CIO shares his vision

• Make it simple—he put his strategy in a visual on one piece of paper

• Reach everyone—he met with all 500 leaders face-to-face in small groups• Help them see—he told compelling, human stories

Digital transformation



13

Four leadership questions every CIO should be asking

Do I communicate effectively?

Am I fostering a culture of innovation?

Is IT focused on the organization’s strategy?

Am I building strong internal and external partnerships?

CIO




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Leadership action items from leading CIOs


1) BFF = Best Friends Forever2) ROI = Return On Investment

Communication• Use storytelling• Be humble and curious

Collaboration• Consistently deliver strategic value to establish the “CIO credibility factor”• Use BFF1 / buddy programs• Make the most of your Informatics team • Establish win-win external partnerships

Strategy• Maintain a deep understanding of the business• Be mission and community focused • Incorporate Agile methodologies

Innovation• Place the “what” before the “how”• Be willing to take risks without a guaranteed, near-term ROI2

• Explore innovation at various levels

• Ask the right questions• Provide strategic direction



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Leaders inspire through the stories they tellStories have the power to change our attitudes, beliefs, and behaviors

Communication

Source: 2014. Harvard Business Review. Why Your Brain Loves Good Storytelling. Advisory Board interviews and analysis.

• Builds trust in leader, explains personal values

Who I am Who we admireWho we are

• Describes a time where the organization or team came together to meet a challenge

• Holds up individual employee as exemplar

• Sets or raises expectations

Main character that seeks to accomplish a goal

Obstacle that makes the hero’s objectives appear impossible to overcome

The process by which the hero overcomes adversity

The inspiring moral or teaching of the story

Three types of stories

Narrative Arc

“When you want to motivate, persuade, or be remembered, start with a story of human struggle and eventual triumph. It will capture people’s hearts – by first attracting their brains.”

Paul J. ZakClaremont Graduate University


https://hbr.org/2014/10/why-your-brain-loves-good-storytelling


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Be humble and curious• Operate less like a captain, more

like a key participant and navigator of the ship

• Spend time learning outside of health care

• Learn from your peers—it’s okay to say, “Can you explain this to me?”

Be willing to say “I don’t know” and use these tactics:

Provide strategic direction• Remove “IT speak”, especially

when providing strategic direction

• Connect opportunities to the strategy before jumping to solutions to the problem

• Talk about the organization’s strategy, not the IT strategy

Ask the right questions• First, listen to the needs of the

organization

• Next, ask open-ended questions instead of asking “why?”

• Then, repeat and reframe your messages for clarity

As senior leaders, you won’t know everything…Communication

As CIO, you won’t know everything. It’s about a set of skills—it’s about how quickly you can learn, knowing the right questions to ask, and the ability to provide strategic direction.”

Michael Kim, CIOMultiplan




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How to be an effective partner to the businessCIOs build trust by consistently delivering strategic value

Internal Collaboration

1Promote complete

transparency

From surveying business partners to IT performance data analysis, use metrics to monitor effectiveness

Use business metrics

42Instill project

ownership

IT should provide clarity and transparency into project goals, expectations, and progress

If a project is done on behalf of a business leader, that leader should say, “this is my project”

Track records build trust—deliver projects on time, on budget, and to scope

3Continuously improve delivery capabilities

The “CIO credibility factor”—do you have it?• Are you involved in developing the

organization’s strategy?

• Do senior leaders come to you to identify solutions to business problems?


• Is IT brought to the table early and often for input and guidance across the organization?

• Have you built a “circle of influence”?



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BFF program opens channels of communicationIT partners with CEOs and senior leaders to identify and deliver innovations


Source: www.viz.ai.com; Advisory Board interviews and analysis.

1) Viz LVO uses artificial intelligence to automatically identify suspected large vessel occlusion strokes on CT angiogram imaging and to alert on-call stroke teams

BFF program model at Baptist Memorial Health Care

Clinical innovations identifiedIT projects delivered on time

IT develops guiding program principles and identifies senior leaders for participation

BFFs conduct monthly calls and/or site visits with CEOs and senior leaders

IT strategy committee receives ideas and IT project requests from BFF visits

Service line leaders bring IT to the table early for projects involving technology

Innovation and contracting teams participate to evaluate ideas and projects

• Neurology service line leader shared Viz LVO1 from Viz.ai with BFF during monthly site visit • Idea processed through IT strategy committee and subsequently implemented to save

critical time for stroke patients

Artificial intelligence (AI) solution identified through BFF program

1

2 3

4 5


http://www.viz.ai.com/


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One CNIO’s1 vision for Nursing Informatics (NI)NI competencies from boardroom to bedside and everywhere in between



1) CNIO = Chief Nursing Informatics Officer

• Centralized model

• Report directly to CNIO

• Certification required and population-focused

Clinical nurse informaticists

• Decentralized model

• A NI “community of practice”

• Nurses spend part of their full time role on NI work/governance

NI collaborative

• Matrixed model

• Unit-based nurses with operationally-funded time for nursing informatics work

NI unit-based champions

• Multi-year vision to equip every nurse and nurse leader with NI competencies

NI at the bedside

NI unit-based champions (NIUBCs) • NIUBCs use knowledge of clinical

workflows to ensure that Clinical Information Systems (CIS) are thoughtfully designed and provide a positive usability experience

JOB DESCRIPTION



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Be selective as partnership opportunities emergeWin-win relationships are essential to digital transformation

External Collaboration


Strategic considerations

Operational considerations

Economic considerations

• Is it a good fit for our patients?

• It’s a good fit for our caregivers (employees)?

• Does the partnership align with our core values?

• Have we clearly defined how the partnership will be managed?

• Does it lower the cost of care in our community?

• Does it bring jobs to our community?

• Can we effectively scale this partnership across the enterprise?

• Can we staff the project?

• Could we serve as a reference / show site for this partner?

• Do we have solid governance in terms of funding, resourcing, and decision making?

• Do we have checkpoints built into the plan?

Additional Health Care IT Advisor resources• The IT Contracting Handbook: A practical

guide for providers and vendors• 30-minute Breakout Session: How to

Negotiate Win-Win Technology Contracts


https://www.advisory.com/research/health-care-it-advisor/resources/2018/the-it-contracting-handbook

https://www.advisory.com/research/health-care-it-advisor/events/webconferences/2019/2019-health-care-it-advisor-virtual-summit/how-to-negotiate-win-win-technology-contracts


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How leading CIOs support the organization’s strategyStrategy


• Invest in self-teaching, personal development, and ongoing education

• Invite non-IT leaders to IT education sessions and briefings

• Volunteer at your organization

• Require all IT staff to shadow a clinician once a year

• Use patient and family advisory councils

• Start with a pilot, but choose carefully

• Choose the team members wisely

• Engage the whole team

• Take a balanced approach to planning the new process

• Align your governance committee meetings with your spring cycle

“I invested time in learning more about revenue cycle management.”

“I scrub into surgery as a technician and volunteer in outpatient chemotherapy.”

“We launch minimal viable products, but understand Agile is not the best for all scenarios.”

Examples from leading CIOs

See our Research Report: Agile IT: A technique to address the increasing pressures and rapidly changing demands of health care IT

ExecutionIncorporate Agile methodologies

FocusBe mission and community focused

KnowledgeMaintain a deep understanding of the business overall


https://www.advisory.com/research/health-care-it-advisor/research-briefings/2019/agile-it


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What problem are we solving?Successful innovators place the “what” before the “how”

Innovation

Innovation—like AI, like population health—means everything and nothing, all at the same time… It may be a whiz-bang technology, it may be a device, it may be a digital solution, it may just be doing something differently. But innovation is a different way of thinking about the same problem that you’ve had. Dr. Richard Zane,

Chief Innovation Officer, UCHealth

Expand specialist capacityTo maximize the investment in specialist and hard-to-recruit providers, Spectrum Health used clinician-to-clinician telehealth to minimize physician travel and maximize specialist capacity.

Market scenario Geographically dispersed practices limit physicians to a traditional in-person visit model.

Return Using telehealth to expand specialist reach reduces physician travel time and boosts productivity. By giving specialists a better work-life balance, some groups may see a cost savings for physician recruitment or turnover.

Spectrum Health

Increase patient accessTo improve patient access and boost productivity, Greenville Health investing in an artificial intelligence (AI)-based technology that automates low-acuity visits and takes less than three minutes of provider time.

Market scenario Rising consumer demands makes patients willing to shop based on price and convenience.

Return Technology that enables patient access provides an opportunity to collect direct revenue on patient visits and enhance patient loyalty. A return is captured by acquiring new patients and enhancing provider efficiency.

Greenville Health

Source: May 2019. Modern Healthcare. Transformation Summit stresses being smart about innovation. Advisory Board interviews and analysis.


https://www.modernhealthcare.com/care-delivery/transformation-summit-stresses-being-smart-about-innovation


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100-Day WorkOut accelerates continuous improvementOpportunities identified and implemented by frontline staff at UnityPoint

Innovation

1) KPI = Key Performance Indicators2) OFI = Opportunity For Improvement3) KaiNexus LLC is a quality improvement program software solution for health care

organizations in the United States4) 2 OFIs per month x 3 months + 1 for good measure

UnityPoint Health Care’s 12-Step WorkOut Cycle

Concentrated and accelerated effort for sustainable results

Unified effort on process improvement• Alignment with strategy and KPIs1

• All hands on deck


7 59413

OFIs per team teams

improvements4

• Project kick-off

• Team meeting kick-off

• Frontline staff identity OFIs2

• Team prioritizes OFIs

• Team validates problems/causes/solutions

• Team lead enters OFIs in KaiNexus3

• Potential cost savings calculated and logged

• Team implements change

• Team monitors change(s)

• Team leader reports out (monthly)

• Cycle continues for 100 days

• Final report-out and celebration

• Structured frequent cadence for accountability

• Forum for timely decisions

• Empower decisions at appropriate levels



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Innovation takes many forms in health care todayAll require innovation-driven leadership

Innovation


1) HCO = Health Care Organization

Individuals• Individuals suggest innovation solutions • Teams and service lines benefit

Industry• HCOs1 take breakthrough innovations to the industry• HCOs partner with other HCOs (including competitors),

vendors, government and other industries toward life science innovations

Organization-wide• Innovation Centers identify practical solutions to implement

and breakthrough innovations to fund and support

Innovation-driven leadership

Must be willing to take risks and experiment with new products and processes even without a guaranteed, near-term financial return on investment

Teams• Interdisciplinary teams identify and vet ideas • IT and clinical teams unite to identify clinical innovation

Download our checklist:Get Started with Digital Innovation


https://www.advisory.com/-/media/Advisory-com/Research/ITSC/Resources/2019/Checklist-Get-Started-with-Digital-Innovation.pdf


ROAD MAP25




4 Action items



26

How to prepare your IT workforce for digital transformation


Three workforce imperatives

Build a unique culturePurposefully invest time, energy, and resources in building a unique culture. This culture is defined by a small set of deliberately chosen core attributes.

1

Find the right talentFind talent and build high-performing teams through a combination of internal hiring and external talent sourcing from the talent cloud.

2

Engage and motivate your teamsDevelop teams to drive strategic value and take IT leadership development to the organization level.

3



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How one CIO ripped out and replaced a “default” culture CIO throws a lifeline by asking, “What culture do we want in IT?”

Build a Unique Culture


Rewards from replacing existing default culture

• IT kept in house

• Shortened IT project timelines

“We can create our own subculture in IT or it will get created for us and we won’t have control over it.”

CIO and leadership team spend the rest of the day charting a path towards a unique culture

CIO receives commitment from senior leaders to replace the default culture with a set of core values for the IT organization

CIO

• Improved clinician satisfaction with IT survey scores

• Improved IT employee engagement survey scores

CIO holds IT organization accountable for building a unique culture



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How to build a unique cultureCrystallize your cultural aspiration and share it in ways that resonate

Build a Unique Culture


1Embed a consistent set of values across IT

2Make values pithy and memorable

3Use values to differentiate your culture from your competition’s

To develop deliberate values, CIOs should follow three strategies:

Tip: CIOs hold remarkable power to advance a unique culture from the stories they tell.

If you're successful in defining the culture, you end up being able to retain a highly valuable workforce. It also helps employees identify with and drive those important values of the organization into the community. As a non-profit, our goal is to support our community; that's why we're here.”

Jon Russell, SVPJohn Muir Health



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Most IT organizations use a combo of talent sourcesNo matter where you get your talent, IT must work as one entity

Find the Right Talent


• Improve your application process to prevent strong candidates from giving up part-way through

• Ensure recruiters can screen candidates for more than technical skill• Create a realistic candidate profile

• Harness the power of employee networks to source referrals

• Tap into overlooked candidate pools

Direct hiring and internal promotions• Fill open positions and promote from entry-

level IT positions, such as your IT Help Desk• Utilize internships from higher education and

community partnerships

• Use performance-based career ladders

• Remove barriers to recruiting talent such as eliminating degree and certification requirements, when possible

Tap into the Talent Cloud• Utilize vendors, partners, and third-party

talent sourcing organizations for IT talent when you need it

• Fill project positions and quickly deploy high-demand skillsets

• Use these roles to educate and mentor your existing staff

Tips from our HR Advancement Center



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Community partnerships help fuel IT talent pipelineHR and D&I connect IT with qualified talent at Partners HealthCare

Find the Right Talent

Source: Advisory Board research and analysis.

Community partners

137 positions filled by Year Up over 7 years, with several elevated to senior management roles

Information Technology (IT)

Diversity and Inclusion

(D&I)

Human Resources

(HR)

U.S. Department of Labor

Benjamin Franklin Institute of Technology

Boston Public Schools

Northwestern University

Our joint relationship with Diversity and Inclusion and HR helps us source talent in support of multiple IT initiatives.”

Jim Noga, VP & CIOPartners HealthCare

Year Up www.yearup.org

Partners HealthCare



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How to utilize your IT Help Desk for talent developmentIT talent development pipeline at Baptist Memorial Health Care

Engage and Motivate Your Teams


CoachingSharing

Learning

Problem solving

IT Help Desk

Provide entry level positions for clinical and technical backgrounds

Annualized IT staff turnover rate at Baptist Memorial Health Care

2.4%

1 Support skill development through “intentional inclusion” in IT projects and daily work with IT teams

2 Provide advancement throughout the IT organization

3

Entry level position

• Core IT

• Clinical informatics

• Applications

Advanced IT role with performance-based

career ladder

Internal skill development

Quarterly interdepartmental survey of IT Services, including the IT Help Desk, consistently yields positive feedback



32

Advisory Board’s IT staff engagement survey resultsTop drivers for IT in 2018 largely the same as employees overall


Ranked highest on survey

• My organization pays me fairly for my job

• I am interested in promotion opportunities in my unit/department

• My manager helps me balance my job and personal life

Ranked lowest on survey

• I know what is required to perform well in my job

• Training and development opportunities offered by my organization have helped me to improve

• I receive effective on the job training

How do your staff really feel?

• The IT department at Bingham Memorial Hospital in Blackfoot, Idaho, uses the POPin app to run live polls and collect anonymous feedback during IT team meetings

• IT Director, Rob Weis, reports more candid feedback and improved staff engagement among employees

?




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Set expectationsTake time to connect IT staff expectations to the organization’s values

CIOs share many employee engagement tactics Engage and Motivate Your Teams

• CIO meets with every new IT employee to share IT principles

• Engage employees in setting expectations for their roles and promoting values

Provide flexibilityProvide remote work options to improve morale, reduce stress, and boost retention

• Use remote options to boost productivity and reduce operating costs

• Prepare management to support virtual teams

Celebrate and have funRecognize achievements,

support team building, and foster excitement in the workplace

• Take celebrations to the business units and include all shifts

• Hold quarterly, family-inclusive events and take part in team

building activities at the organization level

Offer growth opportunities

Invest in training and development opportunities

• Use performance-based career ladders

• Develop mentorship and leadership development programs

• Offer flexible training and education options




34

Two approaches to get IT teams on the same pageCertification and training viewed as investment in people


1) The Information Technology Infrastructure Library (ITIL) is a set of concepts and techniques for managing information technology (IT) infrastructure, development, and operations.

Global certification supports best practices in IT

Global language taught through Innovation Center

All IT employees receive global innovation language curriculum

First group through the course identified data storage innovation that saved $5k per year

IT staff required to achieve IT Infrastructure Library (ITIL)1

certification as condition of employment

Global certification supports the same language, understanding, and expectations across the IT team

Cleveland Clinic, Cleveland, OH Intermountain Healthcare, Salt Lake City, UT

We expect our doctors and nurses to follow best practice. Why don’t we have the same expectation of IT professionals? Everyone in IT gets professional certification. We see this as an investment in people.”

Ed Marx CIO, Cleveland Clinic

Even the small ideas lead to big rewards.”

Marc ProbstCIO, Intermountain Healthcare

Intent is to invest in IT skill development and share innovative ideas




35

Leadership programs develop future IT leadersCleveland Clinic’s Business Technology Leadership Academy



1) Leadership success factors adapted from the College of Healthcare Information Management Executives (CHIME) Health Care IT Leadership Academy curriculum

Identify future leaders

RESULTSPLANNING

Participants learn eight leadership success factors1

1

Participants receivementorship from faculty and senior leadership

2

Program application• Open to everyone

• Applicant required to submit one-page essay on why she/he should be chosen to participate

Participant selection• Senior leadership

team reviews applications

• Ten participants chosen from hundreds of applicants each year

Leadership skill development• Set vision and strategy

• Make change happen

• Demonstrate IT’s business value

• Instill customer service as a core value

• Build a high performance IT organization

• Build networks and community

• Contemporary best practices in HIT industry

• Achieving leadership through life/work balance

PARTICIPATION

3Participants complete capstone leadership project Graduates serve as faculty

for future BTLA programs


https://chimecentral.org/chime-technologies/chimetech-leadership-academy/


ROAD MAP36




4 Action items



37

Leadership action items from leading CIOs


1) BFF = Best Friends Forever2) ROI = Return On Investment

Communication• Use storytelling• Be humble and curious

Collaboration• Consistently deliver strategic value to establish the “CIO credibility factor”• Use BFF1 / buddy programs• Make the most of your Informatics team • Establish win-win external partnerships

Strategy• Maintain a deep understanding of the business• Be mission and community focused • Incorporate Agile methodologies

Innovation• Place the “what” before the “how”• Be willing to take risks without a guaranteed, near-term ROI2

• Explore innovation at various levels

• Ask the right questions• Provide strategic direction



38

How to prepare your IT workforce for digital transformation


Three workforce imperatives

Build a unique culturePurposefully invest time, energy, and resources in building a unique culture. This culture is defined by a small set of deliberately chosen core attributes.

1

Find the right talentFind talent and build high-performing teams through a combination of internal hiring and external talent sourcing from the talent cloud.

2

Engage and motivate your teamsDevelop teams to drive strategic value and take IT leadership development to the organization level.

3



39

2019 Health Care IT Advisor Virtual SummitBuild your business and deliver on digital disruption

Virtual Summit Agenda

One-hour Presentations

Available on demand2019 Health Care State of the Union

Available on demand Build Your Digital Front Door

Tuesday, August 6, at 3:00pm ET Assemble the Digital Transformation Dream Team

On-demand recordings2019 Virtual Summit

30-minute Breakout Sessions

Available on demandNatural Language Processing 101

Available on demandPrecision Medicine 101

Wednesday, August 7 at 3:00pm ET How to Negotiate Win-Win Technology Contracts

Thursday, August 8 at 3:00pm ETEHR Optimization: A Prescription for Clinician Wellness


https://www.advisory.com/research/health-care-it-advisor/events/webconferences/2019/2019-health-care-it-advisor-virtual-summit


40

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Design ConsultantNini Jin

Research TeamCamille Bridger

Nic McCullagh

Bethany JonesMatt Stevens


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assemble the digital transformation dream team

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