A CHIME Leadership Education and Development Forum in collaboration with iHT2

HIT Leader 3.0 Cornerstone: Setting Vision and Strategy in Dynamic Times

Rodney C. Dykehouse, CHCIO, FCHIME

CIO, Penn State Hershey Medical Center & College of Medicine

#LEAD15

Agenda

• What is a HIT Leader/CIO 3.0? – The “New Normal”

– Dynamic times require dynamic, flexible, strategic leaders

• Strategic Leadership – Several examples to reinforce the need for key strategic skills from HIT Leaders

• Strategic Planning – From Values to Mission to Vision to Strategy

– Executive sponsorship….Not an option!

– BUT must execute, too

• Be Strategic. Be Revolutionary. Be Radical. Be Successful in the “New Normal”

CIO 3.0 – What now???

• What is a HIT Leader/CIO 3.0? – Today’s CIO role is shifting as the healthcare landscape is changing at

unprecedented speed.

– This evolution is anticipated to continue at an accelerated pace with mergers, consolidations, new partnerships, and evolving management models.

– Added to this dynamic environment is the rapid advancement of technology and the added pressures from government legislation and compliance mandates.

– Highly skilled HIT leadership in this environment is critical for future success.

CIO 1.0 & 2.0 Yep, you’re accountable

for these, too!

The Healthcare CIO: From Crawling to Walking Upright, to Carrying the Organization

Knowledge Purveyor

Technology Interpreter

Process Visionary

Process Consultant

Financial Analyst

Change Agent

Educator

Lobbyist

Service Broker

Project Advisor

Venture Capitalist

Customer Service

Innovator

Economist

Risk Manager

Political Visionary

Application Purveyor

Vendor Manager

Project Manager

Asset Manager

Problem Manager

Skill Manager

Process Navigator

An Advisor role A Driver role

Tech Manager

A Supportive role

CIO 1.0 CIO 2.0 CIO 1.5

An Enabler role

IT Operations

+ +

Source: Gartner CIO 2.0 Conference

Expectations of CIO 3.0

• Healthcare Information Exchange

• Certified Electronic Health Record

• Patient Portals

• Data Warehouse

• Business Intelligence

• Complete Data Integration

• Data Analytics

• World-class IT Team

• Unified Communications

• ACO System

• Population Health System

• Document Management

Expectations of CIO 3.0

Predicting the Future: NASA ???

The question is no longer, “what planet are you on?”,

but rather “What planet SHOULD you be on…

and how will you get there???”

Evolution: gradual development of

something, especially

from a single to a more

complex form.

Revolution: fundamental change

in a way of thinking

about or visualizing

something.

EVOLUTION REVOLUTION vs.

CIO 3.0 – What now???

• The New Normal…

What is YOUR New Normal???? Do you have a Strategic Plan?

Are you focused on Today or Tomorrow?

Are you ready to deliver it…even as it must remain dynamic?

The New Normal – M&A

The New Normal – M&A

The New Normal – Politics / Govt

The New Normal – ACO’s & more

The New Normal – Payors???

Consolidation of Payors & Providers Can you compete?

Is your “IT” ready to meet this demand?

The New Normal – excluded!

Health Plan Exclusions Can you survive this?

Is your “IT” able to reduce costs & improve quality?

The New Normal – AMC Survival?

The New Normal

Personalized Medicine Can your EMR handle this?

Do you have enough storage for this?

Can you share and capture this from anywhere?

The New Normal – Genomics

The New Normal – More Data!!!

The New Normal – Cyber Security!

CyberSecurity It CAN happen to you!

What are you doing to “prepare” your organization?

In the news….more security breaches… …it has happened to us!!!

Sept 9. 2014

In the news….more security breaches… …it has happened to us!!!

CyberSecurity It WILL happen to you!

What are you doing to “prepare” your organization?

In the news….more security breaches… …it has happened to us!!!

CIO 3.0 – What now???

• The New Normal… – M&A: are you acquiring or being acquired? Corporate IT?

– New Reimbursement models: ACO, MSSP, Population Health

– Optimization and Business Value: commoditize everything and leverage for strategic advantage, e.g. data, quality improvement, cost reduction

– Patient Engagement: social media, wearables, patient empowerment for appts, e-messaging, televisits, etc.

– Personalized Medicine: genomics, provider comparisons, etc.

– Cyber Security: for existing and virtual enterprises

CIO 3.0 – What is a CIO to Do???

CIO 3.0 – What is a CIO to Do???

• What is C-Suite 3.0? – “When external change takes place—for example, the

emergence of a game-changing innovation, or a shift in the regulatory landscape—it rarely affects only one function inside the business. …. If anything, achieving the coherence and alignment across multiple strategies needed to bring about such changes seems to be getting harder, particularly for CIOs.” From Wall Street CIO Journal “Navigating C-Suite 3.0” orig published 2/2/15

CIO 3.0 – What is a CIO to Do???

• What is C-Suite 3.0?

– “In version 3.0,” Kelly says, “success will come to CIOs

through engaging as part of a team, and helping others in the C-suite achieve their goals.”

– From Wall Street CIO Journal “Navigating C-Suite 3.0” orig published 2/2/15

CIO 3.0 – What is a CIO to Do???

CIO 3.0 – What is a CIO to Do??? McKinsey: “Why CIOs should be business-strategy partners” February 2015 | byPedja Arandjelovic, Libby Bulin, and Naufal Khan

CIO 3.0 – What is a CIO to Do??? McKinsey: “Why CIOs should be business-strategy partners” February 2015 | byPedja Arandjelovic, Libby Bulin, and Naufal Khan

• WSJ: “Navigating C-Suite 3.0”

– Engage as part of the C-Suite team

– Help others in C-Suite achieve their goals

• Panel w Glaser, Calhoun, Kleeburg, et al:

– Interpersonal skills plus technological knowledge

– Adaptability

– Positive relationships

• McKinsey: “Why CIO’s should be business strategy partners”

– Reimagine the CIO’s Role

– Develop IT’s Business Savvy

– Build a Distinctive recruiting engine

CIO 3.0 – What is a CIO to Do???

• The New Normal… – M&A: are you acquiring or being acquired? Corporate IT?

– New Reimbursement models: ACO, MSSP, Population Health

– Optimization and Business Value: commoditize everything and leverage for strategic advantage, e.g. data, quality improvement, cost reduction

– Patient Engagement: social media, wearables, patient empowerment for appts, e-messaging, televisits, etc.

– Personalized Medicine: genomics, provider comparisons, etc.

– Cyber Security: for existing and virtual enterprises

CIO 3.0 – What now???

• The New Normal… – M&A: are you at the Planning & Negotiations table?

– New Reimbursement models: is your data architecture and analytics in place to support these?

– Optimization and Business Value: have you commoditized everything and now focused on business process improvement?

– Patient Engagement: are you recognized as a business partner? Are you innovating? Can you?

– Personalized Medicine: is your EMR & SAN ready?

– Cyber Security: is your team, tools and CIRT ready?

CIO 3.0 – What is a CIO to Do???

33

Leadership

“Making IT work demands the same things that other parts of the business

do - inspired leadership, superb execution, motivated people, and the

thoughtful attention and high expectations of senior management.”

“Getting IT Right” by Charlie S. Feld and Donna B. Stoddard Harvard Business Review, February 2004

“ The people in the high-performance IT organization don’t feel different from

other corporate citizens…They operate according to the same corporate values

as everyone else and are measured by the same tough performance standards.”

“Getting IT Right” by Charlie S. Feld and Donna B. Stoddard Harvard Business Review, February 2004

Setting Vision and Strategy

• What is a CIO?

– Pragmatic Visionary

• Define the future

• Plan the steps

Today Understand the

Organization and

Culture

Vision Define the Vision

Identify the steps

Step 1

Step 2

Step 3

Be a Strategic IT Leader

• Understand the business

• Build bridges with clinicians

• Anchor your thinking in process improvement and measurement

• Use simple and straight forward communication

• Establish trust by achieving results

• Look for direction and new approaches

• Contribute ideas and options

Strategy…what are you?

Before Vision and Strategy …

Values

Vision

Mission

Strategy

What we are talking about

• Values: the identity of the organization

• Mission: the reason for being

• Vision: a mental picture of what you want to accomplish or achieve.

• Strategy: how to get there

Who is Penn State Hershey? Penn State Milton S. Hershey Medical Center • 563-bed teaching & research hospital • Children’s Hospital, Cancer Institute

Penn State College of Medicine • $107 million research enterprise • More than 1,600 learners; • Nearly 300 College faculty

Penn State Hershey Medical Group • 59 clinical sites • 750+ physicians/900+ clinical providers

Penn State Hershey Health System • 19 hospital and provider affiliates • Rehabilitation Hospital, PPI • Hershey Outpatient Surgery Center (HOSC) • Hershey Endoscopy Center; Horizon Healthcare Services

Four Integrated Missions:

• Education • Research • Patient Care • Community Service

Milton S. Hershey 1857-1945* • 1905

– Hershey Factory completed

• 1907 – Hershey Park

• 1909 – Milton S. Hershey School

• 1918 – Endowed MSH School with

Hershey Chocolate Co. Stock

• 1963 ……….. Milton S. Hershey Catherine Hershey

How it all got started*

1963 Initial $50 million gift

(Approximately $369 million in today’s dollars)

1967 First medical student class – 40 students, 37 men and 3 women.

3000+ - Doctor of Medicine degrees.

The $50 Million Phone Call

Why are values important? Values Mission Vision Strategy

• Determines distinctiveness

• Prescribes participation

• Expresses essentials • Affects action • Inspires investment • Leverages leadership • Supplies success

• Dictates direction • Formulates function • Focuses future • Directs decisions • Causes congruence • Enhances

effectiveness • Ensures endurance • Facilitates feedback

• Endows energy • Creates cause • Fosters failure

(positive) • Legitimizes

leadership • Sustains structure • Commands

commitment

• Accomplishes mission and vision

• Improves insight • Maximizes

momentum • Retains resources • Accentuates

achievements

Adapted from “Advanced Strategic Planning” by Malphurs

Determines Mission and Vision

“How strategists lead” Cynthia Montgomery, Harvard Business School

McKinsey Quarterly, July 2012

The strategist as meaning (Vision) maker

”After all, defining what an organization will be, and why and to whom that will matter, is at the heart of a leader’s role.”

Strategy Perspectives • Internal: to satisfy or delight our customers, what processes must we

excel at?

• Financial: if we succeed, how will we look?

• Customer: to achieve our vision, how must we look?

• Learning and Growth: to achieve our vision, how must we learn and improve?

Adapted from “Strategy Maps: The Simple Model

of Value Creation” by Kaplan & Norton

Engage Your Senior Team

• Explain and educate on the value of IT; encourage CEO’s visible commitment

• Build relationships with key IT vendors and suppliers

• Partner with the CMO, CMIO and CNO to build a strong clinical informatics function

• Work with the CFO to build effective financial processes and systems

Create a Framework for Strategic Alignment

• Establish an IT executive strategic planning group (IT governance)

• Guide the executive team to set priorities, standards and guidelines

• Contribute to decision-making methods and criteria

• Include regulatory, security and infrastructure requirements

IT Governance…. Situational

IT Governance Council

Zolko

Education IT Advisory

Verderame

Research IT Advisory

Leslie

Clinical IT Advisory

DeFlitch

Bus/Finance IT Advisory

Abbott

Infrastructure & Service MGT IT Advisory

Dykehouse

Data IT Advisory

Young

CyberSecurity IT Advisory

Snyder

System/Project •Student IS •LMS •Room Scheduling •A/V Design - Support •Conf Rms •Patient TV Policies •Room Scheduling •A/V use

System/Project •CRMS •IRB •UP Research •BioRepository •Research PACS •I2b2 Database Policies •Compliance •IRB •

System/Project •EMR •PACS •Lab IS •Pharmacy •Oncology •Endoscopy •Clinical Device Integration Policies •EMR use •Med Rec •

System/Project •Lawson ERP, (HR, Finance, Mat Mgmt) •Kronos •Rev Cycle •Coding •ICD-10 •Web Policies •Web •Compliance •Coding

System/Project •Data Center •Network •IS Security •Authentication •Messaging •Device mgmt •Srvc Delivery – Help Desk, etc. •Storage Policies •IS Security •DR/ BC •Device use

System/Project •Master Data •BI & Analytics •Data integrity •Data reporting •Dashboards •Person Identity Mgmt

Policies •Data use •Master file mgmt •Data integrity •Data Governance

System/Project TBD

Policies TBD

Approaches to Strategy Strategy creation follows a three-stage process:

1. Analyzing the context in which you're operating.

2. Identifying strategic options.

3. Evaluating and selecting the best options.

Adapted from: http://www.mindtools.com/pages/article/developing-strategy.htm#sthash.XE44GKf7.dpuf

Approaches to Strategy Stage 1: Analyzing Your Context and Environment

• In this first stage, you ensure that you fully understand yourself and your environment.

• Analyze Your Organization – First, examine your resources, liabilities, capabilities, strengths, and weaknesses. (SWOT

Analysis).

– Look at your Core Competencies. These highlight your unique strengths - differentiators

• Analyze Your Environment – Are there exciting opportunities that you should pursue? What future scenarios are likely

in your industry, and how will these impact the work that you do?

• Analyze Your Customers and Stakeholders

• Analyze Your Competitors

Approaches to Strategy Stage 2: Identifying Strategic Options

• Means to create a clear advantage and meet your objectives.

1. Brainstorm Options

2. Examine Opportunities and Threats

3. Solve Problems

Approaches to Strategy Stage 3: Evaluating and Selecting Strategic Options

Evaluation

• Evaluate each option in the light of the contextual factors you identified in Stage 1. What do these tell you about each option?

• Techniques like Risk Analysis, Failure Modes and Effects Analysis and Impact Analysis to spot the possible negative consequences of each option.

• Financial techniques like Cost-Benefit Analysis, Break-Even Analysis, use of Net Present Values (NPVs) and Internal Rates of Return (IRRs), and Decision Trees are helpful.

• Grid Analysis is particularly helpful for bringing together financial and non-financial decision criteria

Approaches to Strategy Stage 3: Evaluating and Selecting Strategic Options

Selection

• Check your ideas for consistency with your organization's Vision, Mission and Values.

• Check your assumptions using the Ladder of Inference or other Critical Thinking Model.

• Incorporate feedback processes for stakeholders.

• Move on to Implementation!

Develop the IT Strategic Plan • Start with executive sponsorship

• Match technology options to your organization’s strategies, initiatives and timelines

• Identify key initiatives and due dates

• Develop the high level financial requirements – capital and operating

• Include strategic commitment for infrastructure and life cycle investments

• Include staffing requirements

Cultivate Sponsorship • Seed formal Executive Sponsor for all IT enabled

strategies

• Use IT as an accelerator of strategy

• Build clinician driven structures to design and validate applications and to prioritize demand for optimization and continuous enhancement of systems

Create a Multi-Year Roadmap

• Identify the key IT initiatives

• Identify project schedules and duration

• Include interdependencies

• Use as a basis for developing the business case and Total Cost of Ownership models for projects

Project Plans - Transparency

“How strategists lead” Cynthia Montgomery, Harvard Business School

McKinsey Quarterly, July 2012

Strategy & Execution

“I’ve been struck by how often executives,

even experienced ones, get tripped up: they …overlook how inter-related

strategy and execution are.”

Project Plans - Transparency

The Big Shift in IT Leadership Strategy – Seven Action Steps for CIOs

• Architect the digital blueprint

• Become an information steward

• Get the basics right

• Eliminate cyber threats

• Collaborate around the clock

• Strengthen relationships across the C-suite

• Look above the operational parapet Linda Ban, "Moving from the Back Office to the Front Lines"

Aligned

Aligned Top Five or So

• Thoroughly Understand System Plan

• Determine Enterprise Architecture Requirements

• Build IT Plan to Enable System Plan Success

• Ensure Direct Correlations Between Plans

• External Reviews with Partners & Advisors

• Bounce Concepts & Plan with Steering Cmte

Radical?

Radical • Initiate New Business

• New Executive Orientation

• Embed in Governance and PMO Processes

• Engage Rank and File

• Allow Margin for Innovation

• Review & Adjust Quarterly

• Plans Should Reflect Simplicity and Beauty

• Signatures

• Execution > Pontification

1. Don’t accept the status quo

2. Semper Gumby: “Always Flexible”

3. Plagiarism is skill, not a crime

4. Don’t evolve, REVOLVE!!!!

5. Make somebody mad today!!!!

Rules of the Revolutionary CIO

Everyone thinks of changing the world but no one thinks of changing himself

-Leo Tolstoy

HIT Leader / CIO 3.0 – What you can do now!

• The New Normal… – Leverage your relationships & credibility as a true business partner

focused on business value. Help your peers to succeed! Optimize!

– Demonstrate the value of strategic and operational planning to be agile and effective in meeting the changing requirements • Strategic Foundational efforts: EIM (Enterprise Information Mgmt) strategy,

genomics planning, patient engagement strategies

• Operational efforts: HIE, Patient portals, Telemedicine incl televisits, etc.

– Establish peer and external networks to leverage the leading markets, technologies and lessons learned.

– Don’t forget the basics! Build your team with the right skills. Focus on IT maturity, commoditization, costs…AND customer service!

It is NOT too late!

Thank you!

Q & A

Rodney C. Dykehouse, CHCIO, FCHIME Chief Information Officer

Penn State Hershey Medical Center and Health System

Penn State College of Medicine MC A-310 / ASB 3200

90 Hope Drive / PO Box 855 Hershey, PA 17033

Phone: 717-531-4544 EMail: RDykehouse@hmc.psu.edu Web: http://pennstatehershey.org

A CHIME Leadership Education and Development Forum in collaboration with iHT2

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A CHIME Leadership Education and Development Forum in collaboration with iHT2