The Warring Tribes of Healthcare

By George Curtis, CIO, Houston Healthcare

George Curtis, CIO, Houston Healthcare

Information Technology’s global reach is somewhat of a new concept to many of the original powerhouses of healthcare institutions. In the not so distant past, the CFO, CNO, and the CEO ruled the roost, so to speak, while the CIO and the information technology team were onboard but only as a necessary evil. You wouldn’t have to wait too long in a meeting that included IT to see how off-putting a conversation can be with someone dropping acronyms, techno-jargon, and the array of many bits, bytes, megabytes and terabytes flying through the conversation. In those days past, the CIO had to fight to justify existence and even with an official title and a place on the executive team; when CIO’s spoke it was likened to the petulant little brother who wanted more attention. Those of us who were in the industry at the time will not soon forget this and will continue to harbor those repressed feelings of fight for every meal in a time where all you can eat is the new norm.

It stands to reason that on the opposite shore, the “others” have stood back and watched the evolution of healthcare and its eminent marriage with technology lead to ever-dwindling responsibilities as well as precious real estate and resources. Many hospital areas live and die by numbers on a graph, productivity, overtime, and quality just to mention a few. However, IT has been granted immunity to the normal standard of being measured as all others; “everything is relative to something” my CEO told me, and I do believe him but have never found a single metric that successfully aggregates a hospital, age of providers, skill level of providers, environmental complexities, and the ever different EMR’s on the market. The “others” stand somewhat helpless as IT continues to grow and consume areas of the hospital that no one could have imagined would be under Information Technology. Jaded, they watch as departments like Biomed and Health Information Management are stripped from their resumes and fall under the incredulous CIO.

"Use your global reach and responsibility to be a peacemaker and use your influence as the CIO to calm the warring tribes of Healthcare"

I remember walking into our boardroom for our weekly meeting with the hair on the back of my neck standing on edge; not sure who was going to throw the first stone, not knowing who had been colluding for a political smearing contest, and in a room where the tension could be felt, seen on the participants, and measured as a tangible object. I sat through too many of those meetings and wondered why this was the world that we, as healthcare executives, chose to spend our working lives. Extended periods of time in this type of arena will land the healthiest of us all in a hospital bed stressed out or even battling a heart that might want to attack us.

I was given the opportunity to replace a CIO that had lived the legacy as mentioned above and who was embattled with most if not all departments. He had successfully cleared the sandbox of all who opposed him and established IT as the 800 lb. gorilla and bully of the hospital. Through the interview process I could see the other members of the executive team in doubt, their apprehension, anxiety through their questions and the thoughts of “the devil that you know” running through their minds. Between meaningful use, HIPAA, Joint Commission inspections, Red Flag Rules, and the many other governmental regulations on healthcare, there was much work to be done and IT could not do it alone.

The first time we met as an executive team throughout the past three years there were many lessons learned by all of us and I chose to mention just a few:

There is a significant difference between blame and accountability– blame is indicative of placing fault whereas accountability is holding appropriate staff responsible. Blame serves no purpose in the professional world and when we migrated away from blame and chose to fix the problem (not blame someone for it) our teams were immediately at ease to find and fix the problem for our patients while working quickly and openly with each other.

Communicate openly with each other, “this only works if everyone is honest” our CEO would say and there is much truth in that. You can disagree without being disagreeable and once a decision is made you must have a united front and all support and disseminate the same message. There is a good chance I may be wrong but a very slim chance that all of us will be wrong.

Hear the passion behind the com­plaints–if you and your team listen close enough you will hear that, “I can’t take care of my patients, I was late giving medica­tions, I couldn’t s pend more time with the family” actually live at the core of the com­plaints. Understand that your clinicians must be passionate about taking care of patients because they sure aren’t here to get rich.

Infuse IT with the attitude that if it is safe for the patient, if its legal, and if the system is capable of doing it–we will do it provided that it passes scrutiny and receives approval of the receiving department and department chair. Tell us how we can make it easier for you? How can we help?

Survey every and create a culture of service in IT. Many of the cornerstone traits of the hospitality industry are applicable to your IT department. Create a culture of service, cultivate it, grow it, and celebrate it. Before long your users will celebrate that for you.

We are all now faced with a more eminent threat than each other–survival in the healthcare landscape of today. Use your global reach and responsibility to be a peacemaker and use your influence as the CIO to calm the warring tribes of Healthcare.