The 90 day CIO: Moving Healthcare IT from Basement to Boardroom

Pari: Welcome everyone to a special episode with Dr. Luis. I’m Pari Natarajan, CEO of Zinnov, your host for this episode. In today’s complex healthcare landscape, the role of information technology is occasionally overlooked. Placing IT at the center can lead to optimized patient care, streamlined processes and enhanced data security. IT, which was once an afterthought, has now become a backbone of healthcare records, research, and patient care. I have the distinct privilege of having Dr. Luis for this episode. With years of experience spearheading healthcare IT strategy, he walks the talk. His invaluable perspectives on digital innovation highlight the importance of IT in healthcare. Luis’s book, The 90 Day CIO, equips CIOs with the tools and strategies needed to drive impactful change within Healthcare organizations in 90 days. And I’m really excited to chat with him today. Welcome, Luis. We are so happy to have you here.

Dr. Luis:. Thank you. Thanks for having me here.

Pari: Great. Let’s get started.

You have over 30 years of experience as a distinguished healthcare CIO. What initially motivated you to pursue leadership in health IT?

Dr. Luis: I’ve always had an interest in healthcare and I also had a big interest in technology. So it was a great way to marry the two. I started in healthcare IT back in 1987, when I was with the IBM Corporation. And I had the opportunity to be the manager of all healthcare clients in the state of New Jersey. So that was my start. And it’s taken off since, so it’s been a great journey.

Pari: And the CIO role used to be a technical role. but today it has become a lot more strategic in decision making and business direction. How have you seen it evolve?

Dr. Luis: Oh, it’s, it’s been a tremendous change, all for the good too. I can remember way back when on my first CIO job, when I used to work at a hospital in New York City. And, the IT organization, the data processing department as it used to be called, right? It was down in the basement next to the morgue. And that was that was always the case. We were always down in the basement near the morgue. So I made sure that if people were a little squeamish about encountering a dead body to make sure that if it got too cold, don’t go in that direction anymore. Just stay on this side. Look at it today.
You know, today we’re in the executive suite, making big strategic decision and engage in everything that happens in the organization. So we’ve gone from next to the morgue to the top floor.

Pari: Are there certain inflection points which made this change? That’s a dramatic change you know, a seat in at the table from the morgue room.

Dr. Luis: I think around 2010 or so, when there was a major effort to make sure that all medical records were in electronic format. And everybody started transforming over to electronic medical records. That’s when IT really took off and became center stage in every single healthcare system.

Pari: Amazing. So there is this inflection point now, very interesting. And getting into your book. Can you explain to us your 90-day framework and how it is a path to tangible success?

Dr. Luis: So the key to the 90 days and, I don’t want people to think that is your first 90 days, right? Because if you’ve been a CIO for a while and you see the symptoms that I describe in the book, you can start applying the 90 days.
But the focus of the 90 days is to say, how do we take this time to engage the leadership in the organizations to develop a plan to take us from where we are today to a highly operational excellence environment and ultimately to a high performance organization in a five to seven year period. So in that first 90 days, you have to really, really build the foundation for that five to seven year journey that you’re going to take as a CIO in any organization.
And I’m not talking just healthcare. I think it applies across all different industries.

Pari: So as companies go through this transformation, they realize, so what are the symptoms, maybe a couple of symptoms which the CIOs can identify?

Dr. Luis: So the symptoms that, that I typically find is silos. Lots of silos within the organization, very little communication across these silos.
People focused on what do we have to do today? What do they have to do the next week and not thinking strategically at all? A lot of people that have not really been indoctrinated into the culture or there’s really not a culture that has been developed. Those are some of the major signs that you’ll see and symptoms that you’ll find when you analyze an organization.
And the bottom line is in that kind of scenario, the organization is in a very reactive mode. You’re just reacting to what people want. IT is typically just an order taking organization instead of a strategic part of the organization.

Pari: Got it. Silos, lacking communication within the IT organization, maybe lesser linkage with the business. In this scenario, both administration as well as the customer, right? And patient experience becoming very critical in healthcare.

Dr. Luis: Absolutely. The other thing that, that you’ll typically see is a lack of processes. People just do things the way they’ve learned how to do it, whether it’s the right way or not.
And the focus is on the, on the clinical side, right? We’re taught to practice evidence based medicine. So my message to the IT organizations and healthcare is practice evidence based IT.

Pari: I think the concept of evidence based IT is very interesting. And so the 90 day period, is there a few steps you, you want them to follow?

Dr. Luis: Oh, there’s a number of steps. It’s kind of prescriptive the way that the 90 day works. So at the end of the book, I actually have a 90 day plan broken into 30 days. So the first 30 days. Next 30 days and last 30 days, and it’s a pretty prescriptive plan on exactly what you’re going to do in that time.

Pari: Got it. Got it. Got it. And what is, what is that they can expect in the end of the 90 day framework? So they go through the playbook, they deploy the playbook, like what happens and what should be the expectation? What expectation should they set to their bosses, right? Their CEO of the health system.

Dr. Luis: So at the end of the 90 days, you’re going to have a strategic plan. And not just a strategic plan that you develop as a CIO or the IT organization developed. It’s going to be a plan that has been developed with all the leadership across the organization. Because what’s critical to a plan that’s going to actually be implemented, is that all the leaders can see their fingerprints somewhere in that plan.

That gives them some ownership of the plan, and they really will adopt it and make it work across the organization. The last thing that you want is to sit in a corner again in the IT organization and build a plan and come out of there and say – here it is. It doesn’t work that way.
You’re engaging the executive and the members of the organization right from the beginning and keeping them engaged. So at the 90 day is our plan, not the IT Plan.

Pari: Got it. So there’s a lot of, in the 90 day framework, you have a lot of ways in which you can interact, observe and get the inputs and get the buy in from all the different stakeholders who are required for driving the CIO strategy. Super, super helpful. And that IT function of healthcare organizations was once seen as just mere cost. And how, how have you seen it become you know, suppose strategic investment?

Dr. Luis: So a part of that 90 day is changing the discussion because you’re right. The way that it’s looked like is IT is a cost center.
How much are we spending in IT? We have to change the way that we speak about it. And the way that I want people to phrase it is how much are we investing in IT? It’s an investment that we’re making. And if you’re making an investment, you expect a return in two ways in healthcare. One is value to the organization.
And second, and most important, is improvement in patient care. What are the outcomes that we’re going to drive for our patients that are better than they are today if you make this investment in this IT solution? So the nomenclature, the key buzzwords that we use have to change and the way that we think from an IT. Perspective has to change. We’re not just delivering a solution because somebody says here’s what we need to do. We’re delivering a solution because it has value both to the organization and to the patients and their families.

Pari: Interesting. So almost you’re taking a product centric approach, kind of traditional IT centric up front and we see that changing. across CIO organizations. In your view, what are the biggest challenges healthcare CIOs face today and what advice would you offer for overcoming them?

Dr. Luis: So the biggest challenge that I see us facing is an overwhelming amount of work, an overwhelming amount of opportunities that we have out there.

Pari: I see you’re taking the call at 6:30am.

Dr. Luis: That’s right, yeah. And that’s the way it is. You know, I work 12-14 hours a day and that’s just a given. That’s what we have to do. Because at least in the United States, we’re facing a major, major shortage of healthcare workers.
And part of the solution, not the entire solution, but a good part of that solution is how do we bring automation into the processes so that we can make the people that we do have, much more efficient and therefore not require as many people, which we can’t get anyway, right? So we are a big part of the solution to the shortages that we’re facing across all healthcare workers.
That’s, that’s really big. So that’s one challenge. The second challenge is just, what you mentioned earlier, which is people need to change the perception of IT as a partner, not as somebody you’re going to give orders to. So that, that transformation to the partnership, it’s absolutely critical in moving forward and creating this high performance organization.

Pari: Great. And as one of the top 30 healthcare CIOs in the US, what do you think are the emerging technologies or innovations in healthcare that you’re most excited or hopeful about right now to solve some of the challenges you mentioned?

Dr. Luis: Yeah, absolutely. The artificial intelligence is no question, right? It had hit the map on a big way in the last 12 months and appropriately so. And the big thing now is, what is the difference between hype and reality? And we have to manage that because we have everybody excited about what can we do with artificial intelligence? Well, we have to be very careful in healthcare how we use it.
Not just because of the cybersecurity concerns, but also because we’re a science-based organization, right? And we have to make sure that when you ask one of the ChatGPTs and those type of systems a question, that you’re going to get something that you can really use in a scientific way. And I’m not sure that we’re there yet.
There’s some challenges ahead of us. But by the way, we do have some great solutions that we’re implementing now in our radiology environment. We’re doing great with a couple solutions that we have where the Artificial Intelligence engine actually does the first read of an X ray and things like that and provides a good advice to the medical staff in the background.
Again, part of building the efficiency of those teams, we lack a lot of radiologists in this country. So if we can assist with artificial intelligence for radiology solutions, so far it’s been very good. so we have some pockets, we have seen some good results, But I’m being very cautious about how we roll this out and providing some key guidance to the people on how they use it and how much credence they put in the in the solutions that we get back from a from a query.

Pari: Got it. So you think of this helping more in productivity improvement of the health care workers? Both doctors and the rest of the value chain?

Dr. Luis: Now, from our perspective, absolutely, improving productivity and, the real, real big promise out there is what can it do in a scientific world?
We are limited in the scientific research world by how much data we can consume as individuals. Imagine if you have Artificial Intelligence in the mix and how much they can consume this data and how much better results we could potentially get. So big, big promise in the future for artificial intelligence in terms of medical research.

Pari: Yeah, super exciting. I’m pretty sure the patient experience will also play a big role and how AI is going to help that.

Dr. Luis: Oh, it will, because when you think about the interactions that we have with a patient and doctor today, unfortunately, most doctors finish their day and then they spend three, four hours at night documenting everything that went on.
Now we have what we call ambient notes. So as you’re having the conversation with the patient and doctor in the conversation, the notes being created in the background. So the note content is much better, which the patients can see. But also, again, back to the productivity of the medical staff. They don’t have to spend all that night long documenting their day.

Pari: For aspiring healthcare IT leaders looking to follow in your footsteps, what are one or two leadership principles or qualities you believe are vital to success?

Dr. Luis: There are a number of principles that I follow in terms of leadership. Number one, I am really focused on say, if I’m having this conversation with you.
And I committed to have this conversation with you or this meeting with you. I need to absolutely be focused on that conversation and give you the utmost attention. I don’t like it when I sit in the meeting and I see all these people, whether iPads open, whether on their phone, that means you’re not paying attention.
And if that’s the case, don’t come to the meeting. Yeah, if you’re going to be so busy, don’t come to the meeting. If you do come to the meeting, please pay attention to what’s going on in that meeting because there’s so many things that are being discussed, critical things. And I think half of the people miss it because they’re distracted with something else.

So absolutely be in the moment if you commit to be there be in the moment. I think the other thing that’s critical is people need to be held accountable, whatever we expect from somebody, we really, really need to expect to hold them accountable, but you can’t forget as a CIO that you have to hold yourself accountable.

So make sure before you say something to somebody else about accountability, look in the mirror first and say, how did I contribute to this situation? What role did I play in this situation that just happened? So hold yourself accountable. The other big thing is, absolutely communication. Most of the issues that arise, that come out of meetings and things like that is because people miscommunicated. And a big part of that is setting the expectation right. So when I asked my team, can you please get this done? I don’t just leave it there because it’s how do they know when they’re supposed to get it done? How are they going to get it done if I need something today? I will say please get this back to me at five o’clock today. Not at the end of the day because it could be midnight the end of the day.

I say five o’clock today so that we don’t have a mismatch in expectation. Those are the things that are absolutely critical. We need to engage people. We cannot do things alone. If you and I get together, the solution that we come up for any problem will be much better than the one you come up by yourself or the one that I come up by myself.
So lots of collaboration and lots of communication to start building that culture. a culture of accountability, a culture where communication is king, a culture where we’re all focused on the success of each other, not just my individual success. How am I going to get better? No, how are we going to get better? That’s the key.

Pari: Thank you, Dr. Luis. It was great to hear your perspectives on how the Healthcare CIO’s role is changing, how Healthcare IT is becoming a core, a central part of the overall strategy of the of the company. And also your 90 day framework to think about the strategy planning. And it doesn’t have to be the first 90 day of a CIO, it could be anytime they require a transformation and looking at some of the key signals, be it in silos, be it lack of communication, and be it not having the right level of interaction with the business.
All of these are symptoms to get onto the 90-day plan to create this strategic framework. And also sharing some of your insights on the leadership principles, especially being in the moment, communicating, and being just a professional, to be able to drive that, just being rigorous, professional, disciplined in your approach and making that part of your culture is going to be a very important way for leaders to grow in their career.
Thank you very much. I really enjoyed the conversation.

Dr Luis: Thank you. It’s great to be here.

Pari: Thanks for tuning into this episode. We’ll be back soon with another leader, another exciting topic. Thank you.