CTOs: Agents of Disruptive Change
CTOs from diverse healthcare systems in Georgia, Idaho and Pennsylvania shared with Clinical Innovation + Technology about their responsibilities and biggest challenges, how they get along with their teams and what they aspire to accomplish during this time of furious change.
Responsibilities & Purpose
Michele Molden, executive vice president and CTO at Piedmont Healthcare in Atlanta, says that Piedmont’s former CEO approached her to serve in the newly created role in January 2011. “I need you to be the sand in everyone’s bathing suit,” she recalls him saying.
Molden’s responsibilities include corporate development, physician-hospital partnerships and external relationships. She serves as the bridge between physicians and administrators to create a third lens by solving problems together, she says.
“He mentioned sand in the bathing suit because a lot of administrators are frightened with those relationships and not comfortable with the conflict they bring,” she says. “He knew I had been fire polished and that my skin was about four-feet thick.”
Steven Strongwater, MD, CTO, came on board at Geisinger Health System in Danville, Pa., in August 2012. As CTO, he is charged with administrative oversight and leadership as Geisinger transforms its IT systems to improve health outcomes, access to health services and patient care delivery.
Tony Tomazic was hired as the first CTO of Idaho-based St. Luke’s Health System to provide day-to-day leadership of its transformation. Tomazic previously worked for Humana’s innovation center and has extensive experience in engineering, marketing and the arts. The scope of his job is broad: engaging leaders with St. Luke’s mission, fostering “collaborative and positive disruption” while promoting patient-centered care, and heading up marketing and public relations.
Projects to Transform
Whether promoting population health management, culture change by aligning administrators and physicians, or innovation, CTOs are on the job.
At Piedmont, Molden partnered with Mercer University to form the Center for Health & Learning (CHL). Under this organization, she leads a number of initiatives to foster leadership and deepen relationships between physicians and administrators.
Through the CHL, Piedmont physicians and administrators participate side by side in physician-taught leadership courses run by Mercer University, in which they study organizational communication, team building and effective relationships, client/patient satisfaction, strategic planning, record maintenance and security, compliance and contracting, financial leadership and effective leadership. “Physicians have reacted very positively,” she says.
Also, in January, Piedmont collaborated with Mercer to create the health coach certification program. Open to all employees, the program teaches health professionals how to help identify and manage the care of patients suffering from chronic conditions.
Promoting population health practices is an important part of Tomazic’s role. He works in strategy, marketing and innovation to promote a message fostering transformation. “I try to define the strategy more clearly, so everyone knows but are also able to author their own why,” he says. “My job isn’t to make it pleasant, but rather to build commitment to make that change even though it’s hard. It really comes down to collaborative spirit and a sense of shared ownership.”
At Geisinger, Strongwater is involved in process redesign and process re-engineering to find opportunities to enhance systems and identify innovations that improve care and outcomes for clinical and business processes.
Because Geisinger is both a payer and a provider, “we’re really focused here on process reliability and innovation in order to improve both our clinical and cost outcomes.”
Instead of reducing the workforce amid financial pressure, Geisinger is looking for innovative ways to address challenges, Strongwater says. “We’re very much about disruptive change, so [my team works] out of mainstream operations and it allows us the luxury of crossing business units. We bring together IT with other operating units in different ways.”
For example, Strongwater is working on the process to re-engineer the operating room in the emergency department to improve efficiency of the space and maximize clinician performance. He also is working to integrate a number of pharmacy activities related to inpatient acute platforms, outpatient pharmacies and homecare delivery pharmacies with the health plan, formulary and other activities.
Population health is key to his work as Geisinger seeks to reduce avoidable emergency department visits and readmissions. “Whenever we work on process reliability and closing care gaps, the total cost of care goes down and we have fewer admissions,” he says.
Outlook
The CTOs agree they are a thick-skinned breed with a willingness to embrace friction and seek out novel solutions to traditional problems.
“You have to be comfortable with chaos and a highly ambiguous environment, with a job description that might change daily. You are always working through other people,” says Molden.
“It takes a willingness to tackle difficult projects and lead a change initiative. It’s helpful to understand the tools of process reliability, quality and safety and have a fundamental understanding of the elements changing local healthcare,” says Strongwater.
The CTOs agreed that the role is here to stay, and not just as an interim position designed to help their systems manage healthcare reform.
Tomazic admits that he asked the CEO during his job interview if it was a temporary role; now he is convinced the role is long term. “We’re transforming healthcare, and it’s more than just clinical practice or a single area of experience. It isn’t just the financial model or the business model or even just the experience. There’s a huge amount of work in front of us and it’s going to take time to make that transformation,” he says.
“The CTO job doesn’t have a finite sunset date and particularly not in a market as crazy as this one,” echoes Molden. “Because of the unique situation we’re in and because the stakes are so high, I think they will be around for a long while.”