Winjie Tang Miao
Senior VP & System Integration Officer
Texas Health Resources
This was not the typical interview as we typically are interviewing either the clinical leadership or the IT leadership, but then again – Winjie is anything but typical. Until recently, she was the President of the Texas Health Harris Methodist Hospital Alliance. She has recently been promoted to Texas Health Resources’ Senior Vice President & System Integration Officer.
In her own words, her challenge is to “hard-wire” the behavior of the enterprise such that it couples well to the strategic goals. I can’t wait to see where this goes over the next few years. We will all learn so much as we do with all of our innovation driven providers. I look forward to checking in from time to time and updating this thread.
Philosophically, I enjoyed this comment from Winjie: “Understand the why to the what”. Match the business reason to what is being done before doing it. Our providers are measured on so many fronts that innovators like Winjie are looking for technology partners to help link job performance to all levels of feedback in systems that influence the desired, predictable outcomes. Sounds simple right? Wrong – it is a huge undertaking and I hope that we see this take shape and become second nature in my lifetime.
On the topic of healthcare reform, when asked to share the number one thing she likes about it, her answer was great. “It is driving us as a nation to have a conversation”. In other words, we are finally confronting key issues that were less convenient to discuss before. It is forcing the industry to fix things that will lead to better patient care outcomes. Conversely, the number 1 thing she dislikes is “How polarizing our politicians are making it”. Well put.
As has been the trend for the past several months in my interviews, strategic technology partner collaboration is key to driving innovation and predicable outcomes. Vendor members, take the following questions and answers to heart:
Q: What causes you to trust a vendor?
A: “They don’t turn away when the going gets hard!”.
Q: What causes you to distrust a vendor?
A: “When they give me a reason”.
Congratulations again to Winjie on her promotion, and we are very grateful for her innovative leadership in our industry.
Senior VP & CIO
Children’s Medical Center
It’s always a pleasure to visit with Pamela. It is impossible not to be positively influenced by her passion.
Each time we do a Thought Leadership interview, by the end of the discussion the outcome tends to create a theme. This time the message that emerged was the importance of vendor collaboration. I am seeing this trend more and more, that is, Executives are really focusing on the importance of having a long-term, strategic partnership rather than a supplier relationshi
It’s less theoretical and opinion at this point. Children’s Health (having won the Davies in 2014) and THR both embrace collaborative relationships in their culture of care. The results speak for themselves with measurable outcomes. Technology is becoming secondary to the decision process as it is far more relevant to the provider to add depth of expertise well past the sale as a virtual extension of their own team.
My favorite nugget that says it all. When I asked Pamela, “what causes you to distrust a vendor?” Her response was, “Swapping the ‘A’ sales team with a non-‘A’ implementation team”. The second nugget was equally as clear on the topic. “We want to only do business with top tier vendors because we want them—not the hospital—to invest in their technology.”
During the DFW HIMSS chapter education session, we have been telling our vendor members for 2 years: Don’t waste a providers time if you don’t have a measurable way to demonstrate added value and momentum to the provider’s agenda. It’s about the provider’s agenda and not the vendor’s.
The best outcomes are being achieved where providers carefully select vendors and passionately embrace collaboration. Providers that don’t get this are living in the past and will not achieve the same results. Four years ago, HIMSS national did a survey of Informatics professionals asking about the #1 thing that was holding them back. The answer then was lack of integrations. Now (4 years later), its lack of CAPEX. “Book and box” vendors beware: your days are numbered. Complex systems require extensive collaboration during the sales process and throughout the life of the product. Providers don’t have the necessary skills and experience to do it all themselves, and this is no longer a “nice-to-have.” Now—more than ever—collaborative partnerships are mission-critical.
Baylor Heart & Vascular Hospital
Nancy is full of energy and very passionate about her leadership culture. The theme of this interview was the role of the “care culture” to achieve outstanding quality outcomes.
As an example, when I asked who ultimately owns HCAHPS improvements, she answered, “When a team wins, then it is a win for the coach and for the team”. Right off the bat, you can tell where her mind is focused and what kind of culture she and her team have created.
Another nugget I really enjoyed was her answer to ‘What is the number 1 thing you like about healthcare reform?’. “It is forcing whole care as a continuum rather than the episode”. While I have heard many answers to this question, I have never heard it put quite this way before. Makes you think with more focus than the broader picture, doesn’t it?
What are Doctors looking for most when deciding who to work with? Her answer, “A culture that is focused on ensuring the best outcomes for the patient”. In other words, the provider culture is an extension of the Doctors brand. Exceeding the expectations of the doctor as relates to the patient experience make them look good too, hence, the best doctors are attracted to this type of a provider culture and that is what Nancy and her team are driving.
To live in North Texas is a blessing. It’s leaders like Nancy who are obsessed with a care culture centered around the patient experience that are driving change from the past to the future of care. It’s impossible to spend time with leaders like Nancy and not be confident that, when the time comes, your care will be amazing.
Beth (Houser) Beckman
CNO & COO
Baylor Medical Center Grapevine
I recently had the pleasure to interview Beth Houser, CNO at Baylor Grapevine. [Since the interview, she has been promoted to taking on the role of COO in addition to CNO, and she has also gotten married and changed her last name to “Beckman”. Congratulations on both!] She is delightful and so passionate about her culture of care. As an example, nurses are referred to as “Bedside Leaders”, entrusting the nurse as the patient ambassador.
Let me share with you several gold nuggets. They post 3 of the patient’s priorities for their stay, developing a culture where the patient is at the center of communication. I loved this example; “A patient told her Bedside Leader that she had watched As the World Turns every day for 50 years. She wanted to make sure that she didn’t get disturbed – and she didn’t!”. It’s the small things that can make their stay more enjoyable.
At shift change, the Bedside Leaders will do this at the patient bedside to make sure that the patient is included in this process and to ensure that their goals are seamlessly integrated into the care model for the next shift.
An 83 year old patient was craving her favorite pie. The Bedside Leader she told this to went to the bakery that made her favorite pie when she was off duty and bought her patient her favorite pie! Incredible – I love nurses; bottomless pits of love and compassion.
Shifting to another topic – government involvement – is it helping or hindering? One of the most original answers yet. While everyone I have interviewed over the past 2 years has answered this question with ‘it’s forced needed change, but we don’t like the way it has been implemented’, Beth’s response was spot on. What’s the number one thing you like about healthcare reform; “It has forced the industry to focus on the patient and to drive us to affordable, evidence based medicine”.
The providers that are on the leading edge of positive change are those that have driven their culture to embrace it. Beth is an outstanding example to follow. Dr. Martinez at Parkland once said to me “culture always trumps strategy”, this is a good example of how true that is.
VP Applied Clinical Informatics
I was honored to interview Liz Johnson, VP of Applied clinical Informatics at Tenet Healthcare.
Everyone in the industry knows Liz. She has been such an outspoken leader and has been on the leading edge of change for a long time.
With 80 hospitals in 14 states and growing, Liz has a REALLY big job so I was very humbled that she made time to share her perspectives with us.
While the entire interview was filled with great insight, I felt that the gold nuggets to share in this case were around vendor relationships. With the volume of sites they manage, Liz is selective of the vendors she engages, searching for value that can be leveraged across the health system. “Working with a vendor I can trust and who partners with our organization to meet our short and long term goals is essential” states Liz.
As part of our education programs, we began to teach Vendor Foundations classes before each of the 5 education events put on by the DFW HIMSS chapter each year.
If you are a vendor these are the “vendor musts”.
- What causes you to trust a vendor? “Being truthful and completely honest is a must. Don’t tell me it can do something if it can’t or hasn’t yet been implemented somewhere else successfully”.
- The flipside – What causes you to distrust a vendor? “Misrepresentation, bait and switch, and worst of all are one sided contracts”. While everyone feels the same, this last comment was the first time I have heard this so clearly verbalized. This example was focused on a vendor agreement that was good for the vendor and not the provider.
Every provider I interview, I wrap up the interview with the same question – As an organization have you made it a strategic goal to compress your vendor list? In 100% of the cases the answer isn’t a casual yes – it’s an emphatic yes!
If you are a vendor whose culture isn’t obsessed with placing the providers experience at the top of your strategic objectives, you might find yourself without healthcare customers before long. If you aren’t easy to do business with you will be replaced. This isn’t my subjective opinion it is a fact!
Large providers need strong partnership alliances that add value to their quality of life. Liz and leaders like her are constantly driving and evolving to meet demand, and the message and advice to our vendor members is simply this – be honest. You will pay for it in the long run if you aren’t and reap the rewards if you are.
Liz thank you for supporting HIMSS and the DFW ANIA initiative that is really taking off!
Children’s Medical Center
On 6/17, I had the pleasure to spend time with Debbie – CNIO at Children’s Medical Center Dallas. Like a broken record you have heard me say how my heart goes out to nursing and the depth of their compassion. Nursing Informatics is the compression of IT and clinical. Informatics leaders largely come from a clinical background – most I know are 20+ year nursing veterans. They have become the ambassadors between clinical and IT, “speaking both languages fluently”.
If you have not yet been made aware that DFW has a great informatics association please check it out or call me if you want to know more https://www.linkedin.com/groups/DFW-Nursing-Informatics-Community-4458603.
Debbie was just recently appointed to the board so congratulations to her!
Children’s is so fortunate to have her as a leader – she is a wealth of knowledge and has been very instrumental in driving change.
Some gold nuggets from the interview to share:
- Pediatrics HCAHPS are completed and are expected to be rolled out in late 2015 – FYI.
- Texas having opted out of federal subsidies has made managing the financial impacts to healthcare more difficult.
- Informatics – I loved this definition “If the technology touches the patient or staff then informatics is responsible for it”.
- On the topic of government involvement – helping or hindering – I liked this perspective quite a bit, “It is hindering as CMS regulations prevent caregivers from fully utilizing their licensed ability to provide a wider range of care”.
- On the appeal to doctors of the provider, “The higher the percentage of CMS patients, the tougher it is becoming to attract primary care doctors”.
- She doesn’t trust sales guys – sound familiar? Vendors ask yourself – are you relevant or a noise maker…
If you are a vendor and want to get to know the DFW ANIA group then call me. I am helping them drive sponsorships and so if you do have a relevant message to them, I’d like to understand it and help them and you.
Debbie, congratulations on your appointment and thank you for your leadership!
Texas Health Partners
Debbie, CNO with Texas Health Partners, and I had a chance to visit on 6/9 and discuss her thought leader perspectives.
As of late, the gold nuggets from our interviews keep coming back to the questions surrounding government involvement. Is it helping or hindering? Debbie said “It is helping yet overly tactical. It would be so much better if all measures were outcomes based.” I loved this analogy, “They can tell us how to build a clock, but once we are done, how do we know it’s going to be a better clock than the one we already had?” Really good point. We are all running hard to embrace change, but is it really clear that what we have been asked to do will measurably impact the right things? I’ve recently seen presentations given to our advocacy team where the provider had evidence to show that their huge investment in EMR was actually paying itself off in the form of operational efficiency – it is interesting that we don’t see numerous providers stepping forward with the same results. Then again, perhaps the timing is such that we can start to see more examples come forward.
I liked Debbie’s emphasis on patient satisfaction and focusing on discharge education and medication education. This is a recurring theme that vendors need to step up and help address.
On the topic of attracting doctors, their case is unique and I thought it would be interesting to share this with you. Being a hospital with physician ownership, their doctors have a direct say in how the business is run and as she puts it “it just seems to work better when doctors have skin in the game, it just works very well”.
Lastly I’ll share her answer to ‘do your clinical teams at all levels have access to measureable feedback on how well they are doing their jobs?’. Her response was outstanding, “Just because you have high KPI adherence, it doesn’t make you the best performer. Are you a great caregiver or a great box checker”.
Excellent. Thank you so much for your insight and leadership, Debbie.
VP Enterprise Applications
Baylor Scott & White Health
Deb, it was great to spend time with you and I look forward to seeing you when we tour the new Parkland with Dr. Martinez later this month!
Things run in threes, right? This was my third meeting in a row where we spent meaningful time relating to vendor behavior, good and bad. If you made it to the CIO Roundtable on 1/31/14 (as well as the vendor track if you are a vendor) then you know you had better rethink your behavior if the customers agenda is not substantially more important to you than your own.
Deb has a “tell me how” personality and still takes time to respond to many vendor requests and emails which, to me, says a great deal about how deeply she cares about other people. DFW is the best place on the planet to be in healthcare! We are so fortunate to have so many leaders like Deb that care so deeply about the end game – quality of care and embracing change for the better.
The last thing I would ever want to do is to encourage a ton of calls to Deb just because she is nice enough to accept them. She, like most leaders, expects you to lead with measurable strategic value and deliver it on time and on budget and have evidence to support all of these things. If you have these points ready to concisely communicate, then you are doing all the right things.
Business owners and sales executive leaders, if you aren’t requiring your sales teams to communicate on these terms then you will polarize 100% of the opportunities that you could have otherwise influenced.
It’s a real shame if you have something that could help drive the agenda of our providers… but you blow off your foot instead.
Well if this happens look at the bright side, at least you are at a hospital when you do it!
Senior VP & CIO
Methodist Health System
It was a pleasure to interview Pam in December of 2013 to wrap up the first year of the healthcareTL.com blog! We have had such great participation and support from our healthcare leadership in North Texas completing 30 interviews during the year and gaining valuable insight into the Clinical and IT leadership perspectives on what is most relevant.
Pam is always fascinating to speak with. What a depth of knowledge and experience coupled to strategic brilliance. As with each Leadership Spotlight, I like to share a few nuggets to make you stop and think. The HIMSS mission is all about sharing what works and, equally important, what doesn’t. We are blessed in North Texas with leaders like Pam who are guiding us through one on the most challenging industry redefinitions in our lifetime.
On the topic of cloud computing, Pam’s “bunker mentality” is a great way to frame in my mind what fits in the cloud and what doesn’t. Applications that are tied to real-time patient care belong in the bunker, a hardened data center managed by the provider. “12 hours without these applications and processes begin to implode”. While every provider to some degree has or is planning to use cloud storage and services, I thought this was a great way to define in simple terms where to draw the line.
On the topic of Government involvement, Pam expresses, “Regulations have become so onerous and are moving EMR adoption too fast causing concern over safety. Audits and reinterpretations later are very disruptive. As an example EMR innovations have been stalled because developers are too busy keeping up with governmental requirements”. An interesting perspective I took away was that it may take five or more years for developers to get over this hump and begin to focus on making the products easier and more beneficial to the providers.
So isn’t the point of better more affordable healthcare better served when we can focus on the providers? My 2 cents.
Thank you Pam for your generous contribution of time and insight.
VP & CTO
Texas Health Resources
Greg Johnson, CTO for Texas Health Resources. I interviewed Greg on August 21, 2013. Greg just moved here from Virginia and while new to DFW he’s anything but new to the industry. I really enjoyed our discussion and Greg’s sense of humor and personality are going to be right at home.
“What’s the difference between an introverted and an extroverted engineer? The extroverted engineer is looking at your shoes instead of his own”. Cracked me up. While the sense of humor is great the depth of experience and passion for building a collaborative and stimulating environment for his team will make a great impact.
“We need to take a more external view, becoming more of an in the field ambassador”. Culturally the point made was to emphasize the role of IT integrated into the clinical process and being sensitive to their environment is key to creating effective cross-team collaboration. This I is a clearly a trend I am hearing from regional IT leadership that is taking more of a front seat to achieve better project outcomes. I look forward to hearing more from Greg in the months ahead and please give him a warm Texas welcome when you meet him at future chapter events!
Parkland Memorial Hospital
Dr. Fernando Martinez is the CIO for Parkland Memorial Hospital of Dallas. Dr. Martinez has recently moved here from Florida where he was an active member of his local HIMSS Board of Directors and wants to continue to be actively involved in the DFW chapter. Please take time to welcome him to Dallas when you see him.
Our interview was on August 12, 2013, and he shared really great perspectives on all of the front of mind issues. He’s a very strategic thinker and one comment I really resonated with strongly; “Culture always trumps strategy”. I’ve never heard it put so succinctly, but it’s a phrase that I will never forget as it applies to any business and to the healthcare industry particularly.
The pace of change in healthcare is different than any other business or market on the planet. Constantly poked, measured and prodded, healthcare is a business that is always changing and where continuous improvement is more than a phrase. ‘Culture always trumps strategy’ is saying that no matter how great your strategy and plans for improvement are – the culture has to be able to naturally embrace it or it will fail.
Switching to the topic of mobile health, Dr. Martinez authored a feature article which was published in ACHE’s quarterly management Journal Frontiers of Health Services Management (Volume 29, Number 2, Winter 2012) that is a must read. We recently had an educational event on BYOD and this continues to be a very front of mind issue that is far from being an item anyone can check off their list as being solved. This is a fantastic article and I would encourage everyone to get a copy, read it, and take its advice to heart. A short concluding thought that I will share from the article is this one; “Because mHealth is an evolving new industry, executives should not be swayed by the extensive marketing efforts to promote a plethora of solutions. Adoption of technology should be based on a recognized need or specific strategy, not just because it is the latest technology”.
Mary Beth Mitchell
Texas Health Resources
Mary Beth Mitchell is the CNIO for Texas Health Resources. It was my pleasure to interview her on July 30th, 2013. She and her local Nursing informatics leader peers have been very successful in building a collaborative networking group representing numerous providers in the North Texas region. They meet quarterly and DFW HIMSS is a strong supporter. If you are an informatics professional, reach out to Mary Beth and get involved!
Some takeaways from our interview I want to share:
“It’s all about telling the patient story, synthesizing it, and then presenting it holistically”.
“We need to quit focusing only on gathering data and start using data”.
I personally gain so much from spending time with Mary Beth and the informatics professionals. They are some of the most incredible problem solvers who understand the need to take the complex “behind the curtain” and make it simple, natural and measurably better for the caregiver teams. My advice for IT professionals is (if you haven’t already) to integrate the informatics leaders into your natural thought leader processing to get the most impactful outcomes for patient satisfaction and safety. This collaboration will also drive an environment that will help retain your best clinical team members.
Parkland Memorial Hospital
I enjoyed interviewing Alan Greenslade, the CTO for Parkland this past week.
Here are a few of the highlights that I wanted to share:
- I really enjoyed talking about BYOD and Alan’s perspective on the topic. As he sees that virtualization and streaming of applications will be the best way to provide client services to everyone. Rather than to run a client application on the device – stream it as a virtual session. This then eliminates the need to buy device management software and the logistical expense that goes with it. What a concept! I wonder what the MDM vendors think about this approach. Eliminating the support headaches that go along with running client applications on an endless range of devices and operating systems doesn’t sound like a bad idea, it sounds simple and could potentially save a bundle.
- Regarding the cloud… “Every cloud vendor is a niche vendor and introduces reliability and service issues that can’t be managed as predictably. Uptime and service level predictions will be harder to forecast.”
Thank you for your insight and forward thinking, Alan.
VP & CIO
JPS Health Network
This was (as are most) a delightful interview. Melinda is very passionate about what she does and cares deeply about key issues such as patient satisfaction and safety. “Nurses want to work here because patients show such appreciation for their work”.
What can IT do to improve? Have a better knowledge outside of clinical in the overall operation.
What does IT do really well? Our systems are VERY stable and reliable.
Melinda has only been with JPS for about a year but is laser focused on the right issues. I particularly appreciate the attention she is giving to the clinical side of the operation creating a strong partnership bond. We are looking forward to great things at JPS and will most assuredly be hearing more from Melinda in the coming months as a strong HIMSS supporter!
Texas Health Resources
Ed Marx is a busy man but always takes time out to share his views and leadership experience in support of the HIMSS mission. We had a great interview so let me share a few of the points that I found to be front of mind to us all:
Are government regulations helping move the industry forward or hindering it?
- Helping move forward
What is the number one thing you like about healthcare reform?
- Finally forcing us to look at the cost quality equation.
What is the number one thing you dislike about healthcare reform?
- Too much bureaucracy
Like most healthcare executive leaders the challenge ahead is the interpretation of healthcare reform as relates to implementation. While the intent is moving the industry towards continuous improvement and cost reduction, it requires leaders like Ed to help us define the specifics of how to make it work.
Children’s Medical Center Dallas
Aaron is a delightful, passionate leader. In our interview I really enjoyed several great nuggets to share:
- Getting IT out into the units is key to understanding their world.
- Attitude towards BYOD – “Bring it!”
- Cloud computing – “It’s headed that way and will become the next utility (i.e., compared to water and power needs of a facility).
- The “missing link to driving tele-health is compliance and reimbursement”.
- Government involvement as relates to healthcare reform – “It is helping the industry move forward but too much ‘trust us’ and not enough definition of guidelines”.
- PHR – “excellence is built from the ground up, we will not settle for second place”.
Aaron is the kind of leader that excites and inspires. Being a family man while working on his PhD with a CTO workload might take a toll on anyone’s attitude, but instead he’s a bottomless pit of energy who always has his eye on the ball. I am looking forward to hearing more and following the great things going on with Aaron and the Children’s team!
VP & ACIO Strategy Applications
Before moving into IT, Randy started his career in nursing which has given him a really good perspective when it comes to being sensitive to clinical operations. You can tell after the first 10 minutes that he really does care about the patient experience and continuous improvement.
- Cloud computing – “Over the next 10 years all will go to the cloud – it will be like what power generation was to Americans 100 years ago as this utility moved into connectivity and service standards”.
Thank you Randy for your contribution and we look forward to following up with you and your team in the future!
THE HEART HOSPITAL Baylor Plano
It’s always a pleasure to visit with Nayan in and outside the HIMSS board! Nayan leads by example 24/7.
As a thought leader in our region Nayan has good insight into the key issues and very front of mind is patient safety and satisfaction.
He is passionate about making sure that IT is in lock step with his clinical partners providing them with the support they need to execute the key strategies of the CNO and the Baylor mission.
No question in my mind he is a rising star in DFW healthcare IT!