CIO Unplugged 3/23/11

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Leadership Equations

After receiving my diploma and officer commission, I headed to the Army Engineer School. Next to aviation, engineering was the most sought after Army career. The other 120 lieutenants in my class were either academy or engineer school wunderkinds. What was I, a psychology major, doing here?

The first week of evaluations earned me a pass to engineer “reform school.” Because of a mix-up in orders, I never got there; I stayed and clung for dear life. To make a long story short, I studied my rear off learning a few fundamental equations and applying logic — meaning I forewent partying with the wunderkinds. I eventually grasped the theories and their practical applications …

Fast forward …

i2i. The department chairman of emergency medicine, University Hospitals Case Medical Center, phoned me. “Ed, this is Dr.Michelson. Do you know what is going on in our emergency department right now?” He was so upset I thought I was on speakerphone being broadcast all through the pediatric Level1 Trauma Center.

I politely ended the call. As a new CIO, I did not want to have impersonal relationships. I wanted to talk face to face.

When I arrived, Dr. Michelson was directing traffic and evaluating patients. One of the IT applications had failed and was wreaking havoc on their process flows. Investigating the situation, I realized we could alleviate some of the cramped conditions by updating their technology. Although it took a couple of hours to restore the application, the next day we gave back additional space to the ED. Simple things, like replacing monitors, PCs, and multi-function devices.

The next day, I received a call from the chief medical officer. “Ed, I heard what happened yesterday. Nice work. That is the first time a CIO ever left the ivory tower and walked the walk.” The story went viral, and the benefits to an eye to eye approach become clear. I soon coined the term i2i and encouraged its adoption by all in IT. From that point, I stopped handling serious matters by email or phone.

Another rise in the growth curve. I also began to use i2i in crucial conversations and confrontations.

We had a physician executive who routinely abused anyone standing in his way. Because he produced results, his behavior was tolerated. After exhausting escalations with chain of command and human resources, I took matters into my own hands. Over coffee, I mustered my courage and laid out the situation to this senior officer. He hid behind his coffee cup, but we connected i2i, and my message landed. That was the last time he abused my staff.

p3. I met up with some docs to talk CPOE and how to amp adoption. As hard as I tried to connect, they weren’t buying. My points were valid and my objective admirable, but no progress. I took another run at these influential physicians, this time with my CMIO, and he got it done.

Those docs never disrespected me. They were simply more open to advice from a peer with experience than some suit administrator with a theory. In many of my medical staff interactions, I leverage the strength of having a physician speak to a physician. I engage to learn and support, so I think of it as p3. The situation transcends physician to a physician to the next power, where you have physicians collaborating with physicians and administration. As a result of p3, we have seen our CPOE reach maximum levels.

e4e. I received a call from the medical director of our newborn intensive care unit (NICU). This NICU consistently ranks in the nation’s top five. After several attempts to get resolution on technical matters, the medical director had become exasperated with IT. Out of 20 mobile carts, only two were operational. She stated that nurses and physicians were standing in line to update charts and enter orders to take care of these beautiful babies. I was aware of this escalating over a few days, but was certain we had resolved it. I told her, “I’ll be right over.”

I had our field services manager and three technicians meet me at the unit. I could not believe what I saw. Nurses and physicians were waiting around to use the two available carts. The sides of the halls were littered with unusable carts as if a tornado had passed through.

What if my child were here? I became indignant. As I approached the medical director, I saw the tears of frustration. All I could think to do was embrace her. We both cried. Frustration, anger, compassion. Someone cared. Now it was time to execute. It was critical to meet emotion for emotion, or e4e.

We borrowed carts from other units. Within 30 minutes, we had 10 working. Others were replaced or repaired within 48 hours. When I returned to our IT offices and found my director and VP of operations still chatting about how to fix the problem, I replaced them.

i2i, p3, and e4e have become part of my nature. While there is no formula to leadership, these equations make up the framework from which I operate. At the end of the day, nothing demonstrates care and commitment like looking someone in the eye, identifying on someone’s level, weeping with those who weep, and laughing with those who laugh.

Technology is the easy stuff. Knowing technology can never make you a better leader.

Oh yeah, and engineering school? I learned the basic equations and graduated near the top of the class.

Update 3/28/11

Thanks again for your readership and comments. Dr. Lafsky is correct on my English — thanks for pointing this out!

I like the idea that several shared along the lines of walking in the customers shoes. Early summer, I hope to share some of our success in this area that has helped tremendously.

As for Blah, I embrace him/her and would enjoy the opportunity to chat sometime. His/her facts are incorrect, but I hold no ill will towards him/her. I have made many mistakes, some of which I described in Biggest Blunders. I will make more. Ideally never the same ones. Let the person who is without fault cast the first stone.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.