CIO Unplugged 5/1/13

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

It’s Not About the Rock: The Remote Village that Turned our Lives Upside Down
(Part 2 of 2)

While the majority of us climbed Kili, five of our team — including my wife and daughter — went to the village and succeeded in making introductions, finalizing plans, and educating. The village elders opened the schools, and the advance team covered critical subjects on the basics: nutrition, health, and universal precautions.

By the time the rest of us arrived, clinic construction was still a few days behind. We would open without water or electricity.

June 22, opening day. Seventeen of 20 senators plus the former Tanzanian Prime Minister attended the incredible ribbon-cutting celebration. Doug and Martha represented our team, and with the Prime Minister, blessed the clinic. Villagers dressed in a vast array of colors, surrounded their new clinic, singing in Maa. This put most of our team in tears; I hid mine behind a camera lens. We were all humbled and a little shocked by the fanfare and how much this meant to the Maasai and their country. Media from all over Tanzania rolled cameras and a major party wrapped up opening day.

Talitha Marx

The following morning, we opened for business. Winjie and Liz had us well organized. We had a doc and medical assistant for each of the four treatment rooms plus another working in the lobby. The triage unit included two assistants and two translators. They started the medical records, took vitals, and prioritized patients. Two women manning the supply room / pharmacy / break room dispensed meds and supplies. The rest of us rotated between crowd control and entertaining all the kids. We played lots of soccer and taught them football and Frisbee.

Our first patient was a young mother who had not felt her baby move in 36 hours. “Oh great,” I heard myself saying. “What if our first two patients die?” What would be the risk to the clinic longevity? Would the villagers turn hostile? Had we lured all these people here to die? Even if the village accepted the deaths, it would cast a dour vibe over our clinic. What an ominous beginning. I prayed, but, as much as I hate to admit it, I was more negative than positive.

While I was getting uptight, the team swung into action. One of our docs happened to be an OB/GYN. Liz also went into our “birthing suite.” She held the mother’s hand and assisted her OB/GYN husband with the delivery.

Outside, it seemed the entire village had gathered as news spread quickly (without FaceBook). Crowds pressed in and my thoughts grew darker as we held the line. I could hear the rest of the team behind me going in and out of the room, but no baby. Someone shouted for one of the other docs, who by coincidence happened to be a neonatologist. When he entered the room, I figured the baby had been born. Unbeknownst to me, our CEO, his wife, and some of our ladies met inside the pharmacy room, held hands, and prayed.

Silence fueled my anxiety. The eager crowd grew antsy. Some had traveled many miles to receive treatment and this incident held things up.

Resuscitation attempts were underway. Lacking requisite equipment, improvisation came into play. A plastic baggie turned into an ambu bag; a shoelace became a clamp. Ten minutes passed. The baby took a breath on her own. The precious infant pinked up, and then … the cry that loosed hope. Those in the birthing room heaved deep sighs and shed tears. That one cry carried a message to all the villagers and (as we found out later) reached the Serengeti, a four-hour drive away.

Open Arms Clinic is a good place!

Baby Elizabeth at birth, with neonatologist Darryl Miao, MD

Isina suffered a second-degree tear. The only suture available was a 5-0 chromic suture, and no needle driver. The OB/GYN found makeshift suture scissors and sewed up the tear. All this time, Liz had been consoling Isina, acting as her birthing coach. She had built a bond with this first-time mother. Toward the end, Isina asked her name, and she replied, “Elizabeth Ransom.” While the physicians are working, Isina announced, “I am naming my baby Elizabeth.” 

Everyone in the room broke out in tears. Nine months prior, Elizabeth Ransom had been the doctor who originally suggested we set up a clinic. Coincidence?

Talitha Marx at TEDxKids

We learned many things in June 2011. A few universal leadership gems include:

THR CEO Doug Hawthorne and UNTHSC  CEO Scott Ransom, MD

• Leaders serve. We saw this over and over again, but perhaps nowhere as poignantly as when we caught the Texas Health CEO and UNTHSC CEO kneeling and wiping up urine from an exam room floor. This was not posed.
• Want what you have because you may not have what you want. We had sparse equipment and facilities. But compared to the locals, we were blessed. Had we focused on what we did not have, our time would have been miserable and full of complaint. Rather we learned to accept the circumstances and did what we could. That is where joy came.
• Influence knows no boundaries. My then 17-year-old daughter Talitha was the bridge between the villagers and our team. From the mouth of babes. Don’t ever tell me title or experience matters. This video above tells the story from her perspective via TEDxKids.
• Innovation. Our clinical improvisation saved lives and healed wounds. Always think outside of the box. When the right tools don’t exist, make them.
• Rewards beyond the vision. We came prepared for any opportunity. While Open Arms Clinic was our mission focus, the team was ready for anything. When the elders realized we could teach the village about universal precautions and nutrition, school was called back in session.

Baby Elizabeth at age 20 months, two months ago

The Open Arms Clinic continues to serve the village today. An African physician and nurse run the operation. Residents from UTSW will begin rotations there in 2014. The government continues to honor its commitment of service. Several from our team continue to offer in-kind support.

We took care of 350-plus patients and witnessed various other miracles that week. We went to climb a mountain, but found our trip wasn’t about Kilimanjaro. While we impacted a village of 10,000 in a remote part of the world, that village turned our own world upside down. We came back changed, transformed, as the villagers were. We grew as leaders. As friends. As individuals. We found ourselves. We deepened our faith. Our lives will never be the same. It’s not about the rock.

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.

CIO Unplugged 4/17/13

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

It’s Not About the Rock: The Remote Village that Turned our Lives Upside Down
(Part 1 of 2)

“Ed,” Dr. Liz Ransom whispered in my ear, “why aren’t we doing a medical mission? After all, we’re mostly a bunch of docs.”

I nodded my agreement. How obvious. I announced the change during the meeting. Instead of an education mission, we would set up a medical clinic. And so, approximately nine months before our departure to Tanzania to climb Kilimanjaro, the idea for our modest medical clinic was conceived.

We leveraged important connections, thanks to Jimmy Wynne, one of our employer’s board members. In fact, Jimmy was the one who planted the idea to climb Kilimanjaro. Because of previous personal investments Jimmy had made into this remote village of 10,000 Maasai, he knew the government officials as well as the tribal elders. These relationships would become key to the clinics success and long-term viability.

Team members pooled resources. One thing led to another, and our clinic plans grew from a tent to a permanent structure. Before we broke ground, our CEO, Doug Hawthorne and his wife Martha got involved and enlarged the vision. They donated all the funds needed to create a larger structure that would eventually have running water and electricity. Blueprints were redrawn.

Weeks later, we received a letter from the government pledging their long-term support of the clinic once we left. Sustainability was a non-negotiable for us. With that objective met, dirt began to move.

While we were busy preparing for our climb, construction of the upcoming “Open Arms Clinic” continued. Onsite contacts sent periodic updates with pictures, and we managed the project from afar. One of our hospital presidents, Winjie Tang Miao, agreed to act as the clinic director, and Liz Ransom became the medical director. Generous companies donated two tons of medical supplies. Winjie and Liz worked closely to handle all of the clinic details from supplies, staffing, medical records, workflow, etc.

June 2011, we arrived in Arusha. While the climbing team left for seven days to tackle Kilimanjaro, five of our women traveled four hours by bus in the opposite direction to a remote village near Mto wa Mbu. Our male American liaison, with whom we’d been coordinating over the previous months, could not make the introductory meeting with the village elders.

The first night, our five women sat alone across the table from 15 Maasai village elder warriors armed with spears. Despite having two awesome translators (one for Swahili, a second for Maa), talks were very awkward. The Maasai are a male-dominant culture, and discussions about the clinic wound toward information regarding safe sex and AIDS. This transparent and curious conversation would either develop into a mutual trusting relationship or create a major obstacle.

Lessons learned:

• Vision impels action. A vision without action is just a dream. A true and real vision will draw others to jump aboard. We saw this unfold as dozens of companies donated equipment and clinicians and leaders signed up to give up their vacations and finances to serve people 10,000 miles from home.
• When to lead, when to follow. This was the most challenging lesson to learn. While I was responsible for the entire Tanzanian expedition, running a clinic was not my forte. I had to humble myself and take a backseat. I had to let the appointed leaders lead and not get in the way. Strong leadership means being a good follower.
• Community engagement. Our achievements were based on the foundation of engagement with both the politicians and the village elders. Had we attempted this on our own, we would have failed. We took the time to first develop relationships and approach this mission as a partnership, not as saviors.

(To be continued)

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.

CIO Unplugged 4/3/13

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

Meet the Parents: Making Lasting First Impressions

This past couple of weeks, I’ve had the honor of getting to know the newest member of my team. More than once, I’ve been the newbie on the block, and I know exactly how awkward this can feel. It reminded me of another newbie situation that happened over two decades ago.

My freshman year ended and I was smitten. Forced to part from my college crush made my summer unbearable. I didn’t see Julie for 12 long weeks while participating in Army combat medic school. Testosterone raging, I wanted to marry her. Right then!

When I returned in the fall, our courtship blossomed. We started making life-long plans and set a date 18 months out.

Then it was time to meet the parents.

A friend lent me her Jeep over winter break. I drove my future bride through the ice and snow to introduce her to my parents. Making our way from Ft. Collins south to Colorado Springs, we chatted about family as Julie played with the handcuffs hanging from the rearview mirror. She inadvertently cuffed herself.

Laughing, we searched the Jeep for the key. No key. I had no contact information for my friend, who had headed to Florida for Christmas. Bouncing down I-25, Julie’s arm dangled from the mirror.

Refusing to let her meet my parents in this condition, I pulled into a truck stop and explained our dilemma to a repairman. Smirking up a storm, he cut the chain, freeing Julie’s arm from the mirror. We continued our journey south.

Stopping at the Springs’ police headquarters, we requested assistance to remove the cuff. The suspicious officer pummeled her with questions — “Who did this to you?” — and asked for the Jeep’s registration. The Florida vehicle had no registration. I started to consider my one phone call. “Dad, can you and Mom meet us at the police station and post bail?” Not the ideal first impression.

We have one chance to make a first impression, so make it good. One nice thing about starting in a new organization is the opportunity to begin from scratch—with your management, your team and your customers. It’s critical to think about the mechanics of that first impression long before you arrive. Great books such as Your First 90 Days provide superb guidance.

The best takeaway for me was not to “hit the ground running,” but to “hit the ground listening.” In my current position, I’d spent the first 90 days meeting with 100 key leaders, team, and customers, taking copious notes. Summarizing by theme, I reported these back and used them to guide my priorities that first year. The greatest gift we can give is to listen.

First impressions work both ways and are too easily forgotten when new employees, leaders, or customers jump on board. Go out of your way to make a noble impression on the new team member who clearly feels lost and out of sorts. Newcomers to the organization afford us with golden opportunities to show we care about their success.

When possible, secure their contact information prior to their arrival and reach out in advance with an invite to dinner or coffee. In my role overseeing technology, I aim to guarantee that organizational newbies have all the tools and access needed to be productive on arrival day.

A first impression is more than personal. It’s professional.

The cops finally released us. Unable to de-cuff Julie, they sent us to a locksmith. After hearing our story, the locksmith called the cops and we repeated the cycle. Finally getting police clearance, the locksmith freed Julie.

Although late, we reached my parents’ home sans the suggestive jewelry. She made an incredible first impression, and Mom and Dad immediately embraced Julie as part of the family. I sometimes wonder if their reception would have changed if my fiancée had shown up as a jailbird. A tough gig to recover from, for sure. Perhaps my parents would have bribed me as Julie’s parents had tried to do.

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.

CIO Unplugged 3/27/13

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

Panel Pitfalls and How to Avoid Them

Have you ever attended a panel with anticipation but then ended up wanting to walk out? Well, I’ve participated on a panel and I have walked out.

Panels carry great potential, yet the benefits are seldom realized.

Not long ago, I was part of a panel for a prestigious graduate school career day. The moderator asked us to prepare a five-minute oral overview on our respective organizations and roles. He knew the students would have ample questions and preferred that the panel react to student interests.

We all stayed inside the time boundaries until the final participant. He approached the lectern and began a forced march, death-by-PowerPoint presentation. After 10 minutes, I started catching up on e-mail and Twitter. After 20 minutes, I left the panel and sat in the audience, incredulous. When I left the room at 30 minutes, the panelist was still pontificating and the students had long since checked out.

Shortly thereafter, I was on another panel testifying before the Texas Senate. My fellow panelist asked me beforehand to stay within my time limit because she wanted a fair shot to share her views. That was brash, but I admired her approach. We agreed to split the time, each taking 20 minutes. I also deferred to her, and she spoke first.

At the 25-minute mark, I became slightly annoyed and made subtle motions to get her attention. At the 30-minute mark, I was scrambling to rewrite my script. In the end, I had five minutes. I suppose her earlier brashness should have tipped me off.

I’m sure you have similar stories as an observer or a participant. When a panel hits the mark, I leave fulfilled. When they don’t, I feel as if I’ve squandered my most precious resource.

What’s worse than listening to a bad panel? Participating on a bad panel. Here’s a sprinkling of ideas to help avoid panel pitfalls:

• Moderator. Like an orchestra conductor, the moderator is the key to making the panel work. Ensure the moderator is qualified and skilled to keep the panel focused and effective.
• Practice. I noticed that professional moderators engage panelists, individually and as a group, long before the actual event. They query questions in advance and discuss them in warm-up meetings. Ground rules are established.
• Debate I. I want to pound my head on the table when a panelist says, “I agree with (insert name)” and then goes on to repeat the same point. The value of the panel is in its diversity and getting multiple opinions. If you have nothing new to add, don’t talk.
• Debate II. An alternative approach is to have the moderator present an opinion and and encourage contrarian viewpoints.
• Sound bytes. Strong responses need not take longer than two minutes. Short, to-the-point answers are always best and memorable.
• Size matters. The ideal panel size is three or four. Anything less becomes a speech; anything more becomes annoying.
• Move on. Not every question requires a response from each panelist. See “Debate.”
• PowerPoint. No.
• Furniture. A panel is about the panelists. Tables are a distraction. A row of chairs facing the audience is ideal.
• Clarity. Keep the panel objective in mind throughout the discussion. Some freedom of discussion is good, but it is very easy to then to head down a rabbit trail.
• Panel bios. Less is more. The audience can read about how great you are in supplemental materials.
• Diversity. Individuals should be knowledgeable and articulate, and the group needs to be at least somewhat diverse.
• Distribution. Ensure each panelist has equal opportunity to respond. Corral pontificators.
• Timekeepers. Timekeeping ensures focus and keeps panelists from rambling.
• Parking lot. An effective way of avoiding rabbit trails. “That is a great question; let’s put it on the parking lot.” And then never discuss it again.

While I see the value of a panel, I have to admit I cringe when I’m asked to participate on one. Just because I take personal measures to avoid pitfalls doesn’t guarantee everybody else will.

What ideas do you have on avoiding panel pitfalls and ensuring nobody walks out — including a fellow panelist?

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.

CIO Unplugged 2/27/13

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

Five Degrees of Separation

I’ll be the first to value talent and experience over education. But let me stir the waters. For those with a degree, you might skip this post. For those without, let me persuade you to stop making excuses and get back to school.

Although not always popular, the fact is that possessing a degree provides separation and increases the likelihood of upward mobility and salary for those with such desire. Bill Gates or Mark Zuckerberg are walking proof to the contrary, but they are also outliers. So get back to school.

I was about to get my MBA when my favorite college professor pulled me aside. Dr. Drennen said MBAs were “a dime a dozen” and to get a unique degree that set me apart. She helped persuade me by throwing in a graduate teaching assistantship and other incentives. With a baby at home and mounting expenses, I enrolled in Consumer Sciences (business from a consumer vantage point).

As the university contracted from 11 colleges to eight, Consumer Sciences was pooled with four other orphans: Apparel Design, Merchandising, Interior Design, and Housing. Preparing for graduation after one intense calendar year, the assistant of this newly formed division was unsure how the diplomas should read. Since I’d been required to take a class in each of the disciplines, I suggested it should reflect this. Sure enough, I was essentially conferred all five degrees. Just don’t ask me to pick out your suits or decorate your home!

Are degrees themselves so important? I suppose you can argue yes when it comes down to being a physician or nurse or engineer. Other times, the course content has little correlation with our eventual work or skill requirements or how well we perform. We all know people with lots of books smarts that can’t find their car in the parking lot. I get that. But something of more fundamental value arises from obtaining a degree than just the diploma.

I entered college at 17. Completely clueless, I ended up with a 1.6 GPA my freshman year. While I had some modest grants and loans, I had to work my rear off to live. I was dirt poor. But I stuck to it. I learned how to study. I learned discipline. I learned budget. I learned goal setting. I learned achievement. My grades improved, and I graduated.

My first roommate was an Italian rocker from the Bronx. I was a shaved-head punk. Our suite mates were nerds, and the guy across the hall a dork. Down the hall lived jocks and geeks with punch cards. Some students worked two jobs like me, while others were on Daddy’s dole. We had drinkers and druggies representing every walk of life. You learned to survive and form partnerships.

Life became complex. Unplugged from home. On your own. Mom wasn’t there to wake you up. You had to make tough choices on majors and classes. You had to multi-task, set priorities for studying, and balance a social life. You became immersed and familiar with management. Each decision forced you into rapid maturity.

Few of us escape school without encountering unrealistic professors and drama with jobs and administration. Coordinating with the financial aid office, admissions, guidance counselors, department managers, etc. We learn life is not fair. We learn to fight for ourselves. We develop confidence as we come face to face with politics and negotiate our way.

Between the varied undergrad classes, and moreover as a graduate student, I was exposed to many new ideas, concepts, and experiences. Whether working with lab rats (which in a clandestine early morning operation, I rescued my albino and set him free) or studying business, computers, poetry, design, etc., I was exposed to a world I would’ve never otherwise had the freedom or time to explore.

I have an open door policy and the welcome mat is worn. A common question I’m asked revolves around degrees. Should they go back to school, and if yes, what degree to pursue?

My answer to the first part is almost always, yes! You learn much more than the degree content itself and it opens up doors for advancement. The type of degree depends on career goals and long-range objectives, but you can hardly go wrong with an undergraduate in business or related field. For post-graduate work, I often recommend an MBA or MHA. No matter what, a safe bet is to follow your passion, even if the degree doesn’t seem to fit. I once had a history major run my data centers well. My five-degrees-in-one have nothing to do with IT.

I have written about my parents before. My mom never completed her secondary schooling because of the bombs that rained over Southern Germany for several years. She obtained her GED, enrolled in community college, and graduated the same year I graduated from high school. My dad’s schooling was short circuited by his unique circumstance. But when he retired from the Army, and with seven of us kids still at home, he jumped in and obtained his business degree before starting his second career.

I know many people have tough circumstance that might keep them from getting their degrees. Kids, time . . . all the pressure of the day job. It may need to wait a couple of more years. But for others, you need a kick in the pants.

I hope that after reading this, you’ll explore again. Don’t let pride interfere, nor the specific degree you really want. This is a great opportunity for self-evaluation and reflection. Jump in and separate yourself.

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.

CIO Unplugged 2/13/13

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

Experience is Not the Best Teacher

We took our youngest child Talitha on her first visit to Kauai so she could visit her grandparents. Yes, the same couple who offered me a bribe years earlier not to marry their daughter. They had retired in a condo, high overlooking the Na Pali coast.

One day while they babysat Talitha, we headed out for adventure with our eight-year-old son Brandon and German exchange student Sonja. We began our day intent on making it to Secret Falls, only accessible by foot.

We rented two kayaks, donned lifejackets, and started paddling up the Wailua River to the remote trailhead two klicks away. The evening before, a major storm passed through, so our outfitters warned us that the river would be more challenging than normal to navigate.

Julie and Sonja paddled smoothly and held a great line down the middle of the river. Brandon and I had a difficult time keeping the keel pointed upstream as we beached the banks. A mile in, we came to a choke point where the placid river channeled into a quarter of its normal width, creating a high velocity flow with rapids and eddies.

The women stopped short of the rushing waters and, of course we men would show them how to row into the straight, like salmon looking to spawn. Hal way in, I realized we had no chance. I tried to turn the kayak 180 and go back down in search of an alternate route.

The kayak flipped. I fell out, and the current sucked me 10 yards downstream into a recessed pool. The upside down kayak remained in the fray, tangled in branches and storm debris.

The women witnessed the event and moved in as close as they could where the waters were manageable. No one could see Brandon, and we were afraid he’d been swept under and caught in debris. A muffled “Help!” reached our ears. Trapped under the kayak, he could not escape because his life jacket was keeping him afloat in the air pocket.

Julie’s mother-bear instincts kicked in. She jumped into the water and swam to the kayak.

Grabbing smooth but slippery tree roots along the bank, I pulled myself to the other end of the vessel. Between the two of us, we were able to flip the craft. Brandon floated into the calm pool to safety. We decided the best course of action would be to carry our kayaks on land past the channel and then get back in.

While we collected ourselves, a man and his son rowed past us. They had observed the scene and congratulated us on our remarkable recovery. They then proceeded past us thinking they could muscle their way through the current. Sure enough, at the midpoint, the father turned the kayak to head back. As if a bad rerun, they also flipped, and the kayak got stuck in the same spot.

The dad stayed upstream, holding onto branches. His son was nowhere in sight. No muffled cries for help. He had seat belted himself in. So not only was he under the kayak, but upside down submerged.

I jumped back in and made way to the kayak. We could not flip it given the physics with his son as anchor. Reaching under, I pulled at every strap I could find to break the boy free. Likely seconds but seemingly minutes, he was freed. We eventually got him to shore, shaken but alive.

Julie and I talked afterwards and wondered why on earth our fellow paddlers made the decision to copy our near tragedy. After observing our experience, why would they even want to follow our path? Sure, had we been successful it would have made sense. But we nearly lost our son.

Experience is not always the best teacher. Had this father taken note of my journey, he would have spared his son fear and trouble.

So it is in work. Why do we insist on replicating other leader’s and organization’s failures? Why don’t we take advantage of other’s experiences, both the good and the bad? Is it pride? Is it a feeling of invincibility? Arrogance? Fear?

The next time you embark on a journey, make efforts to prepare in advance. Use two parts planning to one part execution. Research leading practices. Study accounts of success and failures related to your endeavor.

I learned this from one of my mentors. Before embarking on our EHR journey, he insisted we contact successful and unsuccessful organizations and learn. I arranged several CEO/CIO meetings with peer health systems where we actively learned from others experiences. It paid off and is now part of my standard way of operating. There’s no reason to risk drowning when we have access to river guides.

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.

CIO Unplugged 1/23/13

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

The Long View

I proposed to Julie on February 1, 1984. I was 19. I’m not sure I really knew what love meant, but I sure enjoyed being around her. I loved listening to her practice piano for recitals as I stole second glances.

Despite our young age, everyone was pretty stoked about our engagement except her parents. Looking back 27 years later, with my own daughter that age, I can’t really blame them.

Julie defined their marriage. She was the apple of their eyes. They wanted to delay giving her away for as long as they could. When they did, they hoped for a doctor or lawyer. At least those were the types they had over to dinner so Julie could meet them on weekends home from college.

I recall pulling into their driveway one Friday. My Chevy Vega with the duct-taped hood cowered next to their lacquered Mercedes. Wearing baggy sweats and tennis shoes with holes, I was the definition of poor. While I grunted away in the Army Reserve as a private, her dad stood tall as a retired WWII naval officer.

They were against the marriage from the get-go and withheld their support. Then came the final meeting, one last chance to talk us youngsters out of a commitment that had failed them both previously. They hired an investigator who reported everything about me from teenage indiscretions to bank withdrawals to employment history. There was nothing new to Julie. 

Out of exasperation came the final plea came. They offered me a handsome amount of money to walk away.

I had no hesitation. I’d already counted the cost. Despite the fast and easy reward, I took the long view. I’d never had that kind of cash, but I knew money wouldn’t make me happy. I immediately said no. They walked away.

We face many temptations in our careers. Most are not so stark, but others manifest themselves in many forms. We all know of colleagues who took bribes from vendors to influence purchasing decisions. Eventually they got caught and lost their careers and reputations. The short-term gain never pays long-term dividends.

Reviewing hundreds of resumes over the years taught me to spot trends where applicants constantly jumped from job to job, each time trying to bank a modest increase. Although a person might receive payola by making so many moves in a short period, they likely won’t land the big one. Who would hire someone whose trend suggests he or she might leave in a year? At some point, all the jumping catches up to you, especially at the highest levels. Think tortoise and the hare.

I do believe there are times you must go to grow. Other times you need to grind through challenges so your character can form and your leadership can blossom. I see too many people run at the first sight of trouble.

Boy, I’ve been tempted myself. I recall one year a while back showing up at a new employer where it was clear I was way in over my head. Way over. Everyone was nice and it was a stellar advancement opportunity, but my insecurities got the best of me. After a few months, I humbled myself and called my former employer, asking to return.

The COO, who had previously served as my mentor, said no. He explained that I needed to stick it out, learn, ask for help, adjust, and succeed. As much as he wanted me back, he knew if I went in reverse, I would never reach my ultimate goal of CIO. I followed his counsel, and today I am living my career dream. Had I taken the short view, I would likely still be working in the same position today.

My in-laws ultimately had a change of heart and helped us with the wedding expenses. I appreciated the fact they wanted to protect their daughter from making such a huge commitment at a young age, not yet even a junior in college. I would’ve handled it differently, but again, I understood the motivation.

We got married and worked our butts off to get through school and start our family. Today we are richly blessed, having taken the long view.

Whenever challenges hits me, I’m tempted by the short view. But one look at my family and my career reinforces the lesson. The long view pays off.

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.

CIO Unplugged 1/1/13

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

What Do I Stand For?

But I still wake up . . .
Oh Lord, I’m still not sure, what I stand for
What do I stand for? Oh what do I stand for?
Most nights, I don’t know any more.

I like the tune Some Nights by the indie alternative group fun. You can argue the meaning of the song, but the hook, “What do I stand for?” resonates with millions, including me.

The issue people struggle with most is discovering purpose in life. This is one topic I’m frequently invited to speak on and the one concern for which people often ask my help. In light of this, I’m revisiting a blog from a few years ago that I hope you’ll find practical.

I have no secret formula nor warrant that what worked for me and my family will work for you. Making life easy and eliminating challenge is not my goal. Living out purpose involves inherent trials. What I offer are principles and a process that will facilitate your journey into discovery and could possibly transform your life on different levels. I’ve shared these ideas for many years in different cultures and have witnessed dramatic change.

Let’s set the record straight: resolutions don’t work.

The first thing I ask those who ask for help is, “What’s your plan?” Such as, what is your mission, vision, values, objectives, etc. I’ve never received an articulate first-time response. But when I ask people about their organization’s plan, they’re quick to answer.

The dichotomy is evident. Why would you take the time to memorize and labor to achieve the plans of your organization but not do the same for yourself or your family? The good news: you already possess the tools and experience to close this gap. But it takes time, energy, and determination.

I finished grad school in 1989 with business planning concepts drilled in my brain. My company embraced these concepts, and I knew our execs jetted off to resorts to spend considerable time planning. Market performance confirmed a strong correlation.

For me, the disconnect came in hearing of their struggles on the personal side of the ledger. One particular Fortune article reinforced my thought process: “Why Grade ‘A’ Execs get an ‘F’ as Parents.” Having just started a family and career, I was searching for ways to have success in both.

Could I increase the odds of personal success by adopting business theory?

Our First Family Retreat

The Marx family’s strategic planning adventure began modestly. Short, inexpensive trips away from home reduced distraction and stimulated creativity. These trips morphed into more elaborate excursions, but the focus always remained on strategic planning.

Our first retreat in nearby Estes Park cost us about $100. We worked on a one-page plan that became known as the “Marx Family Constitution.” Originally written in 1990, it has withstood the test of time.

Since incorporating this process, we’ve all experienced dramatic increases in the quality of our careers and relationships. Our oldest, now age 25, had coached his college peers in these concepts. Not long ago, my wife heard our youngest, age 19, encourage her boyfriend to discover his life purpose and come up with a plan to live it out. Julie and I recently celebrated our 27th wedding anniversary and are still twitterpated.

I don’t have the space to share the numerous examples, but I can share the one that had the most impact. My son, age eight at the time, took a ruler and pointed to the values section of our Marx Family Constitution that hung prominently in our family room. “Dad,” he said, “was that honoring mom when you yelled?” Seven months prior, when deciding which six values needed improvement, he had contributed the word “honor.” He called me on it. Accountability!

We aim to live out what Rick Warren calls The Purpose Driven Life. Decisions on how to spend our time, energy, and resources are guided by past retreats. I could go back through 20 years of documentation and show you at least one significant event that happened each year in my career, marriage, and family. Could you?

Keeping it Fresh

Take annual retreats to focus on your plan. Get out of Dodge and spend time in a setting where beauty can inspire. A place free of distraction. As leader, your job is to facilitate.

WARNING: never force your ideas down the family’s throat. Instead, invite them to dream and evaluate. Kids especially need to think for themselves. Review your plan and encourage transparent dialogue about performance. Record the highlights of the previous year. What are the gaps and how do you close them? Include significant others and engage your kids. Teach them. Envision them — but NEVER do it FOR them. Commission them. Then watch them rock not only your world, but also the world around them.

Disney makes for great vacations. Planning retreats make for enabling identity and significance.

Take Action

Forget resolutions. They don’t work. No organization runs with resolutions. Market share would drop, and eventually you’d go bankrupt.

Schedule your first retreat and prepare to write, because earth-moving ideas existing ONLY in your head haven’t the magic to propel you forward. Write them out. Teach them. Actualize them. You only live once.

There’s nothing worse than going through planning exercises merely to have the plan collect dust. Create a living vision. When someone asks you a career or life question or you face a major decision, your purpose will keep you standing.

What do you stand for?

***If interested in creating a plan for your career, life, etc., leave a comment. I will send you a copy of my one-page strategic plans (personal, career, family). I will include a retreat guide designed to stimulate thoughts and ideas around your mission, vision, values and objectives as you put your plan together.

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.

CIO Unplugged 11/28/12

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

Chasing Mercury … Leading with Excellence

Each year, I participate in a couple of dozen races. Everything from 5K runs to complex endeavors like Ironman, Spartan Beast or Escape from Alcatraz. I train like I race; I work like I live—purposeful, intending to win.

I don’t like losing. Although I enter races knowing my podium chances are slim, I still race to win. I push as hard as I can.

What hurts more than losing is missing the podium by one athlete. Fourth-place finishes kill me. I can recall every race where I lost because I gave up the will to win or I compromised my performance.

Heading into this year’s Thanksgiving Day half-marathon, I wasn’t about to take another fourth-place slot. As we assembled at the starting line, I saw a man with the wings of Mercury tattooed on his ankles. I figured if I followed on his heels, I’d have a chance for the podium. I chased Mercury for much of the race.

During athletic events, my body talks. Loudly. A fast heartbeat. Strenuous breaths. Muscles strain. Then my mind takes over and makes up appealing excuses. If I heeded my body’s instinctive impulses, I’d stop. I’d hop on the couch, turn on Netflix, and throw down a beer.

Of course, I don’t stop. Instead I start to justify the very behavior I loathe. I slow down or walk. Worse, I become delusional in believing that the lead I built early in the race gives me the right to go on cruise control. Why push harder if I’m already ahead? Does it really matter as long as I finish? Nobody else is working hard, and they are doing just fine. Who would know?

This same digressive situation manifests in the workplace.

Come on, we all wonder how those leaders we consider inept got into their positions in the first place. The Peter Principle explains some, but not all. So what happened to the others? You gotta figure they performed with excellence at one time, but then something changed. Did the energy and passion drain? Perhaps they lost focus. How did the clarity that once existed vanish?

Somewhere along the trail, rationalization turned intolerable excuses into tolerable performance. Many leaders finish the race, but few do so with excellence. I fear embracing the fourth-place mindset in my work.

At Mile 5, with Mercury in sight, I felt strong. But my body was already trash-talking me. I ignored the impulses and stayed focused. At the turnaround point, I could tell I was in the top six, but I had the chase group on my heels.

I thought about those fourth-place finishes and what it would take to stay in the lead pack—a resolve to win. I shunned the mind games and pushed towards the finish. In the last two miles, a few passed me, but I still saw Mercury. I set a personal record for the half-marathon and finished first in my age group.

True leaders don’t give into complacency or entitlement, no matter their age, status, or tenure. Yesterday’s performance made you the CIO, but it won’t make you a podium finisher without an unrelenting resolve to win. Leaders push for the gold, bringing out the best in themselves and in others.

Chase Mercury.

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.

CIO Unplugged 11/14/12

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

Reach

I arrived early to the bar. A bit after five, I was sipping merlot as my first guest arrived. We’d never met.

In fact, I’d never met any of my guests. I had found their contact information a few weeks prior and fired off an e-mail invite. I had no idea who, if anyone, would show. We had little in common, so what should I expect from them?

Our connection? Their CEOs sat on the board of my healthcare system.

I was totally rookie my first year as CIO. My first leadership endeavor was the selection and deployment of an electronic health record. What did I get myself into? I had to guide us through the biggest transformational challenge in the 140-year history of our organization. No pressure!

The guests I had invited all showed. We moved to our private dining room. I was now sitting with seven Fortune 250 CIOs.

I asked them for advice. Although they couldn’t relate specifically to the challenge of the EHR, they had significant experience in other transformative enterprise projects such as ERP. I wanted and needed to learn from their experiences.

Yes, experience is a decent teacher, but other people’s evaluated experience is even better. I had no margin, time, or grace to learn on the job. Unbeknownst to them, they were my lifeline.

The modest dinner cost delivered significant returns. I gleaned more that evening than I ever could have from a library or from endless webinars. I applied their golden nuggets of wisdom and avoided common pitfalls inherent to enterprise projects. Their willingness to share below the surface launched my organization and team down the track of success.

Moreover, these relationships are as important today as they were 10 years ago. Yes, I have maintained these connections. I recently met my friend Tom Lucas (Sherwin-Williams) for breakfast at the Society of Information Management national meeting. Just as I had back in Cleveland, I peppered him with questions, listened, and learned. I needed to talk with someone outside of healthcare, and Tom was there for me.

What I’ve learned: the more I reach out, the more goals I achieve.

I want my direct reports to have similar interactions with their non-healthcare peers. In a post two years ago, I shared how my team routinely collaborates with non-healthcare companies. This summer, we met with the IT leadership team of Kimberly-Clark. The meeting was pretty amazing, at least for us. We shared strategies, challenges, ideas, and opportunities. We commiserated and consoled.

In complete learning mode, I asked questions and took notes throughout the day. I was absolutely humbled. As a result of this interaction, we adopted many of their leading practices, including the following:

• Launching an internal mentoring program
• Deepening our mobile strategy and consumer-centric apps
• Developing a more robust communications capability
• Optimizing our business intelligence

I was schooled and happy. But I have to admit my remorse over the fact we received more than we gave.

Secondary benefits continue: relationships. We have now expanded our network to three non-healthcare companies. My direct reports are genuinely acquainted with their peers in these organizations. They have friends they can call on to give them fresh perspective and to help elevate their capabilities and performance.

Healthcare IT lags behind other industries such as financial services, entertainment, logistics, and retail. This is one way we are closing the gaps.

What I’ve learned: reaching out turns weakness into strength.

What are your approaches to identifying and closing your technology gaps? Find a company you admire and reach.

Post a response and I’ll send you the generic agenda we use for these peer-to-peer meetings.

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.

CIO Unplugged 10/24/12

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

CIO, Wake Up and Lead

Alexander the Great, one of the greatest military generals who ever lived, conquered almost the entire known world with his vast army. As the story goes, one night during a campaign, he couldn’t sleep. He left his tent to walk the campgrounds.

He came across a soldier asleep on guard duty – a serious offense. The penalty for sleeping on guard duty was, in most cases, death.

The soldier began to wake up as Alexander the Great approached. Recognizing who stood before him, the young man feared for his life.

Alexander the Great looked down at the soldier. “Do you know what the penalty is for sleeping on guard duty?”

“Yes, sir.” The young man’s voice quivered.

His features hardened, and Alexander the Great put a hand on his hilt. “What’s your name, soldier?”

“Alexander, sir.”

Alexander the Great studied the young man with a searing gaze. “What is your name?”

“My name is Alexander, sir.” The soldier’s knees shook.

A third time, Alexander the Great demanded with force, “What is your name?”

Breathing heavily, the young man replied, “My name is Alexander, sir.”

Alexander the Great then came face to face with an intense look. “Soldier, either change your name or change your conduct.”

True or not, the story brings out the point that it’s our duty to walk in the authority of our calling. As CIOs, we continually lobby for our voice at the table. We want to be seen and treated as a peer by our C-suite counterparts.

After interviewing several CEOs and CIOs, I wrote a post for Modern Healthcare last summer about this precise dilemma. In our quest to be recognized by the first letters of our title – typically VP (vice president) or SVP  (senior vice president) — we ultimately back down when opportunity presents itself.

A few notable exceptions exist. We all know CIOs who lead business areas of their organizations such as human resources, strategy, finance (yes, finance), and construction, or have gone on to become CEOs. But these are absolute rarities.

Here is a quick pulse check to figure out which one you are:

• Are you presently leading something outside of IT?
• Do you speak as a business person or a techie?
• Do you routinely showcase the business value of IT investments?
• Are you known to resolve challenges or do you run for cover?
• Do you frequently say, “There is no such thing as an IT project” and punt responsibility?
• Do you tell people you “lead from behind?”

Let’s take an example many can relate to. Most CIOs are already on an EHR journey or preparing to embark on one. What an opportunity to lead! Certainly you are not to lead alone, but nor should you abdicate your leadership on this one. And here lies the irony. The majority of troubled EHR initiatives were not led by CIOs, yet the CIO was often the first to go.

Don’t get caught up in my specific example, but rather the heart of the situation described. You might as well take the lead whenever available, because one way or another — despite your best attempt to disassociate — the CIO is integral to almost every action taken by the business. You will take the fall! I advocate that you lead alongside, not in front or behind.

What factors position you so that the coach puts you in the game?

• Excellence. Ensure your credibility is rock solid based on the operational performance of your team. The trains must run on time.
• Intentionality. Have a routine in place where you are getting face time with your peer suite. Throw in a mix of one-on-one time.
• Transparency. Operate and conduct your interactions as openly as possible. Build your own site where peers can get self-help information on what’s taking place in your areas. Publish your budget and show the costs for supporting each business unit down to the application level. Give no one reason to accuse you of hiding anything.
• Knowledge. Success is predicated upon continuous learning. Read the materials popular with your C-suite peers, not just IT.
• Potted or planted. Are you and your directs potted in the organization or planted? When planted, it is hard to tell IT from any other business unit because of the purposeful integration. I want the business units to think my directs work for them. If potted, not planted, the plant does not take root, and eventually withers and dies.
• CEO agenda. Know the agenda of your CEO and your peers and you will start connecting the dots between business strategy and IT. You will become a trusted advisor.

How can you turn to broaden your insights?

• Networking. Continuous interactions with other business leaders, inside and outside of healthcare.
• External connections. Leverage other influences by serving on advisory boards and universities. We bring my team together with IT leadership from a non-healthcare organization annually (see a previous post). i.e. Last month we compared notes with Kimberly-Clark.
• Partnerships. Leverage your organizations partnerships with other companies and vendors. We bring our strategic partners together routinely to learn and grow.

We are all set to lead. Here are some critical success factors to consider:

• Passion. It is contagious. No passion = no energy, and nobody wants to follow a lifeless leader.
• Visibility. Be seen and heard. We rotate our leadership meetings inside of all of our business units. Each time, business and clinical leaders are our special guests, and they are excited to see us on their turf.
• Trust. You know the old adage: do what you say you will do. It’s tough to build trust, yet that trust so easily falls when we stray from the truth.
• Boldness. Being a CIO is not for the faint of heart. Based on advice from my new team, I stopped an EHR implementation so we could regroup before the project went south. This timeout paved the way for a very successful implementation and enabled the kind of returns we had originally hoped for.

Let me close by asking you: what is your name? Or better yet, what is your title? If you are not leading, then downgrade your title. Either start acting like a vice president or senior vice president or give someone else the opportunity. Healthcare is desperate for strong leaders, especially CIOs.

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.

CIO Unplugged 10/3/12

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

Brand, or be Branded!

1997. Reverberating rave music generated a hip vibe. Cameras flashed as the crowd studied the student models.

Attending my first fashion show, I sat at the end of the runway—as one of the judges. The dean of my alma mater had appointed me to the board of the fashion school (long story). I and my fellow judges —all of whom were in the business of fashion models and designers—were responsible for appraising the graduate student champions of design.

Despite my initial excitement over the opportunity to act as a fashion critic, I quickly realized my business skills didn’t match my responsibility. And if you have seen my tie collection, you would understand. I felt as out of place as a punk rocker at a symphony.

But I gained one valuable lesson through that experience. The beauty of a model or her or his clothing design didn’t captivate me. The confidence with which the model walked did. They defined their brand despite the fabric or color.

Whether or not you embrace it, the cold, hard truth is that you are judged daily. Minus your own purposeful brand, your board, executive team, peers, subordinates, and business associates will do the branding for you.

In fact, you already have a brand and you don’t even know it. The work has been done for you. Rather than accept a label that may or may not be accurate, take responsibility and define and project your brand.

Borrowing a truism from my friends in marketing, brand or be branded.

First, do some intensive soul searching and decide on the brand you want. Examine your life. Ensure that your chosen brand is aligned with your core competencies and your personal vision. I posted on this subject several years ago in Taking Control of your Destiny.

Once you’ve defined your brand, here are a few ideas to create and manage it:

Network

Continually expand the breadth and depth of your professional and personal network. Proactively reaching out to others saves you from isolation and becoming irrelevant.

• LinkedIn
• Twitter
• Facebook

Publish

Editors are interested in genuine stories from real leaders. Send queries and don’t give up when initially rejected.

• Magazines
• Online services
• Blogging

Present

Get over your fears. Presenting forces you to nail your subject matter and confront doubts.

• Professional societies
• Neighborhood associations
• Your organization
• Church, Synagogue, etc.

Get Involved

Jump into the community. Let leaders know you’re interested in adding value.

• Professional societies
• Special interest groups

Volunteer

Find regular opportunities, and your network will expand.

• Internal to your organization
• External to your organization

Routinely Self-Review

Build in times to review progress and make adjustments. Ask for feedback.

• Update your brand
• Develop a career strategic plan
• Ask your mentor

Self-Educate

Take the initiative to self-educate. Learn from inside and outside of IT and healthcare.

• Blogosphere
• Marketing resources
• Conferences

Add to the Existing Body of Knowledge

Comment on what others have to say (you don’t always have to be the author).

• Post to blogs
• Contribute whenever the opportunity presents

No action will spoil your brand more than damaged credibility. While I’m all about a personal hallmark, it must be built upon a solid foundation of execution and excellence. These are not sequential tasks. Proactively improve performance and brand simultaneously.

Critics will say your brand is created and reinforced by your actions. This holds some truth, but it would be foolhardy not to be deliberate. Please! Take a look at politics for a second as we head into the presidential election. According to this study in The Journal of Personality and Social Psychology, when evaluating others, people prefer the potential of an individual over their past accomplishments. I maintain that this propensity for potential is stimulated by an effective brand.

Keep your brand in perspective, and let it humble you. The value of a stellar brand should reach far beyond you, and its primary benefits should accrue to the people and the organization served. If not, then it’s all about you. Possessing a personal brand, which should never come from arrogance or false humility, is key to success. For without it, you are allowing others to determine your brand and possibly your future.

You’re on the runway — lights flashing, cameras clicking. You may not always be able to select the specific clothes, but you must maintain poise and grace.

Make no mistake: the crowd is analyzing your every step. Brand yourself and accentuate it with confidence.

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.