Q&A With CIO at St. Luke’s Health System: How One Innovation Workshop Attendee Puts Lessons into Practice
Reid Stephan, vice president and CIO at St. Luke’s Health System in Boise, Idaho, was among a small group of healthcare leaders to participate in CHIME Innovation’s inaugural workshop, “Developing an Innovation Framework.” CHIME Innovation, which is part of the College of Healthcare Information Management Executives, will hold the second in the series with “Innovation Strategy – Launch & Execution” on July 25-26 in Salt Lake City.
In this Q&A, he discusses lessons learned and how he is applying them to spur innovation at St. Luke’s. This article was edited for brevity.
Q: When you think of innovation, what does that mean to you?
RS: I have debates all the time internally. Most folks who I talk to about innovation think it is the next new moonshot, something no one has ever done before. But for me, it is relative. For St. Luke’s, five years ago the majority of our staff still did paper timecards. For us, it was innovative to move to an electronic timecard system (but this is) not innovative for, say, a Microsoft.
I have the mindset of start where you are. Don’t try to benchmark against some company like Amazon. Look around you and think about what we are doing. Innovation can be as simple as taking an existing workflow and modifying it so it is better for the provider, for the patient, for the employee. That can be innovative. I have a maybe lower-level definition for the word innovation than others. One of the things we struggle with is a common vocabulary so we can really have a meaningful dialog about innovation.
Q: After attending the workshop, did your concept of what innovation is change?
RS: No. It reinforced it. What I experienced there was probably the most practical day-and-a-half workshop/conference that I have ever attended. I found the approach very refreshing. I worried that I would leave there and we would have just spent a day and a half at a 50,000-foot view pontificating about what innovation is, having people talk about things they are doing that are innovative, which is interesting. But it doesn’t then let me come back to my job and immediately apply something or immediately be able to take some action and formulate some momentum in a certain area.
What I enjoyed the most about this CHIME workshop was that there was a practical framework and approach built around this idea of innovation. It wasn’t anything that CHIME or Intermountain developed on their own. It was taking some proven best practices from different industries and thought leaders and piecing those together in a way that I found very accessible. It was easy for me to start to, in my mind, think through how I would take this back to my team, share with them what I felt and learned at the workshop and get them as excited about it as I was. That has been the case. It was very easy to take that and apply that to my environment.
Q: I don’t think of innovation as the new shiny object. I think of innovation as a creative way to look at the world, to take existing resources and leverage them. So, when you talk about the workshop itself, would it be fair to argue it is innovative on those grounds?
RS: Absolutely. I attend a variety of conferences and meetings. … It is rare that I leave an event like that with something I feel I have in hand, where I feel I can go back and make a few tweaks, where I have a quasi-operating model that I can really start to work on. I felt I was offered this ala carte menu where I could pick some things that I could immediately share with my team and get started quickly on a journey of, at St. Luke’s, how do we operationalize this so IT can start to facilitate and lead conversations around innovation.
Where we miss the mark, and I don’t think we are unique, is we will have operations or clinical folks come to us with a solution in hand. The problem with that approach is you miss that fundamental first step of, what is the problem you are trying to solve, what is the job to be done? Let’s be curious together to figure out what it is we are trying to do that will then lead to a much more likely successful innovation.
We have a lot of supply-driven innovation ideas. Someone goes to a conference, someone attends a webinar, someone listens to a vendor, and they go, “This is a cool solution.” Figure out how we fit that into our environment vs. looking at the demand-driven innovation. Those are the things we are trying to do. Once you have defined that, then go and look for: Do we own something already that can do this? Is there an existing workflow? Is this net new? The workshop helped provide a good framework – and we are still working through it – to put together a working model that we think will resonate and provide a repeatable process, a common language, that anyone in our health system can operate within.
Q: Can you give an example of what you are applying from what you learned?
RS: I can share from the last couple of months what we have done internally. I have taken my team of direct reports and we did a day offsite and spent our time going through what was taught and learned at the CHIME workshop. Then I started to have conversations with my peers and other executives in the system, framing out, “Here is the challenge I see.” That has completely resonated with them.
We are going to hold a daylong workshop Aug. 1 where we will invite all of our project managers across the system, all of our business analysts, some key clinical operators, some business operators, and we will introduce this framework. It has been great to see how well this has been received. People recognize that this is a challenge. They recognize that it leads to a lot of frustrations because someone brings forward what they think is a good idea and oftentimes it squanders in committee; nothing ever happens. Or you get someone who by sheer force of will, personality, reputation, is able to push something through but once it is implemented it never quite measures up to what they thought it would.
Here’s a way we can go into it, making sure we can clearly understand there is a job we are trying to do and the problem to solve. How will we measure that we are being successful? We will iterate and have rapid experimentation. We will prove out and test hypotheses and we will start and stop things quickly based on that. People love that idea. No longer will it be a “I am going to have an idea and in 12-18 months maybe we will have some funding, and something will get delivered, a prototype.” This will align nicely with our internal governance model. As something gets prioritized and sequenced, then within a matter of weeks we will be able to prove this will or won’t work. As we prove it works, we will be able to move much more quickly in a sort of agile methodology to deliver on that need.
The hope is coming out of the Aug. 1 meeting we will really start to train and build our acumen around this kind of framework going into our fiscal year, which starts Oct. 1. We will create budget in our IT budget for innovation so as people bring forward ideas, we will have not a huge amount initially, but a bucket of funds we can use to prototype, test, prove a hypothesis, in that rapid-cycle methodology.
Q: Some people might think of innovation as I can take 5G and I can do X, Y and Z. It sounds like what you are doing is really building a culture.
RS: We are trying to innovate how we approach innovation. One of the unique projects might be around 5G or advanced machine learning. Who knows? But we will have this clear, repeatable, well-understood process for how we approach those things so that no matter where the idea comes from, we are doing the same (process) across the board. If we do this right, it will also help minimize people who go off and do their own shadow thing. In some cases, they are able to do an end run-around procurement and other things. Before we know it, someone has stood up a business service or a business application that is not connected. It doesn’t have the right support or maturity around it. This will help to create the right intake process to avoid those kinds of shadow innovation activities.
Q: Is there anything you would have changed about the workshop?
RS: No. I thought it was a good pace. I thought it was a good cadence and variety of presentations but also hands-on at a whiteboard working with your peers on what you were just taught about or was discussed. I wouldn’t add more to it or make it longer. That day-and-a-half timeframe is perfect. It is a nice bite-size amount that I could then recreate and share with others.
I would say there is a potential for a 200-level workshop that might dive a bit deeper because in some of these areas we did kind of just waterski. So maybe a 200-level workshop to snorkel or scuba dive in would be great. I think this is the first one that (CHIME Innovation) had done. I was impressed with how well it was done for that beta experience. It was perfect.
Candace Stuart is the director of communications and public relations at the College of Healthcare Information Management Executives.