Innovation is becoming critical to sustained growth and profitability for enterprises. How are organizations embracing and embedding innovation in their DNA? What are the related challenges?

Contributor

• • Michael A. Garcia, Vice President and Chief Information Officer, Jackson Health System

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Transcript

Sanjog Aul [00:00:22]:

Hello, and, welcome to this segment on CIO Talk Network. To learn more, please visit ciotalknetwork.com. And as always, we invite you to join the discussion on Twitter and look for this show as hashtag innovation and hashtag leadership. Today’s, the topic for today’s show is Making Innovation as an Organizational DNA element  . And, our guest for today’s show is Michael A. Garcia, who’s the Vice President and Chief Information Officer for Jackson Health System. Hi, Mike. How are you?

Michael A. Garcia [00:00:52]:

Doing great, Samuel. Thank you. Thank you for having me on the show.

Sanjog Aul [00:00:55]:

Definitely honors all ours. So the topic we picked up and, of course, we have spoken on this topic of innovation in the past, and we have touched it from different angles. Today, what we want to do is to talk about innovation not just as an activity, not as something which you do as a deliberate, process or a set of action items that somebody may have. You try to include or either embed that in your DNA. So even as a regular field staff goes about doing what they’re supposed to do or someone at the top ivory tower is thinking, all parties and all our parties in between, they’re always thinking and always moving in a fashion where innovation happens. And it could be incremental innovation. It can be disruptive innovation and everything in between. So that said, if, Mike, my first question for you is when we look at innovation in general, yes, it has spoken a whole lot, but then more than ever, organizations who need it, but they’re not able to embed it in the DNA. It becomes like, okay. Let’s do innovation, and then they’ll have a separate initiative. Versus saying, this is business as usual for us. Why is that?

Michael A. Garcia [00:02:13]:

Well, it it’s one of those things where you have to fill in the gaps. From a business process perspective or from an off-the-shelf application solution, especially in healthcare, not all best practices or not all applications fill the gap for every possible business process whether clinical or financial or just the business on itself, which those are the three aspects really that affect healthcare. So what you see is folks doing workarounds. And those workarounds from an innovation perspective can be great as we fill in those gaps or could be detrimental to an organization, especially if there’s no standardization or as you said, that it doesn’t become part of the DNA process. Here at Jackson, what we’ve done is we’ve created a governance process to incorporate innovation or workflow redesigns that incorporate innovation as part of our DNA to make sure as we continue to transform, whether it’s redesigning business processes that a nurse or somebody in the corporate business offices leaves on Friday and when they come back to work on Monday, they understand, have knowledge of the changes, the transformations that have occurred as we continue to be innovative. Because change is happening in a very dramatic high pace today in our environment, especially with all the regulatory requirements that are coming down in healthcare. So we want to make sure that we account for all those in a positive, not in a negative manner.

Sanjog Aul [00:03:41]:

So when we use the term innovation, it essentially means that you are going to look at things differently, or not trying to build a better mousetrap, but also, in turn become more creative to say, okay. If this was to be looked at with a fresh pair of eyes, how would you look at it? So is that fresh pair of eyes become difficult because you are working in the business, working versus working on the business. Is that where the problem is?

Michael A. Garcia [00:04:12]:

Yes. Too many folks are focused on the granular details where they’re not allowing to be thinking outside the box and trying to find meaningful ways of really affecting or solving a solution or a problem or a gap, where there needs to be some focus on finding a solution through innovation. Here at Jackson, what we do on a quarterly basis, we provide awards from a business and IT perspective for innovative ways of thinking and solving solutions that are not just because someone went and did something the standard way of practice or solve the problem, but not in a non-innovative way. So we’re really focusing on innovation becoming part of our DNA and in ways of through governance understanding that once somebody has an innovative idea, how do we incorporate that innovation into our everyday operations?

Sanjog Aul [00:05:10]:

So the last thing that you mentioned is that once a person, an individual has an idea, how do you make that idea not fall through the cracks by the instant? Use it to harness and harness the most value out of it. So that’s great. You know? So and that’s more downstream. Now let’s talk about the very ideation process or the idea generation process or even before that, the motivation to think differently. Because a lot of people would come and do their job that they have always done, and it’s a comfort. They find comfort in doing things in a reliable and that’s just being human. Why and then what would be a motivation, and how would you bring that motivation or inculcate that desire to do things differently every day in an with an interest that we want to move forward in a regular field staff? Maybe the people at the top are motivated because they’re incented for it, but why, what would you do to motivate the field staff to innovate or think of even innovation?

Michael A. Garcia [00:06:10]:

Sure. First, you have to communicate. So you have to have the mechanisms for that innovation to be communicated either from top down and specifically from bottom up because the line employees are really the ones that are always asking the whys. Why do we need to click on this button? Why do we need to go and do this business process? They don’t ultimately understand the whys. So here at Jackson, we incorporated a change, transformational management program where we have clinical informatics coordinators that they work with super users and the end users on a daily basis to request and try to find out what are the things that are needed, what are the folks what are folks thinking from an innovative way of really changing, dramatically sort of blowing up their current business processes and incorporating new business processes. And based on that, we do award recognition on employees that do come with that kind of frame of mind of thinking outside the box and coming up really innovative ways of changing business processes, changing the way we use applications today to get the job done either more efficient or more effective way that affect either patient care from a safety, perspective, from a quality perspective or from a financial business operational, perspective.

Sanjog Aul [00:07:26]:

So interestingly, the method that you have potentially utilized here is to reward people who show that inclination, if you will. Right? Yeah. And you would have, say, 1 award, 2 awards. Yeah. So you got 1, 2, 3, 5 awards. Now, with a workforce of, say, 10,000 or more employees, if 5 people are getting awards, that means the rest of them did not do as much. And that does not really indicate that innovation is in their DNA. So if I were to ask you and say challenge you to say, okay, Mike. If I were to have this award happen, I’d like that 5 to become 20. What would you do to have more people come up with those bright ideas?

Michael A. Garcia [00:08:16]:

So, yes, we’re right now crawling from that perspective, as you stated, but it’s maturing day to day. We’ve instilled a superuser program, and that’s what we’ve decided to call it here at Jackson. But it’s our communication from a business perspective. Individuals are pulled out of their day to day job. So in the hospital setting, I’m just using this as an example, every unit has designated individuals that 2 times per shift per month need to get out of their day to day job and then go through a think tank process of saying how can we improve, what kind of innovation can we do. So when you’re talking about 2 employees 2 times a shift per month, it’s quite an amount of hours that we are removing that employee and really from an organizational perspective, seeing how we can improve, how we can innovate, the way we do things today, talking to those specific line employees that are hands on working with our physicians, working with our patients on how we can improve things not just continuing to work as we are day to day in a healthcare organization.

Sanjog Aul [00:09:32]:

If you are looking at that time of pulling them out of their day to day jobs specifically for these purposes. It’s a large number of employees.

Sanjog Aul [00:09:41]:

And so in a way, I know some people used to give example of company like Google. Will they say 20% of your time is supposed to be what you wanna do? And that would help you get your juices flowing, and that would result in you trying to do something new and innovative. Do you think the rest of the organizations who are not truly in that type of a field, like healthcare where you got a patient’s life at stake to allow that 20% buffer, do you think you can have other ways to achieve that level of breathing time for an individual user who’s otherwise up to their eyeballs with the work given healthcare is very taxing? And give them the breathing room so that they can actually innovate. What are you doing with that from that standpoint? 

Michael A. Garcia [00:10:31]:

Yeah. It’s very difficult, especially from a nurse assignment, depending on the acuity of the patient. We’re managing productivity of every nurse. But through this program that I mentioned is how we’re taking them out of their day to day from the bedside at the patient, at the unit, removing them from that process for them to look at workflow, current state to look at and assess how technology, how business processes are being used today to start that innovative process. So they’re being removed from the beds. They’re being removed from their day to day jobs to really communicate with IT, with the business, from the governance process to be able to start giving these suggestions, these innovative ideas so we can embed them and we continuously improve the way we do things today. So we’re trying from that perspective, similar to Google, but from it being just 20% of employees’ time to sort of freelance and be innovative, we’re removing the staff that’s at the bedside to have this time to be able to be part of this DNA maturity process that we’re going through. 

Sanjog Aul [00:11:42]:

So, of course, Jackson Health System will not do what Sanjog Aul, which is me, going to tell them about what you do innovation. So what’s your benchmark as an organization? Because, you know, other, we are limited to how much we can innovate and to what level we can go to is limited to where we think we can be. So would you have, like, that holy grail or a benchmark established for Jackson Health System to say, okay. This is what’s the best that can happen for us, and we are working towards it. What is that in terms of innovation levels?

Michael A. Garcia [00:12:20]:

It’s really all aspects of the system. So whether it’s from a patient satisfaction, physician satisfaction, employee satisfaction, when it comes to patient safety, patient quality, these are our missions. These are the kind of things that we’re looking at. How do we improve on a day to day basis to do things better every single day? So from our governance process, as these innovative ideas come into the process, we measure from a matrix perspective on what would be the return on investment, what would be the prioritization on the impact of doing those kind of changes, whether it’s a business process or a system process, to really decide which of the innovative ideas do we go ahead and tackle first, from a priority list that would really affect and impact the organization positively the most?

Sanjog Aul [00:13:09]:

So let’s take a quick break, listeners. When we come back, I’d like to explore this ROI concept that you mentioned. When we talk innovation and if we start always attaching ROI to it, then innovation in a way gets undermined or the process of innovation gets undermined because then the creativity is substituted by how much money do I make out of it versus what we don’t know yet because we have not even tried it. And we cannot have math for what we don’t know. So how does an organization, while they have a business to run and while they have to report to shareholder or to the citizens for whatever reason, can keep the ROI aside for a second or not make that as the main criteria whether they would even attempt to do innovation or not. Because if it is that way, then it is going back to the same old business model where innovation is seen as a cost and or, overhead because we are looking at numbers first. So please stay tuned, listeners. We’ll be right back.

Sanjog Aul [00:15:17]:

Welcome back. So, Michael, when we look at the ROI, the term ROI, which is pretty good, it helps a company run a tight ship and shareholders are happy. Now when we talk about, innovation and that too, the intent of making innovation as an organizational DNA element, then at that time, if anything which is to be measured before you even created it or the value of what you’re gonna, you’re gonna get out of it, that could, in some ways, undermine the very creative process or the way you’re gonna go and explore the uncharted territories. Can we refrain from it? 

Michael A. Garcia [00:16:00]:

Well, you know, the organization is gonna make an investment, and at the same time, the return and the benefit isn’t always just financial. We’re gonna use innovation to find benefits to help or it’s a more softer benefit, and that’s where really we measure. It’s not just solely on dollars. So it could be a benefit to the patient. It could be a benefit to the employee, the physician, from a quality measure outcome. Those are really the benefits we’re looking for. It’s not just financial, it’s how can we continuously improve the way we do operations today, the way we do business today by the use of innovation. So as we continue and I apologize, there’s a fire alarm going on in the background but, when it comes to innovation, it’s very important for us to invest and continue to invest so it becomes part of our DNA. So when I mentioned a return on investment, it’s that investment to making sure that innovation is part of the way we do things, and the benefit is not solely financial.

Sanjog Aul [00:17:00]:

So when we let somebody be creative, and if they know nobody is truly watching over their shoulder and not asking about what this is going to yield as a result, I’m sure we see things which would surprise us. So are you willing to or not you as such, but an organization like yours or many others who may be listening, are you willing to let go of knowing what is being done and let that be a sandbox and let someone come back and surprise you? Because that’s where innovation truly can shine.

Michael A. Garcia [00:17:35]:

Without a doubt. And there’s many ways. So what we do is we assess from a technology perspective who’s using, for instance, the EHR in a better way. So we monitor the number of clicks a physician does. We monitor how a nurse uses the EHR on their own in many ways to find ways that why is this physician able to do his work using 12 clicks and it takes another physician 20 clicks. So then we start assessing what kind of workflow processes that particular physician that uses 12 clicks and how is he more efficient? Is it because he’s just looking for workarounds that he’s not doing what needs to be done from a standard? Or did he find an innovative way of doing something differently that still meets 100% our needs and the patient needs, but at the same time in a more innovative way that then we could teach others that innovation, that new way of doing things that meets the goals, from an organizational and a patient level, but at the same time in a more efficient, more effective way for others to take advantage of.

Sanjog Aul [00:18:40]:

So we talk about building this culture of innovation where we say, okay, all these different projects that we will do or the even the sandboxing we will do, we would like to have cross functional teams work and show creativity, develop trust, and do collaboration. All that is awesome. Now talk about the diversity that you’d have in your workforce. One is, of course, the geo where they’re located means distributed workforce, the different generations. And then the third one, which is most important, is their propensity to participate in that innovative process because they want to create. They want to create value. Because as we discussed about the reward system, only 5 out of the 10,000 get reward. That means the other people when they have been invited to join hands into this innovative project or things of that nature, they may take it as a job and really not bring their creative juices to the table. How do you minimize that part when you’re essentially trying to move people towards innovation and they’re not really all excited about it? And they are at least among others who are most excited about it, but they are in a way not as excited, so the sum total becomes less than the ideal.

Michael A. Garcia [00:19:53]:

Yes. It’s all about engagement. One thing is you have to keep your staff engaged. And the more that we continue to work on organizational staff engagement and explaining to the employees, explaining to the workers the whys. The why we’re doing things and why we need to continuously improve and why we need to find innovation in the way we do things. Many times it’s not solely about the money, but it’s about the challenges. And so we want to continue challenging our employees. We have many ways for them to submit innovative ideas to the organization. Many of our nurses and staff have worked together even to put a video together on why it’s important to barcode patients and medications as they’re distributing. So they’ve created videos. And throughout the organization, you’ll see our different hospitals participating in the video singing to a Michael Jackson song. So it’s not only being innovative on the work, on the technology, but also on how you explain the whys and engage employees on why it’s important to do what needs to be done. So we’ve seen innovation in many different ways here at Jackson that we are very proud of. And obviously, from our staff, from the line employee, all the way to the executives, on trying to find methods to continuously engage our employees.

Sanjog Aul [00:21:17]:

When we have looked at rewards, I will bring the thought back to the rewards for innovative projects. We have seen that mostly when they get rewarded, they are rewarded for not just purely that, oh, they had this bright idea, but they brought it to completion and brought, created something tangible which can be measured, etcetera, for them to say, okay. Yes. You deserve it. But then there are many others every day that who are making new mistakes. That is they tried something and they learned what doesn’t work. And also they bring some new learnings to the organization. What do you do as an organization, as people who want the best for all people working there so that those even are recognized? The people who tried, they did not deliver the results, but they did bring the learning which actually moves you forward.

Michael A. Garcia [00:22:10]:

No. Those are tough. Those are tough because obviously, many folks from trying something and failing don’t necessarily communicate that failure. That is a lesson learned. And most of the time, you learn more from the lessons learned than you do from the stuff that you do every single day, from just continuing to do the same task day in and day out. So those innovative individuals, although they might have made that mistake that one time, they’ve learned from that lesson and then can come up with a different mechanism where they would come up with a great innovative way that it’s not necessarily the failure, but the way they came up with that great innovative way of thinking or forming that business process or the new way of doing things was due to that lesson learned, was due to that failure that no one found out about. So those are the real difficult ones to track and trying to find out how exactly sparked that innovation. Was it something that someone did that they didn’t even realize was a lesson learned that then came up to fill that gap where they saw that I need to come up with something to do this. And they might have done several things 2 or 3 times, not necessarily perfectly. But through those mistakes or through that imperfection is how they came up with that innovative idea to fill that gap that there was no solution for. So I totally agree, but it’s very difficult to measure those, because those are kind of things that folks need to self report unless we’re able to see it in a system. So by tracking our nurses, by tracking our physician on the use of applications, since that’s audible, we can see where, why did someone use the system in this specific way, and then come up with innovative ways to maybe steer them in using the application a little better or more in a standard way than what they did. But if it’s not through an application that’s audible and it’s not self reported, very difficult to track.

Sanjog Aul [00:24:04]:

So if I were to point this back or connect this back to the engagement that you mentioned, because I asked you a question, how do you get the 95% of your workforce engaged? And you said, okay. The engagement is needed. But then if they are not recognized for their learning and you said that they may not report, but if there was a way to work on that 95%, then do you think that would really move the organization forward? And if yes, then what can be done about it? We know it’s tough, but what could be done about it?

Michael A. Garcia [00:24:34]:

Friendly competition is always great. So what we’ve been focused on is who’s doing things right from an organization. So we’ve been really focusing on who’s in the top 90th percentile. Who are the folks that are always in the green and form friendly competition if it’s between units in a single hospital or if it’s between different hospitals on who is doing it right and why. And if it’s because they’ve come up with an innovative way of doing it, we want to make sure we reward them. And then also let their peers know what they are doing from that perspective. And that friendly competition always forms innovation on itself because you want to compete, you want to shine. And that’s sort of the best kind of competition and best way of really engaging folks to be better, to not only be average, but to exceed above average.

Sanjog Aul [00:25:32]:

Now in terms of the kind of goals that we create, so if you have innovation as the forefront, that’s what you want. And we want different stakeholders who are involved in the planning of that innovation efforts. So how are you getting them translated into something which is very specific, like goals or the incentive plans or specific deadlines or milestones so that while it becomes a project, they also are moving the ball forward, and they’re also effectively contributing towards innovation becoming part of the DNA. Because at the end of the day, people cannot be just sitting there and thinking, and they say, what are you doing? Oh, I’m just thinking towards what innovative can be done. So what is the where rubber meets the road for innovation.

Michael A. Garcia [00:26:25]:

So we formed the streams for folks to submit their innovations, and then we’ve created a governance process, whether it’s clinical or financial, and that’s how we divided it up because we want the business to be driving business processes and using innovation on how we could change business process for them to become more effective or efficient. So IT really engages and serves more of an advisory role of what can and cannot be done from a technology perspective. And when there’s even gaps from a technology perspective, let’s say, from an off-the-shelf solution, we then bring our developers in to see how we could fill those gaps to accommodate that innovative idea. It’s a little dangerous because then you start becoming a development shop. But it’s one of those things that, to continuously be able to support the innovation coming out of the business, we need to be able to fill those gaps at least temporarily until the off-the-shelf big solutions incorporate those kind of workflows, those kind of configurations in their systems to support those innovative business processes. But the key is having a structure for that innovation, those ideas to flow into, and then a multi-disciplined team to really analyze the impact so it’s embedded in the DNA and everyone understands the why. So from the nurse to the social worker to the case manager to the business office to the patient access to IT. Everyone understands the why and everyone working towards that goal to really embrace and act on that innovative idea of business process, system.

Sanjog Aul [00:28:04]:

Now we’ve also always seen at least today’s day and age risk as one of the biggest aspects which we have to manage. We have to identify and we have to manage. And whenever we do innovation, that means we are doing disruption to the existing process, is the way of thinking, the workflows, and then you name it. And anytime when you change something, it introduces risks. So if you are to look at innovation and which we know should be left alone for it to be at its best, how do you let risk management be still incorporated without reducing the flow of creative juices?

Michael A. Garcia [00:28:42]:

It all really depends on the type of risk and the type of innovation that is being thought of, on how it impacts the business. So, you know, from putting a patient’s life at risk, those kind of things, we’re constantly monitoring the systems. We’re not going to allow someone to just ad hoc or roll go into a system and affect patient care. And from a security perspective, we sort of do not allow that to happen, where those ideas have to be vetted, including risk, including the multidiscipline team to see what the impact is. Now from a workflow use of an application of folks that will not be impacting patient care, then there are different ways of scanning the cat, you could say, where they can be creative, we can monitor, we can monitor from a distance, allow them to do their work, and then assess which of these processes to minimize the risk, but at the same time allow them to play in a sandbox where they’re not hurting or impacting patient care or the business. We also have many different domains from an application perspective that we could have users go into and sort of play in the environment and always asking the reason why. From the different generations that we have here, which we have, baby boomers and millennials, the way that they work, the expectation of the application, the expectation of a workflow is very, very different. So we allow them to be creative, no matter the generation they come with. But at the same time, the use and friendliness of the solution, the adaptability, when it comes to change from business processes, that’s all very important. But also how we document these processes from the innovation to make sure that we don’t lose anything along the way is very, very important.

Sanjog Aul [00:30:47]:

So coming to, let’s take actually a quick break, listeners. When we come back, let’s talk about the short term operational necessities that we have in order to get the job done, and they will always be there. And then you would need to have the long term innovation related, you know, needs and aspirations that everyone has. You have to continue to develop that DNA, if you will, of the innovation versus always going into that SOS mode. And that’s what we typically see happening in the organizations because we are even saying we want to become agile. We want to become nimble. And that means you have to be alert at all times and not relaxed enough to be able to innovate. How do we mix the two? So please stay tuned listeners. We’ll be right back.

Sanjog Aul [00:32:33]:

Welcome back. So, Mike, when we look at any organization, and in this case, healthcare, which is always on fire when it comes to an emergency patient or someone’s life at stake or many other things that may be going on, and plus you have the regulations that you are chained by. So you got every day when you wake up, I’m sure you got number of things which always take your attention, and they could be operational necessities, could be SOS fires at business and technology level. But then you cannot lose the sight of becoming that innovative enterprise, which has got innovation embedded at the very DNA, and you have to work on that as well. So while we cannot make you Google where 20% time comes, that has to somewhere be embedded in what you do and what you do every day, not only at the top level, but people at every level. So what is the magic bullet, if you will, that you try to use or at least you’re pursuing so that you can build that balance?

Michael A. Garcia [00:33:38]:

Being in a healthcare environment, especially, here at Jackson, we’re the level 1 trauma safety net hospital here in Miami Dade County where we deal with very acute patients, whether it’s a transplant patient, whether it’s a trauma patient. So the stress level of the employees in trying to meet what they need to do, at the same time, adding the technology overhead in addition to making sure that everything from an SLW, everything from an SOP, everything that they need to just check the box and make sure they did can become a very stressful environment where innovation is not part of it. And that’s why installing those super users in the areas, looking at the workflows, taking them out of the bedside, taking them out of that stressful environment for them to spark those creative juices, to see how we could do things differently, really understanding the job because these are the line employees actually performing the work, living in that stressful environment, and looking at ways that we can improve is very, very important. Also, physician engagement, in ways that we can do things in innovative ways, whether it’s through mobile applications, whether it’s through different mechanisms and redesigning business processes is key to also engage the physicians. So we’ve been able to do many innovative things here at Jackson, to fill gaps. In addition to what you might not consider so innovative, but no one had thought of, oh my god. Why didn’t we just do this? You gotta get out of that frame of mind of the reason we do things is because this is the way we’ve always done them. That cannot be the frame of mind. It can’t be just because it’s your standard operating procedure of this is the way we do things. So it’s engaging those patients. It’s understanding the why we do what we do so folks continue to question on why we really need to do it in that way, and is there a better way of doing it.

Sanjog Aul [00:35:43]:

If you are going to get everyone involved and they will have that type of a mindset where they’re on one hand stressed to deliver the very next thing that is assigned to them, and on the other hand, they’re supposed to look at the innovative ways. What are the resources and blessings and sponsorships that you’re offering and immunity that you’re offering that, you know, you cannot have them do everything at the same time. And if something falls short, then they get penalized. So what is the culture that you’re giving them where they can actually realistically do both? And sometimes make mistakes too.

Michael A. Garcia [00:36:24]:

Yeah. And it’s not being that punitive in an organization. Even when it comes to incidents, we encourage employees to always self report incidents where it’s not going to be punitive, but we just need to know. And it’s through those lessons learned that we’re able to come up with ways of doing things better. I’m sorry, can you repeat the second part of the question?

Sanjog Aul [00:36:50]:

Yeah. So we have to have the conducive culture for people to work in such a stressful environment and still get even though they are not given that 20% breathing room like Google. But they are able to somehow put that in. And being humans, they will make mistakes. And they would need that support and sponsorship from the top. So what kind of culture would you think we need for such environment so that they can really thrive and continue to work towards the long term innovation while handling the short term, operational necessities?

Michael A. Garcia [00:37:26]:

Sure. And many of these things have to come from the top down where the leaders of the organization need to buy in to the culture first. And then that culture needs to trickle down where we wanna be a different type of organization, where we wanna be innovative, we wanna be leading, we wanna be in the 90th percentile as we continue to increase our outcomes in a positive manner. So understanding that there’s going to be an investment, you can’t do this running a thin operation where the employees are tracked purely for their productivity at their job without accounting for time for this kind of innovation. So that’s why we pull them out of the workspace to be able to do this culture. As a matter of fact, when it comes to even paying for productivity and non productivity time, it’s some investment that the organization is making because we see the benefit, not only from a financial return on investment, but the benefits, the soft benefits when it comes to quality patient safety, engagement from the employees, everything having to do with employee satisfaction, physician satisfaction. It’s very, very important for us to be able to continue working on our mission here at Jackson Health System.

Sanjog Aul [00:38:46]:

So let’s take healthcare as an industry, which is going through sometimes a lot of consolidation. Then you’ve got challenges because of the patient centered care approach that we have to take when there is some meaningful news and the payments the way they come to you. So think dollars and cents. Getting paid for the services that you offer is becoming a bigger challenge. So now when an organization’s existence, but the sustained profitability and other items are at stake, do you think it is posing a risk for innovation to take a back seat? Because then you don’t really think about, okay. I’m gonna give the breathing room to this person because we are anyway getting paid less. So how can I pay out more? How do you deal with that, interesting current pressures that healthcare is going through?

Michael A. Garcia [00:39:46]:

It’s very difficult. If you’re running a thin operation and all you’re doing is tracking the performance of each of these individuals minute by minute on their standard operating procedures on what they need to be doing, how they need to be doing, and you allow and you invest the time on these employees to be able to do this, it’s very difficult to accomplish. You have to change the culture. You have to transform the culture, and it has to be from the top down. Everyone needs to understand why. At the end of the day, if you don’t incorporate this innovation and this buy in from the employees and start shifting the culture, healthcare organizations will not survive continuing to practice the way we traditionally practiced. As you stated, reimbursement is not the same. It continues to go down. Cost of technology continues to go up. So there is going to be a breaking point. So if we don’t find innovative ways of handling stressful situations and becoming more efficient and more effective on how we’re doing things from a clinical perspective, from a business perspective, health organizations will not survive in the future.

Sanjog Aul [00:40:59]:

Now with the same healthcare industry in context, we know the interoperability is a big challenge. And that means you have to be able to work with your partners to deliver healthcare to the patient who essentially gives you a thumbs up or thumbs down. Now with that said, innovation, while we are saying it has to be embedded in the DNA of our organization, but it somehow has to also be represented or reflected in what your partners are doing because the patient doesn’t see you as an individual entity. It sees the overall experience. And if innovation has to really be at its peak or at its best, that means all of you will be working like an orchestra, a symphony. But when each of them have their own challenges, their own priorities, and all and then they’re all stretched to get the next dollar, what is to be done or what is possible so that innovation spans and is consistent across the value chain players, if you will?

Michael A. Garcia [00:42:06]:

Difficult, definitely a question because everyone, like you said, has to be in sync, well orchestrated machine kind of thing, as you mentioned in that example. And it’s really getting the multi disciplines of folks not working in silos. And by forming the governance structure we formed here and being a multi-disciplined team from clinical folks, financial folks, business folks, trying to see what we need to do to continuously move forward, is how we’ve been able to sort of help and swing the other way and start really affecting culture in a meaningful way of knowing that we are a transforming organization. And change is going to be part of our DNA constantly and looking for those innovative ideas to help with that change and that transformation. Like I said, it’s something where it has to start being embedded. You have to go across all your partners, whether they’re internal partners or external partners. And then the use of data. I mentioned previously audit trails. But more than audit trails, it’s really grabbing a lot of the raw data and transforming into some kind of knowledge where the systems now really work for you instead of you working for the systems, on how can the data be more represented to you when you need it, how you need it based on your role in the organization, then individuals continue to go fetch data. Because once you have the data in front of you, then you can start planning it and come up with great innovative ideas. And just how you gather the data, it can be innovative on its own. So what correlations between the data and the different types of patients and the different scenarios can formulate use cases on how you could really impact the business in an innovative way.

Sanjog Aul [00:44:07]:

Let’s take a quick break, listeners. And when we come back, let’s talk about the politics, which doesn’t mean that our derogatory in a corporate context. Because innovation could be almost seen as, okay. I have this bright idea, and if that becomes successful, that means I was responsible for this innovation, and I would like to see that credit taken for I’d like to take the credit. And then there would be others who would say, okay. It’s a great idea, but if it was not my idea, I’m going to not support it, and that could lead to factions, that could lead to people pulling that down, and that innovation never seeing the daylight. This could happen at the top level, at the middle management, or even at a field staff. The reason I bring this up is because the intent while there may be intent for everyone to do innovation in the organization, but we are still dealing with human beings who feel that they have an agenda, and their face should shine among others. How do you get everyone above that? Please stay tuned, listeners. We’ll be right back.

Sanjog Aul [00:46:07]:

Welcome back. So politics of innovation where you may have people taking credit that’s not due to them, and that would stifle the next set of innovative ideas someone would want to share. And that’s where the organization implodes with respect to how otherwise innovation could have happened. How do you prevent that?

Michael A. Garcia [00:46:29]:

Yeah. It’s tough because it’s people. Most of the jobs seem to be a lot easier. But once you start adding the human aspects of it and agendas, it makes it much more difficult. We try to open up ways of communication where the line employees themselves have methods to be able to communicate their innovative ideas. And that’s the key. Where if you only go through channels of one leader managing x amount of people, and those individuals never have a way to communicate upstream their innovation. They might be innovative once, but as soon as their manager or their leader, and it can be in all levels of the organization, takes credit, then that disengages them, or they will never be providing any additional innovation or any creative ideas on how we could be doing things better. And they’re the ones that really know. The line employees are the ones that are, I like to say they’re the ones bleeding out there, knowing what needs to be done. And they’re the ones that we need to make sure we keep open channels of communications with in many different ways to be able to get their ideas straight from the horse’s mouth. And when ideas come up, you have to peel that onion. So if it’s a leader in the organization presenting this innovation, it’s getting down and boiling down to the nitty gritty of finding out how exactly did this idea come about, and engaging their employees in the process. And most of the time you’ll find out really where that innovation came from and reward those individuals for that, to have that competitive amongst the teams, amongst the employees in a friendly manner to spark others to present innovative ideas and innovation into the workplace. 

Sanjog Aul [00:48:22]:

So while we talk about innovation at a high level and say, okay. You will reward people at a company level and do other things. But we have usually seen that innovation happens in smaller groups in pockets. And it may just have a spark in one corner of the organization, and then they would work on something and eventually the rest of the organization may eventually embrace it. You want more of such sparks versus only spark at the top or only in a quarterly reward type of structure. So how can we get those sparks flowing in smaller pockets?

Michael A. Garcia [00:49:05]:

Exactly. That’s what we want. We want a lot of sparks in a lot of pockets and at the lower levels. We as leaders assume we know the business or the workflows and the things that our employees go through. But the last time maybe our leaders were actually line employees might have been years ago. What they assume are the workflow processes might not be as accurate because they’re not day to day doing those business processes. So we need to be relevant. And the only way that you get that relevance is dealing with the line employees and making sure that sparks are happening, engaging them, making sure that they’re engaged. And that way we can start creating sparks here and there, and hopefully that’ll drive others to continue creating sparks across the organization at lower levels, not just at the top level.

Sanjog Aul [00:50:06]:

If you are to look at people who are being hired, because, of course, you may have people leave and then there’s a new breed of people who may come in. What would you do so that at the very point of entry, we screen to see you have the DNA at an individual level who have the potential to enhance the organizational DNA to embrace innovation?

Michael A. Garcia [00:50:35]:

Yeah. It’s all about the culture. And strategy beats culture sort of every single time. So we have to have that strategic vision in mind when it comes to how we recruit, how we hire, how we screen our candidates to make sure we’re hiring the right candidates in the end of it, in the organization that are going to not hurt the culture that we’re forming. So we need to make sure we have the right individuals, and through the hiring and screening process, that we’re looking for these key qualities in individuals that are going to be folks that are willing to create sparks. And it has to be in a positive way, because we already spoke about it could also be detrimental to an organization if folks are using the technology, or the innovation in a negative way. Although you do have the lessons learned, but you want to make sure that you don’t put a patient or the organization at risk. But it’s through that screening process, through different types of tests, different types of interviews to really find out the quality of the individual if they’re going to form to your culture.

Sanjog Aul [00:51:50]:

Would you suggest any specific thing? Suppose you had to hire your next person, and you wanted to make sure that person is gonna be a catalyst to innovation. What specific qualities would you look for? 

Michael A. Garcia [00:52:03]:

It’s really showing examples of what they’ve done in their career from an experience perspective. If it’s a student straight out of school, what innovation, how they describe a certain experience, way of thinking as an individual. Many of the jobs, especially in healthcare, from an IT perspective, are not taught at school. So we really have to judge the individuals to make sure that they’re gonna be the right fit for the organization, because most of the time we do need to educate them on the job that they’ll be doing, unless we’re getting someone experienced from another organization. But even when we’re getting them from another organization, just because they know the task at hand doesn’t mean that they meet the qualities of the individuals that we want to be hiring and bringing into our organization to continue driving the culture into a positive direction. So that’s the key, is the people aspect and how you ask questions, how those individuals answer those questions. And you could look at an employee profile and determine if this individual fits our organization or not. And really through those questions, trying to get those experiences where they’ve shown this type of behavior before.

Sanjog Aul [00:53:20]:

One last question. What would you tell your lieutenants who report to you and your bosses or boss in terms of what would be your appeal to them? Because you may be all out for making this whole organization having innovation as its DNA, but maybe they may not see the same way. So what’s your appeal to them or anyone who is in your shoes? What should they appeal to their lieutenants as to and also to their bosses? 

Michael A. Garcia [00:53:45]:

It’s really explaining the whys we need to do it at the time, and the time is now, because continuing to do things as we’ve always done, we’ve seen that organizations are suffering. As we stated before, from a healthcare perspective, reimbursements are not what they used to be, and they’re only going to continue going down. So it’s very difficult to operate, so we have to change our frame of mind. We need to look at innovative ways of doing things. And explaining why it’s not just the dollars that we do need to make that initial financial investment in our employees to be able to then come up with the innovation to hopefully receive a lot of returns, not only financial, but when it comes to, will that patient recommend other individuals to your organization? Will that patient return themselves to your organization? These are the kind of things that we need to make sure that everyone understands that everyone’s going in the same direction as it pertains to the patient care, as it pertains to patient safety, as it pertains to making sure employees are engaged and satisfied. Because when you’re working in an environment that’s conducive to this, it’s going to show and reflect in your work. It’s going to show in the way you treat patients and others of your colleagues. And it’s going to want to create that team atmosphere to continue improving the organization, improving the way they do their job and trying to be innovative in the way they do that, not just through technology innovations, but really business process workflow innovations that can really help an organization.

Sanjog Aul [00:55:31]:

On behalf of the show and our listeners, I’d really like to thank you, Mike, for sharing your thoughts on how other organizations can make innovation as a DNA element. Thank you so much again.

Michael A. Garcia [00:55:43]:

Thank you.

Sanjog Aul [00:55:44]:

And listeners, please like us on Facebook, search for CIO Talk Network, and be sure to follow us on Twitter. We have a podcast on iTunes, Stitcher, and on Voice America Business. Plus, we also have a LinkedIn community. Please join us and exchange your thoughts with us and other leaders who are joining our show. Thank you again for listening to this segment on CIO Talk Network. This is Sanjog Aul, your talk show host. Till next week. Take care, and God bless.