Healthcare Hub

Episode 4: UW Health CIO, Chero Goswami, on what the IT leader needs to change in 2021.

February 18, 2021 Creative Information Technology, Inc.
Healthcare Hub
Episode 4: UW Health CIO, Chero Goswami, on what the IT leader needs to change in 2021.
Show Notes Transcript

CITI sits down with Chero Goswami, CIO of UW Health, to discuss his personal leadership style, what keeps him motivated,  what the IT Executive needs to do differently as we progress through 2021, and more.

Elena Bradley (CITI) 

Hi everyone and welcome back to the first episode of CITI Healthcare Hub for 2021. I think I can speak for everyone when I say last year was extremely difficult for people all over the world. But we are going optimistic into the new year that situations will improve and will be even stronger than before. And we've learned a lot these past several months, but there's always room for furthering your educational development and that is primarily what we hope to accomplish today. Today's guest is Chero Goswami. He is the Chief Information Officer at the University of Wisconsin Health System, Chero comes to us with years of experience in the healthcare IT industry. He was previously at BJC healthcare for 15 years. And you know, typically on our podcast, we speak about more of the technical side of healthcare IT. But we figured what better way to start off 2021 with a fresh approach and switching things up. So today we're going to be speaking about leadership, talent team development, and really what the IT executive needs to do differently in 2021, and a little bit more. Also, as always, I'm going to be joined by CITIs Regional Director Bill Carter. And he is also equally excited to learn the CIO perspective about team motivation and development.

 

Elena Bradley

Now Chero, I think I can speak for both myself and Bill when I say I really appreciate you fitting us into your schedule and opening up the new year with us. I know this past year has been stressful and demanding to say the very least, so I hope you're able to get at least somewhat of a vacation during the holiday season. So with that being said, welcome to our podcast, we’re so happy to have you. 

 

Chero Goswami

Thank you, Elena. And first of all, thank you for having me on this podcast and a very Happy New Year to both of you and being in healthcare have learned one thing, disease, and vaccine, neither of them take a day off. So holidays are all in perspective in health care. But having said that, it was nice. It was nice to spend a festive season with friends and loved ones after the year we had last year.

 

Elena Bradley

You know, I have to agree that those few days would be a few days, a couple weeks that people received to spend time with your family and friends was the perfect time to relax, recharge and rejuvenate for the for the year to come. It may not have been enough, but it was definitely needed. So with that being said, looking at the pace of change we experienced with COVID primarily in healthcare, we really want to open everything by asking, what is the current environment for you like and what are the specific demands that have been placed upon it, and how is that really affected you.

 

 

 

Chero Goswami

So I would say when I first became a manager moving from a technology track, I was given a very important lesson by a mentor that taught me that there are three types of resources any leader gets to manage its material resources, supplies, whatever in the world of technology, it's our drivers or servers or assets, as in devices, projects, etc. financial resources, which is obviously dollars, or better known as budgets. And the last one is human resources, which is our teams. And as we've gone through our last year, we as always have done a phenomenal job as an industry in stepping up and managing despite the financial challenges. And despite some of the technology issues, we got pretty creative in meeting the needs of the country and providing alternative ways of providing care to those who need it. And so when I think of a challenge going into the year 2021, I would use the word opportunity is to focus on that third leg of that stool called human resources. While always important, it became even more important for us to understand, appreciate, nurture, respect, and reward, that third leg of the stool. Human Resources are what I call our talent, that that we all have a privilege to lead and serve every day. So which is why I hope today I get to share some of the nuggets that I've learned through my career, some of the things that my leadership team and myself are focusing here on University of Wisconsin health system, and hopefully inspire a few other folks.

 

Elena Bradley 

You know, Chero, I really appreciated you emphasizing the importance of recognizing the value of your team. I think that's something that all managers and executives really found tremendous weight in last year, especially being in healthcare and constantly surrounding yourself with frontline workers. I mean, those are some of the most dedicated people you ever could really meet. Now on the topic of teams, are there any highlighted areas that occurred last year where you still feel need focus?

 

Chero Goswami

I think development and focus never ends. It's one of those things that consciously every leader needs to look at least every six months because the world of technology is now changing every six to 12 months. If you think of it, your phone gets an upgrade while you're sleeping tonight, which means something in the technology world has changed. Because the provider is using it. So talent map that I talked about needs to be an ongoing, deliberate process in any tool book or a playbook of the leader. And the first step starts by assessing or baseline what I'll use my terms here, what I call a talent map, which is actually a combination of what I would call capacity, capability, and commitment. And let me let me get a little deeper on that, it's very often you will hear we don't have enough people. That's the probably among the top 10 quotes. You can ever hear when in any organization. And capacity means you don't have enough people to do the work. capability means actually, you don't have the skills to do the work. And as you think of how technology is evolved in the last 12 months, we've all stepped up and into new roles that we were either not trained for, but we adapted very quickly. So as a leader, the question now becomes is Do I have the capability to sustain and scale at the at the level that telehealth needs to if we have to keep up at 25 to 30% of all visits being telehealth as an example. So I'm separating capacity from capability? And the third thing is commitment. And while it may sound negative, it's not intended to be commitment is not do I come in motivated to work? No, everyone comes into motivated to work. commitment to me is every employee and the IT team, just as much tech savvy as he or she is in understanding how the technology is embedded to the mission and the margin. All right organization. So those are my three C's. And it's a conscious effort to always go back and you say, how is my talent man map doing in terms of capacity, capability, and commitment? It does change. We simply need to change with the needs versus finding ourselves reacting to it. 

 

Elena Bradley 

Yep. You know, Bill, I think you and I were having a conversation earlier about, you know, what motivates people to the job. And regardless of what their job is, and I like how you mentioned, you know, within it, you have to remind them that their job goes with the mission that they contribute towards the mission. So I like that you pointed that out. 

 

Bill Carter (CITI) 

That's right, Elena. And we would love to hear Cheros thoughts on your motivational style and how you motivate your teams to grow in this ever-changing environment. And seg-waying that as a subsequent question not to be distractive. But to talk about the alignment with your mission and, and margin and mission that you mentioned. And I've heard many, many times you have no mission if you if you don't run up, at least, you know, fairly profitable or at least breakeven ship. So I'd love to get your thoughts on motivation and alignment. 

 

Chero Goswami

So Bill, I would start by saying I have heard that phrase numerous times, no margin, no mission, and especially coming from outside healthcare. Honestly, that comes across a little threatening, you know, it's like scolding a five-year-old kid that if you don't do your homework, you don't get to dinner, you know, so I, I have turned that around. And the phrase I tend to use this technology becomes the bridge between margin and mission, or, you know, from margin to mission. Because it's it sends a different perspective and is speaking of my style, my style is one of empowerment. So this morning, I had all staff, and it was a simple reminder, as we were going through our 2020 accomplishments, it was like, look how we did this. When we did x, we provided additional throughput, which meant additional patients were seen, which means a better community. And oh, by the way, which meant higher revenue for us. So you have a margin and mission. It's not either or, and without technology today, without technology today, it is almost close to impossible for an encounter between a patient and a health system. Whether you are putting in a record, or writing a prescription or collecting revenue, every one of them has some form of technology in between those two actors. And so that's why I use the word bridge from margin to mission. In terms of my personal style, it's all about visibility, even more so during challenging times right now. And I'm you will never find me in my office. I'm always walking the floor as I'm always roaming the hallways, even pre COVID I had a headset on, and I would walk in and make myself visible and I would build time during the day to have that conversation with folks in the rooms or in the breakout rooms and things. And it's challenging during these times. And so in the spirit of being creative now I keep open hours, open hours where people can text call anytime. And between those open hours. It's like hey, you know, Jane or Mary can you do this at 1015, and you get in, and it sends a message, one, you're available for them to, if a leader starts using the term, I don't have time, you have just killed the motivation of that individual who's just put in a 16-hour day. So you make the time, you never say you don't have the time. And the third aspect, I would say, is transparent, be transparent. As we head into the new year, as we are talking about our remote workforce, people ask me quite a few questions that are direct and controversial. And I did not dodge a single one. You don't know don't make up an answer. Tell them you don't know. Tell them when you can come back with an answer. And if it's the bad news, actually stated upfront, they may not like it, but they will respect you for it, because it's one less thing they have to guess. So again, transparency, availability, those are the simple things in life that we were raised with that we need to practice. during these times. 

 

Bill Carter

I think that's fantastic to the leadership qualities you just described, certainly conveyed down to your team. And when they see you operating that way, they'll operate that way. And I think that's a testament to your leadership style. So tomorrow, I really want to drive back into the concept that you had of alignment with your organization and team motivation. Can you elaborate on that?

 

Chero Goswami 

 Sure. Well, so I start by saying Know your business. And what that means is not enough to go home and tell your kid that I'm in healthcare. How does a hospital run? How does an ED run? How does a pharmacy run How does an inpatient unit work or run and oh, by the way, that's completely different than how your PCP clinic might work? And so the way at least I tried to approach in my career, and to those on my team, is using a term from our UW Health way is go and spend time with the business. There's no better time to understand our nursing workflow, than in the morning or evening during a shift change when the person has worked 12 hours and is turning over to his or her successor. And you can imagine he or she is transferring critical, no pun intended lifesaving information for somewhere between six to 12 patients over to the person coming in. Now, why is this important? Because when you're sitting writing code, or configuring programs, or creating reports or things like that, we look at it is sitting in our offices or cubicles, and we say, Oh, wait a minute, if I can create this nice drill down view, and I can click this, and I have a filter, and I have this beautiful fancy button. We are thinking of this as a programmer. But when you get there at six in the morning, and you look at our peered esteemed resource who's worked a 12-hour shift, all she wants to do is go home. At the same time, make sure she turns over this extremely important information that somebody isn't impacted over the next 12 hours. Until you see that in action, you will never be able to come back to your office and write the code the weights to be used. Same thing when we talk about, you know, gadgets, there is a difference between innovation and novelty. novelty is cool. Innovation needs to fix a problem. That's the way you know, I talk about and I practice about everything that's cool. In the day, I have an iPhone or a droid, you can just swipe your hand or do face recognition. And here comes your app that you can see the weather and you can do anything else. Well, well before COVID. Well, before COVID, many of us actually wore masks, because that's what you do in the hospital. Well before COVID. We use gloves for multiple reasons. in a hospital setting. Well guess what? facial recognition and swiping our hands doesn't work that well with gloves and masks on. But that's where it is very important to understand how the systems are going to be used, so that the systems are not systems, but solutions to the folks on the front line. So those go and these are what enlightens you and you go, what was I thinking? But if you come back and you think as to how it's being used. That's what makes a system successful. I hope that addresses the question your bill. thank you notes. 

 

Elena Bradley 

Great. What's your thanks for sharing that, and as I mentioned in our intro, you have a lot of experience. And with that comes a lot of involvement with upper management and different leadership styles. So do you have any perspective that you'd be willing to share as far as what you've personally experienced with your previous leadership and how that's really grown you and affected you and how do you how to influence your team with your personal leadership and developmental style? 

 

Chero Goswami 

Absolutely, absolutely. I would say I am here because of the leaders, the coaches and mentors that took the time to invest in me in and teach me where I am. And hopefully through my career, I do a few things that I make them proud. And it's appeared forward that I can teach a few things along the way to a few other folks. So as I think through my career, especially, since I've been in for-profit organizations, non-healthcare, everything from a $200 billion organization, down to a 50-person organization, then in consulting, they come across in all sizes and shapes. So, but the few things I would say that I've learned over the years is, start with the outcome. Always be outcomes focused, always be outcomes focused effort is easy to measure outcomes at what matters. In the world of healthcare. Nobody wants to hear the surgery was successful, but the patient is dead. Nobody wants to hear that, right. And so what's the outcome? So we talk about project dates and project budgets. Let's ask the question, what gets better when the project is done? So that's a lesson on outcomes focus. Second one is speed and agility. And I did a recent presentation, specifically on this one speed and agility. With all the time and all the money, most things can get done. The question is, how do we do it in the time that we need it? Right, the fact that you have a vaccine in 10 months is a miracle. The question we should ask is, should we ever go back to 10 years to develop a vaccine? I'm not saying everyone should be in 10 months. But if we have figured this out how to do it in 10 months, how do we do it COVID has forced us to be creative. Let's put that backstop not to go back to our old ways of getting time last through governance and consensus building. And all that time matters. Time is the commodity that we all have limited resources. The third one I would say is vulnerability. And this is very key specially, especially for folks in it. We are very analytical; we tend to have a root cause analysis and an answer for everything. We don't sleep well until a bug is resolved. We have to try to do everything ourselves until it's perfect. accepting the fact that I don't have an answer to all the questions, accepting the fact that I cannot do everything by myself. Accepting the fact that I am just as prone to disease and everything else that everyone goes through, is basically developing a sense of humility to say I need others to work with me to design a solution. And to step up and say that requires a lot of courage. And so the word I use is vulnerability. It's something that is to be taught or somebody holds a mirror to you to acknowledge you need that. And the last one in no particular order is versatility. And this one's interesting because as people, people move from management to leadership, people move from operational to strategic, all the words we learn in school, I've learned there's a fundamental difference on how you lead and what you lead. And the versatility goes and they're very interesting papers written across the spectrum, is you forceful? Or are you enabling? Are you strategic? Are you operational? The answer is never either are? The answer is unfortunately that word it depends. And a good leader needs to be versatile in what they are leading, and how they are leading the call before this one in the meeting after this one, I may have to take a completely different tact based on those pieces. So those are the four or five things that come to mind. And the last one I will add, especially after the year we have been through is being inclusive, being inclusive. A leader has to practice inclusiveness, I know Diversity, Equity and Inclusion has come in for a lot of press in the last 12 months. But it should never go away. Diversity needs to be practiced by a leader, every minute, on the job and outside the job. And I don't mean inclusion, just limited to the various factors of the community. It is also respecting different styles, different opinions, different practices. Because healthcare is not about being standard. You don't get to patients with the same DNA. That's why inclusion is important to respect the individual individuality is often of healthcare. 

 

Elena Bradley 

Absolutely, that that segues perfectly into my next question, you know, you mentioned inclusivity needing to be carried into this year, which I 100% agree with. So what else do you think the IT executive needs to do differently this year? You know, 2020 was a year of overcoming obstacles, unfortunately. So what can they do differently this year to, you know, become better and ultimately stay better? 

 

Chero Goswami

So, first, the IT executive needs to understand that he or she, I'm trying to be very gender appropriate over here to say is your first executive or your first and leader. And then by the nature of your job, you happen to be taking care of assets that are technical that makes you an IT leader. Every IT leader is a business leader first. Understand that. So that's the first lesson if you're not doing it, or if you're an aspiring leader, who wants to become an IT leader, back to my point, be a business leader first, then understand how to use technology. And then the second aspect of that, I will say is another term again, is a challenge status quo. In many organizations, it is seen as an order taker. On a good day, on a Friday, you're told about, oh, I bought the system, it's going live on Monday, on a bad day on Tuesday, you're told Oh, I turn the switch on Monday, it doesn't work, and you build me an interface. Right? That's an order taker mindset. Yeah. And as an IT leader, force, being a business leader talking to business counterparts. The question or the opportunity to the individual is how do you move from an order taker to a value enabler? And that goes back to my outcomes proposition. And that requires actually beyond technology knowledge that requires managerial courage, or a term that I've learned over the last few months, intellectual bravery, that means not to be threatening to others. But being the partner in asking the question, what's the problem you're trying to solve? Yeah, and it doesn't go away by buying another system, we already own seven of those, let's try to understand how we work together. But challenging status quo is change management. And I think the role of an IT leader is to be the change agent, that champion and do so more, because, right, wrong, or otherwise, technology leaders are seen as the ones that can do this. And so don't wait for permission to be told to do this. Take it upon yourselves, you will be welcomed. 

 

Bill Carter

Hey, Chero, Oh, that's great that you brought up change and being a change agent. And I've always heard that there's this three-legged stool metaphor or approach to managing or dealing with change, where one leg represents cost, one leg represents quality, and one leg represents time. Can you elaborate more on your approach of balancing those three items?

 

Chero Goswami

 Absolutely, yes. So I would start with that, that three-legged stool metaphor that you just used cost quality time. And I think the first thing the technology leader, or any leader, for that matter needs to look at is another myth. And I'll call that a myth is they're not actually mutually exclusive, even two out of three, that's not mutually exclusive. The challenge happens if you start excluding the third leg, consistently, the third leg of the stool over a period of time, if you sometimes you compromise cost, and sometimes you've cut back on budget, things work out, you just have to be cognizant. And the first thing that I always say is, it's one of the variables you control, I can sit here all day, all week, all month complaining about a certain legislator action, or a certain competitive move by another player in the market or a southern read what I consider in wine, I guess what no one's listening. What are the variables you control? Back to the three resources? What are the three assets, I have technology, people dollars, if you can get a head start by doing something, and learning from it, making it better. While everybody else is still talking about it. That's in our control. We can do it. We don't need permission from someone else to do something. compliance. Absolutely not saying go out and break all the rules. But there is enough written in many of these compliances things that gives you actually a degree of latitude to challenge status quo to do it differently. Let me give you a simple example. When we talk about archiving of data, there are compliance laws written about retention of data. It doesn't say it has to be retained in the same form in which it was written into a tape drive in 1972. Find a way Get creative. Challenge pushback partner with your stakeholders to say I cannot leave that system written in COBOL. Because the spare parts for those systems are not available, leave alone the people who wrote the code, right? So find a way to move it. You’re meeting the letter of the law, but it also leaves it open for you to do it in a different way in the year 2021 compared to 1982 or whatever you mentioned. So again, I'm using these examples because we do actually have a lot of control over our own destiny. And it starts by empowering the people that you have the privilege to serve, because the ones closest to the frontline actually do know more than I do any given day of the week. So when somebody walks to you with a problem, ask them, what would you do? In the world of consumerism when someone wants to be with the thing? I would say, what would you do if this was your mother or your daughter? They answered their own question and give them credit for it at the end of the day. Hope that helps.

 

 

Bill Carter

It does that's an excellent, excellent discussion point. And that is fantastic guidance for all of us.

 

Elena Bradley 

Now, Chiro you spoke to Bill and me about your participation in a focus group, in which he spoke about motivation. And I really like to know what motivates you and what your style is for motivating others?

 

Chero Goswami

Working in healthcare as a leader or for myself for my sanity into other leaders that this was the context of alien builders, in which the question came up. What do you look for in yourself to be constantly motivated, and I wrote down hunger and humor and humility, and my hunger is always be hungry for knowledge? There is always more that you don't know about that one topic in which you call yourself a subject matter expert, always be hungry for knowledge, who is humor, we live in a stressful world, and we work in a very stressful industry. It's the only industry where your consumer doesn't want to be with you, you go to a hotel by choice, you fly an airline by choice. You go to your favorite website by choice, nobody gets up in the morning, and says, I want to go to a hospital today. And let's see if I get a seven-day deal over there. No, and when working in a hospital is stressful. We don't take a day off. It's a 24/7-3 65. Business, you've got to have a sense of humor. And number three is humility. You cannot create magic by yourself, which is what we do. Be humble enough and support the ones and be there for the ones that make you look successful every day.

 

 

Elena Bradley

 And just to say on, you know, the same topic of humility and you know, remaining humble, were there any specific standout moments back in 2020? That really humbled you. I'm sure there were several. I mean, 2020 was a year in itself, that pretty much humbled everybody. But was there one or a couple of standout moments that really stood out to you that you think will stay with you through the remainder of your career?

 

The humbling moments, the humbling moments are 2021. So I've been doing telehealth for years, years. And even for telehealth, the term came up or for a company that probably worked in invented the whole video conferencing piece. My 2020 humbling moment that I could have never ever predicted was when I got a call for how you can use video for a family member to say goodbye to someone who's dying, because he or she could not visit the hospital, I would have never forecasted that I would have thought that the solutions we use for problem x or opportunity x could be leveraged to meet the most human need. There were 10 people that told me, here's why we can do y. Here's why we can do this today. Here's why we can do. And I had a simple question. How do we make it happen? And we did. And we did. And I just wanted to leave that because it just came to my mind where on that question and control. It's easy to say why not? The problem doesn't go away. We always say solutions can be out of school, the problem is never out of scope. So we got creative, we made it happen and so did 500 other health systems. 

 

Elena Bradley 

Well, I think creativity and overcoming obstacles, you know, as quickly as possible, was the overall theme and management and team development last year. I think every job field there were so many curveballs thrown due to COVID that the reaction time had to be almost immediate. So you really had no option but to get creative. And especially when it comes to something as crucial as what you reference with playing a part in a family member being able to say goodbye to a loved one that's extremely humbling. And it really makes you realize just how important your job is and gives you the motivation to come back and do what you do day in and day out. So you know, Chero, I really appreciate you coming on with us today and sharing all your experience and your knowledge and advice for the it executive, you know, moving into 2021 there's so much to learn from last year and you really have shown and shared your wealth of knowledge, so I really appreciate that. And, again, thank you so much for coming on. Bill. Is there anything else you'd like to say? I don't want to steal the spotlight. So I'll let you go ahead and take it away.

 

Bill Carter

Chero, thank you so much for your time today. I know Elena and I have both learned a lot from you. And we are certain that our podcast audience will learn a lot from this session as well. So thank you very much. We greatly appreciate you joining us today. 

 

Chero Goswami

Thank you for the opportunity. truly enjoyed it. 

 

 

Elena Bradley

And thank you all for tuning in. If you'd like to hear more episodes like this from top healthcare executives, be sure to subscribe to our channel CITI Healthcare Hub and that's going to be available on iTunes, Spotify and Buzzsprout. And for updates, be sure to follow us on social media. You can find us on LinkedIn, Twitter, Facebook, and Instagram at Creative Information Technology. And be sure to join us next time for the latest in Healthcare IT.