Enterprise Digital Transformation

This week I am pleased to have Charity Balèe, an accomplished leader with a wealth of experience and expertise in strategic leadership and transformation. Most recently, Charity served as a strategic leader at Ascension, a prominent healthcare organization where she focused on delivering exceptional experiences for consumers, business partners, and associates. Charity is a pursuer of growth and knowledge with a Doctorate from Vanderbilt University. I’m excited to share her message here as Digital Transformation efforts continue to gain steam in not only process reengineering but also reimagining the future of healthcare delivery.

Key Takeaways:

1. The importance of psychological safety for not only team members but leaders when it comes to digital transformation efforts.
2. Transformation success may come down to the questions we ask before a project or effort begins.
3. Transformation leaders cannot get lost in the technology – every effort needs to be on mission and vision enablement.
   
   

Jake: Before we got started, you and I were just chatting about a couple interesting items – first, professional transition and doing work you love and second, how displaying and learning creativity can be challenging for kids in most of our education systems.

Charity: On the professional transition, it’s tough because you find that people really want to put you in some box that you’ve always been in. Skills are so transferrable, but it’s easy to label people via the industry they have spent time, title of their last position or the name of a prior company on their resume. Who you are as a person, your unique set of skills, values, and experiences really does matter.

Jake: It’s so interesting because I do spend time talking to my children on never limiting themselves to what they believe their capabilities to be – go out do stuff you love, lean in to the uncomfortable to keep learning, and you’ll make good things happen. The path or journey with the most people on it, is likely the path to mediocrity, so just keep being the best you possible and make a journey as you go.

Charity: That’s worth lingering on, because it is hard to reward creativity and entrepreneurial skills in a big system like that. It’s important to keep kids moving forward but balancing and rewarding that exploratory creativity, and flourishing the idea that it’s not just okay to fail and iterate, but it’s likely the best path to do something impactful and do that thing well.

We’re talking about digital transformation, and we just don’t have enough people failing within a framework that moves you forward in a gritty way. Yes, we need to accept that you’ll fail probably more than you’re going to succeed at first, but once you get it, you got it. I just wish we had more of this everywhere. It’s funny how education and enterprise digital transformation share so many similar themes.

Jake: Tough to find a bigger system, than healthcare, right? We started our journey as a Data Engineering & AI practice at Technology Partners in healthcare mostly because of our relationships and network with Washington University in St. Louis, but as I mentioned earlier when we spoke, my oldest son has Trisomy 6 and we have been on this long personal journey, so I want to keep making a difference here in this space. On the patient and family side, I want proven modern innovation, but not at the expense of safety or negative consequences – and on the consulting side I see that same struggle internally with our clients. Healthcare presents many system level barriers, not the least of which include generally low margins, highly regulated environments, a competitive regional and national landscape, and the complexity of existing processes.

How do leaders like yourself, usher in change when there are many intimidating system level challenges? How can you switch that paradigm to one that not only tolerates but promotes innovation?

Charity: There are a couple of patterns that are a part of change management, the first is psychological safety. Is there a safe space for people to have the ability to push important innovation forward and make the mistakes that are always going to come with that forward momentum? If your leadership is saying I need this work by this date and creating this rigid environment of waterfall/case study management, they are saying that because there is an ROI or critical business outcome attached. Well, we can’t lose sight of the work that isn’t keeping the lights on today but may very well be the reason the organization survives or doesn’t survive in the next decade. Creating a psychological safe space to explore by communicating that potential ROI can be a challenge as a leader, but it’s really a critical skill.

Think about a project that you may now know what the outcome is – much the waterfall work, that rigid well-defined work will continue to be automated; but that we have to define a vision or visions for our future and explore pathways to get there, we’ll always need talented leaders to do that.

Jake: How can you go about creating a psychologically safe space for yourself and your team? Any tips?

Charity: First, you must realize that it’s not about you – it’s about understanding how to work with your executive team and varying business stakeholders to understand the current constraints. Your executive team can help you find that space if you first work to truly to understand their constraints in terms of budget, timelines, and commitments at the top of the organizational landscape.

Here’s an example. Let’s say your current landscape is made-up of five or six different health systems that have come together. Your executive team has prioritized budget to fix the basic integrations – how can you frame the commitments you make on that journey of accomplishing the basic integration work to also highlight the potential positive impacts to the business of creating a platform and additional budget to explore AI, process reengineering, and rethinking the experience of users.

Can you deliver so much value that it’s possible for that integration platform to be a long-term scalable product? How could you reorganize a data product team to keep the momentum up? Is it possible you did it well enough that it easily surpasses existing industry competition, if so, who can help evaluate the potential revenue stream from commercialization? You don’t know where that journey is going to take you, but that psychological safe space where mistakes lead to quick improvements or directional changes comes from understanding the landscape and needs of your executive stakeholders and meeting them where they are. Then of course, you can ask them to meet you where you and your team are.

Jake: How can you approach executive stakeholders about what’s pulling them?

Charity: You have to offer an ask! Ask what’s pulling them, what are their priorities, why are they doing what they’re doing? Offer to dig down into challenges, problems and they believe they have – NOT what problems you think they have. Understand their preferences for solutions because that’s going to guide the decisions, they make that directly impact you and your team. Offer to dig into their key attribute preferences as well – what do they really believe is necessary, offer to validate those assumptions with users, and say I’ll be back with a suggestion for a pilot and let’s see if we can tell this story better together.

Jake: There are really good points there, it reminds me a bit of our work with Academic Medical Centers – these are teams build to innovate within translational research. It’s such a fast-paced innovative environment on the learning and research side, but it takes real effort to keep that momentum moving on the hospital side with so much risk adversity.

Charity: I see it so many times, that transformation or technology leaders will get hooked on the processes and technology but forget to understand the people you work and partner with. That risk adversity, where does it come from? Not where you believe or assume it comes from, but where does it come from? Can there be a place to speed up innovation and move faster together that doesn’t impact the items that truly drive their risk aversion?

We just don’t ask enough questions like that. We see big barriers and those barriers will stay a reality if we don’t change our capacity to think about transformation and getting things done differently. A lot of people like to say they like change, but a lot of those people don’t actually like change – because real change is driven questions, conversations, and alignment.

Jake: What about when you do get pushback on transformational efforts from the business users themselves?

Charity: Like I said, we all believe we can make a difference and be innovative – and we can if we take our thinking to another level. But when you get that buy in, you actually start those changes, and someone on the business side doesn’t believe for some reason and makes an executive level complaint, what do you do? People don’t like it when you start messing with the system, they have used for two decades, no matter how much better you make it sometimes. How is your executive team going to respond when that physician that’s bringing business in, who is maybe a thought leader in the space, says quit messing with my “XYZ” thing?

If you’re dealing with that ad-hoc and in the moment, it’s likely a failure to plan. Now that failure may have been not including the right users in design and testing, or some other process problem. It may also be that transformational leaders sometimes don’t want to acknowledge this risk of important stakeholders may not always love the work we and our teams are doing. Failure to talk through situations like this before a project kick-off can really stop you cold in your tracks. It’s hard because these systems are so big and complex that at times you may not have access to every decision maker – but you really need to have a plan for influencing these individuals and a clear understanding of what backing will (or will not) come from executive team sponsors in these situations.

Jake: How do you keep up momentum from project to project? Nothing is perfect, but we created Databasin in conjunction with our first consulting client because we just didn’t find a platform that enabled data innovation at the level we needed. That’s crazy to me that we still talk interoperability in healthcare in mid-2023.

Charity: Yeah. So, a lot to unpack there. One thing that I can say is everybody wants a one stop shop. Everybody wants that one thing that can do all things in healthcare. That is not reality right now, so, what you get is as platform that enables the basics – many healthcare systems rely on EMR for innovation, like EPIC. It’s a good start, but it just can’t be the whole story, it can’t be your platform that powers your organization’s innovation.

So, what can you build upon those is really good question that we all need to ask. Extend the basics, show value, create more ROI and of course you must ensure the security. If you have a major security event, you're done, there’s no psychological safe space there unfortunately. It’s that security that keeps people from jumping in deeper in healthcare. It’s tough to go feet first, let alone headfirst into something when security is always your first concern. It can be done, but it does present additional early stage and ongoing challenges that take skilled people and resources to manage.

Look at the questions we ask about AI, in a world that is only talking about AI, as a healthcare industry we need to embrace it responsibly and there is likely first mover major advantages, but many systems are willing to forego those advantages if they can also forego those first mover risks.

How is AI going to impact health systems businesses? How is AI going to help deliver our mission and ROI? We know it will play a crucial role. But you have you to be start that conversation of what that role means in terms of your organizations landscape and how it can move your executive team’s priorities forward first.

In established healthcare systems we have to tear up a lot of systems and uncover a lot of technical debt to drive real and institutional AI enablement. We don’t get the opportunity to act as a start-up who can just innovate, iterate, and move on if it doesn’t go well. We can partner with start-ups and that’s something you are seeing a lot of lately.

Jake: What framework right or tips would you have to help leaders ensure the focus stays where it should be? How can people not get lost in the technology.

Charity: You must keep in mind that executive stakeholders are rarely subject matter experts in transformation, now some are, but largely they are looking to you to be that subject matter expert. You must start in caregiving and dig into those first principle thinking skills. These board members are seeing a lot come across their desks and screens – sometimes its news, sometimes its other board members, sometimes its relationships from other industries.

I don’t know of an executive stakeholder who comes to your office and asks about AI for example and expects you to have a 3-year strategy and roadmap printed for them in 5 minutes. They do, however, want to understand where you see that technology have a place in your business. What exploratory efforts are underway to define that place and capability? How far are you along on those efforts? Is your team and the organization pushing back or readily accepting? Who is doing this well right now and how can we replicate that?

If you recognize that, it’ll take the pressure off starting with a technology and let you put the focus back on where it matters – for us that’s caregiving. Digging in here to understand roles, jobs to be done, tasks, and expected outcomes, that’s where you need the strategy and roadmap to come together. Technology will be there to enable it, likely in a better more mature way in six months, but you’ll run out of time to re-engineer your processes if you lose that commitment to caregiving and rethinking what’s the absolute best possible path and outcomes we can enable.

Jake: Thank you Charity, this has been great, and I know it will be valuable for our readers.