04 Mar CIO Leadership: For Wheaton's Greg Smith, process is paramount
Glendale, Wis. – To call Greg Smith an “accidental CIO” may be stretching the blanket a bit, but there was a bit of a learning curve in 1998 when he became senior vice president and chief information officer for Wheaton Franciscan Healthcare.
Smith actually started in marketing, where his focus was on market research and product development. His was a gradual evolution to CIO, but he was still on a business operations path when, in October of 1998, then CEO Bill Loebig asked him to apply for the system’s recently vacated CIO post.
The thought of pursuing the CIO job hadn’t occurred to Smith, but Loebig helped convince him that what he learned in operations – especially what properly built and deployed technology could mean for the clinical and business sides – would give him a unique perspective in IS.
Armed with a bachelor’s degree in business administration from the University of Iowa, and a master’s degree in business administration from Cardinal Stritch University in Milwaukee, his only technological connection was a previous investment in a computer company, where he helped out on the business side.
“I really didn’t have a technical background, but I’ve learned a lot in past eight years,” said Smith, a native of Burlington, Iowa.
What he has learned is to put technology in its proper perspective. Technology, he said, is really nothing but a series of tools that can accommodate more efficient, more effective work processes. Technology, he believes, is there to support application software, and the software is there to support the workflow of the end user – nothing dramatic, nothing over-hyped.
“My interest is how do you support a more efficient workflow for the end-user,” Smith said. “Technology is simply a way to enable that and make that business process concrete.”
At Wheaton Franciscan, one of the largest integrated regional healthcare delivery systems in Wisconsin, that philosophy comes in handy as the organization completes a redesign of care-delivery processes and the accompanying deployment of McKesson electronic medical records. The organization is 20 months into the three-year project, in which it is working – in accordance with Smith’s order of priorities – to reshape key clinical workflows across its operations in southeastern Wisconsin and Iowa, and then support those workflows with a common body of technology.
Wheaton Franciscan has completed the vast majority of the design work, with the exception of the last piece – computerized physician order entry (COPE). There are months in which Wheaton has 10 or 12 new bodies of technology going live at different sites across Wisconsin and Iowa.
The technological pieces include a series of McKesson products and some non- McKesson tools such as GE Healthcare’s Centricity for picture archiving and communications systems (PACS).
But the technological integration might be easier than the cultural and behavioral challenge of moving from autonomous work environments to a high level of interdependence.
“It’s going well, but it certainly isn’t without its struggles,” Smith said. “You have to appreciate the enormous complexity of trying to build a common approach to clinical practice across nine hospitals that traditionally have been able to define and evolve their own workflows. Now they have to work together, and they are incredibly interdependent on each other because they are running on a common technology.”
Lessons from McKesson
Smith serves on the McKesson Provider Technology’s Strategic Advisory Council, a plumb assignment. McKesson, a $93.0 billion healthcare services company, ranks 18th on the Fortune 500, which is only one reason why service on the council is extremely valuable. For Smith, it’s a rare opportunity to work with a dozen other CIOs with environments similar to Wheaton Franciscan’s, and it has added layers of depth to his ongoing technology education.
Smith revels in the fact there are no shrinking violets in a group that includes the likes of John Wade, chairman of the Healthcare Information Management Systems Society, Lou Hermans of Solaris Healthcare, and Jackie Lucas of Baptist Healthcare.
They are outspoken enough to deliver to McKesson, and sometimes one another, some unwelcome news. “They have become not only colleagues, but we bounce ideas off each other, share policies with one another, and exchange war stories,” Smith said. “We exchange our evaluations of different technologies and share scripts and code at times. It’s enormously valuable.”
Another dimension to Smith’s McKesson service is the opportunity to sit with the company’s upper management and become immersed in subject matter like future direction and how to support different types of customers. Like Wheaton Franciscan’s mission, McKesson’s business is all about relationships, and to be able to provide a global company with strategic and tactical feedback helps Smith with visioning in his own organization.
Areas of influence
Perhaps as a result of his late coming to technology, Smith’s greatest influences are not the likes of Bill Gates and Steve Jobs, but his own father, Sherman Smith. The area where he was the most influential is common to fathers: work ethic and professional standards. That was true at age 13, when Smith landed his first job – as a janitor – and his father helped him realize that even though it involved menial work like cleaning bathrooms and emptying waste baskets, everyone in the office depended on him to do a good job.
In what amounted to his first “real job,” Smith worked for his father, who owned a materials-testing company, the summer after he turned 16. He worked in the company’s soil lab, using a series of processes called ASTM standards to evaluate various materials. One time, he did not follow the protocol in an exacting way, and an engineer who was reviewing the results of his work noticed that it produced an impossible result.
Sherman Smith being Sherman Smith, young Greg found himself conducting the test all over again – this time over the weekend. The second time around, he strictly adhered to the applicable standards when he would much rather have been enjoying the weekend. This was before he started a rock band that played at high school dances and other events, but it still spoiled the weekend of fun he had planned.
Smith acknowledged that some of his father’s influence probably is subconscious and deeply embedded in who he has become, but other influences can be drawn upon and shared with new employees that sit around his conference table on a monthly basis.
“I probably learned more from my father than anyone else, but I’ve had the good fortune over my career of working with very good people,” he said. “I’ve had good supervisors, good mentors, and the good fortune to work for people who were not very good at all. Not only do you learn the difference, but it really influences you in very material way when you can see difference between a good leader and an ineffective manager.”
The work ethic instilled by his father helped Smith establish a reputation for getting things done, which is one of the reasons Bill Loebig thought he could manage an IS staff. Still, even after 10 years on the job, he invests a fair amount of time self-educating on the subject of technology through sources like CIO magazine, the College of Healthcare Information Management Executives website, and occasional re-reads of Steven Covey’s “Seven Habits of Highly Effective People.”
Part of his ongoing technology education is supplied by two co-workers he has come to heavily rely on – Tim Belec, vice president of technology for Wheaton, and Penny Goodyear, vice president of applications and a nurse by training. Smith credits Belec for teaching him about technology and Goodyear for her tutelage on clinical workflows, which just happen to be among the two most important subjects of his job.
For 2-1/2 months, it became apparent that Belec’s advice had sunk in. Belec was seriously injured in a shooting outside Wheaton Franciscan’s Glendale offices last Nov. 21. During his recovery, his direct reports became Smith’s direct reports, and the result was a smooth and (thankfully) temporary transition.
Belec, who admires the way Smith puts ego aside and reaches out to staffers on technology subjects, said his absence was a good test of Smith’s ability to master complex technical material.
“He did a great job handling my reports and projects,” Belec said. “He admitted a couple of times that he didn’t understand some of the technical details, but he did a great job learning them.”
Goodyear noted that Smith formed his staff with specific expertise in mind. She said that her strength is in her clinical experience, Belec’s is on the technical side, and Smith’s strong suit is business acumen. Together, she believes they have all the bases covered.
“I think that was proactive and forward-thinking of Greg to put the three of us together,” she said. “Greg expects a lot of the people he works with, but you always feel you’re working with him, not working for him.”
Leader of the band
Outside the office, Smith enjoys several passions, including sailing and music. Smith credits his musical background with some of the creativity he applies to the job. He is a jazz and blues devotee, a passion he has passed onto his son and daughter. The running joke in the family is that the kids – one in college, the other in high school – have the musical tastes of a 50-year-old adult, “but it’s good taste,” Smith said.
In his youth, Smith turned his passion into performance – sort of. His mother was a music teacher, and made sure her children were exposed to many different musical genres. Smith himself played in swing bands throughout high school in the 1960s, but when it was time to form his own band, jazz was his musical choice. There was, however, one formidable obstacle – nobody wanted to pay his band to play jazz.
So they turned to rock `n roll, and they were a hit at high school dances and similar venues. He happened to enjoy Eric Clapton as a solo artist, and enjoyed Clapton’s work with Cream, but the band – named Sands – played whatever was popular at the time, including material from the Rascals, Buffalo Springfield, and the Association.
Mindful of his mother’s artistic example, both of Smith’s children attended the Waldorf School, which emphasizes the engagement of head, hands, and heart. “I think that we are always at our best in terms of looking at an issue or solving a problem or evaluating an opportunity where we can both think through it using our heads, but also think through it using our hearts,” he said. “Things like music and art can be very helpful in teaching you how to do that.”