Healthcare CIO takes pride in developing future leaders

Sue Schade worked as a nurse's aide in high school and college, and some members of her family were nurses. But while Schade says she "never thought seriously about being a clinician," she did end up in healthcare -- as an IT professional. Since 2012, Schade has been the CIO at the University of Michigan Hospitals and Health Centers, where she oversees a 600-member IT team that supports 25,000 people.

Earlier this year, Schade was named the 2014 John E. Gall Jr. CIO of the Year by the by the College of Healthcare Information Management Executives (CHIME) and HIMSS, a nonprofit group for healthcare IT professionals. Here, she reflects on the challenges and opportunities in healthcare IT and the technology profession in general.

What was your strategy for taking on the Michigan job? When you come into a new role, the organization is where it is. It has its multiyear plan from a business perspective as well as an IT plan. So you come into that, and you have to move that forward. Sometimes you can shape it. In this case, the EHR [electronic health records] journey was fairly well laid out, so I needed to pick up with that and move it forward on time and on budget. Two major phases had been competed in 2012 before I got here, so it was taking it through to fruition.

The other broad thing I'd say is that I took a little bit of time to determine what organizational structure changes were needed. I didn't want to impact the EHR schedule that we were on, so I made my changes about 11 months in, and those changes started to shift the culture within the IT organization.

What was the cultural shift? There was a somewhat separate organization within IT being created and fostered to implement the EHR. And there were duplications of core functions. I saw that and I thought, "It's one IT organization and we don't need that schism, we don't need that duplication." So when I did the reorganization, it was all about consolidating and streamlining functions.

Was that schism a technical issue or a people issue, or both? It was a people issue, too. When you come into an organization at this level, you have to take time to figure out who are your strong leaders and who are your emerging leaders. When I did the restructuring, there were two people I moved up a level because I saw their potential and I saw how they were respected in the organization. That's what takes time: to look closely at your leadership team at multiple levels.

What have been your greatest accomplishments in your current position? What we've been able to do with the EHR: keep it on schedule and on budget, to really deliver on that -- that's one of the major accomplishments. The other thing is the leadership role I've provided within the state on the health information exchange. [Health information exchanges] are at a state or regional level.

The Michigan strategy was a sub-state level, so the one we participate in and another one had become the dominant ones in the state. When I got involved in the state meetings and participating on the board of the one we're involved with, I asked, "Why can't these two big ones come together as one?" and people finally said, "Let's take action." We finally merged the two last summer.

The other thing is the cultural changes I made, to improve communication and transparency, to increase accountability and teamwork among the group. Those things take time and some diligence. We're making progress. We're moving the dial in a positive way.

What about your greatest accomplishment in your career so far? What I hope to be remembered for in the long run is my commitment to developing people -- my interns, students, people coming up in their career. When you get notes years later that say, "You helped, and here's where I am now," you know you have an impact on people.

How do you offer that support? It's formal and informal. We're developing internal coaches within the health system to work with up-and-coming leaders. In terms of my social media presence, I try to bring up the next generation in terms of what I share.

Another thing I do is my monthly CIO breakfast. It's 20 to 25 people, first come, first served, and it's a totally open forum. And if anybody is in school and they have to talk to the CIO, or if they just want my advice whether they're in school or not, I make time on my calendar.

What's the biggest challenge you face right now? The biggest challenge right now and the thing I worry about is security. I had a third-party domain expert in security come in and do an assessment and give us a set of recommendations. We're in the process of recruiting a chief information security officer. We're taking a lot of steps to strengthen our program, but the bad guys are out there, and it's incumbent on us as CIOs to keep closing whatever vulnerabilities and gaps there might be.

University of Michigan Hospitals and Health Centers

What about the biggest opportunity right now? I look forward to getting past the core EHR work so we can get into the other innovative work. Patient engagement is a hot topic. One part of that is how robust is your patient portal, how easy is it to use, how functional is it?

Another area is access. For academic medical centers, that's always an issue -- how quickly can someone get in to see a doctor.

Another area is continuum of care: When a patient leaves the hospital with their discharge instructions, do they have all the information they need and is that integrated into all of your ambulatory-type services? A lot of organizations are bringing in senior people, patient engagement officers, to tie this all together. That's an area that I want us to be in a position to support.

There's a lot of activity around mobile applications, too. The area of telehealth -- I think there are a lot of opportunities to expand, particularly into rural areas.

Do you think enough is done to draw young women into STEM professions? Right now the numbers aren't good. The number of women going into computer-related fields isn't good. It has really dropped since the '80s. It seems like it has gotten more attention, and that's good. Raising awareness and addressing the cultural issues are important, and in the long run equal pay is fundamental.

We need to support programs that get to girls at a young age, before the social norms kick in and they think they can't do math and they can't do the sciences, and that that's just for the boys.

In my talks, one of the visuals I use is my two-and-a-half-year-old granddaughter who loves to dance and loves robots. Her mom, my daughter, drew a ballerina robot on her leotard to combine the two. If she's into robots now, what's the social norm going to do to her? Will it discourage her? I haven't done deep research, but you see interest from girls drop off during those junior high years.

You talk about lean thinking in your organization. What does that mean for your team? By lean, I mean eliminating waste and nonvalue work. We've had an active program here at the health system for eight years. A lot of management got training in lean before I got here, and I'm trying to reinstitute a focus here in the department.

I'd like all my team to have huddle boards and do regular huddles. And I'd like more to learn the A3 problem-solving method. Within my organization we started a lean leadership huddle that we're experimenting with, which is getting good results on surfacing problems in real time.