Balancing compassion and business in the health sector

Patient-centric models are the way forward, according to Community Medical Centers CIO Mical Cayton. In this interview Pulse Q&A talked to Cayton about the importance of non-verbal cues; balancing ‘technolust’ with practicalities; and the most relevant challenges for an IT leader in healthcare.

Pulse Q&A: Welcome to another episode of AMA. Today we have Mical Cayton from Community Medical Centers. Mical, You’ve been in the role of CIO for a year, tell us what the first 30 days might look like.

Mical Cayton: The first 30 days consists of a lot of site visits, a lot of meetings, and a lot of the political aspects when you come into a new organization where you’re trying to cast a favorable first impression You’re not saying too much, but listening quite a bit and paying attention to a lot of the nonverbal cues. If you’re observant, you will pick up and learn some things. 

It’s a very jam-packed period of time, the days tend to be a lot longer than then you would expect. A CIO job could be a 12-hour-a-day job five days a week, depending on the size of the organization. In my first 30 days, I was probably doing between 12 and 14 hours a day. 

The key is trying to balance the compassion with the right level of business acumen and still move the mission forward for the organization.

You take a lot of notes. Then after your normal work day it was going back and consuming all of the notes that I had taken and try to digest all of that information. 

Then there’s the transition from my predecessor, who was also the CFO for the company. Understanding what that person’s vision was, where they were taking the organization, and where you might see any differences. Then trying to understand what the relationships were that individual had with other members of the C-suite. 

Pulse Q&A: Could you extrapolate on the idea of nonverbal cues?

Cayton: Sure. Just basic things like a person sitting like this with their arms folded across their chest when you initially engage with them. Whether they hold that position in the course of the conversation or whether they relax and begin to open themselves up. Folks looking down at the floor, looking in the sky, not looking at you. I observed all of those things when I first came on, so those things tend to tell a lot about how the relationship is going to start. That’s not necessarily indicative of how the relationship is going to progress. But it does give you some idea of how the relationship is going to start.

From a technological perspective, it’s always about the balance between what I call a ‘technolust’–chasing that new shiny object–versus continuing to use something that has worked well.

Pulse Q&A: How would you describe your management style? A sort of psychologist?

Cayton: Yeah, very much so. Because you have to have an understanding of people. You obviously have to have a solid grasp on the business. You are a trusted adviser to your executive peers and certainly to the CEO of the organization, who has invested significant resources to bring you into the organization and make you a key member. There really aren’t any secrets in the C-suite. For the most part, there’s a lot of transparency and a lot of tough conversations–fun conversations–that happen in the C-suite.

Pulse Q&A: A question that has come up in our forum before is on introversion. Does your workplace value introversion?

Cayton: It has, it has its place and it’s not something that I discourage. I mean, there are there are introverts in this business, there are extroverts in this business, and you will find them in different aspects. For example, I think there’s a tendency to think that people who write code as an example, are more comfortable in front of a computer screen than they are in front of an individual.

I have some individuals on my team that are excellent coders, but they’re also extroverts. They don’t have a problem engaging with different things. individuals in larger forums, those kinds of things, they’re actually okay. Whereas I have other individuals on my team, whose roles are extrovert roles, but their personalities are introverted personalities.

And so supporting them and watching them do excellent work, even though it’s almost 180 degrees, you know, opposite of who they are, at their core is always a very interesting dynamic. There is great value in introversion, because my experience has been that introverts tend to look and observe.  And observation is key in this business. Not just from a technological perspective, but just picking up on the rhythms of people, and how to help manage change that oftentimes feels as though it’s been foisted upon on the business and our patients. 

Pulse Q&A: Is there anything particular or specific about managing a team in health?

Cayton: Yes. My organization, like many healthcare organizations, has nonprofit status. In the case of Community Medical Centers we’re known as a federally qualified health center. So we receive a certain level of federal funding. We have a special legal designation that gives us some flexibility in terms of how we are able to make money, recoup costs and still drive a reasonable level of profitability. That allows us to reinvest in technologies and other types of things that help move the patient experience forward.

The models for healthcare are changing. It’s moving from fee for service to value-outcomes.

I would say we have to take great care of the physicians because they’re on the front line dealing with the patients. They’re making the diagnoses, writing the prescriptions, doing exams, all of those kinds of things. 

Then there’s the other side that says whatever technological decisions that are made have to be in the best interests of the patient as well. So trying to strike that balance is absolutely the best course to go.

We don’t care about the cost. This is the best thing for the patient. And so trying to have those conversations and come to the right decision for all of the constituencies involved. The key is trying to balance the compassion with the right level of business acumen and still move the mission forward for the organization.

What was the best advice you received from a mentor? Let us know on our Pulse Q&A forum.

Pulse Q&A: I wonder if we could talk a little bit about what technological challenges that your company faces?

Cayton: From a technological perspective, it’s always about the balance between what I call  ‘technolust’–chasing that new shiny object–versus continuing to use something that has worked worked well. While it may not be the most cutting edge thing, it works and it works well. In some cases it’s a cost-neutral solution. 

The other thing is really keeping up with the pace of change in healthcare technology. The appetite for data-driven solutions and the introduction of data-driven decisions as it applies directly to the healthcare of the patient. 

The models for healthcare are changing. It’s moving from fee for service to value-outcomes. In other words, did my patient base become more healthy as a result of the solutions that are being practiced. We’re trying to align technologies that will help get your organization where it needs to be down that value line, while not casting all of the old stuff to the side just because of its age.

Pulse Q&A: Tell me a little bit about what what works best for you guys–not the shiny objects–some web products that you use that really make a difference?

Cayton: It’s a combination of a lot of on-premises technologies, which is pretty consistent in a healthcare environment. Healthcare historically has not been a rapid adopter of technology, it has tended to be more of a laggard, in terms of implementation of new technologies and those kinds of things. 

One of the things that I want to do for our organization is–where it’s appropriate–move certain types of technologies to cloud-based solutions. So think things like the Microsoft Office suite of products. Office 365 can be a game changer for an organization because you don’t have the investments in on-premises infrastructure. So servers and the people that need to care and fee-for-service and manipulate those devices can offset some of those costs. Then you’ll have some increased operational costs, but not capital costs.

Healthcare and IT: Make sure to catch our interview with Health Sources RI CIO Sumit Ohri 

Pulse Q&A: I wondered if you’d be interested having the last word about your first year at Community medical centers.

Cayton: It has been an excellent ride. Our leadership team is strong and we are a very focused cohesive team. We have some excellent opportunities and we’re an organism that is growing and we’re expanding our medical practices as well as our offerings. We’re moving as quickly as we can to put ourselves in a position to be known as an innovator in the federally-qualified health-center space. 


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