Last fall, my health system officially affiliated with a larger organization, after a year of due diligence. Six weeks later, I left the new organization.
Mergers, acquisitions and affiliations are occurring across the country at a rate that seems to be accelerating. For the chief information officers in particular, demands related to these unions can be as time-sensitive and unforgiving as achieving the CMS' information technology incentive requirements. One of the first activities for the smaller organization is to rapidly replace, upgrade and reconfigure technology in accordance with the larger system to achieve economies of scale and improve patient outcomes. For already strained IT staffs, that means yet another mission-critical project runs simultaneously on a typically tight timeline as other mission-critical initiatives. My staff at the time described the scenario this way: “You want us to change the tires on a race car while it is still racing, right?”
The difference with this new project apart from the others is that it is under the direction and leadership of the larger organization. Changes in IT reporting lines along with new personnel practices and cultural protocols begin to occur about as soon as the ink on the formal agreement dries. While this may be a harsh reality for CIOs in the smaller organization, the larger organization, in terms of net revenue, is not going to lose momentum to sort out what, if anything, the smaller organization's IT operations offer for change and jeopardize the timeline that underpins the collaboration. On the contrary, the larger organization is going to move with swift certainty using the demonstrated practices and methodologies that support continued success. This practice is not a commentary on the smaller organization. It is, rather, an insight into the larger organization's culture that if it is not broken, then don't fix it.
IT is typically at the spear tip of changes to come. During this transition period, the smaller organization begins to let go of long-held protocols and practices as leaders and staffers begin to adapt to the new culture. The IT technical team is the first skill set involved, in particular infrastructure and security engineers. Direct communication begins between technical counterparts, bypassing governance and cultural protocols. Counterparts begin to share the same workspace, bypassing office assignment protocols. The urgent need to establish secure communications between the organizations also challenges physical-access protocols to equipment of the smaller organization, affecting security policies and facilities staff. Resistant behaviors such as clarification of current protocols and methodology are viewed as irrelevant and time consuming.
My best advice to staff during this transition from an old identity to a new one is to let go and embrace the change. Continue to treat one another with the same courtesy and respect as usual, and extend these same courtesies to new colleagues.
As promised during the due-diligence process, leaders could remain but in very different roles with diminished span of control and responsibilities. As it was put to me, “Where would you expect to be placed when your organization's net revenue is only 10% of our business?” After 17 years of CHIME membership, the new position would not have offered me the eligibility to continue my membership and would have changed the trajectory of my career.
In my mind, it is not a question of whether any health system will be exempt from this M&A activity. The only question for me is how will the talents of displaced health system leaders, who are dedicated to healthcare, continue to support healthcare's historic transformation.
Edith Dees is a former health system chief information officer.
