Breaking Down Barriers: Fostering A True IT and Business Partnership

Phil Sobol: Today, we're pleased to welcome to the CereCore podcast, Nayan Patel. Nayan is currently serving as CIO at Upson Regional Medical Center, which provides healthcare to multiple counties in Middle Georgia. Many of you know Nayan through CHIME, or the College of Healthcare Information Management Executives, which is a mouthful, a professional organization for healthcare leaders. Over the years, Nayan has worked with several healthcare organizations through leadership transitions, and growth initiatives as a leadership consultant, and most recently as the interim CIO at Upson Regional. Nayan, welcome to the podcast. 

Nayan Patel: Well, thank you very much, Phil. I'm honored to be here. 

Phil Sobol: Well, we're thrilled to have you as well. And, you know, you've got years of experience working in healthcare leadership. Was there an experience or something that really ignited your interest in healthcare IT? We'd love to learn more about your journey. 

Nayan Patel: Yeah, you know, I think one of the things that you have to recognize who you are as a person, and I've always been a technology person, but I never really understood how to apply what I love to do to people. 

And I think that's where it comes down to it—it was about caring for people and having what I call a servanthood mindset, right? So if you know what the golden rule is, right, it's basically about putting others in front of you type of thing. And I think that's what healthcare is about. Health care is about taking care of people and caring for people. And so, you know, when I got the opportunity to go into healthcare, it was just like an ideal fit because, you know, it's all about people and taking care of people. So there were, you know, several experiences in my life that I went through, and it really comes down to finding the right opportunity that can give back to people. And that's what healthcare did. When I moved from semiconductors to hospitals, it allowed me to take advantage of that and always just looking at how do you take care of people and the patient. 

Phil Sobol: Yeah, I think you're spot on. I think so many of us that came from other industries, as soon as we dipped our toe into healthcare, it was something different. It was certainly that mission driven sort of organization. And you could see the fruits of your labors and the direct impact to the patients, you know, really at their most critical time of need. And you can't underestimate that. So that's certainly wonderful. You know, CIOs, they're, boy, it's such a challenging job. And, you know, they're tackling the most complex IT initiatives, challenges with just limited resources, you know, budget constraints, and often, you know, misalignment sometimes between the business and IT. You know, what are some of the strategies that you've used, either at Upson Regional or other healthcare organizations that, you know, that allows you to make progress or achieve success, you know, given those tough circumstances? 

Nayan Patel: I think the first thing that any technology leader needs to recognize is that every project that you might be involved in, it's still a business project at the end of the day. And that means you have to explain it in business terms. So what also is a vice versa of that is every business project out there probably has some form of IT in it. So we're always doing, you know, working with the business and businesses working with IT. And so in a hospital environment, it really is about getting to understand your hospital administrators and the service line leaders that are within the organization. And then trying to identify what their needs are translating into what is the business impact. A lot of it in the hospital system is about patient care and clinical impact. So nurses, we know, are so challenged today with doing so much of documentation and taking care of a patient. All they just want is simply take care of a patient and not use technology. So they're taxed quite a bit. So I think one of the first things I always try to do is try to be as transparent as possible. You know, I'm new to Upson only several months now. And a lot of it has to do with just documentation. Here's what we're working on and then sharing it and not feel like there's any kind of secretive ownership to it. This is just, here's what we're working on and here's how it impacts your business. And then how can we continue to work together to make those improvements and execute them as best as you can in a timely manner. 

Phil Sobol: Yeah, I think it's certainly words of wisdom there. I think so many times when you look back at challenges and circumstances, inevitably so many can be avoided just through that simple thing we call communication, right? 

Nayan Patel: Yeah. I'll even expand on that. I mean, I think a lot of it has to do with don't complicate the communication and don't try to overwhelm the audience. We have so many different ways to explain everything, but really it's, here's what we're working on, and here's, we call it, even within our current organization, we have a top 10 list that gets a little bit more loving, is what I call it, right? We need to give love to some projects that need more attention than others. And there's a reason why it's just a top 10 list, because if we just put the top 100 on there, we would never really get a true focus of conversation on a weekly basis. 

Phil Sobol: Indeed, you're spot on there. Let's just say that you're a new IT leader coming into an organization. You've probably experienced this several times in your career. As you mentioned, you're relatively new to the Upson family there. Talk to us a little bit about your approach when it comes to establishing trust and earning a seat at that executive table where your expertise and experiences you know, can be utilized. 

Nayan Patel: Yeah. And, you know, one of the key things you need to focus on is identifying who those stakeholders are. Because, and that trust is not something that is going to happen within a day or two, right? It's going to take weeks for sure, maybe months, depending on, you know, what environment you're walking into. But I think part of it has to do with showing up consistently. We have a regular admin, administrative team meeting every week. and being on time, engaged, prepared to come in. You know, we have our top 10. It was funny when I started, the top 10 only had like, you know, two or three IT items on there. Now the running joke is that most of them are ITs. It's okay, because we step in and we either recognize that there is technology impact or that I, you know, step up and say, well, I'll take ownership of that kind of thing. And so it's understanding and making sure that you're being as transparent and saying, hey, this is where we're at every week and coming prepared. I have a team meeting the day before just to make sure that when we go into our admin meeting that whatever's on that top 10, I better have an answer for it or at least some type of update, even if it says we're not moving along. So identifying those stakeholders and gatekeepers to some degree throughout the organization. And you know who the gatekeepers are. They're the ones who keep the hospital president happy, right?  

Phil Sobol: That's exactly right. Pretty easy to spot most of the time. Yeah. Most of the time. So, no, that's great. And I think you hit the nail on the head, right? A lot of this is just about that, you know, it's about that communication. It's about those, you know, making sure that, you know, you come prepared. And at the same point, like you said, hey, if there's no update, there's no update, but at least make people aware of it. So I think that's great.  

Nayan Patel: And some of the stakeholders, in order to build that trust, you have to do a one-on-one with them and then come back to them a second time or consistently, whatever it takes, depending on who that person is. But, you know, like anytime you join a new organization, they're going to tell you, here's what I'd like to see improve. And if you just sit there and listen, but don't take any action, then that's where it's really going to fail. But if you come back and say ok we can't do everything, but here's what I can help you with, and then take some action. That's what it's about. Absolutely.  

Phil Sobol: You know, at the end of the day, we're all human beings, and hopefully everyone's bought into the singular mission of the organization. Yes, everyone might have different approaches and different viewpoints, but at the end of the day, you're all working for that common purpose. Now, you know, there are some instances, right, where IT and perhaps the business aren't on the same page as it relates to, you know, to some of those goals. you know, tell me a little bit about how you've approached that. You know, obviously there's always silos inside of most organizations and some misalignment and goals, expectations, et cetera. In fact, I'm sure, you know, people that are listening now are nodding their heads going, yep, that's exactly right. You know, any advice on how to deal with that? 

Nayan Patel: Well, every organization has something that you can't control is just putting out fires wherever that loudest squeaky wheel is, right, or wherever the noise is coming from. And that's just going to happen regardless of what environment, what kind of structure you have in place. But the easiest way to squash some of that and, you know, the working in silos and having this alignment is to be transparent of what you're working on and then help, you know, the business prioritize. So I talked about that earlier, you know, document what you were working on and start sharing it. We had to formalize an IT steering committee meeting and start really putting the ownership back on the committee to say, hey, what do you want us to work on? Here's how we're working on things. But we are still at the direction and the mercy of the business. So if the business is appropriately set priorities, that's going to help us a lot. 

Phil Sobol: No, you're spot on there. Now more than ever, right? There's so much for CIOs to pay attention to. It's not just a matter of looking at the server rack and making sure the lights are green and not red. So, you know, are there some of those fundamentals that just can't be overlooked? You know, I think, you know, if we look at it, you know, how would you finish this sentence? You know, healthcare IT leaders really need to focus on... 

Nayan Patel: I would say reducing technical debt. I think, you know, we are always looking at how to improve our operations, but most of the applications we have in our environments are because someone within the organization and there's different service lines that we would like to have XYZ application do ABC for us. And not knowing that A and B can also be done in, you know, some other app application that's out there. And so we have a lot of overlap and opportunity to reduce things. Without forgetting that we all still need to continue to improve operations and look for the latest technology that is going to keep us up to speed. But there is a lot of technical debt that's out there. And so modernizing IT to help with that application rationalization, those are the type of things that we need to be aware of while trying to say, hey, how are we going to do AI today? Or where does AI fit into this? But incrementally. 

Phil Sobol: No, you're spot on. I think so many times it's so easy to avoid that conversation, right? Oh, it's there. That's a hole that doesn't exist, so to speak. But I think so many organizations, they're almost afraid to begin that process of really, truly, honestly evaluating that technical debt and what should be done about it. So I appreciate you bringing that up. Part of that too revolves around governance. And I know that you've seen various governance methods across the country, some great, probably some not so great. What makes or breaks IT governance inside of an organization?  

Nayan Patel: I think the biggest thing is having some true oversight and cadence. Governance is about saying, here's what you're working on and helping you set priorities to make sure you're working on the right things aligned with whatever strategic plan might be in there. It could be a three-year strategic plan, it could be a five-year strategic plan, but you're working on different activities that support a strategic plan. Every week is what I would say is when you need to do status checks on because monthly is, you know, certainly valuable, but there's so much that happens on a regular weekly basis. Daily is way too much, but making sure that you're reviewing those statuses on a weekly basis And some organizations are fortunate to have, you know, true PMOs that can help manage the governance process and have a product management office with multiple PMs. But it doesn't take a lot if you keep the process simple, you know, just have a list of some sort, whatever tool you have. And there are multiple complicated tools and simple tools that are out there. And then just start publishing that because, you know, it's really showing the business and the top level leadership that here's what we're working on. And we can do it all, just not all today, right? We can't, we just, you know, we have to be good at having the ability to say yes, but not now, right? So here's, and help us figure out what we want you to work on and then putting that in front of them on a regular weekly basis. 

Phil Sobol: Yeah. Nice. That's your, your spot on there for sure. And You know, we talked a little bit at the top just about your involvement in CHIME. Certainly, you know, a wonderful organization from a healthcare standpoint and, you know, just great from an educational standpoint. And quite frankly, I've seen a whole bunch of mentorship opportunities come out of the relationships built outside of that organization. And so, you know, if you were to pass along some of the best advice that you ever got from a mentor, What would that be? 

Nayan Patel: Yeah, I mean mentors are great. First thing is establish a mentor. If you don't have a mentor or a few mentors, try to identify some. Everybody is generally having a good heart and would love to give their advice because if they think they know something, not only do they feel better about sharing, but it's a win-win usually. you know, make sure you get some mentors. The second thing then is, okay, you know, what do you want to do with them? Make sure that there's a cadence around that. And some of the things that, you know, one that I was told once was make schedule or make space in your schedule, you know, like five to 10% every week to do something else. And that something else is really about building and growing yourself, building relationships, meeting with people, learning. outside of what your normal day-to-day routine is. And that's not easy to do. So you're right. I mean, that involvement in CHIME, I've been involved in HIMSS and many other organizations now. And I've mentored and become a mentee, though, because you are going to learn from others. And then the second thing I'll close on is saying, for me, it's always, I'm not going to be the smartest person in the room. I want to hire the smartest people in the room. I need a system administrator to do that type of role and understand server environment and what it takes to maintain that. But I need the security analyst who's a specialist who can go in and look for any kind of vulnerabilities and really understand how to remediate any vulnerabilities. We're the quarterbacks, right? And we need to hire the best running backs and wide receivers kind of thing and direct the traffic from there. 

Phil Sobol: Indeed. Indeed. I love the fact that you use that football analogy. I use it all the time. And for whatever reason, it resonates with people. And so I appreciate you bringing that up. You know, we always like to close out the podcast with really just kind of an open-ended question, right? For any final words of wisdom that you would like to leave behind with the listening audience. 

Nayan Patel: Yeah, I think I would always say, and this is the same thing I told the team over here, is try to respond and not react. We live in a very reactive environment. It's hard not to just say, OK, something broke. OK, well, let's just go do this to help. Well, let's assess it first and then try to respond versus reacting. And that's not easy to do. And so that is probably the one thing that I champion every time. We're always going to say everything can be improved. but be transparent, you know, and that's about responding and reacting to why you're not immediately and say, I need to understand something so that I can respond appropriately. So the transparency and being responsive is the two, one, the things that I would definitely say has to bring value to your business. 

Phil Sobol: Indeed. It's sage and outstanding advice. Nayan, thank you very much for your time today, for your insights, and really just for your leadership throughout the years in a number of organizations, and certainly in organizations like HIMSS and CHIME as well. So, appreciate it. 

Nayan Patel: No problem. I appreciate the opportunity. Thank you very much. 

Phil Sobol: Thank you very much.