Why IT Governance Leads to Innovation and Growth

Phil Sobol: 

Welcome to the CereCore Podcast, where we focus on the intersection of healthcare and IT from practical conversations to strategic thought leadership. Let's unpack the decisions, challenges, and journey of those whose purpose it is to deliver technology that improves healthcare in their communities. 

Well, today, we are pleased to welcome to the CereCore Podcast, Peyman Zand, the chief strategy officer at CereCore. Peyman is a collaborative leader with vision and healthcare technology acumen that helps organizations develop new business partnerships, expand service lines, execute strategic frameworks to support large transformative initiatives, and much more. He understands the pragmatic requirements of being a healthcare IT leader today because he's served in the role as CIO and is an active participant in professional organizations such as CHIME, HIMSS, and HFMA. Peyman, welcome to the CereCore Podcast. 

Peyman Zand: 

Thanks, Phil. It's great to be with you and with our audience. 

Phil Sobol: 

Indeed. We always start these off with a little bit of background. You've spent really the better part of your career in and around healthcare IT. What are some of those pivotal moments that brought you here as the chief strategy role for CereCore? 

Peyman Zand: 

Yeah. As you know, I have a critical eye whenever I go into a new organization or setting. I look for ways to improve and streamline processes, generally, to allow for growth and scale. Over the years, I've learned to scrutinize these ideas better/work with my colleagues to actually put them to the test before we implement them. I've also been blessed with having the opportunity to work with some visionary leaders in multitude of organizations, including global Fortune 100 companies, in variety of industries. That has provided me with a unique background and I guess qualification to see beyond ordinary IT service provisioning. At CereCore, we are paving the way by implementing these technologies to assist our clients to better care and be more efficient. We're proud of our progress and really look forward to some of the emerging technologies to accelerate this path. 

Phil Sobol: 

Well, I know, certainly, having both the healthcare experience and then experience in those other global organizations and even a little bit inside of government has really given you that unique perspective. In and around healthcare IT, really, leaders anywhere... They're accountable for results. Strategic planning is really the cornerstone, at least in my opinion, to being able to deliver those results on a specific measurable and consistent basis. Maybe talk a little bit about some of the lessons that you've learned in and around that over the years. 

Peyman Zand: 

One of my favorite quotes is "strategy without execution is hallucination." I think that quote is attributed to Thomas Edison. It's a very powerful statement. We have learned that strategic plans need to be grounded in reality and, most importantly, have an achievable tactical plan to go along with them. We live that mantra every day at CereCore. We have measurable and actionable strategies that are tied to a balanced scorecard. Then, we go a step further and cascade those down to the organization and to every single line of business and make sure that they're properly aligned to our strategic goals. We track them. We make sure we stay on target, and if things change, we make adjustments. We also go a step further and make sure that we are helping our clients in their journey and that we are aligned with their strategic goals. That's really been the way we've been really successful in delivering measurable results for our clients. 

Phil Sobol: 

Oh, that's excellent. That's excellent. When we talk to a lot of the hospitals and health system leaders, the whole concept of governance comes up all the time. Let's talk a little bit about that IT governance. Maybe, first, start by defining it and then telling us a little bit about why it's important, and some of the must-dos, and what are those critical components of having an effective IT governance framework that supports the hospital health systems initiatives. 

Peyman Zand: 

Phil, in its most basic form, governance establishes processes, measures performance, and holds accountability consistently across the organization. Done properly, this is helpful in many different ways, but I also appreciate that the processes can delay some projects or decision-making. For that reason, not everyone is in favor of governance. But if we go a little level deeper, governance can address organization, policies, procedures. 

But from my perspective, one of the most important aspects of governance is investment planning and prioritizations. I've seen overly complicated governance structures and loosely defined ones, and neither side of the spectrum is ideal. We recommend a multidisciplinary governance structure that is aligned well with the enterprise and business unit goals, and that's a delicate balance to actually achieve. 

Phil Sobol: 

Indeed. 

Peyman Zand: 

For that reason, that process will take about a year to become institutionalized. In many cases, the existing governance structures may need to be modified. 

Phil Sobol: 

No, that makes really, really good sense. You made mention of governance structures that are on either one end or the other. What are some of the red flags that maybe might indicate that your IT governance might be slightly ineffective or dysfunctional, and, once identified, what should a leader do to get back on track? 

Peyman Zand: 

Let's start with the obvious ones. One of them is if you have too many governance structures. You're asking for trouble in alignment between them and alignment between them and the enterprise goals. Two, if you purposely use governance to slow progress, as we talked about, you lose the trust of your peers. If you're single-threaded... We talked about a multidisciplinary approach, and if you don't have active participants from business or clinical side of the house. Finally, from my perspective, and most importantly, is if your prioritization process is not tightly aligned with overall company objectives, again, as we talked about, and a line of business goals. We know every organization has a certain level of governance already developed. Reassessing them is really a first step that I would go about. Secondly, I would say put some formal process in place to make sure that those attributes that you prioritize or you make decisions on are tightly aligned to your overall organizational objectives. There is a way to do that, and that's what we help our clients with. 

Phil Sobol: 

I think that makes a lot of sense. I think, so many times, it's such a painful proposition to get it in and get it in place. Sometimes, organizations don't realize that... Guess what? The organization's not stagnant, and, therefore, the governance process and structure will probably not be stagnant as well. 

Peyman Zand: 

Exactly. 

Phil Sobol: 

Have you ever seen or been a part of a situation where the governance might not have been quite there, and, therefore, the results were either going to be or were costly to an organization? How were they able to resolve that? 

Peyman Zand: 

Yeah, great question. We got to dig a little deeper now. We talked about the strategic alignments and performance measurements and all of that. But there are a few more that we got to talk about. Governance should be also concerned with value delivery, risk management, resource management. Governance by itself is not an isolated process. It needs to be actively involved in the regular management or oversight of the major projects and programs. We recommend that every major project in the organization should have regular stage gates that evaluates the changes to the value, to resources, to risks, to the cost. From time to time, these projects need to be approved to either go to the next stage or not. This is really important before we go live or operation, especially. If those values change, then the leaders have the responsibility to make changes including shutting down some of these projects if that ROI, if the return on investment, and the value model has changed. 

Phil Sobol: 

It's a hard thing to do, for sure. But honestly, I think if the governance process is in place, like you said, that has the components that you were talking about, I think it makes those decisions for leaders a little bit easier and allows them to really point to a framework in front of the rest of the organization to help explain some of the reasons why they're making the decisions that they're doing. Certainly, a valuable insight there. We've had emerging technologies. Everyone's talking about AI. There's risks and threats like cybersecurity, tighter capital budgets, and just demands that seem to have no end. How might these pressures really change IT governance for organizations and leaders? Does it change some of the decision-making there? 

Peyman Zand: 

Yeah. I'll tell you a funny story. I was attending a session at a recent conference. I heard the speakers recommend using governance to slow down the AI adoption. This was so that the CIOs can get their arms around it. I understand the reason why they were suggesting that. But again, as we mentioned, using governance to slow down adoption is not our recommendation. Although AI is a unique technology and can have major ramifications, will have major ramifications, it is not unlike any other emerging technologies that we've been dealing with. CIOs have been facing this conundrum for years. 

We recommend a stepwise process. Form an active task force that addresses these new technologies and implement it in smaller pilot phases across the organization. Make sure you have a good participation from, as I mentioned, different parts of the organization. This way we're not using governance to slow things down, rather we're using it to better serve the organization by providing those pilots. More importantly, we're actually taking a look at and seeing what other benefits that we can bring to the table, which may not have been identified at the beginning. The second part of your question was about because of the capital budgets that are tight, et cetera. Well, that's exactly why we have these pilot projects because then we can actually see if there is enough return on investment on any of these emerging technologies. 

Phil Sobol: 

It's amazing how sometimes you have to put in the structures to bring the logic of a situation to bear. We've talked a little bit about measuring success, tracking progress, certainly reporting the results to stakeholders/board of directors. What should be in a healthcare IT leader's tool belt to do this effectively? 

Peyman Zand: 

Yeah. I think open and transparent communication is definitely top of the list. I'll use an example. I remember the Toyota CIO had a heat map outside of her office that showed the correlation between the projects underway, their progress, and their alignment with strategic company goals. In one view, anybody who was passing by her office could see how their projects were progressing/how well they were aligned to the company goals, and that was really a powerful tool. We recommend this exact same transparency process. Obviously, this is now online. She does have it online, and anybody can see the decisions being made, and, especially, the reasons their project did or didn't get approved. Current projects should really be openly discussed and their status shared. If you want to get their stakeholders' buy-in, they need to have good visibility into that, what's happening across the organization. That's one of the big things. That's why the transparency and communication still is the underlying success factor. 

Phil Sobol: 

I think it's so simple. But at the end of the day, I think it's one of those things that sometimes, because it is so simple, it gets overlooked. It's a great reminder for all of us. You talk to healthcare leaders almost daily. What do you wish they understood or understood better about IT strategy? 

Peyman Zand: 

Again, as we've talked, is that it doesn't exist on its own. It cascades from enterprise strategy. Most importantly, it's reasonable, achievable, et cetera. To be impactful, and as we just talked about communication... And by the way, the communication we just talked about... It's simple, but we can forget it. We need to stay on top of it. I think those are the, really, two key areas that I would concentrate on. 

Phil Sobol: 

I think that's so valid. Honestly, it's once you institutionalize that and work across the C-suite in that capacity, that strategy becomes a little easier and certainly a lot more aligned. Well, I know you pretty well. You tend to be a pretty creative thinker from time to time. What's perhaps the most creative approach that you've ever taken or seen executed, really, when it comes to healthcare IT leadership or governance? 

Peyman Zand: 

I'll use a couple of examples. I was asked by a CIO and C-suite to establish a governance for a healthcare system. I asked them the question. I said, "Do you have a project prioritization process?" They said, "Yeah, we do. It's our capital planning each year." I said, "Okay, so how do you prioritize?" "Well, the CEO gets priority one. The other C-suites get priority two and so on." 

Well, the problem with that... It's lacking a lot of rigor, substantiating alignment to the goals. Once we developed the proper framework, which was aligned with the key attributes of the strategy, and we loaded up the cost and resources and the risks and other things... because you have to do the value analysis as well as the execution ability, how well you can execute on that. When we put all that together, the priorities completely changed from their capital planning process. That was an aha moment, that I had a lot of C-suite members coming to me saying, "Peyman, you need to do something to bubble up." I said, "No, we don't. You just did that." The other example that I... just a short story, is when I went into another organization, and I was working with the CIO, I asked, "How do I know if I'm going to be successful?" The CIO turned to me and she said, "When you've upset half of my leadership, then I know you've achieved your goal." 

Phil Sobol: 

I think you make a very great point, and that is proper governance that aligns with corporate initiatives and strategies is never going to be popular with everybody. It's a difficult thing to execute for an organization that's... from an internal perspective. I do think, sometimes, having an outside moderator or voice can really help an organization make that breakthrough that they need to make to get the IT structure governance in place to make the decisions that truly need to be made for an organization. You bring up some very, very valid points, and ones that are sometimes a little difficult for organizations to want to think through and then act on. 

Peyman Zand: 

Thanks. 

Phil Sobol: 

Thank you for that. We always love to wrap up these podcasts with just any open-ended final words of wisdom that you would want to share with healthcare leaders or, really, any of the rest of our listening audience as well. 

Peyman Zand: 

I'll use another one of my favorite quotes. This one is from Albert Einstein, who said, "Everything should be made as simple as possible but not simpler." This is really important. Implementing governance processes are challenging. You have to make sure you cover a lot of different aspects. But it's also really incumbent on us to make sure that it is simple enough so that people can follow it. Because if you make those processes too complicated, adoption and adherence may lag. I would say that that's why when we see a lot of different governance models/governance structures, that doesn't work either. Too simplistic doesn't align well, as I mentioned earlier. That's really it. Just everything should be made as simple as possible but not simpler. 

Phil Sobol: 

It's amazing how those quotes stand the test of time, those words of wisdom. Appreciate you sharing that. Peyman, thank you so much for all you do for CereCore, for all you do for our clients, and for taking your time today to share your insights with our listening audience. 

Peyman Zand: 

Thanks for having me, Phil. 

Phil Sobol: 

Thanks for listening to the CereCore Podcast. We hope you enjoyed this conversation. Follow us on your favorite podcast platform for more episodes. Connect with us on LinkedIn. Visit our US website at cerecore.net, and for those abroad, visit cerecoreinternational.net. Learn more about our services and find resources. At CereCore, we are healthcare operators at heart and know the difference that the right IT partner can make in delivering quality patient care 24/7. Let's help make IT better. Here's to the journey.