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 Welcome to this Week in Health It where we amplify Great thinking to Propel Healthcare forward. Today we're gonna talk with Myra Davis, the CIO and CIO of Texas Children's Hospital. I. If you're wondering what CIO and CIO is chief Information Officer and Chief Innovation officer, we're gonna talk innovation, we're gonna talk covid response talent, a bunch of other things.

This is a really fun conversation and I'm looking forward to sharing it with you. My name is Bill Russell, former healthcare, C-I-O-C-I-O, coach, consultant, and creator of this week in health. It a set of podcast videos and collaboration events dedicated to developing the next generation of health leaders.

So if you're listening to the show thinking, man, I wish my company were a sponsor of this week in Health it, this is your opportunity. Go ahead and shoot me a note bill at this week in health it.com. I will get you the. The sponsorship materials, you can share it with your marketing team, your sales team, whoever's in charge of it for you.

Here to join us. Good morning, Myra. How, how's it going down there? Good morning. It's a beautiful day in Houston. Yes. High seventies, low. Woke up to about 50 this morning. That's actually really good. I, I have found it best not to talk about the weather where I'm at because I, I get hate mail from people , so, yeah, don't, don't, I'm pretty excited today though, so it's good.

Yeah. I'm, I'm in, I'm in Naples, Florida and it's, uh, 82 here today and sunny, so. If you could, if you could tolerate the hurricanes. We live in very nice places. Nice. Alright, so today we're gonna, we're, we're gonna talk a lot of things. We're gonna talk innovation, we're gonna talk Covid 19 response talent and whatever else we happen to stumble upon.

I'm really looking forward to this conversation. Let's start with Texas Children's. Give us some background on your health system. So it's Texas Children's is a four hospital system, one of which is women. We take care of, we have OB GYN services. It's primarily pediatric base. We have over 60 primary care practices distributed throughout the greater Texas area.

We are also, most recently, you may have heard. We're in Austin, which is about two Austin, Texas, two hours. From the main area in the Texas Medical Center, we are licensed for about 900 beds across all of our hospitals, and occupancy is anywhere to 75, 80% of the time. We, in the last year, just to give you some stats, we had more than.

40,000 surgeries close to 200,000. Emergency center visits, over 4.6 million, do million, uh, patient encounters. Our clinic visits are close to 800,000. We also have the largest pediatric based health plan where we serve close to, uh, half million members in Texas as well. And. Our admissions has been about 37,000 in the last year, and deliveries have been in excess of 6,000 deliveries in a given year.

Just because my daughter goes to Baylor. I have to. Oh, awesome. I, I have to say that. So, no, that's, I mean, that is a significant. Four hospital for a children's, usually a children's hospital is not that extensive. The, the, the amount of work you guys are doing in, in Southern Texas is, is pretty, pretty amazing.

Tell us, tell, tell us a little bit about your journey though. How, how did you get into computer science? How did you, uh, land at Texas Children's? Childrens? Yeah, so I've been at Texas Children's 18 years. It was 18 years in August, this past August. I. Started my journey or origin originated from out of New Orleans, Louisiana, where my mother was a math teacher.

And so I really didn't have a choice, um, but to be good in math. And as a result of that, when I went to college, I actually wanted to be a teacher and she. Firmly said, no, that's, that's not what you're going to do, . So in, in the spirit of being really honest here, I, I thought, well, what else can I do?

Understanding math. So kind of perused the catalog and said, oh, why don't I try this computer science thing? So I really didn't set out to, to do that. So I received my degree at Loyola University in New, went into software development and realized. Early on that I did not really wanna have a relationship with the computer just sitting behind the desk and coding somewhere in the translation of what I was asked to code and what was desired of the customer.

There was, um, always some disconnects. And so one day I just thought, I'm gonna go talk to the customer myself. And only to learn that the translation was not really happening. But more importantly, my niche was in the ability to really not only facilitate in problem solving, but to be able a good translator and speaking English to code and code to English.

And so that sort of took me out from behind the desk and into the journey of project management, leadership, et cetera, and, and throughout my career. And when I started Texas Children's, I was in consulting and had one son at the time and really thought we probably should, I should probably sort of land somewhere where I can just come in to work and not travel.

And so I, I paused and found this opportunity at Texas Children's. I went from New Orleans to Northern California. And then from Northern California to Minnesota, where I received my master's in software design and development in the engineering program there. Once again, though, all for the purposes of truly understanding the base of what it takes to, for how software operates, but more importantly, in wanting to translate that, um, in the partnership and customers that I would desire to serve.

Yeah. You know, uh, that's one of the things that really resonates with me is the, uh, idea of having a relationship with a computer as opposed to people. And that, that's, that sort of mirrors my journey as well. of just, yeah. After, after a while you're like, I'm an introvert and I like this stuff, but you know, I gotta talk to more people.

Exactly. That, that was, that was, those were my words actually. Um. While I may be an introvert, I actually like talking to people, so, yeah. Yeah. And, and yeah. And there, there's a, there's a good path there. In fact, I, when I talk to people who are aspiring to be CIOs, they say, tell me what the path is to the cio.

And I'm like, talk to 50 CIOs and you'll get 50 different stories. I mean, they're so true. They're all very different, but one of the things they have in common is at some point everybody makes a transition from really being computer focused, individual contributor to being team focused and building out information systems and solutions for the organization that they work for.

Yeah, so that seems commonality.

Really challenges the leaders in this organization, everyone to have a leadership statement. And he may from time to time if he see you. What's your leadership statement, Myra? And for me, my leadership statement is really around accountable and transparent partnerships for the success of any problem we're trying to solve.

So when you really unpack that and break it down, I. It really speaks to the ability to have dialogue to articulate the problem that we're trying to solve. And oh, by the way, maybe it needs to be solved technically, but it may be need to be solved operationally. And so I think that dialogue and facilitating, which is what I've really grown to love, is just we talk about technology as a secondary source of solving a problem.

We actually talk through the problem first, and that's . It's been very invaluable for us here. Yeah. So I, I said earlier I want to talk about innovation. We're gonna talk Covid response and talent. Let, let's start with innovation. You, you have, you have an interesting title, right? So you're the chief innovation and chief information.

Officer for Texas Children's, give us an idea of what the role entails at at your organization. Yeah, so here when I was appointed this role, maybe close to almost 18 months now, I went on a journey to when it was, when the announcement went out that I was, my title was going to change. I received congratulatory, but I also received.

Some interesting data points that said I probably should go . And start defining and look, go on a journey to define innovation. And so I worked really closely with the executive that's over the area, um, and said, let's define innovation for Texas Children's. Because we've been around for 60 years, we've been very innovative.

So what makes me think by having that in my title, people would see me any different than how Texas Children's has been innovative. Throughout its its entirety. So when defining that word and asking board members, senior leaders, what does innovation mean? Couple things became obvious. One, innovation is everyone's responsibility.

Just because I have it in my title does not make me the brain trust for all things innovative, however. The second one that the aha moment was that. When you ask people for that definition, there was a lot of conversations on big, bold, innovative ideas, creation of products, buying companies, creating their own companies initiatives that had a really long runway to truly bring value to it.

And then there was a small footprint of innovative ideas that just had to do with making some change. So then I did some research and said, well, let me go look up the word, what does innovation really means? And at its core, it means to change. So. Period. And I went, okay, I, I can do that. So having that in my title, what it led me to work with my team on is how do we build a very nimble, we call it the innovation hub, where we would sort of bring forth ideas that, problems that we need to have solved in the organization.

And we would basically determine can those problems be solved by simple change. and or does the problem need to be solved by partnering with an outside company, or does the problem need to be solved by looking at in, in a opportunities to create new products? And so essentially it encompasses a little eye, just some changes that are right at your fingertips.

And then the really big eye that has a very long runway and investment of dollars. That is creation of products of, of the like. So by facilitating it that way and having a very small, nimble team, we're able to sort of be the conduit to all the great ideas that the organization has and a place to go because everybody's responsible for innovation and so therefore it allows us to facilitate based on true problems that we need to solve.

We stood up an innovation advisory group that's our senior execs. So when we bring problems that need to be solved, we wanna make sure with their representation and understanding that it actually is seen, that those are problems that we really need to solve for. And then we go from there. But it's a long way to answer how it became innovation.

But I share that because I think. I mean, I've said this in many other forums that CIOs are, many of my colleagues are doing just that. They just haven't been afforded the second I in their title formally. But I would say the first I is that it's more about innovative ways to translate information. That is now the second I in the title, so, so your innovation group is really focused on enhancing the operation and the performance and the, and just all aspects of your health systems.

Operation. Is that, is that pretty? Yes, that's it. And, and, and oh, by the way, we may have a small footprint of opportunity with new products or creation of products, but that is not front of mind. What's front of mind is really enhancing existing opportunities and optimizing, and also leveraging the assets that we have.

With an absence of going out and buying more technologies. Yeah. That's interesting. So, so let's talk, let's talk Covid-19 response a little bit. So, COVID was, uh, was really a challenge unlike anything we've ever experienced in, uh, in healthcare. Let's start with your health systems journey through Covid.

How did, how did Texas Children's experience, or, or is experiencing the pandemic? What was the health system's response or health IT response to that? Really, let's focus in on that. Yeah. We just, we, prior to covid, like many other organizations, we were starting on the journey of using tele, going down telemedicine, teles, and we were slow and forming and

Moving at a and not at a rapid pace. Since Covid, or at the onset of Covid, we went from maybe one to two visits in a day to over 800 visits in a day. We've leveled out at about 40% of our overarching patient visits are leveled out in tele visits. But what it afforded us, a couple things is one. The good news is we had already, we had put all the technology in place, so it was just a matter of really training the organization on how to use it.

We had started down a journey of embedding the visits in our EMR, but we accelerated it and did it in like three weeks record time to where the experience for the patient and the provider would be a whole lot easier. We actually stood up sort of a, a makeshift training health center to help patients and providers with these types of visits.

We also converted about 500 appointment types to make them available in online scheduling for the telemedicine. Visit tights. So we, we rapidly did this in record time. I think now that, I mean, COVID still, the pandemic is still here actually in the state of Texas. I heard this statistic this morning that we've had over a million covid cases just in the state of Texas alone.

We're actually starting to see some ramp up. So the good news with that is that we are prepared. To continue to care for our patients in a telemedicine way. We also internally through provided remote monitoring visits. So if there were families wanting to see patients, we provide them with an iPad and they're able to have the visit via a telepresence, a video visit presence.

The rounding of our physicians have now taken place. Via video visits by which they're not all crowding the the workstation on wheels, some are in, they're in their disparate locations, al be at home or conference rooms, but they're still able to still have the rounding that once to place pre covid. So basically, our world has really shifted to being video presence and I'm very pleased to say.

That our teams delivered in record time and now, and we've actually been optimizing it along the way. And when this next wave occurs, 'cause it definitely looks like we're gonna have another wave. We are well prepared. Yeah. So now, now Myra, I do have to, I, I have to call you on the here, so. It took you three weeks to do this stuff.

So if I were your CEO at this point, , can I just condense all your projects down to three weeks if your team is that, of course not amazing. Of course not. No, you can't. No. The reason we were able to do that in record time is that we were afforded the resources. And the time that it takes and also the prioritization that it, the governance that it takes to make that happen.

I have a same bill that anything can be done with time, money, and resources. Right. And we were afforded all three. And so with that said, we were able to get it done. Yeah. And that's, um. That's, that, that's what we've heard from CIOs across the board is just all these barriers went down. First of all, we used to have to talk to physicians and convince them to do telehealth.

That's right. And that, that barrier came down. The regulatory barrier came down the financial barrier. We were given a a, a bunch of money. The focus barrier. Right. We're working on a hundred projects. It was. That's right. Hey, get, get these three things done and allocate all your resources to those three things.

Yeah. We, we can do a lot of things if, if all those barriers fall down at once. Yeah. And that's a really good example of how governance, how I believe I as A-C-I-O-I aspire governance to work. because we all know that there will always be more demand than there is supply. And even if you match the supply with the demand, you're that that sort of gives an indirect understanding that you can actually do more.

So there's more demand. So there's never this catch up mode. Um, so I think. Having a true governance where you are intentionally focused on the initiatives that will aid the organization in progressing going forward. I think that's the right balance and what, what played out in Covid is a textbook of great governance.

All right. We'll get back to our show in just a minute. I want to give you an update on the CliffNotes Referral Program. For those of you who don't know what CliffNotes is, what we have done is we create a summary of what goes on on each show, and we get that into your inbox 24 hours after the show airs.

So what you get is a. Brief summary of the show, you get bullet points as to what the high points were with timestamps, and then you get one to four video clips. So if you just wanna see that the highlights, the key moments of the show, you can just click, click on those, watch those, and stay current. We did that in response to some of the things you guys were telling us.

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And we have, we've had just a ton of referrals to this point, so we really appreciate all that you guys are doing, and, uh, we hope that the content is helping you to stay current and helping you to do your jobs more effectively. So, with that in mind, let's get back to the show. Um. Let's, let's talk about your leadership journey during covid.

So what, what challenges did, did you have adapted those pandemic? Obviously we worked from home a bunch. Different things changed. Number of things being thrown at you. Amount of given.

Professionally, but also personally. Mm-Hmm. . How, how did you address those things? Um, very transparent with my team. I, I have a really good team, a great team. I'm very proud of them when it hit at the onset. I will say this team has done more during this time than they may argue, Myra, we did more before that.

Well, I think in record time. I'm, I'm so proud of the work that they have done that, and despite their own personal challenges with whether the kids are going back to school. When you think about when Covid hit, kids were immediately sent home post spring break, I don't think they went back. And so now you have families having to juggle and figure out, how am I gonna do this?

Then there was a remote work component of it. I had to work with the organization to help them stand up a workforce to work remote. And oh, by the way, I too must work. Remote. Remote. And oh, by the way, I have to figure out what to do with my kiddos who are now at home having to work remote. I share all that bill because I had to step back.

My, my kids are grown, are older, they're in college, they're away. But as I looked at that and looked at what my team was going through, it was important that I made sure they understood that I recognized that, and how do we balance what they're going through personally and how what we must, what we needed to do professionally.

I'm pleased to say in addition to all the work we did ramping up for Covid and continuing to see patients, we actually have done two major upgrades in that time. In, in March when Covid hit, we were scheduled to do an epic upgrade that we delayed to later in the summer, and we did it in June and the team did it remotely, primarily working remotely.

Recently, last week we did a second upgrade and the next semi-annual upgrade, and once again, we did it primarily remotely during that window, . Healthcare has been challenged and threatened by cyber attacks. The team has worked tirelessly ensuring that the org that we, our environment is protected by continuing to stay on top of patching and any areas of gaps that we have to close them to ensure that we're protected.

So the team, through its tireless efforts. They really are amazing in terms of the energy that they continue to give. And I think it speaks to the mission of Texas Children's. Our mission is to take care of women and children and the sickest of the sick. And when you step back and think about this and we talk about it a lot, that's a, that's a mission anybody should want to be a part of.

And I think it's a testament of our mission and their. Wheel and fortitude speaks volumes. And I forgot to mention, oh by the way, we went through a hurricane season as well. And so we've had our command structures stood up since Covid through hurricane season and we we're just, we're kind of used to it to some extent, but I think it just speaks volumes to their commitment to, to the organization.

It's interesting, I was talking to somebody from Ner and. The, the fact that and, and, and NYU Langone and they both made the, the case of we go through emergencies pretty often. Mm-Hmm. . And so we've, we've, we've really vetted and built out those capabilities and, and Houston's the same in a, in a, um, hurricane path every other year or so, there's a major hurricane that comes through.

So you guys probably had pretty solid. Procedures in place. Although the pan pandemic was unlike anything I think we've experienced, but still having that foundation is, is probably extremely helpful. Mm-Hmm. . So you chose a predominantly male profession. You also, as a person of color, I would imagine you found yourself in a lot of rooms where you were the, uh, only person that looked like you.

How were you able to push through those barriers, uh, to get to where you're at? Yeah. It's, uh, a lot of humor. The good news is, the good thing is you're an introvert, so you can, you could probably relate to this. You have a lot of conversations with yourself and talk. You, you, you have lots . I know, but the people around me don't understand that When I'm talking to myself, myself, they're like, they're like, you should not do that out loud anymore.

I think is what people are telling has definitely helped. And just the support of my family. That sort of gives me the confidence and the courage that I need to sort of embrace times when I'm going into a room and know that, that I'm it. And I think just, just the confidence too and that instilled in me to say, this is not, this doesn't threaten me.

I've been very fortunate and and blessed to have great mentors who have been males, white males who have been very transparent with me about being a African American female and some of the challenges. And it had really coached me through some of the things that I could potentially be up against. And at the time when, you know, first.

They became work friends. But then over time they became mentors because they shared wisdom and knowledge. It really opened up some really good dialogue for me to have with them about honesty, subtle biases, et cetera. And that really helped. And at the end of the day, I have the saying that. It doesn't really matter what room I'm in because we all put our pants on the same way, which is one leg at a time.

And so if I level set my audience that way, it really kind of affords me to say, we're really equal. We might not look a lot, but, but we're human first. And so that really has . That may sound simple, but that has played a significant role in just giving me, outside of everything else I've said that that confidence, that nudge to say I, it doesn't matter who you are, we need to have this dialogue.

And just in school along, just in my projects, it was all males. I mean, everywhere I looked it was predominantly males. And so I think just that trajectory. Just sort of affording me to become immune to it and just not even pay attention to it over time. Yeah. You, and you and I had a conversation offline where we talked about diversity and you, you, you stress the importance of having deep people with a, with a different view of the world, different lens of the world, so that yes, it helps you to identify better solutions, the community, because made up of very diverse, uh.

Tell us a little bit about how that's played out in your team and how you've, how you've really, uh, yeah. Made sure that you had diversity.

I think it was several years ago. It became apparent through an exercise that I'd gone through with our HR development group, org development group, where we, we performed this exercise called DISC profiles, where we sort of look and understand the profiles of each individual and, and it's the DISC and.

What became apparent is I had, there were many Ds, which is a demanding group in my, on my team, and many of them I had hired. And so when I was sitting and talking to my org development person, she said. You gravitate towards theses because they're results driven. They don't do, they don't process. They're quick to analyze.

They're quick to solve. They're quick. They're quick, they're quick. But you have a tendency to scare off Cs that are more conscientious S who are a little bit, I think, I think the S is sensitive or, and then the I is more influential. And you scare that group off and you don't have as many. And so we had a great dialogue and I said, I wanna mix this up because I didn't feel good by real.

And when I reflected on people who had left the organization or encounters I had with individuals who are not Ds, it became crystal clear to me that I came across as intimidating. Or the comments that they would make are. I, I needed to have the feeling that they needed all the answers before they can talk to me.

The feeling that they needed to go through AQ and A process with someone else before they can talk to me, they couldn't just come and talk to me. And so I thought, wow, yeah, I could see that. I actually could see that. And so I thought about that Bill and I said, okay, we're gonna change this up. And the new hiring is to ensure that I create a very diverse group around the table that are not Ds.

And so I'm pleased to say since that time and now I have a very well-rounded group where I actually, and I'm actually pretty good at recognizing who's DS and who's not dss. But more importantly, I have become, I've sort of changed in my demeanor to make sure I'm coming across as open and wanting to welcome the dialogue from those that are not Ds.

So to me, when, now, when, when people talk to me about diversity inclusion, I think to myself, oh, I, I've been doing that. I didn't call it that. I just said everybody's voice matters. And we need to look at it from the lens of everyone's voice matters. And definition of everyone is that we must have a really diverse group around the table.

And so it's more than ethnicity, uh, race, . It's around ensuring or, or gender, it's more about the voice and the representation that that person will bring to the table. And oh, by the way, gender and race is a part of it, but it's also the voice of the gender and race that's makes it much more rich and diverse in nature.

Yeah, I I, I appreciate you sharing that story. I, when I became the CIO, one of the departments. They had all taken the disc and they put their results on their door. Yeah. And I remember go going into one of their offices and I said, Hey, what, what's, what's the story with this? And we got up, we walked over and he goes, okay, let me tell you about my profile.

He, he said, here's, here's how I address problems. Here's how I respond best. I mean, and he just walked it through. And I'm like, yeah. Wow. That's really helpful. Yeah. And, and we, we actually used to have laminate cards for the leaders so that they knew. And this helped them because then when they are ready to go talk to someone, it gave them a chance to do some reflection.

Oh, let me, let me make sure I understand the style. So we also did some things around how to negotiate, how to talk about the problem you're trying to solve, how to influence. And so all of that sort of plays into the ability to look at someone, not judge them immediately, really. Think through, this is a style I'm going to encounter and here's my style.

So now how do we work together going forward? Yeah, I think that I've gotten a lot of great feedback around it. I, I aspire to do it again because we have many more leaders on, at, on the team now and we haven't done that exercise in a while. But it is my to-do list because now in the heightened conversations around diversity, inclusivity.

I think the voice plays a big role there. If you don't understand where that person's coming from in terms of their profile, their situation, you're still not hitting the mark on creating inclusiveness and diversity in the work environment. Gosh, I have so many other, so many things I wanna talk to you about.

We'll have to have you back on the show, uh, next year sometime. But the, but the last I, I would be, uh, here's the question I want to ask you, which is. We have to cover longevity. And so the, the role of the CIO is, is a precarious role as, as. I had somebody say to me, we, we started our EHR implementation and, and I thought they jokingly said, Hey, you should get your resume together.

I don't think they were joking. They were, they were serious. They're like, Hey, this is really hard. It doesn't end well for a lot of CIOs. Make sure you're prepared. But, but you've been there for what, 16, 18 years. 18 years. Wow. Uh. Uh, what's the secret? I mean, what do you attribute your, your longevity to in, in the role that you're currently in?

I think it speaks to my leadership statement, which is transparent and accountable. Partnerships. I spend a lot of time. Partnering with many of the executives and my colleagues in the organization. I spent a lot of time also speaking at the role I play, the role I look for them to play. And when it comes to initiatives like electronic medical record, I remember at the time my predecessor was here and he left.

I was asked to, um, lead the IS organization and my immediate response wasn't. Yes, it was. I will not lead the electronic medical record. That is not, I don't, I don't have a user id, I don't use that system. I support that system. I. Right. I, there was a creation of partners, executive vice president, nurse leader, safety officer, and we created a team and he was, he led it.

I was a very big supporter and leading what I needed to lead, but I think clarity in terms of roles, though, I have found that to be the secret sauce. I am very clear. My responsibilities are to ensure, and I think many CIO's responsibilities are to ensure, one, first and foremost, we're keeping our systems available, reliable and secure.

Anybody on my team, you ask ARS what does that mean? They're gonna tell you this is what it means. Okay? That's first and foremost. Second is partnerships. We will drive solutions and possibility by leveraging technology, speaking to problems that we need to solve. That means facilitative conversations. We will even share with you some possibilities, but it's up to you to understand how to use them and more importantly, operating it using, making sure your operating models are leveraging it for success.

Recent conversations are, we wanna do more online scheduling. Great. We'll spin it up. But I, I can't drive you to the water if you don't know how to get there. Right. So lots of conversations around changing the operating model, and I think I work for really great organization that has allowed me to have these types of dialogues, welcome them conversations and, and it's been great.

I mean, I think I don't, I know that many of my colleagues are having the same type of dialogue and I think. I, I, I would like to be able to say the days where I, I felt like there was a trend going on with CIOs just getting left out, left out to dry when an EMR didn't go, didn't go well, and I struggled with that because I thought, well, how can that be?

It doesn't make sense to me. That's only one individual. So there's, there clearly was a group around that individual that . Should have been supporting them and helping them create the success needed for those systems. So I've just been very blessed not to be in that situation. , I, it's, I, I hear what you're saying, but it's sort of like when the, when the manager for a baseball team or the coach for a football team gets fired and you're like, well, wait a minute, he didn't.

You're the, you're the one, you're the one in the big chair. So you're the one in the chair. But I think that the two things you said there, which I loved, was one, there's a, there's a core set of things, uh, that would you, availability, reliability, and security. Right? There's a core set of things that you just have to do.

And if you don't do 'em well, you're not gonna be able, wants to talk to you. Yeah. Yeah. And then. Of partnering and humans helping humans and just, just coming alongside and. Uh, here's my role, here's your role. Creating clarity, creating that, that great working relationship, being approachable that, that people are looking for.

And, uh, that that's how you get to be 18 years in the role. So that's, I I think that's a, that's a great, uh, thank you. I think you framed that up really well. Thank you, uh, Myra, thank you. Thank you for your time. I really appreciate it. And I, I look forward to catching up again next year. Yeah, same. Thanks, bill.

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