St. Luke’s University Health Network is a fully integrated, regional, non-profit network of more than 20,000 employees providing services at 15 campuses and 300+ outpatient sites in Pennsylvania and New Jersey.

Chad’s passion for IT at an early age led him to a short career progression from tech support to a 21-year career as a CIO.

Key Takeaways

• When evaluating AI and other initiatives, use evaluation tools that compare level of lift to expected value – this helped his organization narrow 150 initiatives down to about 15 priority projects.
• Consolidate technology governance under one leader to avoid duplication – as Chad notes, allowing “federated technology decision-making” leads to duplicate purchases and complexity.
• Build internship programs with multiple universities (13 in Chad’s case) and place interns in departments with anticipated future job openings – over 50% of their interns go on to take full-time positions at the organization.

Q & A with Chad

Judy Kirby: How did your career in healthcare technology leadership begin

JK: Your career rise from tech support to CIO was relatively short. Can you talk about that progression and how you advanced in such a short amount of time?

CB: I think I just loved it so much that it wasn’t work for me. I was young and ambitious, I didn’t mind working late, and always wanted to take on more projects. I was constantly asking what else I could do, and what projects people had that I could help with. I guess people thought I did a good job with them, which kept accelerating my career.

After working as a technologist in several different domains – engineer, programmer, etc. – I moved into project management and got into healthcare. I was helping open up a large ambulatory center and was project manager for a $110 million project. I was still fairly young and I was enjoying it. After being promoted to manager, I worked on a bunch of projects with some of our C-suite in different departments – PACS projects and stuff like that. These gave me the chance to work with our VPs and COOs, and when the CIO position job opened up, I applied and got it. Now it’s been 20 or 21 years as a CIO.

JK: Wow, that is very impressive! Did you have a mentor who helped you move your career forward?

CB: I have had multiple mentors, especially if you count my parents. My dad was a construction business owner, and he was always a mentor to me. But the reason I got started in healthcare was because of my mom. She was a nurse, and she would always talk about all the technology they were using, and thought I could really help out and have a career in healthcare. But when I reached director level, I realized that I needed to branch out beyond my parents. I met mentors both inside and outside the organization working at levels above me, always in technology, who I trust and respect.

I have really learned a tremendous amount from all of them. When I stumble upon an issue or a situation, I might bounce it off one or two of them for their perspective or advice. That’s how I have always done it. I’m always doing something new at St. Luke’s, and I think one of the key things about leadership is being able to learn new things, especially by seeking advice from others who have been successful in similar situations.

JK: So you’ve had CIO experiences in a couple of organizations over 20 years now. How do you see the role of the healthcare CIO evolving over the next three to five years?

CB: It is going to be interesting because of the acceleration of technology. We’re seeing AI hit the ground pretty hard and there’s a lot of opportunity, but there’s also a lot of noise. It is important to be a strong communicator, and knowing how to handle the hype cycle.

When it comes to innovation, probably 60 to 70 percent of it is noise, and the rest is real tangible work that will produce solid outcomes for your business if you put a lot of effort into it. And that is what I think CIOs need to do is latch onto those things that are going to have real ROI, and to get rid of the things that are just noise, clogging up your IT resources.

JK: As CIO, how do you help people separate the signal from the noise?

CB: We have tools we use to look at the level of lift required compared to the expected value. We have used this tool in multiple areas but we’re doing this right now for the AI portfolio, in particular. It’s an ongoing process to bring an idea in, evaluate it, do a quick analysis on it, figure out where it fits, and then decide what to do. We have had as many as 150 different initiatives on the list, and we’ve already executed on about 36, but we’ve refined it down to about 15.

JK: How do you deal with a situation where someone is really passionate about an initiative, but the ROI just isn’t there? How do you handle that?

CB: You have the leaders be part of the process. It has to become a group effort. A lot of these types of projects come up through the specialties like oncology, cardiology, and radiology. It’s a discussion with the organization, including the leadership, to clearly say “Here is what we’re going to focus in on. This is what we’re going to commit to, and this is the number of initiatives we’re going to commit to this year,” and getting the organization to buy into that. Then it’s just a discussion on which ones are going to be selected.

JK: You have had a lot of success with innovation. What have been some of your biggest wins in that area, Chad?

CB: We created an innovation fund in 2015 and it has been one of the biggest wins that we’ve had. It has had a definite financial return that is easy to measure. We have about $50 million in that fund, and we’ve produced solid market returns in the low double digits. It’s very easy to report. You have some winners and you have some losers. You have some really big winners, and you have some small losers, hopefully, and some companies in between.

We also benefit from what we call “strategic project value.” We might have 10 companies in the fund, and we might execute two or three really big transformational projects inside of that, which generate returns in the form of high ROI, but also when we sell the company.

JK: Can you share what some of those projects have been?

CB: The projects that have the highest ROI in healthcare tend to be in the revenue cycle areas. Anything around case management, denial management, clinical query systems, and what we are getting paid on inpatient cases.

A big transformational area for clinical would be the integration with our scheduling platform. We originally built this with a third-party vendor back in 2016 or 2017, and when we integrated it with scheduling, it was a game changer for our physicians. It was an enterprise-wide communication system for who is on call and where people are. In a big organization like ours, it is very complicated to know all that information. We moved it over to Epic about four months ago and every day we have around 18,000 users on that system. It’s huge and it’s highly utilized, and now that it is integrated with the clinical schedule, it provides a lot of value.

JK: There is a lot of talk about the CIO position and what it should be titled. Should it be called the chief digital officer? CDIO? CHIO? What are your thoughts?

CB: I have been wondering the same thing, Judy. In my organization, my title is CIO and other domains like informatics, the technology organization, security, innovation, all report up to me. When organizations start hiring a lot more C levels reporting to different people in the organization, I think the governance around that creates complexity and duplication. I’m not sure it really matters what the top person’s title is, but in my opinion, you should have all your technology initiatives in a cohesive integrated strategy underneath one leader.

JK: That makes a huge difference. At some healthcare organizations we have seen the IT department go out and buy something, and then another department goes out and buys the same thing.

CB: That’s what happens. Do you think Apple or Tesla allows that to happen? No. But in healthcare, for some reason, we’re allowing all this duplication and federated technology decision-making. It’s not good.

JK: Why is that?

CB: I think the problem is that some of these organizations don’t operate as a single entity because they’re in different markets, and they might not be able to share resources to the same extent that we can. I definitely think geography plays a role in that. And culture too, especially after a merger. Which organization prevails on clinical decisions and order sets and workflows? That can be complex when you have two large organizations coming together.

JK: With continued financial pressures on healthcare, and technology vendors raising their prices, how do you meet demand within your organization?

CB: We try to find technology projects with ROI high enough to pay for the other technology projects. It’s like the healthcare business. Some of your business units aren’t going to make money but others will, and those subsidize the ones that don’t make money. The same thing goes with technology. We’re looking for projects that can generate enough ROI to offset the costs for other projects we need to do in our portfolio.

JK: Succession planning is the responsibility of all senior leaders. Can you talk a little bit about the status of your succession plan and the approach you’ve taken?

CB: We have formal succession planning in our organization. We identify potential successors and we work with them on their development plans. I have several folks that are potential successors for me and I meet with them frequently. I just gave one of them one of the first CIO books that I ever read, “The New CIO Leader – Setting the Agenda and Delivering Results” by Marianne Broadbent and Ellen S. Kitzis.

JK: You mentioned AI earlier. How is generative AI impacting your organization or your company’s strategy? And what type of work are you leading to plan, evaluate, or implement generative AI?

CB: We’ve done a lot of work in the area of predictive analytics or predictive AI, which is the precursor to generative AI. GenAI has only been market-ready for a year or so. We have a few projects that we’ve been piloting with a low number of users – 300 or less. One of them is ambient documentation, another one is the revenue cycle using Microsoft Copilot. So we have some of those projects lined up over the coming months. In the clinical area, we’re okay having Epic do chart summarization and other things, but we definitely are ensuring that we have a clinician in between and analyzing the interface of that system before it gets scaled. So, we are cautiously optimistic but we’re pacing ourselves, and focusing more in the back office instead of the front office on GenAI projects.

JK: Recruiting and retaining top talent has been a challenge in IT even before the pandemic. What is one of your most effective recruiting or retention strategies?

CB: The hardest roles to hire now are in data science and AI, and high-end developers. I think we’ve been fairly good and consistent. Our turnover has been steady at about 4 percent in IT, which is relatively low. I think that it’s due to our culture, to be honest. We’re a very flexible and team-oriented culture. We onboard people quickly into our teams and the teams are good at making feel like they are part of the family.

A lot of our talent has come from the consulting world. We’ll have a consultant working with us and they’re like, “Hey, I really love your team and your organization. I want to come work for you full time.” We’ve had a lot of that over the years.

In addition, we have a large internship program, working with 13 different colleges and universities. This past year we had 22 or 23 IT interns, including eight in cybersecurity. Some students will intern with us for three or four years, starting when they are freshmen.

We like it when they come from the local area because they’ll be more likely to stay. Their families are here and they want to stay in the area. We select them based on the specialties where we want to grow. It’s been very successful.

JK: Of the interns, what percentage of them end up staying?

CB: We’re north of 50 percent of our interns who get a full time job and stay with us.

JK: Oh, that’s amazing.

CB: We don’t always have a position open for every one of them, but we try to. That’s why we position them in areas in which we know we will have open jobs in the future.

JK: If you hadn’t become an IT leader, what other career do you think you were cut out for?

CB: I don’t really know. I have the CIO job, but I’m also responsible for other operating areas: cardiology, radiology, and supply chain. So, it would definitely in leadership. I enjoy working with people and developing people. If I hadn’t become a healthcare CIO, I’d probably have my own company, or two or three or four. Who knows?

JK: Outside of work and spending time with friends and family, what’s something that you love to do when you have the time?

CB: My son is going off to college, so the last kid will be out of the house and I will have more free time. My top priority is probably hunting. I love that the most. But hunting season is only a couple of months a year. My second priority is golf. I used to play a lot before my kids were born. So now I’m getting back into golf and playing a little more. And then my third thing is fishing.

JK: What’s your golf handicap?

CB: It’s an 18 right now, which is not good. But I used to carry a single digit handicap. So my goal is to play some more golf and get it back down.