Data. Leadership. Diversity...A Primer for Data-Driven Leaders of Color
A Research Brief By: Jeremy Jagers & Ebbin Dotson
In an interview with a mid-career and senior leader at two different, yet successful health systems, I learned the pride of data-driven leadership and the distinction between operational and strategic dimensions. As our society progresses further into the age of information, technology, and data, many sectors of our country's infrastructure must adapt to the rapidly changing work environment, including healthcare. According to a study published in the Journal of the American Medical Association1; "data-driven clinical decision support tools could also lead to cost savings and help with appropriate standardization of (health)care." As medical technology continues to improve and evolve on a day-to-day basis, the dynamics and exchange of information will simultaneously change in nature. The medical information flowing through health systems around the world that was once kept on paper in filing cabinets and drawers now float about in an online cloud stored in servers, readily available to physicians, nurses, patients, and administrators to access on their electronic devices.
Pertaining to the role that operationally-focused data-driven leadership and decision making plays in the success of healthcare leaders, I introduce Adrienne Ford, the System Director of Neurosciences at Saint Luke's Marion Bloch Neuroscience Institute. In interviews conducted with Ford along with her support staff, Ford was asked directly about her leadership style. She stated, "I'm definitely a data person, and I like data. I like information presented to me in a very specific way." She was also quoted in saying that her Chief Financial Officer once stated that "I don't trust anybody else with data except you, I can give you a raw data file and I know you'll do fine with it, but I can't do that with other directors." And given the rapidly occurring transformation that the field of healthcare is currently undergoing, the need for leaders like Adrienne Ford is paramount in progressing the capabilities and efficiencies of health systems around the world.
According to a study published in the Journal of Biosocieties2, the authors state that: "in healthcare, data from diagnostic tests, medical records, 'omics' sciences (sequencing data), digital devices, and facilities operations in the U.S. are estimated to grow from 500 petabytes in 2012 to 25,000 petabytes in 2020 (about 500 billion file cabinets)". An American Hospital Association study showed that adoption of EHRs (electronic health records) has doubled from 2009 to 2011, partly a result of funding provided by the Health Information Technology for Economic and Clinical Health Act of 2009. The study also claims that "most EHRs now contain quantitative data (eg, laboratory values), qualitative data (eg, text-based documents and demographics), and transactional data (eg, a record of medication delivery). However, much of this rich data set is currently perceived as a byproduct of health care delivery, rather than a central asset to improve its efficiency."
While the type of data that healthcare administrators themselves deal with on a day-to-day basis may be different, collaborating with and leading staff to complete tasks with data analysis techniques will be a competency required of most, if not all healthcare leaders, including physicians, nurse practitioners, and even frontline staff. When asked about what would best prepare students in graduate programs for administrative roles in healthcare, Ford was quoted in saying that "one (characteristic to train) is being able to be a critical thinker, and I know they say they teach that in schools, but what the actual application of it is, is different. It's not having a reading comprehension question, and then being able to answer A, B, C, or D. I think it's, especially in today's world, being able to ask questions in order to get to a strategic answer." According to a study published in the Journal of Computer Science3: "Traditionally, decision making in health care is based on the ground information, lessons learnt in the past resources and funds constraints. However, data mining techniques and knowledge management technology can be applied to create knowledge rich health care environment. A healthcare organization may implement Knowledge Discovery in databases (KDD) with the help of a skilled employee who has good understanding of healthcare industry. KDD can be effective at working with large volume of data to determine meaningful pattern and to develop strategic solutions."
The rapidly increasing amount of data in healthcare will require future administrators to at the very least be familiar with data management, if not to possess proficient skillsets in management and analysis. A study published in the Journal of Healthcare Management4 claims that "the construction of hybrid data sets combining clinical and administrative data, has strong potential to improve the cost-effectiveness of hospital quality reporting processes, improve the accuracy of quality measures and rankings, and strengthen data systems." The study also states that "enhancing administrative data with additional clinical information in hybrid data sets may benefit hospitals in three specific ways: by improving the cost-effectiveness of reporting processes, by improving the accuracy of quality measures and rankings, and by strengthening data systems" Ms. Ford believes being able to critically look at data, analyze, and interpret has helped her tremendously as a leader. She noted her high school summer intern (Lachelle) as a good example of the impending task before leaders. "I think especially for (Lachelle), and people her age coming up, there is so much more data being thrown at them. [This generation] has access to so much more data than we ever had with the internet and apps. You have to be able to question everything you see."
Adrienne Ford is an excellent example of a professional in the field who not only implements data-driven decision making in her own tasks and responsibilities, but also encourages her team members to strategize and collaborate from data-driven perspectives and thinking for the completion of tasks. To provide an interesting contrast of operational data-driven leadership with strategic data-driven leadership, I introduce Mr. Eric Williams, the Chief Operating Officer at Kaiser Permanente Santa Clara Medical Center, and former Vice President of Organ Transplant Service Line and Operational Planning and Integration at Stanford Health Care. His senior leadership roles are responsible for data-driven decision making in a different way. Williams' leadership style, data-driven. Williams described his team dynamics and the reasoning behind his data-driven leadership perspective as "a strategic deployment and alignment system. His office wall is meticulously plastered with a complex set of schedules, tasks, and statements. Williams uses a very strategic process to keep up with and communicate with his team. He states, "I go out and look at [my team members] and rate them, are they making problems visible? Are they setting and holding standards? Are they supporting problem solving and involving their teams? Do they have active improvement? These are all things that I round on them and I would look, and the red and green, there's no yellow. So it's either meeting the expectation or it's not. And that is not a critical thing, it's a teachable moment. That's what I think is very clear about the process, because I myself, am rated by my leading as well."
A study on St. Joseph Mercy Oakland (SJMO), published in the Journal of Healthcare Management5, observed how the implementation of digital dashboards with "key performance indicators" (KPI's) of hospital staff for administrators supported an "alignment of strategic planning and information technology (IT) initiatives supporting operational goals. As stated in the study, "an ability to track KPIs over time and against established targets, with drill‐down capabilities, allowed leadership to hold staff members accountable for achieving their performance targets. By displaying the dashboards in prominent locations (such as operational unit floors, the physicians' cafeteria, and nursing stations), SJMO ushered in transparency in the planning and monitoring processes. The need to develop KPI metrics and drive data collection efforts became ingrained in the work ethos of people at every level of the organization. Although IT‐enabled dashboards have been instrumental in supporting this cultural transformation, the focus of investment was the ability of technology to make collective vision and action the responsibility of all stakeholders."
The integration of this type of technology is positively received amongst William's team-members. When asked about Williams' specific leadership style, Jared Roberts, an administrative fellow at Stanford University who worked closely with Williams did not have a succinct answer, but it highlights the strategic challenge facing many senior leaders processing significant data-driven decisions. Roberts stated "it's knowing that if Eric is involved, it's going to be organized, there are going to be goals, clear directives, and people for the most part are going to know what's expected of them. He does a great job of setting those expectations, and that comes with the who what when and where right? I also think that he's no slouch, if there's a goal, we're going to meet that goal. But he's also reasonable in the sense that, ok if the goal needs to change, if the target has changed due to new information, we can work with that." Another team member, Williams' former nurse manager, Caron Burch, stated "I'm not quite sure what you call it, besides, he's very transparent, having everything visual and knowing what's going on in each program, because we're one big solid organ transplant program, so sometimes if there's a problem here, that I'm watching in our huddle, they're having a problem, maybe I'm going to have that problem two months from now. So it really helps, you don't feel like you're sitting in this tower and not knowing what everyone else is doing".
The positive reception of the strategic integration of technology and team-based decision making attest to the both the organizational, and data-driven leadership traits that make Eric Williams an effective leader in healthcare. In a book titled "Leading Organizations-Perspectives for a New Era", a passage states that "evidence suggests that studying TMTs (top-management teams), rather than CEO's alone, provides better predictions of organizational outcomes" (Hage and Dewar 1973; Tushman, Virany, and Romanelli 1985; Finkelstein 1988; Ancona 1990; O'Reilly, Snyder, and Boothe 1993; Tushman and Rosenkopf 1996)
To summarize, the transition that healthcare is undergoing will require those currently working in, and hoping to enter the field to become comfortable working with, analyzing, and utilizing data to drive their decision making and collaborating with individuals from varying academic and professional disciplines. Adrienne Ford is an excellent example of a leader in healthcare who is strategically utilizing data to further increase not only her own efficiency in completing tasks, but also the efficiency and cohesiveness of her own team. Eric Williams is an excellent example of a leader in healthcare who strategically implements and integrates technology to assist and improve his team's ability to complete tasks, collaborate, and use organizational leadership and decision making to solve problems and operate efficiently.