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 Inside the Head of Keith Livingston, SR. VP and CIO, ThedaCare, Inc.
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SERVICE AT THE CENTER It all started in a small-town Wisconsin gas station. At the young age of 12, Keith Livingston began to learn the management and leadership principles that still guide him. Understand people. Treat your customers and employees with respect. Stay cool in a crisis. Have fun when you can.
These values, which helped his father build the successful service station he worked in as a boy, today help Livingston lead a successful team of IT professionals.
"It doesn't matter whether the technology in question is a car or a computer program," he says. "If it doesn't improve people's lives, it's not doing its job."
To shed a little more light on what makes this dynamic CIO such a respected leader, LEAD IT asked Livingston a few questions about his life – at the office, at home, and "Up North."
Q: What job prior to ThedaCare has best prepared you for your leadership role as it is today?
A: Well, seeing as I started at ThedaCare straight out of college – almost 24 years ago now! – I guess you could say I "grew up" here. I didn't hold any other leadership positions in business before ThedaCare. I started as a programmer in one of our hospitals in 1986. (Yes, they really did have computers back then!)
You can't beat the on-the-job training I've gotten here, though. I've had several great mentors, from Jim, our retired CEO, who hired me as a very green CIO; to Roger, our Chief Learning Officer; to Mike, our past Senior VP of HR; to Pat, our previous CFO; to Stan, our previous CIO; and several others who hold leadership positions. They've all helped me learn, both by teaching me the how's and why's of the job, and by getting in my face when I screwed up. Having said that, however, the person who prepared me most – and had the greatest impact on my life – was my dad.
Working in his business (a gas station/repair center with a towing and recovery operation) during high school and college really helped me understand people and develop leadership skills. We lived in a very small town, and thinking back to how he treated customers and employees taught me that there's a right way to do certain things. He was more interested in pleasing customers and helping people learn than he was in the financials of the business.
Developing people (and a great team) is what the IT leadership team and I focus on most. When things get tough or a big project heats up, you need two things. The first is a team leader who's always under control (and in control) who can think clearly about what to do next. The second is a team with the knowledge and willingness to do what it takes to get the project done. It takes time to develop those two things but once you get there, you really have something special.
I realize now – though I didn't necessarily at the time – that I learned those principles from working with my dad.
Q: How would you describe the culture within the ThedaCare IT organization?
A: The ThedaCare IT team is absolutely the best! We've worked for years to create a strong team environment and those efforts have really paid off. Employees routinely step up to help others on project work, work extra hours when needed, provide extra coverage at the help desk if asked, help team members in need outside of work, and on and on. That team attitude even goes to the disciplinary process, which consists of three general steps. Step one is a one-on-one discussion with the team member. If someone has an issue with another team member, they take it up with that person one on one, regardless of the issue. If that doesn't resolve the issue, step two is that the entire team discusses the issue with the team member. The hope is that as a team they can develop a plan and work it out. Step three is that the manager meets with that team member. Usually, by the time it gets to this step, the manager's action is pretty clear. But because steps one and two work so well, we find step three is seldom necessary.
Q: What's the hardest thing about being a chief information officer?
A: Without a doubt, managing priorities. With a business as diverse as ThedaCare is – as healthcare is – there's always more demand than capacity. So we have to find the right projects to work on, the ones that'll have the greatest impact on quality and safety.
Q: As an IT guy, how are you "getting out of IT" and into your industry?
A: My job makes getting out of IT rather simple. I have operational responsibilities outside of IT, so I get to experience IT support first hand. Over the years, our CEOs, past and present, have challenged me with the oversight responsibilities of Imaging; Orthopedics; Physical, Occupational, and Speech Therapy; Business Analytics; Biomedical Engineering; and Transcription. Having those responsibilities has been a tremendous help to me in better understanding the impact IT can have. In fact, I would recommend all CIOs have an operational area as part of their responsibilities.
Q: How is the executive leadership team approaching the healthcare reform initiative coming from Washington?
A: Our previous CEO, Dr. John Toussaint, is very active in advancing healthcare reform. As the CEO of the ThedaCare Center for Healthcare Value, he's working with government leaders, insurance companies, and employers to drive reform based on value. Our goal is to earn the maximum on the IT components of the American Recovery and Reinvestment Act. Once "meaningful use" is defined, we'll develop plans to meet those terms. We've been implementing an Electronic Medical Record [EMR] system for nine years, so we're well positioned to earn the maximum amount available.
Some may ask, "Nine years, what's taking so long?" ThedaCare started on a "Lean Transformation" six years ago. One of the things we've learned from this journey is that you can always improve something. Healthcare, certainly including ThedaCare, is fraught with waste. It is our intent to use lean tools for process improvement and our EMR to remove as much waste as possible year after year. We'll never be done, but we'll improve every year.
Q: What are a few recent unique IT accomplishments at ThedaCare?
A: We've developed a Project Management Office that has helped us achieve better project coordination. It ensures that projects have metrics and that they're achieved. We're implementing speech recognition across the ThedaCare system, producing a 50 percent productivity improvement in transcription and improving quality of care by having results available in four hours or less. We've reduced our IT costs by five percent without affecting staffing or slowing a project, and are implementing a green desktop initiative.
ThedaCare is partnering with several independent specialty physicians to open Encircle Health, a clinic location that will coordinate care between primary care, internal medicine, all the specialty physicians, and all imaging modalities – all within the same day. Technology plays a large part in making that coordination achievable, from a single registration process to a shared EMR.
We could go on for hours on this question! The ThedaCare IT team does a fantastic job, and we it do while having fun most days.
But here's one last example that really sums up what we do. I recently heard a provider comment that the EMR saved a life. Immediate access to office notes for an emergency room patient allowed the provider to quickly make critical, life-saving decisions. The outcome would have been different in the absence of this information. This real-life story helps me remember that at the end of the day, it's not about technology for its own sake; it's about technology helping the clinician help the patient.
Q: How do you self-educate?
A: By reading business journals, IT magazines, books; attending seminars and webinars; talking to vendors; and especially listening to others. Even if the conversation is not about IT, a person can learn so much by just listening and turning the thoughts around to how IT could help. Lastly, just by getting out and seeing. Being in the business, whether ours or others', I feel you learn so much more being out of the office with customers and colleagues than you could ever learn on your own.
Q: What early career advice would you have for anyone getting into IT today?
A: First, prepare yourself for constant change. The technology business is changing all the time. If a person doesn't like change, IT is going to be a big challenge. Secondly, get out of your workspace in IT and go meet, job shadow, or work for a while in your customer's environment. It'll be so helpful for you in your IT role to see the world from your customer's eye.
Q: If you could immediately impact the world to be a better place, where would you start?
A: Making sure every child in the world receives a quality education. Most children will need a quality education to be successful in life, and, unfortunately, some will never have the chance.
Q: What's your poison when it comes to personal technology?
A: It might not be personal technology, but e-mail. E-mail is so overused today, and we receive so many unwanted e-mails. Thanks to the Blackberry, I can keep my Inbox cleaned out most of the time.
Q: Your life is your life because...
A: It's what I chose to do. That sounds really simple, but you hear of people who are unhappy with their job, home life, education, community, or whatever they're unhappy with. Everything in life is a choice, and YOU have to choose what's best for you.
Q: Where is your home-away-from-home?
A: I would have to say it's the athletic fields across the state of Wisconsin! Our kids are very active in sports, and I really enjoy watching them play or coaching them. As with a lot of parents, my wife, Catherine, and I spend a lot of time in the bleachers or on the sidelines. It's a great way to spend time with our two kids, Austin, 15, and Adam, 13.
Q: Favorite movies?
A: Hoosiers and Road House.
Q: Hobbies?
A: I enjoy hunting, fishing, working on food plots at the hunting camp, being at our cottage "Up North" in Wisconsin … anything having to do with the outdoors. Preferably, someplace beyond the reach of my Blackberry – where "Information Technology" means knowing the best place to set up your tree stand. My favorite part of deer hunting is the night before the hunt. There's a group of guys that hunts at our camp near Hurley, and the stories on that Friday night are always the best. Everyone is so ready to go out the next morning, talking about where they're going and what they anticipate happening. The anticipation of the hunt is often more exciting than the hunt itself.
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