Q&A: HCA Healthcare CIO shares insights on technology innovation and building team culture

HCA Healthcare senior vice president and chief information officer (CIO) Marty Paslick recently was interviewed by Bill Russell, managing editor of This Week Health, for an episode of the “This Week In Health IT” podcast. Marty shared insights on HCA Healthcare’s approach to technology related to business continuity and innovation and his personal approach to building an IT culture of excellence.

As one of the healthcare industry’s longest-tenured CIOs, Marty is uniquely qualified to offer perspective on where healthcare IT has been, and where technology innovation is going to advance health in our communities. Read on for a recap of the conversation, through which he offers wisdom and practical advice for the next generation of healthcare IT leaders.

Q: HCA Healthcare is one of the nation’s leading healthcare providers, with 182 hospitals and approximately 2,300 other sites of care. As CIO, how do you ensure its technology systems are effective, efficient and consistent across so many facilities?

Across the healthcare industry, generally speaking, if you’ve seen one hospital, you’ve seen one hospital. The beauty of HCA Healthcare’s approach to operations is that decades ago, we began implementing a shared services model. If you go into many other hospitals today, you’ll likely see numerous business offices and a fairly significant IT presence. You won’t see that in an HCA Healthcare facility.

That’s because the IT function and other business operations such as HR are all pulled together in a consolidated state across our divisions. Those consolidated centers provide multiple shared services for our hospitals and other care sites. With that business model, we foster consistency and efficiency across the organization, including for our IT systems and teams that support operations.

With that said, much of our IT innovation comes from the local level. Hospital CEOs and other leaders can find new technologies they think are interesting, and we have a process to vet them to see if they work well, are secure and meet our needs. We determine whether any other facilities have looked at an application — or discovered different solutions — and then we consider whether we can leverage it at scale across multiple or all facilities.

So we play both sides. We try to keep a very standardized set of technologies that our corporate teams identify, but we also embrace new technologies wherever they come from within the organization.

Q: As CIO, you have a significant responsibility for day-to-day IT operations, but also for continuously leveraging new technology to advance patient care. How do you balance the dual priorities of operations and innovation?

I would have said, a few years ago, that it was a give and take between the resources dedicated to operations versus those dedicated to innovation. We don’t live in that world anymore.

Healthcare leaders now live in a world with two gas pedals on operations and innovation. Both are pressed to the ground as they are equally important. And to some degree, they feed off of each other.

In our Information Technology Group (ITG), we have a continuous operational mindset to be excellent stewards of the company’s resources in support of our mission: Above all else, we are committed to the care and improvement of human life. But in order to continually live out that mission, we have to maintain an aggressive innovation agenda.

Never in my career until the last few years have I experienced an environment where it is equally essential to prioritize operations at the same time as we prioritize innovation to support our patients and colleagues. The pandemic and other evolving healthcare industry challenges have introduced a new paradigm to do both at once, not one over the other.

Full speed ahead, on both fronts.

Q: What technologies are you keeping an eye on today that you believe will make a significant impact on healthcare in the near future?

In healthcare generally, there are fundamental technologies that still have pretty long runways. At HCA Healthcare, we’re unique in that we’ve made a large investment in mobility, with more than a hundred thousand iPhones in the hands of our clinicians. It’s changed the way we communicate and collaborate in support of patient care and the colleague experience. When you think about generative AI and other new technologies, that mobility platform is critical for delivering them.

When it comes to camera vision, there’s been a stigma about cameras in our society generally. But I think we’re beginning to understand that it’s an important element, whether you’re protecting a city or taking care of patients. One thing we’re really excited about right now is virtual nursing, where we’re employing highly tenured nurses, who have spent time walking those floors every day, and putting them behind a camera and zooming them into patient rooms to help reduce the administrative burden of bedside nurses. They’re helping with admission assessments, discharge planning and much more.

Then, of course, we have generative AI. We recently announced our collaboration with Google Cloud to use generative AI technology to improve workflows on time-consuming tasks, such as clinical documentation, so physicians and nurses can focus more on patient care. That collaboration is very intentional from a foundational perspective. We need more speed and elasticity with infrastructure, and wanted a partner we believe is going to be a leader in this space. We’re putting the right controls and governance in place, but we also will be looking over the edge to be a leader in healthcare when it comes to that next generation capability.

Related article: (Forbes) HCA, One Of The Largest Healthcare Organizations In The World, Is Deploying Generative AI

Q: With so many new technologies competing for your attention, how do you prioritize technology investment to advance healthcare delivery at HCA Healthcare?

I’m fortunate to work with a senior leadership team that is technologically savvy and fully understands the value and risks technologies can bring, as well as the challenges of deploying them. It’s a continual conversation among our CEO, CFO, COO, other leaders and clinicians about the opportunities in front of us, which we weigh against other types of investment opportunities — both in front of and behind the IT curtain.

We discuss what we want to do from an operational perspective and the related technology needs in the same context. I think the fluid nature of that ongoing discussion informs excellent decisions. It’s a need-driven conversation, and that has worked extremely well for us.

Q: What is the most significant change you’ve witnessed in the healthcare IT landscape since you began your tenure at HCA Healthcare?

I began my career at HCA Healthcare as a software developer and recently celebrated my 38th year with the organization.

When I came into ITG, we were 100% a support function, largely operating in the background. Wind that clocks nearly four decades into the future and now every conversation around a key strategies at HCA Healthcare involves ITG.

Today, IT is an absolute partner. We are not just the deliverer of technology, but a full participant in discussions around our needs and technology solutions to meet them. It’s a day and night scenario from 30-some years ago.

And, it’s more than just delivering a solution to meet a need. We come to the table now and say, have you ever thought about doing this with our patients? Have you ever thought about this technology and how it could improve workflow? That is really powerful, and it says a lot for how far we’ve come.

Q: With such a large team in the Information Technology Group at HCA Healthcare, how do you develop and maintain a culture of excellence?

It is a large team, with about 6,200 IT professionals. About 65% of them are here in Nashville at our corporate headquarters and the other 35% are in our 15 divisions across the country. Fostering a great culture for all of our colleagues begins with the roots of our organization. HCA Healthcare was founded by physicians who wanted a better way to provide healthcare.

If you say the first three words of our mission statement, “Above all else,” to our colleagues, they immediately know what you’re talking about. There’s a connection. And that is to our commitment to the care and improvement of human life. When you have that kind of connection from a culture perspective, it’s priceless. I would say that a majority of our technologists would rather be referred to as a healthcare professional first and a technologist second.

So the culture at HCA Healthcare has a good starting point, and in ITG we have one of the highest employee engagement scores in the organization. I’d say part of that is because we are pretty active listeners, which feeds back into the culture.

We do a biannual employee engagement survey, and of our 6,200 ITG colleagues, we receive nearly 9,000 comments. If we want a culture that helps us produce the results we want, we have to listen and we have to react. We learn from those comments and create action plans to address any constructive criticism. And we do it consistently. That’s a big part of building a great culture.

I hope that my colleagues, regardless of the level of the organization they are at, view me first as a colleague and not as the CIO. We have multiple channels that allow me to sit and work with people on a one-to-one basis. As an individual contributor, each of my colleagues has an opportunity to offer ideas and provide direct feedback. There’s a freedom of communication where everybody’s pulling in the same direction and it doesn’t matter where you are in the org chart.

Q: What are some of the practices you leverage to engage with colleagues in the IT organization to listen to them and foster that feedback loop? Any advice for other IT leaders?

First I would say that you have to implement practices that fit your own style. But also I think it should involve multiple channels.

Every month I meet with a roundtable of people from ITG that has nothing to do with the organizational chart. We share what we’re working on and it allows me to learn from them and provide feedback. It’s the kind of conversation you’d have around your dinner table.

Another extremely valuable practice is our Virtual Hallways. Every Friday from 8:00 to 11:00 we do six, 30-minute segments that cover a rotating list of topics. There is no agenda, no prepared list of questions, just open conversation about key projects. I can remember back in 2010 when I started it, people were intimidated. They were preparing for the meeting and having meetings before the meeting and all of that. Today, we’ve gotten to the place where people just walk in, grab a doughnut out front and share what’s on their minds. It’s just a dialogue as if we had bumped into each other in a hallway.

All of this creates an atmosphere of, “Hey, we’re all in this together.” I have my role, you have your role. We’re just trying to get to the finish line.

Q: What have you learned about working with vendor partners over the years, and what advice would you give to those trying to work with healthcare organizations? What makes a good partner?

I always make a distinction between vendors and partners. Vendors typically provide us with technology that already exists, that we might get from multiple providers. Partners can also sell us that exact same thing, but they put in the time and effort to help us customize and fully utilize it.

A majority of technologies we use in the healthcare industry are probably 50% or less utilized. A partner helps us take that 50% to 90% on their own time. When I see that level of commitment, the next time they have a great idea, I’m listening. Because I’m all in on partners that will help us leverage technology to the greatest extent possible to advance healthcare.

Q: You are one of the most tenured CIOs in healthcare today. How do you see the role of the CIO evolving in the healthcare industry?

I am proud to say that I have been CIO at HCA Healthcare for 11 years, which Becker’s Health IT recently noted makes me the longest-tenured CIO of the top 10 health systems in the country. I don’t track that personally, and was surprised to know! I’ve been very fortunate to have the opportunity to do this work and lead our organization in pursuit of excellence at HCA Healthcare.

Of course, you have to be a good technologist, but you also need to have pretty strong business acumen. You have to speak the language of your key stakeholders. You need a sense of understanding of the operational challenges our healthcare leaders are facing.

High-level creativity about how to apply technology to improve care and experiences for patients and clinicians is key. Our leaders and healthcare organizations are looking for more than just a technology provider. They’re looking for a partner that’s going to help them create solutions together.

Watch the full conversation and additional insight from Marty on “This Week Health”: