The Role of a Leader

I've written many blog posts about leadership and the challenges of running large complex organizations. Recently, I've thought about how I have personally changed during my 15 years in healthcare leadership positions.

In my early years, the initial challenges were to break through technical barriers by creating prototype applications and demonstrating the possibilities of the emerging web in the mid 1990's.

I then progressed to organization building, devising the strategy, structure and staffing of a growing IT organization.

From there I evolved to thinking about processes - how to ensure reliability, security, and performance of complex infrastructure and applications.

I then moved on to education - writing and speaking about our efforts inside and outside my organizations.

Where am I today as a leader? I believe I'm a convener.

Whether it's my Federal, State, hospital or medical school roles, my most important leadership task is assembling people with various opinions, some of them very vocal, and achieving a set of priorities, next steps, and policies.

In some ways, I'm becoming less technology focused and more business focused. Many of the technologies that were risky/bleeding edge a few years ago - the web, clouds, clusters, enterprise storage, and thin clients, are now mainstream. My day is less about getting the technology working right and more about ensuring we're using the right technology to meet the needs of business owners. Unfortunately, many business owners do not know what they need, although they have high expectations.

The theme of my next leadership year will be governance.

Of course there is meaningful use, EHR implementation, and privacy policy change - but convening stakeholders via a recognized governance model is a prerequisite to getting those done.

It's painful at times to gather everyone together and hear a multitude of diverse opinions, some of which may be factually incorrect and many of which can be critical. All of us are tempted to 'wait to speak' instead of listen. However, the best way I can serve my staff and ultimately all my stakeholders is to condense the messiness of contentious viewpoints and competition for resources into a well communicated list of priorities.

Now that Meaningful Use Stage 1 and the Standards Rules are final, the pace of my Federal responsibilities will be a bit less. This will give me a chance to focus on Massachusetts and hospital/medical school governance. The measure of my success should be the projects we decide NOT to do, since great governance will set priorities and align them with limited budgets and fixed timeframes. A sign of failed governance is saying yes to everything, flogging staff until they resign in fatigue, and creating general dissatisfaction throughout the organization because scope is too large and resources are too small.

Convening and governance will be my role as a leader over the next year. Only when I can master that can I progress to my next leadership stage.