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Healthcare In The Age Of Personalization Part 6: People Experts - We Need You

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This is Part 6, the final part of this series on Healthcare in the Age of Personalization.  Part 5 is here.

Glenn Llopis Group, LLC

This entire series has been about this new age of personalization – the need for organizations to elevate and activate individuals. And who in an organization is responsible for the people of the organization? Human Resources.

But most HR leaders have been trained in standardization. They report to CEOs and boards steeped in standardization. They manage clinical and non-clinical leaders who are used to standardization.

Even when HR leaders agree 100% with the need for inclusion that honors this age of personalization, and even when the people they lead and report to agree as well – we are all up against massive systems designed for the opposite.

In the opening article of this series, I introduced the age of personalization, how it’s connected to inclusion, why it is significant for healthcare, and why healthcare in particular can help point the way for all industries to lead in the age of personalization. In the articles that followed, I discussed the real metrics of inclusion, how business models must evolve, how personalization intersects with population health and the clinical implications.

This time I’ll explore the role and opportunity for HR to move this transformation forward.

As I’ve said before – the way an organization functions, and the way its leaders function, depends on the systems and methods and processes that are in place. We can have all the high-minded goals we want, but we will not reach them if the system is designed for something else.

We have to change the system. HR can either be the biggest advocate for creating a system designed for personalization, or its biggest hurdle.

Individuals are in control now – of your workplace, of your brand, of how they want to experience your services and care.

HR needs to play a much greater role in influencing the decisions that are made not only among patients, but also among employees and the role that the entire enterprise plays in shifting the mindset of the healthcare industry from services to individuals.

The way we work is changing.

One of the reasons this is so urgent is the world of work itself is changing drastically. I spoke with Anton Andrews, director of Office Envisioning at Microsoft.

Andrews described the emergence of what he called the “discoverer’s mindset” within an organization: “In an age of uncertainty, in order to stay relevant, people are having to constantly redefine themselves. Whether it's a government, whether it's a large company, whether it's a hospital. So the ability for people to learn and grow is becoming increasingly critical. And that doesn't happen if you have a static job description and a static job function.”

No matter our place in the organization, we have to adopt this mindset of being entrepreneurial with our own careers. And HR needs to build the system that enables people to do that. As you’ll see throughout this article, healthcare needs to boost its ability to attract top talent and keep people included and engaged in meaningful work.

As Andrews put it: “The idea of fluidizing internally is not a fancy idea. It's an idea that really accelerates learning and growth of individuals, and by doing that accelerates the ability of the organization to fully tap in to the power and the energy of the people in it.”

There is so much overlapping change happening in healthcare (for all the reasons I’ve addressed throughout this series). It’s critical that HR use its influence to tap into the power and energy of people.

This brings everything together – this age of personalization, the corresponding need for inclusion, and the strategic role that HR can and should be playing to help organizations make these transitions.

Uprooting ourselves from standardization.

I spoke about this topic with CEOs and chief HR officers for major U.S. healthcare organizations. They share my emphasis on inclusion and were open about the challenges of evolving an organization and an industry.

Teri Fontenot is CEO Emeritus of Woman’s Hospital in Baton Rouge, Louisiana – the only independent, nonprofit women’s hospital in the country. In February 2019 Fontenot announced her plans to retire.

She offered some insight into why evolving out of standardization can be so difficult within healthcare in particular.

In this industry, “people are used to working under policies, procedures and protocols, and are accustomed to and comfortable with working in routines that are known and proven to them,” she said. “Because we are talking about healthcare, and so there's not a lot of experimenting that ought to go on in healthcare, except in the most controlled circumstances. Patients want what they want, but they don't always know what is going to be safest or best for them. On the other hand, providers cannot act like they know what's best for a patient either.”

But adherence to standards is a practice that has been instilled and reinforced throughout entire careers, from early training through to leadership positions.

“Physicians who entered practice 30 years ago were taught: ‘you are the captain of the ship, you are completely responsible for this patient,’ – that's why they call it ‘writing orders,’” said Fontenot.

But she said that’s changing.

“I think it's really moving more into a team and multidisciplinary approach,” she said. “I'm really pleased and proud of our business sector. The healthcare field has worked very, very hard. The medical schools are training physicians differently. The disruptors are the clients, the customers, the patients. We think a lot in healthcare about disruption coming from other competitors doing things that are progressive or innovative. But it's really the patients as consumers who see new ways of accessing services that better meet their needs than the traditional way.”

She also mentioned the challenge of trying to change an industry when the regulations hold you back.

“Another reason why there's been a drag on transformation is all the governmental regulations just don't keep up with what we're trying to do,” said Fontenot. “So it's also having to navigate around those other kinds of limitations.”

She sets a great example of leadership based on the future.

“My job is to aspire and inspire,” she said. “My job is to be thinking about where we're trying to be five or 10 years from now, not what we're doing today, and try to think strategically about how we're going to get there.”

HR needs to be part of corporate strategy.

Margie Vargas is senior vice president and chief human resources officer for Memorial Healthcare System in South Florida.

She agrees that the role of HR needs to evolve to be consultative.

“We have to evolve the practice of human resources to truly be consultative,” she said. “I think HR professionals have developed that skill over time – to be a consultant that impacts all areas of the industry, not just human resources.”

But she also sees the challenges embedded within a function that has been born and bred to be compliance-driven.

“Back in the day, when you became an HR professional you really honed your skills on the HR-specific competencies that were necessary to be compliant,” she explained. “Just be compliant, that was all that was needed, right? Tell the organization what it needs to do to be compliant.”

She said that’s changing.

“I had a conversation with a group of HR business partners that we're mentoring right now, where none of their mentoring learning objectives have anything to do with HR,” she said. “[The objectives now] have to do with how involved are you in understanding what drives your business? What is your business acumen? Where is your contribution to the critical evaluation of program development? What drives the organization, and how are you connected to the mission?”

She gave an example of one way HR is contributing to the larger business goals. She said they’re looking to see if there’s a correlation with employee turnover and patient satisfaction.

“We correlated the turnover to the employee engagement survey to the patient satisfaction scores over the last 12 months and to leadership performance,” she said. “That's the type of people analytics that tells a story, so we can then create strategies on how to improve the patient experience, elevate caregiver contribution, and also identify gaps in leadership and create strategies to mitigate some of those gaps.”

The usual starting point – unconscious bias training.

Whenever the subject is inclusion, especially related to HR and compliance, the common starting point is unconscious bias training. I usually view that as a PR-motivated move as a way for a company to manage its reputation, often after a race-related scandal.

I always have a similar thought: I don’t want to hear about your unconscious bias training – I want to hear about what comes AFTER your unconscious bias training. How are you using that as a starting point? How are you pivoting from that training to then start to create the structure that will embed awareness about our individuality into every project, every team, every department, every interaction with peers and patients?

Pamela Abner is doing just that. She is vice president and chief administrative officer of diversity and inclusion for Mount Sinai Health System in New York City. She’s laying a foundation for inclusion by developing education and training, by creating best practices for things like how they collect patient information, and she and some people on her team are even getting certified as patient experience professionals. All so they help embed inclusive thinking throughout the organization.

She uses unconscious bias training as a starting point. But that’s just the beginning.

“We want to embrace or recognize that we have varying backgrounds,” she said. “I want us not talking about one particular thing – whether it’s race, sexual identity, sexual orientation, gender identity, state of ability, disability or religion. Those are all things that fall into that bucket. All that means is that we're thinking about everyone. Then, what do we do when we're aware and we're thinking about everyone? If we can even assume that everybody is aware that people are different, it's how do we then provide the appropriate care and bring people what they need that's right for them. That's the hardest part, for sure.”

The training can be valuable and can have a direct impact on patient care. Because bias is not just about stereotypes – it’s about how our brains use shortcuts to help us understand the vast array of stimuli the brain processes every minute. Those shortcuts can be helpful, but they can also limit our ability to understand each other. Abner shared an example with me.

She said the head of their trauma unit was doing rounds. Before he walked into a room, someone gave him the summary of the patient. He was told the patient was an elderly white woman who they said had dementia.

Abner said this doctor happens to be black and Jamaican. He went into the room and started asking the screening questions you ask when you hear someone has dementia.

“The person seemed to respond fine,” said Abner. “She did not seem to present at all as someone with dementia. However, she had an incredibly thick and authentic Jamaican accent. The doctor turned to his team and he said, ‘this patient doesn't have dementia. She's Jamaican.’”

This is where the shortcuts our brains take can actually slow us down.

According to Abner: “This is a bias thing, because they see the woman as being white, and people sometimes don't realize that in the Caribbean you have island people who are white, or otherwise Caucasian-looking, but they speak just like the island folks. When we teach about unconscious bias we say ‘hear with your eyes.’ They saw something their brains could not connect as a Jamaican accent. They just thought: there's something wrong with this woman. She must not have all her faculties. Now, if that attending physician had not been a person from a background different from the rest of the team, that woman would have been treated and handled as though she had dementia when she did not.”

That’s such an important lesson about bias – it goes well beyond the stereotyping we usually associate with it, to include general misunderstandings among people. In healthcare, misunderstandings can lead to the wrong kind of treatment. Worst case, it can be a matter of life and death.

“When we teach we say don't be fooled by what you hear and what you see because your mind plays tricks on you,” said Abner.

Her approach beyond the unconscious bias training is intentional and specific.

“Those are my two favorite words, by the way – intention and specific – because you don't get anywhere without some intention and being specific,” she said. “Once we identify what [inclusion] problem we’re trying to solve, and what have we identified as our key issues, then let's start to measure something. We have to come out of this endeavor with a measurement.”

If people are so mission-driven these days, why does healthcare have a talent shortage?

In a survey of healthcare leaders released in January 2019, J.P. Morgan found that the talent shortage is top of mind, with 92 percent of respondents saying they were at least somewhat concerned with finding candidates with the right skill set. For 35 percent of respondents, the talent shortage is one of their top three challenges. While the physicians and nurses topped the list of most challenging positions to fill, nearly a third (29%) of respondents said it’s hard to fill mid-level management, 21% have trouble filling administrative positions, and 18% said senior management positions are most challenging to fill.

In an age when more and more people say they want their careers to be meaningful, they want to do something with purpose – why isn’t healthcare able to overcome its talent shortage? Of all possible career fields, if your goal is to make a difference in the world, healthcare should be at the top of your mind as a place to anchor your career, whether you’re a caregiver or an accountant.

But it’s not. Why? At least partly, it’s because healthcare struggles with this transition to personalization.

I talked with Joe Moscola, senior vice president and chief people officer for Northwell Health in New York, about how to prepare for the age of personalization. He agreed that there is a lot of innovation needed in healthcare today.

“The consumer is looking for [individuality], because it exists in the rest of our lives – that ability to have that individual approach that is unique to them, their own thumbprint,” said Moscola. “To be able to get my own medical records in a way that is useful for me, that I can understand, in the language that I speak, and the ability to communicate with someone who communicates the way I need to communicate.”

Those are big challenges that require many different types of expertise to meet those challenges. Now if we can just help people see the opportunity to make their own impact.

Moscola talked about the role of HR in the context of all that: “How are we able to build a pipeline, build enthusiasm around the work that we're doing, grow diverse skill sets, with people who understand all those complexities and those challenges that exist in each individual community, each individual culture and gender? And how do we begin to really advance that strategy through the talent that we bring in? That's a big part of how we're beginning to look at it.”

As it so often does in this age of personalization, it comes down to the experience that each individual feels like he or she can get as an employee. He said when people leave an organization, it’s often because they don’t feel like they can follow their mission there.

He described it like this: “To dig down a little bit deeper, [people are asking themselves] ‘am I able to go after my career mission? That passion I have to help people or to cure people – can I follow that mission here?’ And I think the way we begin to have really changed leadership, and how they think on it. This is just one person's opinion, but do I think it goes back to some basics about how to unlock someone's total, maximum potential through the mentorship, the coaching, and then sponsorship of that individual. And then, how many people can you realistically do that for? And what tools do you need to do that?”

Challenge of talent pool – people don’t think of healthcare careers beyond doctors and nurses.

The industry needs to be better at selling itself beyond the obvious medical careers.

Cathy Fraser is chief human resources officer of Mayo Clinic, and she shared some of those challenges with the talent shortages. She said she visits middle schools and high schools and asks the students why they’re interested in healthcare. They all say they want to be doctors and nurses. But there are so many other ways to help people live healthy lives.

“One of the best things we also can do is treat healthcare as a vertical, as an industry, it is not a function,” said Fraser. “Kids are taught early that you see yourself as a caregiver in some form because you helped your teddy bear when it got ripped, and you took it to your mommy to give it a band-aid. That’s caregiving. But there’s also the ability to be successful in healthcare as a finance person, as an IT person, as a mechanic, as a glassblower – you can do it because the vertical has every job in it. We have not done a good job as an industry to promote the concept that healthcare is all professions, not just clinical.”

Her own career path includes multiple industries before moving into healthcare. She values a diversity of experience, and has created a structure within the organization for people to move around and experiment with their careers.

“We hire good people and we give them the freedom to do a lot of different things in the organization,” said Fraser. “The guy who was my second person, my next level in HR, just took a job working as the vice chair of administration of research for Mayo Clinic's research organization. You don't typically get someone who's a high-level HR executive going over to run an administration job in research. But we see more and more of that here because we are looking at talented people, and we're rotating them through different roles, sometimes full-time, but sometimes they're only part-time.”

She said people can take a six-month agile staffing opportunity, experience something new, and then come back.

“This allows people to navigate their own careers, and with actually pretty robust programs for tuition reimbursement as well,” she said. “Humans want to learn, they want to expand, they want to grow, but most organizations make it really, really difficult to do something new.”

She said it’s difficult to be a successful CHRO if you've only come up through the HR discipline.

“People meet me, and they'll think, ‘you're in HR, that's odd,’ – I get that a lot,” she said. “It has to do with the fact that when I came out of grad school I was a finance person working for an airline. Then I actually worked at McKinsey & Company and worked on retail and consumer goods. It's that variety of experience that makes it easy for me to see things clearly that are not traditional HR. So the best thing I would ever advise someone who's coming up through HR is to get out of HR, go spend some time somewhere else, enhance your ability to see things from a different view.”

A systematic approach to inclusion.

In the last article I mentioned my conversation with two leaders from the University of Pennsylvania: Jaya Aysola, MD, MPH, assistant professor of medicine and pediatrics at the Perelman School of Medicine and executive director for Penn Medicine Health Equity Initiative; and Eve Higginbotham, SM, MD, is a professor of ophthalmology and vice dean for inclusion and diversity of the Perelman School of Medicine.

They work together to take the concepts of inclusion and equity and translate them into action items that can be operationalized within the health system – focusing on culture to enhance patient care delivery, scientific innovation and retention efforts.

They conducted a qualitative narrative analysis to better understand what can be done to improve inclusion within healthcare organizations.

They said something I agree with wholeheartedly: Some of the first ways in which to operationalize inclusion is to measure it. They looked into identifying the key factors that organizations can look at when they're thinking about inclusion.

Through their study, they found six factors were consistent regardless of subgroup. The study (see link above) offers the details, but I’ll rely on how Dr. Aysola described the results to me.

Overwhelmingly, minorities and women said they feel like there isn’t a level playing field, that standards in general within an organization aren’t applied equally. Many reported micro-affirmations and nepotism at play in favor of white males.

There was also a significant narrative around the silent bystander: “Often, discriminatory remarks or bigoted remarks happen in an environment with many witnesses, who remain silent,” said Dr. Aysola.

She believes empowering those silent witnesses is a key first step in changing an organization’s culture: “It can be as simple as when, in a committee meeting, a female might raise a really wonderful point, then that point is repeated directly by someone else and presented as their own point. That’s an opportunity for the chair to say, ‘Oh, that's really great, Dan, that you highlighted Mary's point.’”

That’s such a concrete way that leaders can operationalize inclusion in the moment and begin to move the culture toward personalization one interaction at a time.

Build trust by building relationships.

How do you take people who are not engaged and are unwilling to show their true individuality if they don't trust leaders? How do you tackle that?

Nikki Sumpter is senior vice president and chief HR officer for Atlantic Health System in New Jersey. I asked her about building trust and her first response was to say: “This is my favorite part of what I do.”

From previous jobs, she shared examples of taking care of employees, addressing issues of living wage, increasing the training that’s available for development. When she joined Atlantic Health she saw that the organization already had a strong foundation of trust. That came in handy as she helped navigate what she described as a tremendous amount of transformation: a new CEO, other new executives, the rollout of a new Electronic Health Record (EHR) system.

“We have to listen,” said Sumpter. “I can focus HR and get a whole bunch of stuff done, but it may not be what the organization needs today. If we can't be inclusive in our thoughts, if we can't get any of that right, you will have silos. How do you break through those barriers? By meeting people where they are, literally. Literally. It's taking things in one bite at a time in building trust. Culture doesn't happen overnight.”

She brought it back to relationships and to making sure HR plays a role in organizational strategy.

“I think relationships are important,” she said. “Start with everyone on the executive team and find out what the priorities are. But it's not enough to just know what their goals are. What role does HR play in every one of the goals? Because all of the work occurs through people. I mean there's nothing that is happening that a person isn't touching. How is HR supporting everyone's goal? If you could figure that out, that's the start.”

To be ready for personalization, you need your people.

It all comes back to people. To individuals.

To return to Anton Andrews from Microsoft: “New challenges are going to be arising constantly in real time. Is your organization making use of the people in it? Is your network making use of the people in it and allowing them to actually cluster around those challenges as they arise, and bring their expertise to those challenges?”

This is the role HR must play in the age of personalization.

At a time when we are personalizing healthcare, HR should be one of the most sophisticated departments in the organization. You’re the ones who can see what needs to be solved at every level throughout the organization, help individuals know what they are uniquely suited to solve for, then connect people so they can cluster around those challenges and work together to overcome them.

You’re the ones who connect all the dots (take this assessment to measure your effectiveness).

In this age of personalization, the role of chief people officer is the most important role in any organization. It’s PEOPLE who will deliver the innovation needed to take advantage of opportunities for growth. It’s PEOPLE who will revolutionize the way you serve patients, employees and your community. It’s PEOPLE who will transform healthcare for this age of personalization.

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