For John Hummel, managing the way all 41,000 employees across the Sutter Health network \n\nperceive his IT department is one of the most important aspects of his job. Hummel, \n\nsenior vice president and CIO at Sutter, a 28-hospital health-care system in Northern \n\nCalifornia, believes he can't accomplish anything without paying careful heed to the way \n\nhis IT department is seen, heard and understood. And there's quite a lot that Hummel \n\nhopes to accomplish\u2014including an electronic medical records system, an electronic \n\nmedical orders system for administering prescriptions (known as computerized physician \n\norder entry, or CPOE), a virtual ICU initiative, an ERP implementation and a network \n\nupgrade.\n\nTo make sure that the administrative, clinical and executive staff think about IT in the \n\nway Hummel wants them to, he engages in what he calls political theater. And it's a \n\nleadership skill he's mastered. On a Monday morning in February, for example, Hummel \n\nsits in a regularly scheduled meeting with his executive IT staff to ensure that they're \n\nall delivering a consistent message about the status of several key projects, including \n\nthe ERP implementation and the electronic medical records system. Later that day, Hummel \n\nand two members of his staff will be going into a meeting of the Executive Information \n\nTechnology Committee (EITC), Sutter's IT governance body, and he wants everyone to be \n\nprepared. One thing that he wants to happen in the meeting is to get the EITC (which \n\nconsists of the CEO, COO, chief medical officers and executive vice presidents) to agree \n\non the group of individuals who will make decisions about the electronic medical records \n\nproject. So Hummel rehearses his staff as if he were directing a play, cuing them on \n\nwhen and how to ask various questions.\n\n"When we get to the agenda item on the charter, governance and budget for EHR \n\n[electronic health records], say, 'We would like to have EITC approve the EHR committee \n\nstructure. We are here to gain approval for the current structure,'" he instructs his \n\nstaff.\n\nJohn Hummel, CIO at Sutter Health, believes the best way to advance his IT agenda is to \n\nunderstand his stakeholders, customize his messages and maintain a sense of humor.\nSuch staged communications are necessary at Sutter and, indeed, at every \n\norganization\u2014especially for CIOs. That's because IT is so complicated, involves so \n\nmuch change and creates such anxiety in employees. Therefore, CIOs have to carefully \n\ncraft their message. "The idea is to make everything seem so well-planned and well-done \n\nthat people get this overwhelming sense of confidence in you and don't mind being led \n\ndown the primrose path," says Hummel. And because CIOs have a limited amount of time \n\nwith an audience\u2014whether that audience is the board, the executive team or the \n\nCEO\u2014they have to spend time up-front to research and rehearse their message so \n\nthat when they do get that minute in the elevator with the CEO, their delivery is \n\nflawless and convincing, says Hummel.\n\nAt Sutter, Hummel's practiced and deliberate communications and attentive hand-holding \n\nare particularly instrumental in helping him overcome doctors' traditional resistance to \n\ntechnology. He has used his powers of persuasion to push through expensive and high-risk \n\ninitiatives\u2014such as a $150 million picture archival computer system (PACS) that \n\nwill help doctors to more quickly and accurately diagnose patients' conditions (the \n\nproject also includes a $30 million ERP installation); a $25 million remote virtual \n\nphysician system for intensive care units (known as eICU) that has decreased the \n\nmortality rates among those monitored by the system by up to 30 percent; a $30 million \n\nbar-coding system that has prevented approximately 28,000 medication errors across more \n\nthan 4.6 million attempted drug administrations in 12 hospitals from the time it was \n\nimplemented in May 2003 through December 2004; a $154 million investment in an \n\nelectronic health record system that will also enable computerized physician order entry \n\n(CPOE), which gives patients and medical professionals secure access to digital medical \n\nrecords housed in one system across both inpatient and ambulatory settings.\n\nIn total, Sutter will spend $1.5 billion on IT over 10 years.\n\n"The stuff John was doing a few years ago is now seen as just de rigueur," says Scott \n\nWallace, president and CEO of the National Alliance for Health Information Technology, a \n\nprofessional organization and lobbying group in which Hummel participates. "The things \n\nhe's done have really been impressive." Because of his reputation, Hummel is rapidly \n\nbecoming a big name in health care. "He is as sophisticated and savvy as any Fortune 500 \n\nCIO," Wallace adds. Perhaps even more so.The Director of Communications\n\n"I have to make sure people understand why we're doing what we're doing in IT," says \n\nHummel. If we're not all reading from the Book of John, IT can't give out a consistent \n\nmessage about what we're doing."\n\nConsistency is of tantamount importance at an organization as large and geographically \n\ndiverse as Sutter, where it can take Hummel as long as nine months to assign the proper \n\nbusiness or clinical owner to an IT project and then sell all key stakeholders on the \n\nvalue of that project. (Hummel, who has been with Sutter since 1998, says it's a \n\ntremendously consensus-driven organization.) Consistency is also instrumental in \n\nreminding Sutter's top executives why they approved technology investments. "In the IT \n\nworld, because these projects take months and months and months and years to roll out, \n\nyou have to remind people of the reasons they invested in them in the first place," \n\nHummel says. If you don't, says Hummel, the top brass may decide to pull the plug on a \n\nproject if it's costing too much money, or worse, yank the welcome mat from under your \n\nfeet. Effective politicians do the same thing: They constantly reinforce messages, \n\npersistently repeat hopes and steadfastly reiterate dreams.\n\nHummel uses the tactic of repetition when discussing a Lawson software ERP \n\nimplementation that's been going on for seven years. The reason it's taking so long: \n\nSutter spent the first few years building the system, and the organization's resources \n\nlimit rollouts to 12 business units each year. (Sutter currently has rolled out the \n\nsystem to 65 business units, with another 25 to go.) At the February EITC meeting, the \n\nERP implementation is the agenda item that Hummel is most concerned about because \n\nseveral user groups need to be retrained before Sutter can fully realize the cost \n\nsavings from the system. The message he wants his staff to reiterate to the EITC is that \n\nERP will save up to $38 million based on ROI analysis.\n\nLike a politician, Hummel carefully considers his audience before addressing them and \n\ntailors his message accordingly. For example, when selling doctors on the benefits of \n\nbar-coding medications, he emphasized patient safety. To reinforce his message, Hummel \n\nshared with them studies from medical journals indicating that more than 51 percent of \n\nadverse drug reactions occur at the point of medication administration versus the point \n\nof ordering. When discussing the same initiative with the CFO, Hummel included an \n\nemphasis on ROI. He showed the CFO how much medical errors cost, how often they take \n\nplace, as well as the costs Sutter incurs when it has to credit patients' bills for \n\nmedication when it is not administered.\n\n"He understands the audience he is presenting to and how to operate in that context," \n\nsays Todd Peterson, Sutter's vice president and CIO of systems support operations, one \n\nof Hummel's top lieutenants.\n\nJohn Hummel knows that if he's not visible to employees throughout the organization, \n\nthey won't know what he's doing or recognize IT's value.\nIn addition, Hummel uses his background in clinical care to relate to doctors. He spent \n\npart of his career in the mid-1970s working as a biomedical engineer for lithotripsy and \n\nlaparoscopic devices, teaching doctors how to use an articulated ultrasound arm\u2014then new \n\nequipment for breaking up kidney stone\u2014among other things. His experience working \n\ndirectly with medical personnel gave him a valuable insight: He now knows better than to \n\nbring his laptop to a meeting with doctors. "Physicians are very intuitive and rely on \n\neye contact to read how people are feeling. They see laptops as a barrier," he \n\nsays.\n\nDr. Gordon Hunt, a senior vice president and Sutter's chief medical officer, says that \n\nthe many hours Hummel has spent in operating rooms gives him credibility with the \n\nmedical staff. "John was close enough to the problems doctors see in delivering care to \n\nunderstand how real those problems are," he says.Making the Rounds\nHummel puts 35,000 miles on his Ford Escape each year driving to and from Sutter's \n\nvarious hospitals and facilities in Northern California. During his travels, he attends \n\nboard meetings, pitches doctors, nurses and pharmacists on IT initiatives, and checks in \n\nwith local IT staff. The informal check-ins keep him in touch with employees' \n\nperceptions about Sutter's business and technology initiatives, and help to inform his \n\nown opinions when he addresses Sutter's leadership in meetings. "I liken what I do to \n\npassing a bill in Congress," Hummel says. "By the time the senators and congressmen make \n\ntheir formal arguments on the floor, they've already visited all the people, done all \n\nthe arm-twisting and made all the concessions they need to get that bill passed."\n\nWhile preparing for February's EITC meeting, Hummel discussed one of the agenda \n\nitems\u2014a potential partnership with another health-care system\u2014with other \n\nSutter executives. The other hospital group (which Hummel won't identify) had approached \n\nSutter in 2004 with a proposal to partner with Sutter to extend Sutter's electronic \n\nintensive care unit (eICU), a remote monitoring system, to its hospitals. In those \n\nconversations, Hummel learned that executives had mixed feelings about Sutter sharing \n\nits eICU. There were those who, like him, saw the partnership as a strategic \n\nopportunity. Proponents believed that by extending its technical and clinical \n\ncapabilities into hospitals that might not otherwise have the resources to afford them, \n\nSutter could enhance its reputation. Opponents saw the idea as a burden for a company \n\nthat was already juggling 800 IT projects, building new hospitals and negotiating with \n\nlabor unions. Hummel understood this perspective as well, having encountered similar \n\nconcerns in his own thinly stretched IT organization.The Power of the Informal\nBefore scheduled meetings, Hummel makes the time to speak with people privately because \n\nhe says people rarely oppose popular ideas publicly for fear of being branded as a \n\nnaysayer. By meeting informally with executives, Hummel's aim is to see if they have \n\nspecific concerns, and to address those concerns up front. Hummel strives to meet \n\ninformally in environments where people feel comfortable enough to speak \n\nfrankly\u2014whether in someone's office, a hallway or the bathroom. The sooner Hummel \n\ncan head off people's concerns, the sooner he can get them into his corner, and the more \n\nlikely he's able to prevent them from engaging in passive forms of resistance\u2014such \n\nas agreeing with him in public meetings but then failing to act when he needs them to \n\nmove forward.\n\nHummel's goal in the EITC meeting was to gauge how serious Sutter's top executives were \n\nabout the partnership. Hummel wanted them to make a clear, unwavering decision in favor \n\nof or against the partnership because in the past, executives had committed to moving \n\nforward with initiatives without adequate consideration, only to conclude later that \n\ntheir decision wasn't such a good one. Unfortunately, such changes of heart came after \n\nIT had devoted time and effort to such initiatives. Even though Hummel believed the \n\npartnership was a good move, he was prepared to live with a decision against it.\n\nHummel had to carefully lead the committee into a discussion about extending Sutter's \n\neICU. He didn't want to be too forceful because he worried that if the project was \n\nviewed strictly from an IT perspective, businesspeople wouldn't see it as a priority and \n\nthus wouldn't take the actions necessary to move the project forward. Instead, Hummel \n\nwanted the CEO and the EITC to make the call. If the partnership was viewed as the will \n\nof the CEO, the organization would intrinsically see it as strategic, and it would be \n\neasier for Hummel to get the necessary funding.\n\nWhen the topic of the partnership came up, Hummel and his staff, while in support of it, \n\nbalanced their opinions with their own reservations and the general concerns about the \n\ninitiative that Hummel gathered from other executives. They then asked the EITC to weigh \n\nin.\n\nAt the end of the meeting, Van Johnson, Sutter's president and CEO, decided that \n\nextending the eICU, while risky, was a good strategic move for Sutter. The partnership \n\ngot the green light; Hummel's magic worked again.About Users, Not Computers\nHummel didn't always think political machinations were so important. When he had to \n\npractice politics for the first time (while at Brim & Associates, a health-care \n\nmanagement company), he considered it "cheating" and "a huge waste of time." The value \n\nof technology, he figured, would trump any political issues.\n\n\nHe had an epiphany after an unsuccessful attempt to facilitate a meeting with doctors \n\nabout an effort to set up a pharmacy system in the clinic where the doctors worked. The \n\nsystem was designed to show patients' overall use of health-care \n\nservices\u2014including the pharmacy, radiology and lab. Doctors didn't see the value \n\nof the system because they didn't see it as enhancing patient care. Hummel was convinced \n\nthe doctors would value the data that the system could provide if only he could show \n\nthem how useful it was, so he armed himself with a 200-page binder filled with charts \n\nand stats to demonstrate how the system would help doctors control costs.\n\nHummel's strategy didn't work. He was so hung up on the system and data that he couldn't \n\nsee what doctors really cared about. "Over the course of a three-hour meeting, I learned \n\nthat the doctors...didn't care about the data. No one was listening to me, and I was \n\nreally frustrated," he recalls.\n\nSensing Hummel's frustration, Lee Zenlee, his boss at the time, suggested that he speak \n\nwith a few of the doctors one-on-one before the next meeting.\n\nHummel didn't want to spend his time talking with doctors. His job, after all, was to \n\nrun the computer systems. But he did it anyway because that's what Zenlee advised him to \n\ndo. Meanwhile, Zenlee was also working behind the scenes to rally the doctors in their \n\ncourt. When Hummel was ready to restate his case, he delivered it in a short report and \n\nthe doctors were receptive because he and his boss had addressed their concerns prior to \n\nthe meeting. "There was a remarkable change in attitude," says Hummel. "No one was \n\nangry, and they were willing to listen to me. I sat back and thought, 'Wow. Maybe part \n\nof my job isn't just running the computer systems. Maybe part of my job is managing the \n\nprocess.'"Overcoming the Introvert Within\nDespite his political savvy and his constant outreach, Hummel considers himself an \n\nintrovert whose idea of a good time is hiding in a corner reading. He's had to fight his \n\ninnate shyness in order to get to where he is today, a professional sought out by top \n\npoliticians for advice and by conference organizers who need articulate \n\npresenters.\n\nSchmoozing, says Hummel, is the hardest part of his job, yet something he does out of \n\nnecessity. He knows that if he's not visible to employees throughout the organization, \n\nthey won't know what he's doing or recognize IT's value at Sutter. So Hummel sets goals \n\nfor himself. For example, members of Sutter's senior management ranks are supposed to \n\nattend one to two charitable events each year. Hummel attends seven to eight because it \n\nforces him to get out of his comfort zone and interact with people. In such social \n\nsituations, Hummel's wife of 34 years, Ruth Ann, is his role model. From her, he's \n\nlearned to discover other people's interests and makes a point of discussing those \n\ninterests with them. It's basic Dale Carnegie stuff, but it works.\n\nWhat also works for Hummel, particularly in the high-pressure world of health-care IT, \n\nis maintaining a sense of humor and remembering to have fun. "There is so much pressure \n\ninside the technology operations of health-care providers that if you're not careful, it \n\nwill eat you up," says the Alliance's Wallace.\n\nHummel tries to leaven the often sober atmosphere in IT by staging themed annual \n\nteam-building and employee recognition events. "He understands that to drive people, you \n\nhave to have fun," says Peterson.\n\nOne year, Hummel asked more than 700 members of the IT staff to dress up as cowboys, \n\ncompose a poem about a technology-enabled patient safety initiative, such as the eICU, \n\nand sing it in small groups to the tune of a Gene Autry song. The purpose of the \n\nexercise was twofold: to force people out of their comfort zone by having them do \n\nsomething they normally wouldn't (such as singing in public) and to rally them around \n\nthe patient safety initiatives they were working on.\n\nIn the end, Hummel's soft side is an asset when it comes to charming his most important \n\nstakeholders: the physicians and finance executives. "Joyous, fun people attract you to \n\ntheir way of thinking," says Dr. Toni Brayer, chief medical officer for Sutter's Bay \n\nArea region.\n\nAdds Hummel's boss, Sutter CEO Johnson: "John has built an incredibly trustworthy IT \n\norganization. He listens carefully. He doesn't overpromise. He's very flexible. He meets \n\nhis time lines, and he has a lot of champions."\n\nAnd that's how Hummel has convinced this "tremendously consensus-driven" hospital system \n\nto invest $1.5 billion in IT.