Episode 10: Visionary Voices with Charity Darnell

Larry Kaiser:
Hello, and welcome to this episode of Visionary Voices. Today, I’m joined by Charity Darnell, Vice President and Assistant Chief Information Officer from the Methodist Health System in Dallas, Texas. Methodist is a faith-based organization that’s been a trusted choice for health and wellness for almost 100 years. They have 13 hospitals, award-winning organization with recent awards, including Time Magazine, Best Companies for Future Leaders, Glassdoor, Best Places to Work, and several awards around being a military-friendly employer.

Charity started her career as a registered nurse and has spent more than 14 years at Cook Children’s before moving over to Methodist, and I’m excited for today’s conversation. We’re going to explore several topics, including leadership, some application rationalization, and communication through digital transformation. Charity, welcome to Visionary Voices today.

Charity Darnell:
Yeah, thanks, Larry. Thanks for having me. I’m super excited to be here today.

Larry Kaiser:
Definitely, I think it’s gonna be a fun conversation. And like we do in all of our episodes here, we do start things off with our segment called Bandwidth Banter, which is our fun take on icebreakers, and it really allows our listeners to get to know our guests a little better.

So this… I’m gonna take a different approach this time, since I used to live where you live, which is in the DFW area, and I’ve visited several times since I moved away, but I moved away like 25 years ago or so. But what is your favorite thing about DFW? And then a second question would be, do you lean towards more Dallas or more Fort Worth? Because they’re basically two separate worlds.

Charity Darnell:
Yeah, so… well, there’s a lot of great things about DFW. I am from the Mansfield area, which is a suburb of Fort Worth and Dallas. So, like you mentioned, I worked at Cook Children’s in Fort Worth for almost 14 years, and then I just started here at Methodist Health System six months ago yesterday, so I had a brief time here. And I would have told you that Fort Worth was my place, so… you know, even though I live in Mansfield, I, you know, went to restaurants in Fort Worth, we went to, you know, the Fort Worth Stockyards, we did all of those things.

But I have to say, since my favorite thing about DFW is shopping, because there’s a lot of it everywhere, I would say that I’ve done more in Dallas lately, just because of, you know, how close we are, and I have found some really great things in Dallas. So, really great restaurants, the NorthPark Mall is over here, has lots more shopping. And so, since shopping is my downfall, I’m gonna say that I’m leaning more towards a Dallas person these days.

I mean, I have friends that are going to be upset about that, but it’s true. I think there is more to do here. Now, in Arlington, if you’re a sports fan, you have Cowboys and Rangers, and I’m a huge sports fan, more football than baseball. So, I’ve been to quite a few Cowboy games and quite a few college games. Ohio State’s my team. They play at AT&T Stadium sometimes, and so I will venture off that one.

Larry Kaiser:
You know, I, like I said, I lived there 25 years ago, and I’ve been back a few times, and the area, it’s a lot different than when I used to live there. But Deep Ellum is, like, I love to go there, because it’s a Diners, Drive-Ins, and Dives haven.

Thing when I travel is Diners, Drive-Ins, and Dives, so I was there a couple years ago, and I needed to go to the Pecan Lodge barbecue place, because I went there, and I was the happiest… I was happier than a pig in slop in that place. That barbecue was amazing.

Charity Darnell:
I mean, that line will wrap around that building, like, around the building. I mean, great place to go eat. And they’re really, I think, trying to make that area more welcoming. I think it used to be a nightlife place, like people would go.

Larry Kaiser:
Back in the day.

Charity Darnell:
Yeah, yeah, back in the day. And so, yeah, there’s tons of places to eat, and bars, and places to drink, and have fun, so yeah.

Larry Kaiser:
There used to be a great club right in the outskirts of the area called the Have a Nice Day Cafe, if you remember that one.

Charity Darnell:
No.

Larry Kaiser:
It was an 80s-themed club that we used to go to quite a bit. It had the light-up dance floor and all the… it was like magazine covers and everything, and they played 80s music until the cows came home. Those are my favorite places when I was younger, going there.

Charity Darnell:
Yeah, that’s my…

Larry Kaiser:
…this entire conversation talking about all the…

Charity Darnell:
No, we could.

Larry Kaiser:
Alright, so, Dallas it is because of the shopping. Fair enough. Our listeners will probably hit you up next time they’re in town to tell you the best place…

Charity Darnell:
Please do, please do, yeah.

Larry Kaiser:
Let’s dive into the conversation. We have some stuff to touch on today.

So, as I mentioned earlier in the introduction, I know you began your career in healthcare as a nurse, and I’m curious, as well as I’m sure our listeners are, about your journey from that side of healthcare to where you are now. I mean, it’s not an uncommon journey, but every single one of those journeys is different. So, curious if you’d just kind of tell us a little bit about your journey from a nurse to, let’s say, to the administration side.

Charity Darnell:
Yeah, so, good question. I’m gonna say that since I was a kid, my mom would say that I have a wicked curiosity. And so, I am often questioning the status quo, or why we’re doing things. And so, in 2010, our organization was implementing some changes to the electronic medical record at the time. We were on Meditech, related to some meaningful use measures that we were trying to meet.

And I just felt like the workflow was really bad, and I just didn’t understand why we were doing the things that we were doing. And definitely felt that if we were making changes, that the clinician’s voice wasn’t being heard, or we weren’t asking their opinion on the things that were changing.

And so, I went to my nurse manager at the time and just said, hey, you know, I notice some things are changing in Meditech, you know, not for the better. I’d really love to know, you know, who I could talk to about being a subject matter expert for some of these workflow changes and some things that are coming down the pike.

And my nurse manager at the time said, it’s funny that you ask that. We have a brand new CIO here at Cook. And she just recently started. She’s also a nurse, and she was like, it’s really rare. At that time, it really was. There weren’t a lot of nurses in CIO roles. And she said, so I’d love to connect you.

That’s Teresa Meadows. Many of you know Teresa Meadows. She was my CIO at Cook Children’s for a very long time. She was also a fierce advocate for, you know, human-centered design and having staff be a part of that.

So, I got connected with her team and with her, and really was able to immerse myself in the world of informatics. And as a nursing student, as somebody who was at the bedside, I really hadn’t heard about informatics before that time. We didn’t learn about it in nursing school, and so technology was fairly new to me.

And so I just loved being someone that could provide feedback to our IT teams about what it was really like to be a clinician at the bedside, and what worked for us and what didn’t.

And so I really learned Meditech. I, soon after, you know, a couple years as being a subject matter expert, led me into being our Meditech educator, and then a nurse informaticist, and then it was really just… I’ve spent the last 12 years in IT, and I absolutely love it. And I would say that even today, everything I do is really rooted in that foundation of, you know, is this going to improve care at the bedside? Is it going to improve cognitive burden for the staff? Is it going to deliver safer and more efficient care? And so, when I am looking to adapt technology, or I’m moving towards that discussion, it comes back to, why are we doing this?

Larry Kaiser:
Interesting. That’s a good answer. That’s a good perspective.

So, as a follow-up to that, then, I’ll ask: if you were not a nurse and got into IT, do you think your perspective of making the decisions on new technologies or adopting those new technologies would have been different?

Charity Darnell:
I mean, I work with technologists every day that do not have a clinical background, and I think being in IT, one of the things I’ve loved the most… because when I first went into IT, people were like, aren’t you gonna miss doing patient care? And I remember thinking, I’m still providing care to our patients, just in a very different way. And in fact, I get to do it more globally, so I don’t just impact our patients, but I impact our team, and the work that our team is doing impacts our patients and our families.

And when I’m interacting with technologists, engineers, network engineers, telecom engineers, Epic analysts that don’t have a clinical background, I appreciate their skill set, because it is different than mine. And so, we each have different thought processes, and we all bring something, you know, really important to the table.

And so, yes, I think my lens is often geared more towards patient outcomes and clinician experience. And I have that special lens when I’m evaluating technology, or I’m looking at workflows, or we’re talking about making changes.

But I really leverage the people on my team to look at things from a more technical aspect and really bring their lens and their thoughts to the table. And together, we all can come up with a solution that works best for our organizations. So yes, I do think that my view is a little bit different.

Yeah, but it’s exciting to work with so many different kinds of people. There are definitely times I’m in a room where I’m like, I feel like I have imposter syndrome, and they’re talking about server specs and network things, and it’s like up here. But I learn something new every day, and I think that’s the best part of my job, and what keeps me really excited to work in IT.

Larry Kaiser:
Yeah, you know, I’m a proponent of learning something new every day. I make an effort to do that, you know. In the industry that we’re in, it’s not that complicated to actually do, because…

Charity Darnell:
No.

Larry Kaiser:
…it’s changing, literally.

Charity Darnell:
All the time.

Larry Kaiser:
It’s not even… it’s minute by minute, hour by hour, day by day in some cases, so I can definitely appreciate that, and I think that’s a great perspective. So thank you for providing that for us.

You know, so, healthcare organizations are constantly battling budget shortfalls, budgeting issues across the board. Obviously, I think the average health system has 70 applications plus installed. In some cases, I’ve heard some that have over 1,000.

Charity Darnell:
Yeah, a lot.

Larry Kaiser:
Yeah, application rationalization is a common area of focus these days when they’re looking to focus on making room for innovation or new software and so forth. And it’s definitely not an easy task.

Do you have any insights or suggestions for other organizations who may be preparing to go through an application rationalization process as they’re looking to bring on new technology or new innovation?

Charity Darnell:
Yeah, absolutely. You know, I look at application rationalization probably from a little bit different lens. I think it’s less about cutting, and more about clarifying. So, one of the things that I’ve looked at when I am really looking at our ecosystem holistically, I’m trying to understand really, what are we trying to make room for?

So you talked about innovation, you talked about, you know, for example, if we’re looking to implement AI, or ambient listening, I’m first looking at, do I have tools that already do that thing, right? So, we are a Dragon customer, you know. Do I look at DAX? Do I build off of programs I already have?

We are not here at Methodist Health System—we’re a Dragon customer—but we chose to go to a bridge for a couple different reasons. But I think it’s about looking at your ecosystem holistically and deciding, do the vendor partners that you have today have the ability to provide that service, and can you scale that? Or do you need to go with a different vendor for different reasons?

And I think cutting applications to cut them isn’t or shouldn’t be the goal. I really think it’s about why are we doing that? We want to be bold, we want to be future-facing, we need to ensure we don’t have a thousand applications that we’re trying to support, so where do we start?

Low-hanging fruit first. We can get rid of some older applications that are running on older infrastructure that we don’t need anymore. But I think it’s about lifecycle management. I think it’s about looking at what tools we have in our tool belt today, and how we can partner with those vendors moving forward, and then taking some of those smaller chunks out where we’re not utilizing technology anymore and really getting rid of those.

And that’s really how I’ve looked at app rationalization in the past. I think it’s a journey of empowerment for organizations, and not a journey of just elimination.

Larry Kaiser:
Yeah, you know, it can be, I mean… terabytes, you know, petabytes of data any hospital has, any health system has, so I’m sure that comes into play when you’re thinking about that, and, you know…

Charity Darnell:
You can only support so many applications, you know. That’s right. I mean, and there’s only so many people, and you have to upskill your staff, right? And so you’re constantly evolving.

And I think it goes back to looking at applications and teams, not just by function, but by value, right? So what clinical value is it bringing? What operational value? What financial value? And then, what experiential value is it bringing?

And if it’s not, then we need to have a real discussion with the users that are using it whether we need that application or not, or do we already have other tools that can do something similar? Or is this just not even a problem that needs solving anymore, right? Because sometimes we just have applications that sit in our ecosystem for 10 years that likely a couple of users use, or may not even really use anymore, because that problem is not a problem any longer. So, it’s definitely looking at your whole ecosystem.

Larry Kaiser:
Yeah, you know, and there are certain applications that drive most organizations. In most cases, I know you guys are on Epic, and that’s your EHR platform, and you have your ERP platform, and, you know, ServiceNow could be a platform that you guys are using. So those are your main platforms, and it’s innovation off of those platforms, or whether you’re bringing in another application to bolt onto it. So yeah, definitely, I don’t envy those decisions that have to get made there.

Charity Darnell:
Yeah, they’re tough, especially when you want to be on the cutting edge of innovation. And you’re right, we’re likely going to be an Epic-first organization. We’re going to look at tools with partners, and I’ve said it a couple of times because one of the things that you and I have talked about in the past, outside of here, is the partnerships that we have with our vendor partners.

And a lot of the reasons why we choose Epic and Workday—and we’re not a ServiceNow shop here—but those larger vendor partners, is because they’re willing to partner. You can see they provide roadmaps to you, they’re willing to work with you.

And so, my recommendation when I’m talking to startups and things like that is we need to develop partnerships, right? If you’re willing to develop a partnership with us, and you’re willing to design with us, that is such a huge, important part of what I’m looking for.

When I’m working with people, I want to ensure that we are co-designing something together, and that you take our input into consideration when building your application if I’m going to look to you from a startup perspective. But it’s all about that relationship, and building that, and building upon that.

Larry Kaiser:
Yeah, and that’s a key thing right there. I met an individual at the CHIME Fall Forum who is an Oracle shop, and she was explaining to me how she feels so empowered by them right now, because they’re reaching out to the organization and specifically asking them, what do you need here? Help us make this better for you. And that’s what all vendors need to do, because that is how you’re gonna get where you need to be.

Charity Darnell:
Yeah, I think when we’re looking at all aspects of technology, I think we need… for our staff and for our patients and families, we need to ask… we need to come with… we may not have all of the answers, but we can solve them together, right?

And that’s the same sort of my motto, both internally with my team and externally with our partners, right? We don’t have all the answers. You said it’s changing all the time, and we need to be really thinking about the future. So, knowing that we don’t have the answers for tomorrow or the next one year to three years, what can we do to solve the problems that we’re having together? And I think that’s the most important part.

Larry Kaiser:
Yeah, I agree. I agree. Good stuff.

Alright, so let’s talk about the role of human touch, and let’s focus on AI. So, during a recent CHIME Thought Leadership Roundtable you participated in, the discussion really turned to sustaining the push for innovation in challenging environments, and I think everybody in the room agreed that successful digital transformation requires a shift in mindset and a shift in culture.

So, how does that start?

Charity Darnell:
Yeah, you know, you talked about being human-centered. The question you just asked should never be looked at as a technical question, right? That is a culture question.

We need to look at sort of being vulnerable, but having a vision, and understanding that at the center, it’s always people, right? It’s always people. It’s patients, it’s families, it’s clinicians, it’s our staff.

And so I really feel like in order to get to a place where we’re moving human-centered innovation, we all need to come to the table saying, okay, what is it that we don’t know, and how do we get there, right? It goes right… I mean, you practically just looped back to what I just said, which is we may not know what we don’t know, but how do we get there together?

I think digital maturity isn’t about just the tools that we use—AI, for example. We know we’re gonna use it. We know people are chomping at the bit to use AI. We know physicians, clinicians are ready to use it, and patients feel like when they go to organizations, they’re hearing about it.

And so, let’s be curious, let’s experiment with these things, let’s experiment with AI, but let’s co-design it and do it together.

One of the things I did at Cook Children’s, or the team did at Cook Children’s that I think is really valuable, is when we were implementing virtual nursing, and we were looking at implementing Artisite there, we really looked at having the nurses and even our Patient and Family Advisory Council come into what we called the patient-centered room, and it’s really like an innovation center.

It’s a fully designed inpatient room in the technical area, where they could come and they could put their hands on it, and they could provide feedback, and they could see how it worked before we ever piloted or went live, because to them, they felt like a partner, right? They felt like they could co-design that workflow, and they could provide insight, and therefore, they were more trusting in the technology.

And so, I think innovation is a shared pursuit. Right? It is not a top-down mandate. So if we’re looking at AI, or we’re looking to implement new technology, it has to be together. We have to co-design that together, and people have to feel like they have a voice at the table.

At the very beginning of our conversation, we talked about my skill set and my background as a nurse brings something to the table. Your voice and your experience brings something to the table, and so clinicians want to feel like technology is not being done to them—that they are a part of the process, and that they can contribute in that process, and so do our patients and our families.

So, when we’re looking at human-centered design, that is where we become more innovative. And it seems so simple. It seems so simple, but we’re also working so hard and so fast to get things done that sometimes we just forget that other people need to be involved, right? And so, you know, I would always say that don’t design something, or don’t implement technology, depending upon what the technology’s use case is for, without having a subject matter expert or somebody that has had the opportunity to provide feedback on that project.

Larry Kaiser:
I think you stated personally, it all starts with culture. Culture and people. So, you know, in your role here at Methodist, or even at Cook’s under… in that area, what types of conversations, as a leader, do you need to have to start that shift to things being culture- and people-focused, and not technology-focused?

Charity Darnell:
Yeah, so anytime we’re in a governance meeting, you know, or we’re talking about new technology, one of the things that Pam McNutt will ask, or I will ask, to the group is, have you run this problem past the cardiology council? Have you talked to them? Have you talked to the other cardiologists about this new CV tool? Have you talked to them about, is this truly a problem for all, or is this a problem that’s unique to one person or one department, right?

And so I think the way that you change that mindset is by also asking the question to the end users. Are we doing our due diligence to ensure that we’re being inclusive of everyone’s thoughts and opinions that this would impact, rather than just one or two?

Oftentimes, when you get to the why, or you’re trying to solve a problem, there are often times that the result is that it’s not a technology problem, right? It’s a people-process problem.

And so I think it comes down to asking the questions and really digging into what the problem is, and ensuring you have the right people at the table. The culture will begin to shift and change when people feel the psychological safety to be able to share how they’re feeling about the way that their current state workflow is, and what they would like to see their future state workflow be.

And so when people feel safe to speak up, or they feel like they are part of the process, they don’t push back so much. They’re much more bought in to the process, and they’re much more willing to provide feedback.

And so I think that’s how that culture changes. I think it’s about empowering people to speak up and having people feel that their voice is actually being heard.

Larry Kaiser:
I like that. I like the term you used, psychological safety. I think I’ve never heard that term before, but it makes so much sense to me in the context in which you used it.

And, you know, I’ve always liked to say, I’m not saying anything that’s never been said before, but you’re only as strong as your weakest link. And if the whole team is not involved in doing something, then are you really doing yourself the best service possible to do whatever it is you’re doing, whether it’s marketing, whether it’s implementing a new application, whether it’s designing a car, right? Everybody needs to have their input felt, and then by doing that, they feel that they are involved in the process, and therefore bought into the process.

Charity Darnell:
Yeah, absolutely. I mean, people are very fearful of change. When you’re like, I’m going to change what you’re doing, immediately they’re like, hold on a second, is that going to add more time? Is it going to add more clicks? Is it going to add more burden to me?

They’re less likely to feel that way if they’re not being told about the change after the fact, and they’re part of the change from the get-go. And so, I think that’s the most important part of innovation.

And so we have to get to a place in healthcare IT that we start bringing our end users and our subject matter experts to the table sooner rather than later. That is where innovation happens, because even in the very beginning conversations, when you start to talk, it’s amazing the things that come out of it, where you’re like, oh, I didn’t even think about that problem, or I didn’t even know that that was an issue.

Instead of getting 10 steps down the road and being like, oh, well, we didn’t solve for that or budget for that in the very beginning, all of that would be mitigated if we had those conversations up front. So, I think that’s the most important part of innovation, is collaboration.

And really building off the strengths and weaknesses of the team as a whole, right? And so I think that definitely is the most important part.

Larry Kaiser:
I can’t agree with you any more on that one, and I appreciate that.

Yeah, I think this was a great conversation. I appreciate it.

Charity Darnell:
Yeah, thank you for having me.

Larry Kaiser:
Yeah, of course. Well, you know, that does conclude our conversation on Visionary Voices. I want to thank you, Charity, for joining us today. Any last insights or comments you want to share with our…

Charity Darnell:
No, I appreciate… no, I appreciate you so much. I’ve had the opportunity to work with Larry and the Optimum team quite a, quite a bit, and so I couldn’t plug their services enough, but more than that, they’re trusted vendors, people, and partners. And so, thank you for having me, and thank you for giving me the opportunity to share my voice and my thoughts today.

Larry Kaiser:
Awesome, thank you. Well, to our listeners, thank you for tuning in to this episode of Visionary Voices, powered by Optimum Healthcare IT. And remember, the future of healthcare IT starts with your vision. We’ll catch you next time on Visionary Voices.