Lisa Emery: The uniqueness of an idea and the ownership - the right people wanting to do it, is one of the key ingredients bringing the right individual experts. There needs to be, doesn't there, an underlying absolute imperative that everybody's trying to solve and that is committed to solving, and then you bring the smart people in the room. Without a real case for change and a real driver to do it, it's very hard. That sense of purpose is a massive, massive component, isn't it?
ANNCR: You're listening to The Game-Changing Women of Healthcare, a podcast, celebrating courage, perseverance, creativity, and vision in the pursuit of healthcare innovation. Join host Meg Escobosa in conversation with some of the most inspiring and forward-thinking women working in healthcare today. Meg goes behind the scenes to uncover previously untold stories of struggle and success in a notoriously complex and highly-regulated industry.
As the worlds of healthcare and technology continue to converge, and as women take on increasingly more important roles in both, these are timely tales that deserve to be told. And now, here's your host, Meg Escobosa.
Meg Escobosa: Welcome back to The Game-Changing Women of Healthcare. I'm your host, Meg Escobosa. This month on the podcast, we're celebrating International Women's Day, which lands on March 8th, which means we're releasing four episodes this month. Today, we're speaking with Lisa Emery, who is the Chief Information Officer at the Royal Marsden National Health Service Foundation Trust where she oversees the digital transformation program and she is the Chair of the NHS London CIO Council.
Lisa Emery: It has been one of the real privileges of working at the Royal Marsden, actually, is that there's a fundamental unity of purpose in that organization. Everybody knows why they're there and what they want to be there for.
Meg Escobosa: Lisa has held multiple roles within the NHS, which include CIO at West Hertz NHS Trust, and IM&T Strategy Program Director at the West Hertfordshire NHS Trust. Lisa has spent over 30 years in healthcare, she began as a biomedical scientist, and thanks to an interest and passion for technology, she ultimately transitioned to healthcare IT. She is a really sought-out speaker in the field and we are delighted to have her as our guest today. Hi and welcome, Lisa. I'm so happy to be speaking with you.
Lisa Emery: Hi Meg, lovely to be talking with you, too. Really pleased to be here.
Meg Escobosa: Could you tell us a little bit about your background and you can add some that we missed that you would feel is relevant. And of course, I'm going to dive into some questions about your experience.
Lisa Emery: So background is an unusual one and I think it's a common theme running through NHS, the National Health Service, chief information officers. If I'm honest, we all come from incredibly diverse backgrounds. So I actually started out in science, as you said, I got my master's in medical microbiology. So all things bacteria and viruses, which is, you can imagine, in the current climate leads me to be being asked about a lot more than it quite often.
So that's been quite interesting to get my knowledge going back over that from many, too many years ago that I should say. So I started out there and then really just got interested. I've always had a real interest in technology and gadgets and it sits well with science, I think it's fair to say, and really just kind of started moving into projects, putting my hands up, I guess, to participate in IT projects as part of my laboratory science world, I just became more and more interested really in that side of technology and moved into project roles, which then just spiraled as these things often do into sort of more senior and more significant roles in IT, and I eventually made the move across from a scientific role into a full-time project role, which I did for about a year. And then completely out of the blue, had an offer to go and work in the Middle East for a period to put systems in. And this was one of those things that was really just all of the stars colliding, if you’d like.
So I had the requirement was for somebody that had a laboratory background, had knowledge of project management and was willing to, you know, jump ship and go across to the Middle East. And it was one of those opportunities where I just thought it was, you know, too exciting not to do it. So I spent two and a half years in the Middle East putting systems in there and then came back and just stayed in technology, really. I spent some time on the national program for IT, which was a big UK program looking to try and streamline systems across the healthcare system.
So I worked in London then, and I've just stayed in IT ever since, but always held pretty much always healthcare. Always come back to healthcare, absolutely love it. And now I've gone full circle in a way by coming joining the Royal Marsden and about three, four years ago into what is a very scientifically-led organization. So it's been a real thrill coming back and getting back into the science, as well as the technology. So a strange pathway. But as I said at the start, we all had strange pathways into being CIOs, I think, in healthcare.
Meg Escobosa: We really love the idea of intersections. The fact that you bring your lab, experience your biomedical scientist mindset to an IT role, and just the blending of those two paths obviously make you a very unique asset. And I think that those out there might be listening, who are considering a transition considering the next path, I mean, there are really nice benefits when you blend some experience from something else. There are a lot of learnings that can be applied. Are there some specific learnings that you've had that, you know, from your scientist background that you apply in a way that surprised you? Is there anything that you specifically leverage, on behalf of IT?
Lisa Emery: I think that’s a good point, certainly in terms of leverage the combination, I suppose, of when you're in the science career, in the NHS, you spend a reasonable amount of time understanding how the organization ticks, how things work. What the clinical imperatives are and what some of those priorities are.
And that knowledge is inherently a good thing. So when you come into an IT career, having a mix of clinical understanding and operational understanding, and the technical knowledge makes you a good translator, potentially it puts you in a good position to have the door already slightly half open. I guess if you're talking to a doctor, if you're talking to a nurse you're not coming from a position of no knowledge, right?
So that gives you just that little bit of cachet, that little bit of an opportunity to spark the conversation. So that's been, that's been a sort of a personal, and a person-to-person advantage. I would say it has been, that's been something that's been really good. And then from a more of the technology side, I think having a more scientific brain has stood me in good stead.
So quite analytical and structured. A bit technical and approach has been no bad thing in ways that have, as you said, have surprised me where I wouldn't have thought I could see a direct correlation or an application across the two career types, but there are, there are a number of things like that that have been really beneficial and continue to actually.
Meg Escobosa: Yeah, would you mind giving us an example?
Lisa Emery: The one that I absolutely loved coming back to the Royal Marsden was it was a bit like a school kid actually going into a sweet shop was going to have what I knew was going to be quite a difficult conversation with one of our very high profile genomics. So one of our genetics experts. He was having some real struggles around the IT provision that we were giving him.
And it was one of those opportunities where I when I thought about it, rather than go in and think defensively about why we weren't delivering what we needed to or what I might need to do from a technology perspective. I just said, can I come and see what you do? And it was so exciting to see how, from my career in science, it had moved on to this spectacular level that we spent the first half an hour, just walking around his lab, having an absolutely brilliant conversation about the science. And then the conversation about the technology was completely different. It's more of an interpersonal-skill thing. I think that's been a massive benefit than, than the science itself, if that makes sense. So it's been great.
Meg Escobosa: And you're building a relationship and then there's built trust really, which is so crucial. Were there scientists in your family, was there something about your home environment that enabled you to dig into science or your school?
Lisa Emery: There absolutely was. So I had always intended to go into teaching. I really, really wanted to do teaching and I didn't really work hard enough at the time. Didn't get the levels I should have done. So I didn't get the qualifications I needed to get into the particular university I wanted to, but at the time my mum was a biomedical scientist as well, herself. So she was in histopathology and cytology, and I'd always admired what she'd been doing when she gave me the nudge in the summer holidays when I was a bit down in the dumps about what to do next and encouraged me to go to my local hospital, which was the West Hertfordshire area, which you mentioned earlier and just see what was on offer and see if there were any opportunities. And I did that with her support and leadership and guidance in there. That's how I ended up getting into the idea of doing microbiology.
So I took an apprenticeship there and studied from there. And what was lovely about it was my mum was obviously on a break at that point, there were four of us kids, so she'd done. She'd been bringing us all up wonderfully well, and she went back into her career and got her degree in her forties, which was just fantastic. So you've got, if you talk about role models, there was one. So that's what got me into the science side.
Meg Escobosa: Oh, that's great. Oh, I love to hear that your mom was such a good influence. You know, I have teenage daughters myself, and it's interesting the dance between influence and patience and, you know, and it's just, it's so good for her. She's something about how she does, you know, I'm sure it was a debate in her own mind. Do you know how much to tell you to pursue what she was doing?
Lisa Emery: And you don’t think about that when you're 18 do you or you're just a bit, you know, you can be a bit reluctant to be moved around. She was doing the right thing. So I'm glad she did it.
Meg Escobosa: That's great and it's true. We won't see the results of our labor as parents until way far down the line. They, you know, the kids will recognize that someday. Maybe in their thirties.
So our American listeners may not know much about the UK’s national health system structure. I know that your hospital, the Royal Marsden Foundation Trust, was founded in 1851 by William Mardsen, who was a surgeon with a passion for helping the poor get access to care, and he also lost his first wife to cancer. So he opened the world Marsden with an idea to treat cancer patients, which is amazing. You're leading a major digital transformation effort at that hospital. Can you tell us a little bit about that work and even just the transformation that's going on at the NHS overall around health IT?
Lisa Emery: Yeah. The Royal Marsden specializes in cancer. And we were in a very interesting arrangement in terms of our approach to research and treatment, where we have a partnership with the Institute of Cancer Research. And what that effectively means is that we sit in as a joint biomedical research center. We share our resources and our staff and our absolutely incredible scientists and experts across the two organizations.
The Institute of Cancer Research focuses very much on the development and the academia of that science and then that's translated. So the way we it's always described as bench-to-bedside. So the treatment becomes the bedside treatment within the Royal Marsden. So it's a partnership that's been there for many, many years, and that's what that focuses on. So huge research emphasis, and then obviously a bigger emphasis, as you'd expect in the moment as well on prevention, early diagnosis, ongoing treatment through the pathway. So we'll have patients referred into us through primarily West London because that's where we're situated, but absolutely from national referral centers. And we see a lot of international patients as well. So we see patients from the Middle East, from China, from the US who come in, either for second opinions or very specific treatment-based on some of the experts that we have in the organization.
So at the moment what's happening broadly within the NHS and makes the technology aspect really challenging and interesting and exciting is looking at how we ensure that care is place-based for the person. So it's centered around the needs of an individual and the, all of those component parts, I've just sort of, not very well, but broadly described are able to interoperate with each other and to share information and to ensure that what the person who's having the care gets is a complete end-to-end experience rather than repetition as they visit each of those component parts.
If that makes sense.
Meg Escobosa: Right, let's do another test here that you've just had in this other department.
Lisa Emery: And we describe your conduct, you know, re-describe your symptoms or go back through your history. So there's a big emphasis in technology, in the NHS at the moment in really genuinely putting that interoperability together. I think if you think about the comparison to the US we're implementing a system and you have a health record system, that's very widespread in the US is Epic. There are lots of examples in the US of multi-organization health records. It's less the case here and we were working hard to make sure we can join up a bit more.
Meg Escobosa: Well, good luck. I mean, I know that it's a huge effort. What is the payoff of, I mean, you've sort of described it already, but maybe let's just be more explicit about what the benefits are of interoperability.
Lisa Emery: So we think about patients that may have come to us from their first interaction with the health service in the NHS, maybe has been seeing the GP. A potential diagnosis of cancer as a concern coming in through that, perhaps either their local hospital and that raising the need for referral they'll then come to us for diagnosis and treatment.
So by the time they arrive with the Royal Marsden, they've probably seen multiple healthcare professionals. So to that earlier point, wouldn't it be great if as they come to us, we have all of that digitally to hand, straight away to ease the anxiety of the patient, because we know that we have everything captured and in front of the clinician. Clinician can spend more time with the patient rather than gathering information and we can be speedier to see them in to diagnose.
So the core imperative really is to speed up the time between a concern being raised and somebody being through diagnosis and into treatment. And then obviously the opportunity we have with our Institute of Cancer Research partnership is how can we make that period from arriving in the door to diagnosis and a treatment plan, as short as we possibly can and as painless and easy for that, for that person in a very difficult time, or is a very difficult time of life - obviously a cancer diagnosis as short and efficient as possible and get them onto treatment. So these are the real, you know, the real world benefits of doing this better.
Meg Escobosa: Absolutely. The pandemic has impacted health IT dramatically and health systems overall. I imagine that you all had to do a lot of pivoting or prioritizing or speeding up your effort. Can you describe what that was like? The process of adjusting to the demands of a suddenly virtual workforce and just much more pressure on the digital function of the hospital?
Lisa Emery: Yeah. It's had a huge impact. If you say, you know, for really sad reasons and a way a colleague, a peer of mine describes it, is that it is absent the period of time where we've been responding to COVID is just turbocharged the technology agenda, particularly in the health service. So we had to, you know, from the practicalities, if you like of just provisioning, working from home for large proportion of the teams, which was a huge challenge to everybody, I know absolutely everybody had the same challenge to some of the practical elements around patient care - so implementing virtual appointments and the ability to do video consultations was a huge one.
Some of the really impactful things, would it seemed quite small. So as an example, we had our charity donated a number of iPads, which we got out onto the wards quite quickly so people could have virtual visits with their carers and relatives and those things that are seemingly quite small, had such massive impacts on a personal level.
Meg Escobosa: Human contact.
Lisa Emery: Exactly that. And we had, you know, examples of, for example, you know, one of the, I recall was a patient, was going in for a really difficult diagnosis discussion and treatment discussion. And because of the visits, the restrictions we obviously had. They couldn't bring as many people as they normally would with them, but we were able to put some technology in the room so that they could have their partner on the call, at least, and with them. And that was, that was really important and impactful, I think.
And then on a sort of scale level, we have as a cancer center, you spoke about it earlier. We have teams of clinicians working together to discuss cases and talk about treatment protocols and things. And that's across not only our hospital, but 3, 4, 5 other hospitals across, you know, 30 or 40 different types of care.
So we had to set, send them all virtual as well. You're right. We did in the space of a week, it was unbelievable. But what was, what was really amazing about that? It's one of those great change agents things. Isn't it? So where we had real reluctance to move that kind of a discussion from a room full of finishings to a virtual fitting, suddenly necessity. Everybody had to do it. We got some grumbles and some groans, but it was adopted incredibly fast. And now it's the de facto how we do things. And if I just got discussed with them, whether there's any chance they might like to go back. Absolutely not. So accelerated change necessity has been very interesting.
Meg Escobosa: Amazing. I know. And that's, that's really the, the silver lining of this difficult, horrible experience that we've all lived through. You know, the resistance that, you know, because health IT is often change management. Absolutely. You know, you're asking people to adapt the way they work, because it's such a fundamental part of how information is shared and managed. We don't appreciate it's not just a technical job. There's a leadership change management process, innovation component. Maybe you could share some of your insights and learnings about change management and how you get an organization to a new place and how they work. And maybe it's just shedding light on timelines.
There's a technical transition, the physical implementation of a new machine or computer system, but then there's the, how long does it take to get people to actually use it and adopt it properly so that you're actually benefiting from this new implementation?
Lisa Emery: That's a fascinating question, isn't it? You're absolutely right. I mean, it's hardly ever about the technology, is it? It's usually about the change and people, and the motivations for the change. So our implementation of our new health record system, which would you go live with in March of next year. So it's very much upon us. We've got our T minus one countdown coming up soon.
It's exciting, it's what everyone's been asking for. But now everyone's slightly concerned because it's coming upon us, but that's been a fantastically interesting case in point. So we talked about COVID and COVID driving change through necessity. And then some of those things being fantastic, some of them, you know, may need tweaking, or we might change back.
But when we think about our electronic health record, which is such a huge undertaking that touches everyone in the organization. For some time, the motivation was the difficult part of that question. So if you look at it, we're an outstanding center of care. We're one of the leading cancer hospitals. The standard of care is just exceptional and the staff that deliver it are amazing.
And when you therefore then layer onto that, a conversation about, shall we change one of the biggest things that we have in our arsenal, the question comes back as to why. So then your, your whole thing is how do you have the discussion and how do you frame the why? Because we're great anyway, why do we need to change?
What would we change? There's risk, and does it mean we would become, you know, we'd lose those things that are special about us. Would we become less effective and so on, but. That was a really good challenge because what we did there was spend lots of time talking to people in all different levels of the organization with lots of different interests and framing for us, what's been successful in terms of engaging for this program of work has been framing what we expect the outcomes to be around, what it means for primarily our patients, clearly.
But what does it mean for different groups of staff? So if you're a researcher at the Royal Marsden, you're suddenly going to get a much richer set of data. You'll have more access to far more to inform your research and to really drive forward how we treat cancers in future. Better, take better information more at your fingertips and so on.
If you're operational you’ll have far more real-time reports to show you how the organization's functioning, where we can make improvements. If you're a nurse, does it mean you get to have this time filling out paperwork and more time doing what you'd like to do on the know in your ward? If you're a doctor, what does it mean? If we implement elements, like for example, voice recognition and ultimately things like ambient listening, when you get to spend more face-to-face time with your patient and less time taking down notes. So those are the sort of positive comp bits of conversation we've had. But at the same time, injecting that realism, that this is going to be really difficult and it will be harder. And it does mean we have to commit to it really hard and get over the bumps together. And it will be a little while till we start really seeing the benefits.
There's one of my colleagues. I wouldn't say it was, but very senior and I loved the way he described it. He was asked by a consultant body, would he, how would he describe how he felt about the whole thing? Just, it was a great question about implementing epic and our new health record. And he said, “You know what??” He said, “I'm excited and terrified.” He said, “I think in equal measure, but I'm definitely landing on the excited side,” but I thought that was such an honest reflection rather than say, “Hey, it's all going to be great.” He knows what it's going to be and what it would deliver for us. But he also knows it's going to be hard. Yeah. And I think you've got to be honest with those conversations.
Meg Escobosa: Well, and it actually, it makes me think that when you take any big leap, there is just a natural risk and scary moment there. So you have to have a leap of faith.You have to believe that it's going to work out otherwise. How are you going to do it confidently? And confidence makes a big difference in terms of outcome.
Lisa Emery: It does and also thinking about how you position that a program like that. So, you know, timescale wise, we're being relatively aggressive with that timescale, but what was fundamentally important there was that this wasn't an IT project. It's a clinically-led change. And we've got to be true to that. We've got to mean it. So putting the right clinical leaders front and center of the program and making sure that they're driving the decision-making - really the services my team offer are there to enable and lift and ensure the underpinning fundamentals are right, but we're not there to drive the decisions and how we use the system. Because if we want user adoption, we've got to do that. And you're a hundred percent correct in the danger if you don't do that, is that you it's the old, you know, buy-a-Ferrari-and-leave-it-in-the-garage analogy, isn't it?
If you're doing something, buying something that is as expensive, important and game-changing it's like, you have to mean it and you have to mean it for the next 10 years. You don't have to mean it to get yourself over the line, go live, sigh a bit of relief and then relax. It's got to be a long-term event.
Meg Escobosa: Something like this requires a great deal of leadership skills. Can you reflect on your own leadership and how it may have changed over the years and what you've learned about leading in this kind of an effort, something that impacts the entire organization. So just share some insights and learnings from your experience as a leader.
Lisa Emery: Gosh, I've learned so much because partly if you think about it and never having intended to get into this kind of a role, you just learn, you're learning as you go along, aren't you, and obviously picking some really fantastic role models and mentors has been hugely important, but even just for me, it's been just really taking insights and good criticism and guidance from people because if I think to my last CIO role, which was most of my first role, it was the first time I'd also been on an executive team as well. So in a lot of respect, as a woman, in a sudden leadership role in IT, first executive post I'd ever done, I felt really quite at sea. You know, it was one of those things of, well, who am I, how do I behave? And then you've got the old imposter syndrome. Should I be here? What do I do? And I had to take it on board that I needed to ask for help when I needed help. So I offered coaching, took some coaching that was really helpful. Find some really good mentorship as I mentioned, and really learn from both positive and negative experiences.
So some great leaders that I've worked with who have delivered, you know, amazing insights and help and been fantastic role models. But I'd also, and I've always said this to people - learn from the things that didn't go so well. So be willing to take on the chin if you've done something that didn't quite work out, go and ask some serious questions about how and why and what you could've done better, but also learning from people who may be, you wouldn't necessarily choose to follow from a leadership perspective, but you still learn, you know. I've definitely had experiences where I think I would not have done it like that, but there's always been some nugget that I'll have taken from it.
What I've learned over time, particularly in this type of role, is that having moved from kind of practical science into program management, where I've been very, very hands-on in those roles…I can directly influence everything, you know, I've got control. I can, I can get things done. So then as you get into more strategic leadership roles, realizing that you can't and you shouldn't be either. So it was all about your team then, isn't it? So learning and being critical of yourself, of backing away from things that either you shouldn't be doing and you can't do, and someone else can better do, and really feeling that sense of trust that, you know, you've got the right people around you to get it done and to do it really well. That's been a very big learning curve and I've had to sit myself down a number of times; less so as I've got older, but certainly to say, you know, back away takes it, let people take some risks have their backs, make sure everything overall is okay, but you've got to let people learn and grow.
So I know people took a risk on me through the course of my career. I now try really hard to make sure I pay that back, if you like. And then not the other one I've is really listening to the people that use your services or the people that need to use the things you have. So I've done it in the past, have been very guilty of bowling in with what I think is wonderful piece of technology, which is gonna change, you know, game-changing or change the way you do things. You'll love it. It's amazing. And coming, you know, five weeks later and it's covered in dust because I haven't actually asked that person or group of users what they want. I just think I've solved their problem before I’ve even walked in the door. And that's a hard lesson because it feels like criticism, but actually it's just, you not starting in the right place with going and talking to people about what they're probably more what they're looking for and then do your job, which has come with suggestions after that. So, yeah, listening rather than jumping straight into solution-mode has been a big one.
Meg Escobosa: I can really relate to both of those examples. Certainly even the first one, just letting your team step up and deliver and the learning that they will go through by stepping up and knowing that it's on them. I mean, you're there in the background and you're there to support them and you'll make sure that everything goes well, but on the other hand, it's their opportunity to step up and their responsibility. And so when it's, when it's like that, they know it. And so there's something else comes out in the way that they own the work. So I really salute you for doing that and making that transition. Cause I've seen it myself that I benefit when, when my leaders step back and let me step forward.
Lisa Emery: It's a hard lesson though, isn't it? Because if you feel like you carry the responsibility of making sure something gets over the line, you can very easily do that. And I think there's also a tendency, isn't there, we all have it: we go for safety nets as well as human beings. So trying to operate outside your own safety net and give other people the latitude to do it as well, is quite hard to, to learn and to stick with
Meg Escobosa: What skills or know-how do you think the next generation of IT leaders in healthcare need to know or have to succeed in a modern era of health?
Lisa Emery: This is a really interesting one, isn't it? Because I think it's, it is moving along. And I have this conversation with particularly actually with, with female colleagues and with people coming through from sort of schooling-university age, I think there's been a tendency and it's been particularly the case in the field I'm in of looking at future IT leaders as needing to be technically adept and focusing very heavily on the it component, what you see more and more, and certainly I've seen it even in my own time in the evolution of the CIO role in the NHS, for example, is moving that role, that strategic role, more to a transformational type of individual.
And so somebody that ideally sits on the board makes works with colleagues to make decisions and help make decisions about a holistic, you know, talk about the whole needs of the organization and not necessarily what whilst understanding the technology clearly and being, you know, having deep knowledge and the right team around you really it's more can that individual understand business needs and requirements and translate those into the technology that needs to be delivered. We’re moving in towards that now. So we're moving more away from a sort of more traditional IT director type role.
What I think we're possibly failing at, and not possibly, we are failing at is starting to get that message out more. So if you're coming through university coming out of college, what are those opportunities? How do you aim towards these kinds of roles? And actually, do we pay enough focus to the fact that some of those soft skills are just as important as the technology understanding and encourage people with, you know, you can learn both. Absolutely, but you can learn technology. If you've got some of those interpersonal skills and that fantastic approach to stakeholder management and, you know, listening to business needs, why wouldn't we encourage you to get into this kind of job? I think we don't signpost career direction very well. And we probably don't give enough guidance at a younger age to make some of these technology jobs in healthcare sound as exciting as they actually are.
Meg Escobosa: Right. People just have a superficial understanding if they're not in it.
Lisa Emery: It tends to be the case. Yeah. You tend to rely more on either knowing sort of word-of-mouth or knowing somebody who's been in a role, you know, you can't be what you can't see. I just think we could do more. And so I, you know, I tried to get involved in opportunities where I can to go out and promote what we do in healthcare IT, and talk to people about those career opportunities, but I think we need to get a bit better at it from schools really.
Meg Escobosa: I know that you really believe in the notion of hospital leadership, really reflecting the population that you serve and the diversity of the population. What are some of the challenges or barriers in achieving that goal? And what more do you think we can do to draw more people in? I know we're sort of just getting to that topic.
Lisa Emery: We're getting better at having the conversation aren't we, but it's still the case. When you look at it that we've got an incredibly diverse population of patients that we see, I've got a very diverse team actually, within my digital services team, but what we're not really seeing still, at that leadership level so leadership and board levels within within health care systems, is that community being represented at that level. So for whatever reason, we are failing people coming through on those sort of lower-grade jobs. Being able to see that path to leadership. So we've got to do a lot better at that.
There've been some brilliant initiatives–certainly within the UK looking to try and help with that. So I've been actively supporting a group called the Sheree network who are doing a fantastic job around increasing diversity particularly for women within healthcare. Because again, there aren't enough women in, in IT, but when you extrapolate that out to women from different ethnic backgrounds as well, there's even less representation. And we've got to try and do all we can as proper allies to help push that agenda forward because the conversations I have with my team and, and it works well for us is that if we're serving a huge population of our patients and relatives and so on, us looking and thinking and having that diversity of thought that is representative is really important. By diversity, I mean right across the board, you know, diversity of thought as well. So I'll be taking everything into account. We've had some good conversations now, but if you look at some of the innovations in healthcare, around AI and algorithms and things and making, you know, the chance that you can introduce an inherent bias into those as an example.
So we've got to get smart at how we do it. It's on all of us. I think that's the important thing, you know? Yes, I'm a white female in IT. I'm relatively rare, but not comparatively. The best thing I can do is be a genuine ally. So not a performative ally, but really actually getting out and doing what I can - listening, “What is it that people need to get on? And how can I help move the agenda forward?”
It's on everybody, isn't it to try and take this forward, but we do need to see positive action. I think from, from leadership teams within organizations, to make sure that we really are driving that agenda forward. It's very difficult, isn't it? If you think I know it was for me, when I walked into an IT career, there were hardly any women in the room when I walked into that scenario and I've had great support and help. I've got to wear a hat on or putting the ladder up, making sure that I'm helping future generations of people that want to do the same job.
Meg Escobosa: Yeah, I wanted to hear more about your, I know mentorship is really important to you. Can you tell us about what you've learned from mentoring others and some of the biggest mentors?
Lisa Emery: It's such an important component, isn't it? So I've, I've had some amazing people that have really stepped out for me over the years, particularly coming, I think, into what was a very new area for me. So when I came back from the Middle East back into the UK healthcare scene and everything was quite up in the air and it was a big new program of work, I had a colleague who was just really inspiring to watch working.
She was a fantastic Australian lady who just moved back to Australia now, but that will always stick with me in that she did the things I now try to do, which was, she knew I was relatively new. You needed to take some risks because we had lots to deliver. And she did exactly what I described earlier, where she took me under her wing, but let me get on with the job and let me make a few mistakes, jump in and stand up for me when I did, which was fantastic. But also just somebody I could watch, particularly a female in a very, at that time, incredibly male-dominated environment, being her true self, which was a massive learning. So not feeling she had to put on a performance to be a woman in that room, but she was just herself and firm in her leadership, understood her skill-sets, held to her values. I'll always thank her for that because it just made me realize I needed to stick to my principles and my values and be myself and be an authentic sort of leader. I won't ever quite do it to her standards, but I do try and pass it on.
And what I've found over the last few years, in particular, is what I'm seeing too. It was to earlier point actually about how do we see new leaders coming through is I've been talking to a lot of young women coming into either IT or looking to get into healthcare IT roles, and lots of those conversations that we have haven't actually been about the technicalities of doing the job at all. They've been about what do I do in that environment? How should I be, what do I need to think about? What's my approach? We have those kinds of conversations and it's been fantastic. Lots of the conversations are about how to manage difficult situations and conversations and how to manage people with varying priorities and takes on things. So it's been a lot more people-centric than it has about technology careers, but really good.
Meg Escobosa: What are some of the ways that you handled difficult conversations or any other examples of things that they might have taught you.
Lisa Emery: I have so many things because the problem with working in an it career in healthcare, I've always said this. I had a colleague actually, who I was mentoring. And he, he said, “I really, really want to be a CIO.” And I said, “Okay. And why?” And we talked about why, and there were lots of good reasons. And I said, “Are you sure?” And he said, “Well, what, what do you mean, are you sure?” And I said, “You will never be the most popular member of the team,” because IT is never, never going to quite do what everybody wants it to do.
You know, it is a bit of a hidden dark art. And when it works, it's great. And as long as no one's talking about it, you're in a brilliant spot. But as soon as something goes wrong, hey. So you'll need a thick skin and you'll need to really love what you do. And that's been, that's been something to sort of hold true to naturally, I think, but yeah.
Meg Escobosa: That is great advice.
Lisa Emery: Well, you kind of think that, but what I found in terms of the difficult conversations, if you like, is always say to people, see if you can have that person think about it from a slightly different angle.
Can you play back why it's difficult for you to deliver for them what they'd like to have in a way that fits their role or their challenges, if you like. So if you're talking to somebody whose default position might be, “Well the IT doesn't work, it's all terrible. This is awful. I don't see why you can't do X, Y and Z,” you wouldn't probably come into that environment to a clinician and say, well, I don't really understand why you can't just see 50 patients in an hour.
It just makes no sense to me, it's nonsense. And when you start breaking down your problem and they break down their problem and you sort of play it back carefully and respectfully in terms of why it's hard or why it's difficult for you to deliver that you find the dynamic changes a bit. Yes, listen; yes, digest the problem. But don't always go out of your way to accept that there must be a problem on your side and you need to run away and fix it. There's something about respectful challenge and dialogue, isn't there? So you need to be able to hold your ground to the degree that you can explain why it's hard, why it's difficult, what else you might be trying to manage at the same time and encouraging that dialogue and debate because you're talking to somebody that's saving lives and delivering patient care. And you're, you know, you're over here with your wires and boxes and things. And it's never that simple.
It is very easy to feel several layers back from direct patient care if you work in it, but it's not the case. You know, everything you do has an impact. If you can't run the network, the hospital can't run. If you can't provide the devices, people can't enter the clinical data. And once you start sort of trying to stitch it in that way, people feel more connected to the services they’re delivering.
Meg Escobosa: What risks have you taken that ultimately did not work out and what did you learn from that experience, and how does that inform how you operate today?
Lisa Emery: That's a really good question, actually. A good example, without getting into too much detail of it, is probably something we really pushed to do in a, in a role I was in before that we absolutely needed investment forums was the right thing to do.
And we went hell for leather to make it happen. And we were let down by what was then delivered. And when I look back on it is still the right thing to put time, investment and direction into, but I probably would have asked some hard questions and not had quite such optimism bias around how it might work out.
And in terms of what it's made me look at now, I probably wouldn't go down the same route to deliver the outcome as well. I have taken on the lessons from what I was probably incredibly enthusiastic about and had a bias towards thinking would work just because I genuinely believed it would have been a little bit more critical and consulted more widely on reasons why it might not.
Meg Escobosa: Yeah. You had the optimism, but you're essentially saying you needed to bring a little more skepticism to the process.
Lisa Emery: I think so. Generally speaking, if you tend to have the attitude of really want to make it happen, I will make it happen. But, you need to check you're not overly optimistic, but also that can be a bit difficult for people around you as well, and you don't necessarily realize that. So you're, you know, you're driving at something that you're absolutely sure will work can shut you off a little bit to listening to people who may have very valid reasons why it might now.
Meg Escobosa: The optimist is going to drive us to the new new direction, but it needs to be balanced.
Lisa Emery: I think that's true. And so, yeah, you tend as well then when you're surfing this wave of optimism, not to. So if you were in a group setting and it's harder, and it’s harder now with virtual, but when you're in big program meetings, I try and make a conscious effort now to look around the room and make sure everyone's got to have a say, because sometimes those most quiet and insightful and reflective people are just taking the time to then make a point. You can allow that to get swept away if you're not careful.
Meg Escobosa: And they may be raising a point that sort of deflates the balloon. That doesn't feel good to be the deflator. So you hold back because everyone seems pretty happy and excited about this new idea.
Lisa Emery: And it goes back again, doesn't it, to what we were talking about earlier around having genuinely proper representation as well. If you surround yourself in that bubble of people that look and sound and feel and say what you do, you will miss some hugely important things.
Meg Escobosa: In our work in innovation too, we want to create a space for the idea to be explored, but then there has to be an analytical time. We separate those two steps. We generate ideas in a certain mindset where it's don't judge, don't criticize, and then we come back to that and we use some analysis and we, you know, informed criticism, so to speak. So there's value in both of those steps.
Lisa Emery: Absolutely.
Meg Escobosa: When you think of innovation, what comes to mind?
Lisa Emery: So in its purest sense at the moment for, for me in the role I'm in, it's the absolutely amazing opportunities around what we can do with algorithms and AI and speeding up diagnosis and using this amazing data and information that we have to do things like tailored care, tailored chemotherapy, but as importantly, how you then take all of that data in a research setting and start to use it to inform faster diagnosis or prevention. There's lots of technology that is unbelievable in that space. When I sit down with some of our clinicians and researchers and watch what they're doing, it blows your mind. Some of it is absolutely incredible and all you're thinking there is how do I give them the technology to make sure they can do this? It's amazing.
But at the same time, for some people at the moment, with what they're struggling with tech, it would be innovative if they could just log in to a device in less than five minutes and not have to flick through 25 tabs to get to the record they want. That would be innovative.
So, you know what I mean? It's one person's thing is not another's. And when you talk to people who are suffering from that kind of frustration, if you offered a simple elegant solution, it wouldn't be innovative in that sense of the word, but it would be a game-changer for them. Right. So I kind of try to see it across a bit of a spectrum.
Meg Escobosa: Absolutely. What is one of the most exciting innovations in the healthcare industry from your perspective?
Lisa Emery: From what I've been seeing with the teams we've been working on at the moment. And it's very particular to the setting. I mean, I guess I think it's the opportunities now around bringing together the various elements of research and treatment into a single space so that you can start treating cancers and patients in an incredibly specific way.
So if you bring pathology, you bring blood results, you bring scans, you bring all of the amazing diagnostic work that's been done into a space into one place, pull it together. The power of that data together versus being analyzed separately has got the capacity to completely change the way that cancer is treated. That for me is the sort of innovation that I'm incredibly excited about and it's not my innovation to be in the middle of, but it's certainly hugely influenced by technology delivery. So really excited to be part of it.
Meg Escobosa: From a patient perspective, it is thrilling to think that yes, all this data can be used to help get us insights and knowledge and clarity about what's happening.
Lisa Emery: Exactly.
Meg Escobosa: What do you believe are the most essential ingredients to healthcare innovation?
Lisa Emery: Well, that's a good question. Isn't it? Clearly funding is important, but it's not the only thing. Is it the uniqueness of an idea and the ownership and that, you know, the right people wanting to do it is one of the key ingredients, isn't it? So bringing the right individual experts under an absolutely collective banner of the reason they want to do that needs to be, doesn't there, an underlying absolute imperative that everybody's trying to solve and that is committed to solving. And then you bring the smart people in the room, don't you? Without a real case for change and a real driver to do it is very hard. It's great to have all these fantastic ideas, but to actually make it happen, you've got to have that really committed group. Haven't you? That understands why they're doing it and wants to do it. It's been one of the real privileges of working at the Royal Marsden actually, is that there is this fundamental unity of purpose in that organization.
Everybody knows why they're there and what they want to be there for. And it makes driving innovation still challenging for all the other reasons we've spoken about today, but that sense of purpose is a massive, massive component. Isn't it?
Meg Escobosa: Lisa, thank you so much for making the time to talk with us and to share your insights and experience with our audience. It's really wonderful, and I know people will really benefit from hearing your story and your perspective. So we appreciate it. Thank you.
Lisa Emery: No problem, it's been lovely talking to you.
Meg Escobosa: And thank you to our listeners for joining us today. If you enjoy our show, please consider leaving a rating and review wherever you listen. It helps us reach new listeners. And if you know other folks who might enjoy it, please spread the word. To find out more about The Krinsky Company. Check out our website. See you next time.
ANNCR: Thank you for listening to The Game-Changing Women of Healthcare. This podcast was produced, engineered, edited, and scored by Calvin Marty. Please take a moment to subscribe via your favorite streaming service. The Game-Changing Women of Healthcare is a production of The Krinsky Company, a growth strategy and healthcare innovation consultancy.
Visit us on the web at www.thekrinskyco.com.
