Leading Through a Merger

Craig Richardville [00:00:00]:
When you go through a merger, you actually have an opportunity to create a new culture, respecting and trying to understand what the past cultures were, but you do have the opportunity to create new. And Intermountain is recognized for its history and the quality and patient safety and high outcomes and lowering the cost of care. So it could have been very easy to be absorbed. But I will say with the board and with the leadership team really took a step back and put all the cards on the table, started figuring out which cards are we missing and which ones do we want to move forward with.

Narrator [00:00:36]:
From healthcare it leaders, you’re listening to Leader to Leader with Ben Hilmes. On today’s episode, our guest is Craig Richardville, chief digital and information officer at Intermountain Health. Craig has made transformational impacts to the healthcare industry with his innovative approach that champions innovative technologies and a dedication to putting patients first.

Ben Hilmes [00:00:59]:
Craig, it’s great to see you.

Ben Hilmes [00:01:00]:
Thank you so much for joining the Leader to Leader podcast with me. I know your time is pulled in many, many different directions, so having you on the show is an absolute treat. So welcome.

Craig Richardville [00:01:12]:
Thank you, Ben. It’s a pleasure to be here. It’s great to see you.

Ben Hilmes [00:01:15]:
We’re going to talk a little bit about your organization, all the things that have been going on there. Then I want to get into some leadership conversations. So we try to infuse leadership journeys and insights to our listeners. And I know they’re going to get a lot out of listening to your journey and then just land with a couple general questions. So let’s get started. So 53 hospital mergers in the first three quarters of 2023. And I’d say 90% of those have a defensive posture. And then you look at the last 18 months, there’s been a handful of what, mega mergers, if you would, you got BJC and St.

Ben Hilmes [00:01:56]:
Luke’s, Kaiser Geisinger atrium advocate, and then Intermountain SCL, which you’re right in the center of for our listeners. I’d love for you to get an insider view of how these things come about. Take us into those discussions. What are the key drivers? Challenges? And you’re kind of 18 months in. So have there been some wild cards along the way that maybe you didn’t anticipate or were unexpected?

Craig Richardville [00:02:23]:
Yeah, great question. So when you have a merger or even an acquisition, but primarily a merger, I would say those things start a couple of years before the actual date. It takes time to work through the process. When you look at our merger, certainly it was important that our service areas are contiguous to each other. It was important that our missions were aligned. It was important that we had very clear visions of where we believe healthcare should be going and our roles within that. So as you kind of start going through this, there’s always, like, probabilities, and the first couple of months, like, oh, there’s a 5% chance, there’s a 10% chance. And as things continue on, all of a sudden, well, there’s a 50% chance, I think you could go or not go, and then you start getting into.

Craig Richardville [00:03:14]:
There’s actually a high probability this is going to happen. Then you get to the last six to nine months, and you’re really working out a lot of the details. And what I would say is, when we went through this process and came up with the letter of intent, the letter of intent was a very large document that almost defined, completed the definitive agreement. So all the different aspects of why mergers or acquisitions come together and why they’re successful, or in some cases not successful, has to do with kind of agreed upon and aligned focus of why we’re doing the merger and the process that would go through it. The two things that were outstanding before the definitive agreement was that we wanted to make sure we had a combined board, and that we wanted to make sure that the leadership team, the executive leadership team, was defined. We wouldn’t go in with two of this. And so over the next several months, that happened, and then we signed the definitive agreement that we would lie with in April of last year. And as you said, we’re actually approaching almost our two year horizon.

Craig Richardville [00:04:21]:
We’re 21 months into the merger, and it’s been a very fun, challenging, but very fun opportunity within anybody’s career to go through change, massive change such as this. And when you look at a merger and an acquisition, a lot of people talk about M A and M A. Clearly, there’s a difference between an m and an a. When there’s an m, there’s a lot of negotiation, there’s a lot of sharing of ideas. There’s really two people sitting at a table having a discussion about what that new is going to look like. And in the a part of it, more of it is being dictated from one or the other. Now, being a merger. In this situation, it was a merger of two unequals.

Craig Richardville [00:05:04]:
One company was much larger than the others, but it was clear that it was a merger and that we’re going in with a mutual respect for each other’s thoughts, decisions, our history, and also where we were going to be going. And as I look at where we sit today. It’s actually pretty exciting. The first six months, you’re kind of still kind of filling each other out. You’re new people you’re working with. You’re in a new role. Everybody basically is in a new role because not only does responsibilities potentially change, but also your scope is certainly much broader. And in the first six months, you’re kind of feeling out who the players are.

Craig Richardville [00:05:39]:
And we had some change. We had a CEO change and a few other members of our team change throughout that first year and a half. But now we have a very solid executive leadership team, and it feels totally like one inner mountain.

Ben Hilmes [00:05:57]:
That’s great.

Ben Hilmes [00:05:58]:
It kind of leads me, because you talked about the m being the know, one of the things that probably weighed heavy on the leadership team’s minds is culture. Right? So you’re bringing a Catholic based SCL, which actually, its roots are in Kansas City, my hometown, but obviously a big health system, faith based, with a secular intermountain, much larger. Did you see one culture consume the other, or have you actually started to see a new culture emerge? And just curious about the insights you have there.

Craig Richardville [00:06:33]:
Yeah, it’s definitely a new culture that we’re creating when you go through this. And if it was more of an acquisition, I think you would see, as you describe, probably one culture consuming the other. When you go through a merger, you actually have an opportunity to create a new culture. Respecting and trying to understand what the past cultures were, the personalities of the organization, the different communities that are being served, to try to make sure that you understand the larger picture of the merged entity. But you do have the opportunity to create new, and that’s what it’s really fun, is to come into this organization with respecting what Sel had done in the past. Certainly what Intermountain has done. And Intermountain, as you know, is one of the few brands that are really nationally, if not globally, recognized for its history and the quality and patient safety and high outcomes and lowering the cost of care. So it could have been very easy to be absorbed.

Craig Richardville [00:07:35]:
But I will say with the board and with the leadership team, really took a step back and put all the cards on the table and started figuring out which cards are we missing and which ones do we want to move forward with. So it’s been a fun process. And like I said, after about six months, you get into that next year of working with all the details of the integration and as those entities or divisions start coming together. And for us, it was finance and human resources, and we named a new division, digital technology services. We were the first cohort to go through the integration. Then you come out really with one intermountain.

Ben Hilmes [00:08:14]:
Right.

Ben Hilmes [00:08:15]:
Well, I mean, that’s pivoting to the it side of things. Both orgs came with a pretty sophisticated it organization, lots of investment, major platforms. And typically in these mergers, it’s kind of the original intent is to pause.

Craig Richardville [00:08:33]:
Right.

Ben Hilmes [00:08:33]:
For years I’ve seen some mergers are upwards of five to seven years of no platform changes. You guys not only are just a year and a half into it, but you’re going to make some major changes. So changing to an integrated EMR platform, workforce management platform, I mean, the work going on inside your newly formed organization is tremendous. Talk to us about how that got accelerated and kind of what some of the drivers were, because typically you don’t see mergers move that fast on this large of decisions.

Craig Richardville [00:09:10]:
Yeah, well, it’s all about leadership and it starts at the top with our CEO. But within my division, we’re touching every part of our portfolio. Even the night before the merger, there was a large Microsoft commitment that was signed. So we knew who one of our technology partners were going to be for the new combined organization. That forced us to change, get things off of Google, get things off AWS, and really start focusing on Microsoft as being one of our technology platforms. And that led us to being cloud first. So we do have a large data center presence and those will be slowly disassembled and start moving ourselves to colos, but also very heavy investment in cloud and mobile. And when you look at the application portfolio, in order to be able to provide the standardization, the consistency, not only for our providers, but for our patients, our members, and our health plan, and also our caregivers, we wanted to move to single platforms, we wanted to be systemized.

Craig Richardville [00:10:14]:
So I went through a very thoughtful process of looking to see who those partners were going to be. And in some cases the partnerships were new to both parties. So for example, on the EMR side or EHR side, Epic was selected as our core system moving forward. And as you know, that impacts not only the EHR, but also impacts the revenue cycle and also impacts our patient engagement strategy and what tools we’ll be using for that. So that was a big decision. We had multiple ERP platforms in play, and we recently selected workday to be our single ERP. Now, what I will say is, right at the beginning, there were two decisions that were made. Microsoft, I mentioned.

Craig Richardville [00:10:57]:
So we’re moving everybody to Microsoft 365 to the Azure platform, but also we selected workday HR for human Capital. And so that has within the first year, everybody was on a single HR system. So from a technology perspective, those decisions were made right at the time of the merger being implemented. But since then we’ve settled on finance, supply chain as well. A new partner altogether. For part of our consumer and caregiver journey was Qualtrics. So from an experience perspective, neither party had used qualtrics in the past. But we went through our process with who our current partnerships were with.

Craig Richardville [00:11:37]:
We wanted to go the clear partner for us in terms of leading and being different within the industry was to partner with Qualtrics. We did the same thing with Salesforce Servicenow. We were a vizian and premier and we consolidated a Vizian. So there’s just been a lot of work, a lot of decisions that have been decided, a lot of work already done. But as you mentioned, we have a mound of work ahead of us and everybody is really excited about how we’re going to end up in the next two to three years. And it’s going to be something that will be monumental for not only intermountain health, but also for the communities that we impact and serve.

Ben Hilmes [00:12:18]:
That’s great.

Ben Hilmes [00:12:19]:
I look at that and I think just how much work that is and a lot going on, a lot of moving parts. It takes incredible teams and leadership from you, Craig, and it’s admirable to see you leading at such scale and trying to get so many things done. And I know you attribute a lot of that success to your teams and stuff, but just incredible amount of work. Once you get beyond that plumbing, it gets to be pretty exciting. And so I know you as the leader, you can’t spend much of your time today thinking about that plumbing. That’s your teams. I’d love to hear kind of your thinking beyond the plumbing. I mean, in the industry, there’s a lot of noise about AI, machine learning, all these advanced technologies.

Ben Hilmes [00:13:07]:
Where are you making your bets? Where’s intermountain saying, here’s where we’re going? And are you guys all in or are you kind of waiting to see what happens with some of these emerging.

Craig Richardville [00:13:18]:
Yeah, no, we’re all in the history of intermountain in terms of innovation and leading, piloting, proving things out. In some cases they don’t work out, but for us, we’re leading in this space. So I’ve mentioned some of our partners. If we made these decisions, much of our AI will come from those partnerships. So if you look at Epic, for example, they have over 60 AI initiatives in place. We’re actually just talked to one of our cmis just before this meeting, and we went live yesterday with a few of our providers to do the AI for inbox messaging. And we’ve been on the ambient intelligence with nuance for a couple of years. But the new version, which is really the copilot version, really picks up and starts with AI versus a human and then machine learning.

Craig Richardville [00:14:13]:
So we’re at both feet. We’re very cautious about the clinical aspects of it, and we should be, and the industry should be. So those things, we have some gloves on, but some of the more administrative or regulatory pieces of our work, we are moving full steam ahead with taking the technology and bringing it in. The thing that I will say is we have a strong belief, as many others. We look at our labor pool and the resources, and historically we’ve solved a lot of things within healthcare with more headcount, with more people. Right now, those people aren’t available, and if they are available, it’s difficult to afford. So we really have to assist those caregivers that we have with technology to help them be able to achieve the outcomes that we expect and the new outcomes that we’ll be setting the new bars for. So technology will be an assistant or a copilot is one of the terms that’s used frequently as well.

Craig Richardville [00:15:14]:
It’ll never take place of, but it’ll remove some of the duties of some current jobs. So a whole thing in terms of new, new job description, new roles being created, how we’re doing that work will be with technology side by side with the humans.

Ben Hilmes [00:15:30]:
Yeah, I think the workforce development and just the evolution of that workforce is going to be intriguing over the next decade as we get out of this stage of just digitizing things and actually starting to advance. I love the term copilot that really has taken a hold, and I hear a lot of people use that. Let’s pivot to leadership. The simplest definition of a leader is if you turn around, it’s anybody following you. And Craig, I know you’ve had people that you work back with on the east coast that moved with you to Denver and then now to Intermountain. And so you’re by definition the epitome of a leader because you’ve had a lot of people follow you for a lot of years. And so you should be very proud of that. I’d love for you to share.

Ben Hilmes [00:16:19]:
Just how did you develop your style? Well, how would you describe your style? What are the influences you’ve had along the way? And just to give some insights into somebody that’s leading one of the largest health systems. From an IT perspective, one of the better known people in the industry, help us understand how you got to where you are in your style.

Craig Richardville [00:16:43]:
Well, if I had to say there was one part of my style, there’s probably two pieces. First, I kind of consider myself a professional parent. So for those of us that are blessed enough to have children, part of your job or your role as a parent is to make sure that you bring good people to this world, and also that they surpass you in terms of the different qualities or values or contributions that you’re making to others and to society as a parent, to be able to allow your children to go above you. And so for me, it’s really fun to sit back and to watch my children, who are all young adults now, just doing things that there was no way at their age and their experience, I would even come close to what they’re contributing with and the lifestyles and the work that they’re doing. It’s fun to watch, and I bring that to work. So for me, at one point, I think I’m up to maybe over my career, maybe 13 now that have been CIOs or CDOs in the past. A few of them still active, some of them have moved into vendor situations, and a couple of them are no longer working. I’ve retired, but from my stand, it’s just great.

Craig Richardville [00:17:58]:
It’s kind of like as being a professional parent, you really care about them and you really want to help them do more than maybe what they could have done on their own and give them the confidence and the courage and the opportunities to do those things. Then I would say the other one is, I like moving fast. It’s kind of hard to hit a moving target. I think some people have said in the past. But for me it’s really been fun to go through and to move things because as you know, when you wake up every day, there’s probably going to be something that you didn’t anticipate that’s going to happen. So the things that I know that need to happen, and we just talked about half a dozen or so of pretty major partners and implementations that we’ll be leading and be part of, there’s going to be something else that I don’t know about. So if I can get through the things that I do know, I now create the capacity for more to come in, and they both kind of relate to each other. And the only way I can get rid of the things that we do need to be done or get those accomplished is to have great people on the team, and the reason why you’re able to attract or to maintain or keep great people is because you give them opportunities to be successful and to fulfill their career goals and aspirations as well.

Craig Richardville [00:19:13]:
I’ll say, too, though, when you come into a new environment, that I have been blessed to have a few people that have followed me to come out to this new place out west, which I’m really enjoying it. The west is actually a part of the country I didn’t have much of an opportunity to live in, and I’m just having a blast out here. But there’s so many other great talent that I’ve been very fortunate to bring onto my team through the mergers or just through the growth that Sel had and also the merger with Intermountain. The talent there was absolutely phenomenal. So to be able to bring all this great talent together just makes even for an extra special, that’s awesome.

Ben Hilmes [00:19:53]:
So you’re an industry rock. Like, everybody wants a little bit of Craig’s time. Everybody wants to get your perspective. You got suppliers pulling on you, industry groups that want you to be part of their events. You’re on stage more than anybody I know of in this industry. You’ve won every award. You have a big day job, you have a family that is. I personally know how important they are to you.

Ben Hilmes [00:20:19]:
You like to live life to the fullest. We have a lot of listeners that are climbing this ladder and all of those things, any of those things, you could see how that could just consume somebody, yet you somehow are magical in how you strike a balance. And so I’d love for you to share with our listeners, specifically those that are racing to climb the ladder, that find themselves overwhelmed and consumed. How is it that somebody like you that has all this stuff going on, can still maintain balance and find time for the things that I know are most important to you. Your fitness, your faith, your family, all those things. I just love to hear your perspectives on that.

Craig Richardville [00:21:03]:
Yeah. The one f you missed was fun. And I think that’s know, for me, all those things that you talk about, I enjoy. I have fun. Whether it’s a sporting event or a concert or going to DC or to be in front of our caregivers or our patients, to be driving what’s happened within the industry and bring some set of skills and experience to decision making, I have fun with all that. And part of that, too, is I learn. I learn so much. And I think to be a student for life is a key piece to being not only successful, but having fun with your success, because if you’re always the professor out in front teaching the class, that could be pretty mundane.

Craig Richardville [00:21:51]:
That can not be very exciting. But the fact that you are continuing to reinvent yourself, you’re continuing to maybe replace pieces of yourself that need to be replaced or adding to things that you have not had in the past is, to me is growing. So for me, the person you see today is a different person that there was last week or last year and will likely be a different person next week or next year. There’s certainly a core part, and you mentioned with the three f’s and now adding fun into it, those are core to who you are, but all the other pieces of it are so interchangeable. And whatever you feed will end up growing. And so for me really just to kind of have fun with it, if I run into a very challenging or difficult situation or experience, I try to bring laughter to it because you need to laugh or cry in some situations. And I choose, I think that’s right.

Ben Hilmes [00:22:49]:
I love that and I love what you feed grows.

Ben Hilmes [00:22:52]:
I think that’s a really important takeaway because it’s so true. And if you feed the negative, it’s going to grow. And if you feed the positive, that’s going to grow.

Ben Hilmes [00:23:02]:
Well, Craig, we’re going to land.

Ben Hilmes [00:23:03]:
This has been absolutely fantastic. I appreciate your time more than you’ll ever know. It’s been fun being in and around you for many, many years. And so I look forward to our continued dialogues and the opportunity to work together. So appreciate it. And with that, we’re going to wrap.

Craig Richardville [00:23:23]:
Great. Thank you, Ben, really appreciate you. You’re a staple.

Ben Hilmes [00:23:26]:
Thanks, Craig.

Craig Richardville [00:23:26]:
In this industry and it’s certainly been a privilege to maintain a very strong relationship. So thank you.

Ben Hilmes [00:23:36]:
It’s always great to talk to Craig. I really enjoyed getting his behind the scenes look at the merger between SCL and Intermountain health. Here are my top takeaways from our conversation. One, in a merger, it’s up to the leaders to ensure alignment on the vision. A clear vision reduces cultural impact and helps individuals focus on shared goals. Two, choosing strong partners is a key to growth. Intermountain Health is consolidating its application stack around innovative and trusted partners like Microsoft, workday and epic. Three, what you feed grows.

Ben Hilmes [00:24:12]:
Craig invests in his own team and is committed to continual learning for his own personal and professional growth. So what did you think?

Ben Hilmes [00:24:20]:
What were your big takeaways from this episode?

Ben Hilmes [00:24:22]:
I’d love to hear from you on our social media channels or drop me an email from our website@healthcareitleaders.com, until next time, I’m Ben Hilmes.

Narrator [00:24:32]:
Thanks for joining us. For leader to leader. To learn more about how to fuel your own personal leadership journey through the healthcare industry, visit healthcareitleaders.com. Don’t forget to subscribe so you don’t miss any insights, and we’ll see you on the next episode.