Dan Howard Simplifies, Supports, and Succeeds

Getting your Trinity Audio player ready...

For Dan Howard, every IT initiative in healthcare begins with a single question: How can he make the lives of clinicians and caregivers easier?  

The vice president and chief information officer (CIO) at San Ysidro Health has asked that question at every stage of his career. But while his cornerstone hasn’t changed, he found a new way to answer his favorite question when he came to San Ysidro Health in 2022. With a background primarily in large academic medical institutions, including adjunct teaching positions, the IT leader intentionally moved to a smaller health system where he could collaborate with the operations side of a health system and create system-wide change.

At San Ysidro, making people’s lives easier meant Howard had to consolidate five separate electronic health records (EHRs) into a single, unified system and source of truth. To further complicate matters, the health system has two distinct business units. Its federally qualified health center (FQHC) serves patients regardless of their ability to pay, immigration status, or insurance coverage. Its Program for All-Inclusive Care for the Elderly (PACE), a medical and social services program that serves older people, is the fourth largest of its kind the US.

“You have to realize that outside of your department, this is a sea change for people. Supporting people in adapting to that new change is something I see as part of our job.”

Dan Howard

Both business units now share a common EHR, which simplifies access to patient information. As with any large-scale tech transformation, however, challenges have surfaced.

“It’s been all-consuming,” Howard explains. “I would love to say that we were further along than we are currently, but we are learning some lessons that are going to be essential for this integration to be successful. Sometimes that takes more time than you want it to, but I know it’s going to have a positive, long-term impact.”

The system went live about a year ago. While the heavy lifting is complete, Howard and his team are helping users get familiar with the system while his organization works to address some unforeseen challenges, like pulling old data from a new system. But the most serious lessons learned thus far are ones every IT leader should take to heart.

“The biggest takeaway thus far is that you have got to make sure that you have built solid relationships with key stakeholders on the operations side, because this is a big lift,” Howard explains. “People on the IT side of things can sometimes approach a project like this a little too IT-centric. Our goal is to focus on adding value to operations with a speed to market mindset. Technology can often simplify the existing friction within workflows, but as IT practitioners we need to understand the changes we are asking the organization to undertake and meet that cadence of change thoughtfully.”

Howard says it’s been imperative to provide blocks of time for training for staff, who are always more focused on caring for patients. Clinicians and staff often need more time for training than IT teams anticipate. An IT team can be so focused on creating change as quickly and efficiently as possible that they can lose sight of the people they’re ultimately creating the change for.

“You have to realize that outside of your department, this is a sea change for people,”  Howard explains. “Supporting people in adapting to that new change is something I see as part of our job.”

Howard’s entire tenure has been centered on preparing for, implementing, and now ironing out a massive technological shift for San Ysidro. At the same time, he had to address another issue he inherited: an IT department struggling with high attrition. The CIO has focused on cultivating internal talent. He has developed a working knowledge of employees’ strong suits and skill sets and plans to help them grow into the roles they aspire to.

“If people have interest in getting certified, we want to help them get there,” Howard explains. “We want a culture here that values the individual and what they bring to their roles. We hold regular town halls and bring together our organization as much as we can.”

Culture building wasn’t necessarily Howard’s area of expertise in previous roles at larger academic institutions, where entire departments handled organizational culture. But at San Ysidro, a 3,500-person health system, the CIO has taken on a more hands-on leadership approach so his team feels heard and supported.

You can tell Howard is the right leader for this work because he doesn’t want to make any predictions about the future. All he knows is that his people and his organization are on a path, and he wants to help them get there not as quickly as possible but as fully as possible. There’s a massive difference between those two, and Howard knows it.

---