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    Today on Keynote

(Intro)  You want to change it from an environment that just evolves as to one that's intentionally being built a way that actually gains those and really optimizes the resources that you have.

  📍 📍

My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare one connection at a time. Our keynote show is designed to share conference level value with you every week.

Now, let's jump right into the episode.

  (Main) All right. It's Keynote. And today we're joined by Sarah Hatchett, the Chief Information Officer at the Cleveland Clinic.

Welcome to the show.

Thank you so much, Bill. It's just a pleasure to be here.

I'm excited. This is gonna be fun. I've interviewed previous CIOs at the clinic. I've visited the clinic and been up there for a couple of things. It's an organization that is just known for excellence and congratulations in getting that role.

And I think that speaks volumes to who you are and what you've been able to do over your 20 plus your career in health IT. So congratulations, first of all, on getting that role.

Thank you. Thank you so much. Yeah, it's been quite a journey. I'll go on and on about the Cleveland Clinic and what an amazing organization it is to work at.

I've actually been here for seven years in a number of different roles in IT. I've had the opportunity to be interim CIO since last summer and just got the position officially in the last two months. It's been just a great journey, testament to the team and how amazing they are.

I it's an honor to be able to continue on in this role.

I'm going to go right off on a tangent already. That interim role is interesting, isn't it? You're in the role, they expect you to run it and run it effectively and even push forward some strategies and things that are going on, but you are interim.

you feel that tug, that's a very difficult role to be in.

Yeah, I actually got some very valuable early coaching was to just own it from day one. That's shows that you can demonstrate the leadership that's expected. It shows that you not only have the capability, but the confidence to be able to lead the team.

I agree with you. I think some people might feel like, oh only certain decisions I can make, or I'm going to hold off on these bigger things. It's, in fact, your ability to drive that execution, keep the team on track that I think really speaks a testament of whether or not you can do the job.

It's stressful, right? Because every day is an interview, if you will. But then by the time the actual hiring decision comes up, people see what you're capable of and there's a known, try before you buy element to it and there's a level of confidence that they're making the right decision.

So again, it was certainly a long interim period as well. And very glad that the hard work and patience paid off in that regard.

I assume they did a national search, so you had to participate those interviews and. Go in front and there's an advantage to it because they know you and you're doing work and there's a disadvantage to it because they know you and you're doing work.

Absolutely.

Invariably when you're doing the work, there is some tension of, you have to say no to some things and sometimes things don't go well. That's a really interesting process.

Yeah, and I'd like to think that because I was doing a great job, there wasn't a huge sense of urgency, right?

It's an important role, an absolutely strategic, important role, but the fact that we were able to, Stay focused on the mission. The team continued to perform, meet all expectations. We had very low instability across the senior leadership teams. I think that was evident the interim phase and again was a great milestone, great success for the entire team to see that come to closure with a very positive outcome.

I want to start with this because it's first of all women leaders significantly underrepresented in the CIO chair. When did you have the inkling that, hey, this is a direction you want to go? Who are you? playing in the playground at the age of six and said someday I want to be a CIO for the Cleveland Clinic or did it gradually happen?

I know it's silly, but when did you say that leadership in a technology role is something that really interested you?

It's actually I am not one of those people that dreamed as a child that I'd be a CIO one day. I do feel that, I've always been in healthcare IT. I started my career at Epic actually.

I just fell in love with both aspects of the job healthcare and IT. And I just had this passion to continue to drive change and make a positive impact for the organizations I work for and the patients that we take care of. So it really was just a sort of like, how can I help, how can I be of service, how can I continue to make a bigger impact that just led me to those increasing roles of responsibility.

I had the opportunity to manage a number of large programs that I think gave me that sort of condensed experience short period of time that I was able to just, again, make that impact and continue to grow. it's been an amazing journey. And never would I have thought seven years ago when I joined the Cleveland Clinic that I'd be in this position one day, but I'm certainly, proud again, honored to be able to lead the team.

have been times in my career If you get to your position there, I'm almost sure you've had this same experience where you reach beyond what you believe you're capable of. Like you end up getting to, like you open the door, you get to the other side and go, how did I get here?

Oh my gosh, how are we, how am I, and you're like picking up books, you're phoning a friend you're like, okay, know I can do this based on the Things I've been able to accomplish before, but this will be a first. I'm going to, have you had those experiences through your career of really getting out over your skis and then, Finding your balance.

Yeah, absolutely. And, studies have shown females and males struggle with that imposter syndrome of like, why am I here? Was this the right fit? Am I able to meet the demands of the job? And I really think it's a consistent amount of focus, leadership, guidance, mentoring, Just like you said, phoning a friend, really having that confidence that you believe you are the person until you slowly come to internalize that and actually recognize that this is indeed you are exactly who's needed.

You're in the right spot at the time that the organization needs you to be. And you do have the skills and the ability to continue to deliver. So I think it's a daily journey. I know it's something that many leaders struggle with. Lots of resources out there, for those listening, if that's you, there's lots of resources out there if you want to pursue that, something I highly recommend taking a mastery of early on as you continue to grow in your leadership development journey.

Yeah, and it's interesting when you get into those roles the people who come in and say, I'm the leader usually struggle. The people who realize, Hey, you know what, the Cleveland Clinic is loaded with some of the smartest people in the country and we're gonna do this together. You realize it's really building teams around the problem sets that you have.

I want to talk about some of the problem sets. 'cause you did go through the pandemic at the clinic and that was interesting. Have the IT projects. shifted as a result of the pandemic or dramatically as a result of the pandemic?

Oh, certainly, I think having been through the pandemic, we all experienced that level of disruption, but also the amazing amount of innovation and focus that we were able to achieve during that time.

We've really tried to capture that and continue to apply that throughout our organization. Some of that comes through. Prioritization of key initiatives that are the right things for us to be working on, having conversations with the business about what's going to drive value for them.

Those are the kinds of things that I think get our teams can just continue to activate and be excited about helping to push forward the mission of the Cleveland Clinic.

would assume the clinic is probably one of those organizations that has a three year outlook or a five year outlook. that is driven by needs of the clinicians and of the patients.

is that set out and then how does IT play a role identifying those initiatives making those initiatives a reality?

we're a very large, complex organization. We have a very clear mission and vision that comes directly from the top down to the organization, but there's also a fair amount of latitude for business units to come up with strategies and OKRs, if you will, for their specific areas that typically generate a lot of IT demand.

So I think it's both a top down and a bottom up effort here at the clinic for any of those of you who are familiar with kind of our organizational model, we have clinical institutes that drive like patient care standards. We have our markets, which are the physical locations where the care is delivered, our hospitals and ambulatory centers.

And then we also have shared services, which kind of supports the whole organization. So we get IT requests from all quarters of the organization. And a lot of times we're the glue that's bringing synergies together to say, Hey, did you know so and so is already working on that strategy?

Or let's try and bring these groups together. So I really think a lot of our key success factors are trying to standardize and gain efficiencies across the different initiatives that we're seeing the organization work on.

will ask you about governance later. It's just not an exciting enough topic be talking about in the first 10 minutes.

Talk to me about some of the current IT initiatives that going on.

again any number of things going on right now. I would say we group our work into several buckets. We want to focus on innovation, business transformation, and then resiliency. Innovation is not just a hot topic, but something that's been part of kind of the Cleveland Clinic brand and culture.

We've just launched a digital strategy, which outlines a number of ways that we want to continue to leverage. AI and automation throughout our organization. Transformation is really focused on increasing the adoption of digital tools. Further automating business processes and the like. And then resiliency, which is really about making our organization more stable and sustainable.

We have a very large IT infrastructure and we want to make sure that we're really stewarding that in a way that's a highly reliable environment for our organization to stay on. At any given point, we have probably about 120 projects running that, span those different categories.

And it's really just interesting and exciting to see how those dynamics play out. as we manage our portfolio and begin to align resources to each of those priorities.

Are there specific projects around being a destination? Because the clinic is a destination. live in Southwest Florida and I know a of people who live in my neighborhood that will drive you know, two hours over there.

And I know people fly from around the world. to get care at the clinic. Are there specific projects to support that kind of, I want to say, care model or business model?

Yeah, that's actually, part of the DNA of the Cleveland Clinic is that specialty tertiary quaternary care, right? Even though we're Cleveland Clinic, and we are based in Northeast Ohio, our main campus is there, and it's a, our community presence is a huge part of what we do.

It's that destination health care, that specialization that really brings people in. Being number one in heart care in the U. S., just really, we're the place where people go where they really just don't have any more answers, right? They want that specialty care, specialty help.

We do a ton of work in that space mostly on the clinical and operational side to accommodate those patients. And then again, of course, from an IT perspective, making that care interoperable, making that care patient centered and available as that patient journey continues throughout their care at the Cleveland Clinic and when they go back to their home health care organizations.

Yeah, I would think that interoperability, pulling all those records in, chart summary, just all that stuff. And then sending them back also is a very interesting challenge for a lot of health systems, like our health system, specifically when we looked at interoperability we looked within our markets, you're looking across the world.

I, that's an interesting challenge, I would think. Talk about role of technology with regard to patients, what are patients looking for from the clinic when they come there an experience standpoint that technology really plays a role in.

I've spoken a little bit about the mission of the Cleveland Clinic, and one of our key focus areas is patients first. Whenever you come to Cleveland Clinic, you're going to see it branded all over, everywhere, patients first. And I really challenge my team to think about this every day.

Part of the way that we do that. shows up for us is we're all caregivers, okay? We're, there's no employees at the Cleveland Clinic. Everyone's a caregiver and that's the title that we use and I think that helps bring home the impact. You could argue that every piece of technology that we do in some way ties back to patient care and that's our core mission.

I'll just give you an example. One of the things that we're pretty proud of is our telehealth or virtual care model. Currently, it's about 11 percent of our total visit volume is done in a telehealth encounter. And this is really important because it just improves access to care.

It's that convenience. As you mentioned, patients travel in, so being able to offer that as an option given that, geography and travel can be sometimes a challenge. As well as just, continuity of care and early intervention. We were in the telehealth space well before the pandemic.

Many organizations saw it spike and then it dropped down. We've remained pretty stable throughout that period, and we are looking at ways that we can continue to increase our telehealth volume, now morphing into what we're calling a virtual care platform. How do we extend just telehealth from a visit to visit perspective and see it as more of a continuity continuous care, whether that's through, using tools like Care Companion to guide the patient through their journey, continuous monitoring of devices, that sort of thing.

There's certainly patient care benefits, operational benefits to that kind of care model, and there's a ton of appetite and ambition to begin to expand those platforms in many different specialties here at the Cleveland Clinic.

want to move into the organization. So we talked earlier, so you're over the U. S. and London.

So London was a new venture for us. We've been open in London for two years now. It's absolutely gorgeous hospital and it's located right in central London. It's in the backyard of Buckingham Palace on the upper floor levels.

You can actually see into the courtyards. It's pretty fantastic. And the point of the London space was to create You mentioned about patients being able to travel. We want to create model where we can begin UK market with, for specific types of services. In that certainly challenging healthcare delivery model in the UK.

And Abu Dhabi, Cleveland Clinic, Abu Dhabi runs more as a standalone that is obviously related to Cleveland Clinic and you work very closely with them, but it's not a direct report kind of relationship for you.

That's correct. Actually, we have an international consortium now between our London, U.

S. Abu Dhabi sites. We often talk and share best practices and a lot of the same IT needs and infrastructure sort of crop up. So we're able to share a lot of best practices and lessons learned across our organizations.

I want to talk to you about, fostering innovation, a lot of the innovation came from the floor.

It came from the nurses. It came from the doctors. And how do you cultivate that? How do you bring all that in? when it's so dispersed, when you're talking about, literally a global organization.

So as far as the organization goes being an academic medical center, there's this built in culture of innovation and collaboration, right?

That's core to our mission and something that we want to do. And does that, does

that permeate IT as well?

Yeah. In IT, we really want to make sure we're creating an environment where there's a lot of creativity and experimenting. That being said, there's a huge amount of run work that just has to be done, right?

You're keeping the lights on. So we want to make sure that there's an actual, balance of those types of things, even though it may be smaller amounts of time spent on innovation, that there's at least line of sight into what those things are. That we're not only making sure that we're focused on those efforts, but that we're sharing those efforts across teams.

Many might relate to the fact that working remotely can be challenging as far as building kind of a team culture. We've started doing what we call lightning rounds where teams are able to showcase or individuals are able to showcase for each other the cool things that we're working on.

That not only helps us get excited about the projects themselves, but we start to learn who each other is and what all those projects are. That's been a real valuable add to the overall culture in our team.

The run seems to take more and more of the budget every year. And in the innovative cultures, just find some way to just, take the percent that isn't there and say, hey, think about what you're doing.

Maybe there is a different way to do it. And I love the lightning rounds. That's great. That's a chance for them to come in and go, hey, I've been looking at automation. I've been thinking we might be able to automate this whole process over here. And if we do that, it has this impact.

And then the other departments are going, I think we can do the same thing. And that's really awesome.

What we're trying to help people understand is there's opportunities to innovate in your run work, especially with a lot of these new technologies that are coming out, AI, automation, there's a lot of opportunity to layer in innovative ways of doing the same thing you've always done, like we actually encourage that and want people to share those successes, things that they do to learn how to work more efficiently because those are things that you could theoretically scale across your team and then across the entire division.

  📍 📍 📍 📍

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📍 I'm going to come back to governance because every time we have a 229 meeting and we bring CIOs together governance comes up. And you would think it's something that we've wrestled to the ground and we're never gonna have a problem with it again and that kind of stuff. But it's very dependent on the organization, their desire to innovate, to move fast and to move forward.

it's hard to say no. How do you effectively govern, because you have limited resources and you have a certain book of run business, do you educate the organization on this is the capacity, this is what we can actually do for the organization and how do you make room for more to be able to take on more?

To the extent that governance sometimes invokes a very negative feeling, we 📍 actually intentionally try not to use the word governance in the titles of our forums and processes that are essentially fulfilling that function. For example, we have an architecture review board that looks at new technology capability analysis and whether it fits within our product roadmap.

We have an enterprise technology steering committee that looks at what are our overall priorities and the value of the work that we're providing to the organization and the resource allocation to those priorities. And we have an AI task force that is focused on responsible use of these new technologies.

So you'll know we're in the name of those meetings that we use the word governance, but we're effectively trying to infuse those concepts to make sure that we're. Really allocating our time and resources to the things that matter most to our organization.

I want to drill into one of those, the Architecture Review Board.

One of the things I've been saying to healthcare leaders for a while now is we've never been really good at architecture. And the reason I say that is, you know, whenever you go into an organization and they have 1, 500 applications or 2, 500 applications, you're like, there's no way that was architected that way.

We would never, we'd never step back and go, yeah let's make a system of 2, 500 applications. Complex pieces and then try to secure it and make it run and those kind of things. When the architectural review board looks at things first of all, what's the makeup of that group?

Is it just technology or are you looking, obviously it's technology security, but is it other aspects of the business as well?

Yeah, absolutely. So obviously. Enterprise IT is leading the effort. It includes, infrastructure, cybersecurity, architecture those disciplines, but we also pull in representatives from our business unit IT groups.

We recognize that in order to have a cohesive architecture, it needs to be a full picture of what's actually going on at your organization. So while IT leads, we do engage the business in those conversations. And that's part of the reason why it is, a tall task though, because by the time you actually realize you need something like that, you not only have a huge application portfolio, but it's has a ton of history there.

There's a fair amount of technical debt, but we're, trying to tackle while new technologies are coming in at the same time. It's easy to get overwhelmed by the pure volume of the type of work that group needs to do. That being said we continue to chip away at it.

We've also had, just add to the stack. We've also had a pretty aggressive M& A roadmap over the last few years as well that has added to the need to really rationalize those applications and get them into a pipeline of. Decommissioning and eventually archiving and eventually removing them from our environment.

So as many organizations, are facing, cost pressures, we want to be more efficient. This is definitely an area we're continuing to double down on here at the clinic.

Yeah, we can talk about this for the next 30 minutes of how challenging this is. When I came into St. Joe's, I looked at the, just the imaging platform. I was like, How did we end up with so many different imaging platforms? This is nobody would design this. And it was, they made a decision. They made a decision. They made a decision and we did not have an architectural review board. And so it was like, they just looked at it and said it integrates with the EHR and it works.

So

we

just kept going. And so when I got there, I was like, Oh man, this is going to be. Once it's in, it's very difficult conversations and it's a lot harder.

You want to change it from an environment that just evolves as to one that's intentionally being built in a way that actually gains those and really optimizes the resources that you have.

I completely agree. I think IT has evolved over the last 20 years. Now we need to change the dynamic to making it a more directed process.

You just got off the phone with Judy Faulkner, and she was on the call. It wasn't just you and Judy, I assume. It was probably the teams. But I want to talk a little bit about EHR transformation.

And I would imagine the same kind of thing we just talked about happens in the EHR as well. You end up with multiple instances, or you end up with multiple You may or may not be on foundation. There's benefits to being on foundation, but also there's desire for the clinic to be way out in front.

is EHR? I don't know. Transformation is the word I'm going to use, but you could use a better word if you want. What does that look like at the clinic?

It's exactly the word because we actually had a dedicated program for EHR transformation. It was part of my directive when I first joined the clinic to stand up that program.

Cleveland Clinic was a very early adopter of Epic's tools. I think our first agreement with Epic dates back to 1999. And when I had joined in 2017, we had just signed on for Enterprise. Think about the years of sort of pieces, parts. Third party niche systems, lack of integration, lack of data structures.

We really wanted to take a look at how do we leverage EPIC? How do we get back to core foundational build and architecture, not having the foundation system in our environment? And then where do we begin to get us back to a platform of EPIC? that fully matches our scope and size and complexity.

We launched a multi year, multi million dollar effort to implement those modules that we were missing, infuse content into our system, and really get those integrations up and running in a way that benefited both our caregivers and our patients. And actually, the benefit of that is now that we had a cogent EHR system that we could use, as we continued to build our M& A roadmap, we now had a global design that we could quickly roll out Epic in a standard way to the hospitals that we had most recently acquired, bringing them on to our platform in a rapid fashion.

So what started as an EHR transformation journey actually became an M& A playbook. which we now call kind of our growth and global design program, which we use to rapidly do, major new construction, other new transformation programs. We follow that same program methodology and we built a lot of the internal muscle that we need to do those types of major programs.

of the challenges when you get off foundation is the update cycles and taking those releases and then also The regression test, the testing and the regression, all the, just all the testing. I'm not going to go into the details, but just all the testing that needs to happen. how did you get in front of that?

That's a significant challenge for a lot of the organizations that aren't on like just pure foundation.

I would love to say we've unwound every single piece of custom code that is out there, but unfortunately that's not the case. And these elements of custom or differences do tend to be blockers for either adopting new features or actually just completing the upgrade cycle.

I'm happy to say that CHR transformation program, we're much more standard. We constantly ask ourselves the question, how can we be more standard in the work that we're doing. In the cases where we actually have exception to standard, those things are documented, understood, and something that we're continually checking as we go forward.

So it's really just a matter of if you do have some of that technical debt, at least operationalizing it and making it so that it's still the most efficient process it can possibly be to do that testing and upgrade.

We're going to go into the futures now. Every CIO I bring on, I, love to have this conversation of, what are you keeping an eye on right now?

What do you think, I'm talking about the future stuff what are you looking at saying, hey, we believe this is going to have a significant impact in some way around the care continuum in the next five years.

I've personally given up on trying to be an expert on every single new and emerging technology.

And because those things do come up from time to time at the Cleveland Clinic. I think, my goal or my vision for the future of the Cleveland Clinic is that we can actually build the team. to position them for success and being able to adopt these new tools as they come up, as well as create an environment in which innovation can happen both in our team and throughout the business.

I certainly, as a CIO, I'm not going to have all the answers. I'm not going to be able To understand the latest and greatest that's happening. Bill, you mentioned early on I literally work with the Michael Jordans of healthcare in every single discipline. There's no way that I'm going to stay on top of what those technology innovations need to be for those specific disciplines.

But what we can do is create an environment that enables that innovation to happen. How do we create platforms and patterns that can allow those things to plug in seamlessly and speed the time to execution as it relates to being able to do new things, whether that's partnerships or point solutions or what have you, we need to be able to be agile to to be able to adapt to those things as they show up.

By the way, that was really well said. And that is the argument I always give. For architecture, right there. It's look, with architecture, with standardization, with modernization, with all those things, we're able to be ready for the things we don't even know about yet. Like, how are we going to use data?

How are we going to integrate AI? How are we going to use robots? How are we, and people want to talk about those things. It's and they expect it all to work on top of the platform. And that's the reason architecture is so important because we want to have standard ways to plug that stuff in and move the data in and out secure that data as it's moving in and out.

was fantastic. want to talk about the path you've taken to get here. What has happened in this role that maybe you didn't anticipate? What's the aspect of the CI role that you're looking at and you're going, not sure I expected it to be this.

I watched other people do it. I've asked this question before and some people will go, man, I didn't realize how much I really should have paid more attention in my accounting class. It's like I'm looking at these numbers an awful lot and I thought I was in IT, but I, I'm over a very large portion of the budget.

So I'm just curious, as you sit in the chair now and you think back on it what's something that maybe has surprised you about the role now that you're in it?

That's a great question. I think, The last few years have shown us just how dynamic the healthcare industry actually is. I think some folks, like I mentioned, my background is in EPIC. I have EPIC expertise, but even just look at the way that EPIC has evolved the last few years.

It's something you have to constantly grow and learn and adapt to. I think maybe The myth is that when you get the CIO seat, you've somehow arrived at something where you're now there and you don't need to learn and grow and develop. And I think, realizing that's a journey something that you need to take on personally, be comfortable with change, be able to adapt and respond to change.

But then again, I mentioned this a minute ago too, really positioning your team as well. I think the emphasis on the team, working on building a team that complements you and not just reflects who you are. ability to be able to bring in different points of view and a diversity of skills that make for a stronger whole and just managing that dynamic and Really working towards ultimate productivity and high performance as a team, I think just continues be something that I get super excited about.

One, because we have an amazing team but two, because it's actually something I think continues to keep me going. On my edge. I think I just saw an article the other day about how to manage people that are smarter than you. And I feel that all the time, like not only my own team, but when I think about the organization as well, and the role that I'm here to play and activating and engaging the entire organization.

That's definitely been an inspiration and excitement for me as I continue on in this journey.

That's fantastic. Hopefully we're all surrounding ourselves. I always commend people now when they disagree with me. I'm like, it just doesn't happen enough. I really value when people look at me and go, yeah, I don't think you have that right.

I'm like, thank you. That's it's

Just to double click on that bill, I think leadership can sometimes feel like a very lonely place, right? Like you don't always know, how people perceive you, or am I thinking of everything? You really rely on your team to help fill in those gaps, to hold you accountable to things that you've said and done.

And it's only through that open dialogue full of trust and respect that you can really, count on your team to serve that role for you. And whether it's through disagreements or things that we need to come together on I really appreciate that open dialogue. And I think that's, that just builds our integrity as an organization when that's part of just the day to day culture.

was talking to somebody yesterday about, when I was a CIO, I made a mind map because I felt like. I was dropping things like there's, I had hallway conversations. I'm like, Oh yeah, I need to follow up on that. And it was happening too much. And I'm like, I'm just going to dump all this stuff.

And I found that mind map a couple weeks ago. And I looked at it, I'm like, Oh my gosh, like the things that you have to think about on a daily basis. It's it's perpetual problem solving. And there's just a lot of them to think about every day. Let's close with this. It's July. There's a new class getting ready to go into college, and many of which don't know what their major is going to be, but they're like, you know what healthcare looks like an interesting place for me to go. I really like helping people. I like technology. Yeah.

I feel like I've been a leader in high school and different things, that kind of stuff. If you were talking to a group of aspiring leaders about what they would study or what they would do during their college years in order to prepare them for a role in healthcare around technology, are some of the things you might say to them?

So the first thing I would suggest is to actually have a plan. If you haven't thought about what your journey looks like, actually sit down and make an intentional effort to write about what does the next three years look like? What does the next five years look like? I mentioned early on, I never dreamed I would be a CIO, but how much more impactful and effective would my journey have been had I actually looked towards something like that and actually dreamed big like that.

Leadership development is a sustained and intentional effort that you build on with every day that you're out in the world doing the things that you're doing. So you'll want to align with those who can actually help build you up, who can contribute to your plan. And you can actually point to the things that you're trying to do on a daily basis.

I also, my second piece of advice would be to actually pursue a formal mentorship relationship. I think we use that word a lot and, it gets thrown around. I really mean formal, which means that you actually enter an agreement with someone that says, I'd like you to mentor me.

These are my specific goals. And these are the things that, I hope we get out of it. I found a ton of value in being mentored and being a mentor to others. And I think a lot of that comes through, again, intentionality and discipline that you're going to keep that kind of practice up. I think these are the folks that are going to become a permanent part of your network.

Whether you maintain that mentoring relationship so you can continue to rely on them throughout your career. I think about all the folks that I've had interactions with over the years and I may reach out to them with a question or I might just even provide a reference. That's extremely valuable and it starts with kind of that mentoring relationship.

So those are two key things that you can start on. The last piece would be have some grace for yourself. I think in our current culture, there's this idea that you always need to be advancing or that you need to have, a title or that you need to have these things that actually, mark your journey.

Just know that there's small wins along the way. And if you don't achieve the things that you have in mind, just understand that your journey is unique. And that, a lot of this is behaviors and mindsets and things that you're going to continue to work on day over day. Have grace for yourself if it doesn't all show up for you right away.

There's opportunity to continue to learn and grow even through those experiences.

You were a much more mature person going into college than I was. I was a knucklehead. I'm pretty sure I didn't have a three year plan but the thing is I always wanted to be better. And so when I finally got into that mentoring relationship and the person said to me, look, Bill you've got to go buy two new suits.

Like your suits aren't nice enough. If you want to project a certain image and I didn't have the money, but I went and bought two new suits. And, it's responding to that mentor with the understanding that they have, I don't know, sometimes it's 15 years, sometimes it's 20, sometimes it's 30, but a lot of stuff happens in those 15 years or 20 years or 30 years that is really valuable to somebody who's young, just starting out.

If they'll just put themselves in a in a learning role, in a humble role of, yeah, me what you've learned. don't want to start from scratch. I want to learn based on where you've been and what you've accomplished. And love that advice. That's fantastic. That's it. Sarah, I am so to get the opportunity to interview you and I really appreciate you being so flexible to come on a Friday afternoon at four o'clock to do this interview.

can honestly say you're the first CIO I've interviewed. this late in the week. So thank you very much. I really appreciate it.

Trust me, the honor's all mine. It's a pleasure to have this conversation. I'd love to come back at any time and build upon any of these topics that we've just touched on here and appreciate you and the work that you do for the overall CIO community.

It's much appreciated and I find a lot of value in it. So the fact that I could be on here is truly a pleasure and an honor. So thank you so much.  

Thanks for listening to this week's keynote. If you found value, share it with a peer. It's a great chance to discuss and in some cases start a mentoring relationship. One way you can support the show is to subscribe and leave us a rating. it if you could do that. Thanks for listening. That's all for now..