Pioneering the CNIO Role (ft. MaryAnn Connor)

Thanks for tuning to Digital Voices Podcast, where we chat digital transformation challenges and opportunities across healthcare and life sciences. And now your host, Ed Marx.

Welcome to another edition of Digital Voices. And I don't wanna say I have a favorite type of role that I love to feature, but I do love nurses. So welcome, Mary Ann Connor to Digital Voices.

Thank you.

Mary Ann, you are the CNIO over at Memorial Sloan Kettering. Yes, I am. How long have you been part of Memorial Sloan Kettering?

I've been part of Memorial Sloan Kettering for over 30 years, about 33 years. Yes. But not as, not in different roles at MSK. Yeah.

Yeah. We're gonna jump into that. I wanna get all the details about your career and I think we just sort of met through time at various conferences. But the most important question, Mary Ann, that we have on Digital Voices are what songs are on your playlist? What kind of music do you like to listen to?

Well, I'm a girl of the '80s and '90s. So I mean, I love Billy Joel and Elton John, Rolling Stones, U2. I'm kind of, in that respect, those are my favorites, like go-tos and what I listened to when I was— growing up. So yeah, those are still the favorites.

And you're in the Metroplex where you get exposed to a lot of concerts in New York City metro area. Did you ever see any of them in concert?

Yeah, of course. Billy Joel, Elton John, did see, actually saw Elton John in Las Vegas, which was fantastic.

Yeah.

Rolling Stones, no. U2, yes. And actually I forgot Bruce Springsteen. Of course we've seen Bruce, you know, Bruce from, uh, he's been right from New Jersey. So another one.

Living where you live, you get exposure to all those concerts and the arts and Broadway and such. What about life message? Are there words that sort of guide you or that you live by?

Yeah, I really, I've realized through my years of experience that something that I'm really, I really kind of stay, stays with me and I try to remind myself all the time that is that words matter and learn from experience and never sort of, you know, kind of keep, stop focusing on the past, but really learn from it and use that moving forward.

Yeah, I love that. So we already sort of gave some hints about, you know, who you are and the role and where you are located, but tell us more about who you are as a person. Like, what is your story? Where did you grow up?

I grew up, I grew up on Long Island in New York. I'm one of 9 children and I'm number 7, but really I'm a twin. So we were number 6 and 7 together. So I have a twin brother. Which is phenomenal and a really amazing thing to have. But I'm very close to all my siblings, so I can't say that, you know, they're all wonderful people. So I really am very blessed. My parents were really very, we have a very loving, caring family. So I can only say good things about my childhood, almost idyllic in a way. You know, learning as I have through the years of other people's not having that same experience, I really know how blessed I was and am.

Yeah.

So it kind of really was the foundation of who I am and how I moved on in my life is really from my parents and my grandparents, and really a lot about how they cared about family and the importance of family and hard work. They were very much examples of that.

Wow. So you're definitely a New Yorker through and through. Yes.

Yeah. Yeah.

That's pretty cool. And are you the only one that went into healthcare or did any of your other brothers and sisters also enter healthcare?

That's a great question. My older brother became a pharmacist, And has had a very exciting, interesting career, mostly in Virginia, UVA, and is still now working in some really interesting— doing some interesting work as a pharmacist, really guiding people's medication histories and helping people really manage their medications. It's really great to see how he's evolved his role as a pharmacist throughout his career. And my twin brother is a podiatrist. So we've got a nurse. doctor and pharmacist in the family.

Yeah, that's very cool. And what was the primary catalyst for you to get into nursing?

You know, honestly, in high school, I really excelled at math and science. I enjoyed it. You know, people think I'm crazy, but I loved algebra and I love formulas. And that was definitely an area where if you went ahead and did your tests that they did in those days about what you might be, you know, what might look good for you to go to college. Nursing was one of them. So I was like, well, that kind of makes sense for me. I have, it's kind of a path for me to go to school for. It gave me some direction around that. So I did it. I really had, there were no nurses in the family. It was very much people, my grandmother was very excited when I said I was going into nursing and my parents were very encouraging. But that was really my reason. I was good at math and science and thought this is a good career path for me. And it turned out to be. Much more than I realized, a much more meaningful career path.

And then you went on to get your, right, your master's and your doctorate. Tell us about that. What, what was the thinking behind continuing your education?

It, it started with the first, when I first went to nursing school, I, I went into an associate degree program because for me going and getting to college and all, I paid for it myself. I, I was supported, you know, I really had to do it all myself. Not that my parents weren't supportive, but my grades were good. So I had a scholarship and things like that, but I went into associate degree program, which of course gave me the ability to sit for my boards in 2 years. And, um, and it was a lot of work. It's very hard, but, um, I learned a, I learned a lot, but I also learned that there might be, I really needed to think about what, you know, bachelor's degree looked like. Again, that was something they kind of encouraged you to, but you didn't have to do it, which today, of course, that is the push, right? To go and get the bachelor's degree. The good news was I met some really great colleagues in nursing school that were also going on. So we all did it together. So we had this sort of camaraderie that we would go on. We went on and all got our bachelor's degree at the same time. I learned a lot in the bachelor's degree program, more about leadership. You learn about the skills and the task in the associate degree program. And then I really learned about leadership and more about sort of what nursing is from a leadership perspective. So it kind of gave me the impetus to look outside of— I was already working then as a staff nurse. I started, and I actually started my career in oncology. It was the first oncology unit in a community hospital out on Long Island that I was able to join the team on. And I again learned a lot, but also realized that there might be other opportunities out there and went on to NIH after I got my bachelor's degree and again saw, wow, there's more.

Right.

When you go out there, they were already using computers at the end of the day, which most of the Oregon hospitals outside of there were not. So I was like, oh my goodness, this is another world, computers and technology, and also research, clinical research. And that really spurred me on to say, oh, a master's degree. Let me see what a master's degree in nursing would look like. And kind of where I went into nursing administration. as my degree, kind of thinking, where am I going to go with this? And it led me to nursing education. So when I started as a nurse educator after my master's degree, I started at MSK as a clinical, as a nurse educator. And that's where, you know, I worked as a nurse educator for a few years before informatics came along, which I can, you know, share a little more about that.

Yeah.

And the PhD has come much later on and for a lot of reasons. You know, again, it's a lot, it's an important step, but it's also a commitment.

Yes.

So I had to really make that commitment. But the more I've done the work that I've done in informatics, the more I realized the importance of the PhD for me to really contribute to nursing science and really informatics and implementation science. Because I do believe there's a lot of connection there and a lot of opportunity for us to continue to look at. how we implement systems, how we use technology, and how we deliver care in evolving role models and how we contribute to nursing science. So the PhD is the latest, you know, for me. And, um, I'm happy that it's over, but it was, it was definitely a commitment.

Yeah. Worthwhile commitment. Now, uh, we'll call you Dr. Connor, cuz that's a, that's a pretty, that's a pretty great accomplishment, um, that you made. And yeah, I, like you, I grew up youngest of 7, not 9 kids, but, uh, big family where my parents stressed education, but we were gonna have to pay our own way. So, but we learned something from that, right? You learned something, how to, how to be resilient and, you know, work hard and make, make things happen. And I'm sure it paid off later in your career. You mentioned 30-plus years at MSK. Tell me why you've stayed so long.

Well, I, you know, when I first came to MSK, I saw the focus on patient-centered care and the commitment to that. that care delivery model. And since I had been in other places, not that I didn't see amazing care delivery models, I did, but I thought, I haven't— there's something here that is wanting me to really sort of step my game up a little bit and also contribute. And I had a lot of opportunities at MSK as an educator and then moving right into something that was brand new really for nursing at MSK, which was to partner with IT and to understand how technology should be implemented, you know, in nursing because of the clinical piece of that. So there was these growth opportunities that enabled me to sort of grow and develop, but also I needed to, I needed also to expand my knowledge around these areas and MSK allowed me to do that. And even to the point of, so I became a clinical nurse manager of clinical systems and then moved into finally CNIO at MSK and implemented a lot of systems in between.

Yeah.

Did you pioneer the CNIO role at MSK, or was there someone before you?

No, I'm the first. I'm in the inaugural. Yes.

I figured as much. That's pretty cool you could do that. You know, I try to minimize how much I speak in a podcast, but I just gotta tell you a quick MSK story and then we'll, we'll keep moving right along. But I have great respect for MSK, and I think it was over 25 years ago, one of my employees, when I was CIO of Texas Health, his young son had neuroblastoma and could only be treated at MSK. And it required my employee to really spend all of his time out in New York City. Now remember, this is 25 years ago before the advent of work from home and, and things that are kind of second nature to us today.

Right.

And, uh, your organization and Pat Skorulis, uh, specifically, but your organization gave him an office.

Oh.

And he was able to work, be productive, make money, take care of his family, I'll never forget that. I thought that was really cool. Even though we weren't directly part of MSK family, MSK became like our family and certainly family for this person. So yeah, great organization. So I can see why you've stayed as long as you have.

Yeah.

Let's talk about, as a pioneer, there's gonna be listeners. And so I wanna break this down too, but there's gonna be some new nurse grads that are digital natives that might want to follow a similar path as you, and that is to grow into this leadership role. What's, what's one piece of advice for that new grad? And then I'm going to ask you the same question sort of for a mid, you know, someone who might be the manager right now of a nursing unit. So for the first one, the new grad, what would you say?

New grads, I say this all the time, even to my graduate students, build your confidence in your clinical skills. Make sure that you develop that foundation and you understand what nursing and nursing practice And be confident in that patient care delivery model because it definitely stays with you for the rest of your career. The rest, the leadership and all of the things that come after those first years of nursing and training will be there. And they'll actually, you'll be able to really relate better to whatever you're exposed to if you have those skills and that background and backdrop. Now, of course, informatics is like a core competency and it's going to be taught hopefully in nursing schools the way we expect it to. So even for nurses now at the bedside, chairside, wherever you are, learn how that technology supports your practice and how workflows are so important when it comes to using the technology and how that's incorporated into the care that you deliver. They can certainly do that. And when they're ready, there's always opportunities to be like, we call them super users.

Yeah.

Learn how to be like a superuser on a unit, understand how you can help others who might be newer to that technology, and explore how digital tools impact care delivery. So all of these things are really like, keep that as a focus, the technology, but technology, as we know, is a tool. And it's all about the care delivery model and how, and evolving care delivery models and how technology can support that. So that's what I would say to a newer nurse coming in and interested in informatics. It's really gonna be around them anyway, but understanding how that technology supports the practice.

Yeah. I love how you started off about building the foundational bread and butter of your skillset before you jump too far ahead. Because I think sometimes we wanna skip that and it'll hurt us later on. So it's always best to build your confidence in that area. That's wisdom right there.

Yeah.

Yeah. What about for the mid-career nurse? Is there something different than that?

Yeah. I think at that point, you really wanna— nurses should really think about what they wanna focus on and where they wanna move into their leadership. There's so many different areas and paths for nursing leadership, and especially now. So, do they wanna be a people leader? Because not everyone is a people leader or wants to be a people leader. They just think that they have to do that in order to move up, as they say, but do you want to look at practice? Do you want to be somebody like a clinical nurse specialist or a leader in nursing practice? Do you want to look at informatics and be a leader in the technology side? Or do you want to look at education? Because these are all important leadership, and quality is another one. There are all certain leadership paths that require a nurse to reflect on. What do I want to be as a leader? Who do I want to be? Most organizations, at least in academia, provide courses in communication skills and leadership just to see what your leadership style might be and how you sort of fit in. And 'cause I also think that it's not just going to school and getting the degree, it's also understanding your skillset and how you communicate and how you articulate where your knowledge and your skillset. So I think those are things I would suggest and, you know, offer as to mid-career nurses seeking sort of that next level.

Yeah, no, I love it. That's super helpful. You've been a pioneer, as I've mentioned already, with nursing informatics. What are one or two examples of some major gains that have been made? You know, because you were talking about when you first started, I think the organization may have been paper-based till you went to NIH. It's like, so you saw and you helped usher in this whole computerization era. What do you think are some of the biggest gains to date?

Well, I think the technology's evolved. Certainly the EHR has evolved from the day of just sort of going, getting, becoming electronic, right? So that we now have, we're really looking at it as a way to incorporate the care delivery into the system and using that data back, right? Of course, with clinical decision support tools, that's certainly evolved, right? In the day, it was more almost a paper to the computer.

Right.

I've been through that, right? Versus sort of how do we want to develop this? And of course we still have to meet regulatory requirements and practice requirements, but it's definitely evolved from that perspective. And then, you know, the other is really, you know, I mean, certainly the clinical decision support. And then I think informatics has helped elevate the visibility of nursing, you know, in ways of looking at sort of the data, again, looking at nursing sensitive indicators, et cetera. So those are some of the examples. Yeah.

And I know you were recently at a user group meeting and not only were you there, but you see other things. You're well-read, you keep up to date, all that kind of stuff. Where do you think there might be some pretty big gains in the future? Like one or two areas that'll help nursing?

Yeah, of course. Yes, of course. So, I mean, we're all talking about AI, of course.

Yeah.

And it's exciting to see that. There's a focus on nursing and nursing documentation and just ambient versus the other types of artificial intelligence. But I think it's going to change, hopefully, if we do this right and we really understand how to incorporate it into our care delivery models. I hope, because it's my focus on caring and relationships, that the documentation becomes something that's part of the conversations and the assessment of the nurse. And it's just integrated into the electronic health record. And I think that's where AI can really help. And it can also help what we're starting— I mean, what we're hearing, right? And when we see, and what we'll start to test is kind of helps to summarize what nurses do that sometimes they don't do today because there's just not enough time to get that documentation in.

Yeah.

But hopefully to really emphasize those caring relationships and some of the things that maybe even nurses don't think it's important to document, but it's important from that perspective of that's what's patient-centered. That's important to the patient. Even if it's like, I lowered the lights because I know you like that, or are we keeping the curtains closed because we know that that's important to you? Those are patient-centered caring behaviors that, you know, sometimes nurses would never document, but are important to the care delivery.

Yeah, those are great, great examples. Now, we take for granted that there's leaders like you at every organization, CNIOs, who are sort of leading the informatics charge specifically for nursing. But the reality is not every hospital's there. In fact, at that same user group, I was in a line with a chief nurse officer from a health system not to be named. And she was lamenting the fact that they didn't have one, a CNIO. And I was like, oh yeah, you definitely need one. And, and, you know, she obviously knew that already. What would you say to a hospital like that that's sort of thinking about, hey, should we or should we not? increase our focus on nurse informatics? So you were invited to their C-suite. What would you say?

Well, I would say that the role that we play, and those of us that are educated in informatics and really understand and have that clinical experience, is that we bring that. And it's been said, but just to say it clearly again, nurse informaticists help to translate the technology and the practice and also help strategically to align what's important for the organization and where they want to go.

Yeah.

So it is the translation. And it's important because surprisingly, not everyone is techie, even if you understand technology, but how to incorporate that into the care model strategically as the organization looks to their— the future of how they're delivering care in our evolving care models. The nursing informatics can really help to guide that transition and help strategically and partner. It's about a partnership. It's never about nursing informatics leading it. It's actually a partnership with operations, operational leadership, the chief nurse, the CIO, and really kind of bring it together and ensure that we have those metrics, we understand our gap analyses, and we're also thinking about workflow. I'm a big believer in workflow and ensuring, because this is the way we educate the nurses and the clinicians to use the technology.

Yeah, no, you're absolutely right. You, you've mentioned workflow a couple times, and that's the key to any sort of, uh, successful transformation is at the end of the day, you gotta be concerned with the workflow for all the clinicians. Let's, let's shift over into leadership. Was there anything early in life that happened to you that sort of prepared you for your roles today, you know, as a leader?

I had the best mentors in nursing. Um, When I started out nursing, I was a brand new nurse and I was like, not, I was like, I don't know. I just came out of a 2-year program and I don't know what to do. Help me. And I really was mentored by some amazing leaders. And so that was something. And I also had experiences where when I first started, I actually was a float nurse. Can you believe it? They put a brand new nurse in as a float. Um, and I floated to certain floors and where I saw where I was like, people were like, come on, we'll go and we'll, you know, we're gonna show you what we need to do. And, you know, once you show someone it's, you know, and got, and just give them a little bit of grace.

Yeah.

You can be fine. But I also had some experiences where that didn't happen. And I think it made me realize, you know, how do I wanna be in the future? Who do I wanna be? I don't wanna be that person that's saying, oh, why I want a person who has more experience. I wanna be that person to say, come on, let's go and learn how to do this together. And that's kind of what led me into education because I actually had learned so much in oncology and I learned so much from my mentors that I worked with.

Yeah.

That I was like, I could do this too. I could go now and be that person that mentors and helps nurses gain that confidence in those skills. 'Cause it is a skill and it's a competency that we need to learn. So I think those are the things that really, I'm not really the one that would come and say, I know it all for sure. I'm clearly going back to school and getting all the certifications. I really, I believe in education. I'm a lifelong learner. So, you know, I'm always looking to learn and to understand.

So, you know, you make me curious now, Mary Ann, about what advice would you have For new CIOs coming into the organization? So they're not necessarily new CIO, they could be an experienced CIO, but they're new coming into your organization. What, and here you are as a nursing informatics lead, what sort of advice would you have for some, for some new people who maybe not haven't worked with a CNI before?

Well, certainly meet and, and discuss, you know, sort of the vision of, you know, because clearly you come in with a strategy as well, or a strategic some strategic goals and really partner.

Yeah.

I honestly think we all bring so much experience and value to the table, and we're all there to really move that forward, move the strategic goals forward and the care delivery models forward. So partnering and understanding sort of what's worked and what hasn't also could, especially someone that's been in the organization for a while, That's always a helpful tool, I would say, to understand what's been going really well and where have we learned to do things differently. I would say that that would be a piece of advice I would give.

Yeah, no, that's great. Because I have a lot of listeners also on the CIO side and they come to new organizations and not all of them have the same level of experience working with their counterparts in nursing. So, what's one thing that you learned the hard way?

Okay. I think what I, um, uh, learned the hard way in, in moving into leadership was always be prepared. That, you know, I, uh, you know, don't try to wing it too much. That's me.

That's just me.

That could be my personality. And don't delay in addressing difficult conversations and situations, especially when you're realizing that something isn't right and it's easier to sort of let it go or Step away from the situation. And I had great advice once from another mentor who said, go and speak to that person directly. Like, I wanted that other person to speak to this person. They're like, go and speak to them and tell them what you are experiencing from their behavior. And that was the hardest thing for me, but it was amazing learning experience.

Yeah.

And I had an amazing outcome, which I never expected.

That's awesome. You're super busy. We talked about that already. High leadership position at a world-famous organization. What do you do to recharge your batteries and sort of remain fresh?

I do my best to get out to run at least a little bit. So I've been a runner. I was a stronger runner a number of years back. The PhD sort of put a little A little bit of a stop in that, but I'm trying to get back into it again. Biking. My husband and I are both runners and cyclists, so we both do that. So anything physical is, and I kind of come from a family of that. My dad was very active. My mom was a big walker and we, you know, so our family is pretty much that way. So that kind of taught me what, you know, how that can really help you stay, really does clear your mind. And even though it's sometimes—

Yeah.

effort, you come back with a lot of different thoughts around what you're stressed about or what you can, you know, how you can address a situation.

Mary Ann, this has been amazing. Fabulous. We talked a lot early about some of your musical influences, about some of your mantras. One, words matter, and that we need to learn from experience, which came through everything that you talked about since then. You became a pioneer for the CNIO role. You're someone that many, many of us look up to. You gave some great advice for both new nurses As well as mid-career nurses. And I think the best one, which will be the 3rd time now that we say it, but is really focus on the fundamentals and build up those skills, cuz that's where you can always fall back to and have that confidence.

That's right.

And that's the springboard for everything else. That is so good. We spent a lot of time also on leadership and the, you know, the things that stood out to me, MaryAnn, where you talked about having a mentor. So mentors have been very instrumental to you. Mm-hmm. And a couple words that you said I think are really important for all of us to practice and embrace, and that's grace. Give grace. Awesome. What did I miss, or is there anything else you want to double down on? I'll give you the last word.

No, I think I believe in nursing. I believe in nursing practice. I believe nurses bring so much to the care delivery and how we care, caring being the most important thing that nurses do. And that's not measurable and always in electronic health record. And so how do we look at ways to demonstrate that caring behavior is something that, that's my study, that was my research, and that's what I'm gonna continue to study and look at in my career.

Dr. Maryanne Connor, thank you so much for being a guest on Digital Voices.

Thank you.

Thank you for listening to Digital Voices podcast with Ed Marx. If you enjoyed this episode, Subscribe on your preferred streaming service and leave a rating and review. And most importantly, thanks again for listening.

Thank you.