Women in Healthcare, Annie Steelman, RWJBarnabas Health

June 14 2021

In the latest episode of the Women in Healthcare series, our guest is Annie Steelman, who is the vice president of system strategy at RWJBarnabas Health, an 11-hospital academic healthcare system in New Jersey. She talks about her role in helping craft strategy for a growing healthcare provider. In addition, she talks about how previous roles prepared her for current duties, and discusses ways that women healthcare executives can grow their careers.

Transcript

Annie Steelman

Welcome to PointByPoint. This is the host of the podcast and the firm's Chief Business Development Officer, Morgan Ribeiro. On today's episode, we are continuing our Women in Healthcare series, and I'm pleased to welcome my guest, Annie Steelman, who is the vice president of system strategy at RWJBarnabas Health, which is an 11-hospital academic healthcare system in New Jersey.

And for those of you who are new to the series, these interviews are with women who are leading the way in the healthcare industry. And we've interviewed women offering diverse perspectives and serving their organizations in a variety of roles. In these conversations, we are talking about female leadership, the pressures that females leading in their healthcare organizations face, mentorship, the change they are driving forward within each of their organizations and much more.

 So with that introduction, Annie, welcome to the show.

Annie:  Thanks for having me.

So, could you provide us with a description of your role as VP of system strategy at RWJBarnabas and more background on the system?

Sure. I'll start with the background on the system.  RWJBarnabas was established in 2016 as a merger between the RWJ health system and Saint Barnabas health.

And we serve eight counties in central and northern New Jersey.  We're made up of 11 acute care hospitals.  We're actually one of the largest providers in the country of behavioral health services.  We have a children's hospital and we also have New Jersey's only NCI-designated comprehensive cancer center.

 And our academic partner is Rutgers University. So we are the largest system in New Jersey for all those reasons. My role as the vice president of system strategy is really to partner with our leaders to help drive overall success and growth.

So what does that mean? That means that my team and I identify, explore and analyze opportunities that we then discuss with our leadership.  We research best practices and the key success for those opportunities and then we help them understand the competitive landscape. We build population-based demand forecasting models that help us understand what's required in terms of utilization in terms of facilities, in terms of providers and then we really bring value to what we do in that we ask questions, we facilitate conversations and we help leaders make decisions so that we drive change and we're in the best position that we can be as a health system. 

Morgan:  I imagine in that role, you're obviously that you're working with leadership across the system.

I imagine that's operations, finance, the CEO - really people wearing a variety of different hats that you all are working with and that you need their input and sign-off as you all are making recommendations on strategies for the system.

Annie:  Yes that's you hit the nail on the head. And when we work with all of those different stakeholders across the system it's really important that in our role,  we're flexible, we are adaptable to changes.  And we're patient.

There are different leadership styles across all of those stakeholders that you mentioned and if we're flexible with them, we can help them better make those decisions in terms of: What's their style? What kind of data do they like looking at? Who do they like bringing to the table to help them make decisions? What kind of time do they need?  What kind of process do they need?  Yes, it's a lot of juggling and it's a lot of flexibility so that we can really all come to the best conclusions together.

 Morgan:  You answered my next question which was do you find that particular skills are needed in your role to advise overall system strategies? You mentioned flexibility, adaptability, patience. Like you said, I think the adaptability piece is so key and being able to make recommendations and work with different stakeholders.

As you put it, the leaders that are tasked with very specific roles of, okay, I'm an operations person. So what's important to me may be different than what's important to finance or legal or compliance, marketing - there are all these different sorts of perspectives on the best ways to approach the strategy and implement the strategy. 

So I think that the adaptability piece is really key and knowing what's important to each of those people and how to work together. So do you find it in your role too? You mentioned flexibility, but just when you have stakeholders with maybe differing perspectives, do you have a seat at the table to really bring them together and compromise on kind of the best path forward?

Annie:  Yeah that's one of the toughest parts of our job, I think. And that happens a lot and it can happen when you're in the room with the different stakeholders. It can also happen behind the scenes when you're speaking with one stakeholder and then you have a meeting with a different stakeholder and,  oh, these people are on completely different pages.

And so it's thinking about creative ways. Like how can we bring these people together so that they see eye-to-eye so that they see may be different perspectives on something that they didn't see before? And that we can all get to that ultimate decision of whatever the planning may be together.

Morgan:  Absolutely.  And I think this leads to my next question, which is prior to RWJBarnabas Health, you were a consultant with Health Strategies and Solutions in Philadelphia, I imagine that role as a consultant certainly has benefited you in your role now with RWJBarnabas and so you really have also spent your entire career in the healthcare industry. 

Were you always interested in a career in healthcare?

Annie:  Yes. I always was interested in a career in healthcare though I didn't quite know what that was before college. And to try on the different fits, I was a medical explorer at my local community hospital, I also doing my local rescue squad and I'd suit up at all times of the day or night, depending on when the brick went off for a call to see if I really wanted to be in the clinical aspect of healthcare. And both of those journeys helped me decide that was not for me.  And so when I applied to St Joe's, where I received my undergraduate degree, they had a major called interdisciplinary health services and you could tailor that major to go to into clinical, social science for more of the behavioral side, or business. And so I did that, graduated and went straight to Temple for my MBA in healthcare. And during that time, I discovered consulting, and more specifically, strategy consulting.

I spent 11 years at that consulting firm before making the move to the provider side.

Morgan:  So I've had a number of guests on the show who have made transitions similar to yours from the advisory or consulting side of healthcare to in-house positions. How did you decide to make that transition from consultant?  Working with a lot of clients at one time and they all have different needs or objectives, concerns, whatever the situation may be to going in-house to a large health system. And was that an easy transition?

That was one of the most difficult decisions I think I've ever made in my life. I loved my consulting family and working there.  We all are still in touch, which is fantastic, and the partners of that firm taught me everything that I know. But the main driver for me to leave consulting was my family.

Annie:  I was pregnant with my second child and the decision was hard to make, but I have to say the transition was easy. I was well-prepared for the role that I accepted and it turns out looking back, it was one of the best decisions I've ever made.  It's so rewarding to be working now on the provider side using all the skills that I learned on the consulting side, all the exposure I had to all different health systems across the country. And now I'm using that within our big health system.

Morgan:  That has to be a difficult decision, right? Especially when you're happy in your current role, but your gut is telling you that it's time to go seek a new opportunity and whether or not that's because of something going on in your personal life, there's a change happening there, or it's just that the crossroads in your career and I think sometimes those hardest decisions can sometimes be the best decisions at the end of the day. In looking at your resume, you seem to be a constant learner. You're currently pursuing your doctorate in business administration degree from Drexel University. What do you plan to do with that degree and how will that impact your future career plans?

Annie:  The degree was my 40th birthday present to myself.  I've always wanted to earn a terminal degree and I also, at the same time, I want it not only for personal reasons, but I want to be ready for the rest of my career, wherever that may take me. So in my current role, I would use the degree not only to help me make better decisions but also to help me ask the questions that potentially no one else is asking, which I think is very important in a rapidly changing healthcare environment.

Morgan:  It's not that you necessarily have the answers to everything, but to know, and to question, why do we do things a certain way? And like you said, that is so important in healthcare. And I think COVID has certainly pushed people in a variety of different roles within healthcare, particularly healthcare providers, to be more open to having those conversations and to say maybe there is a better way for us to deliver care, or maybe there is a better way for patients to access our clinics and our services. And I think telehealth is a great example that everyone's talking about right now. I think there was some resistance to that and the industry generally speaking and that certainly, I think, COVID forced us to be more open to that and to adapt to that delivery model when it's appropriate. You mentioned that you transitioned into your current role when you were pregnant with your second child. How do you make time for the schoolwork and addition to all of your other responsibilities?

I don't know. It's a constant juggling act. I have a wonderful support system at home. I have a wonderful support system at work.  I'm very blessed for both of those things. I could not do this without my husband, without my parents and without my boss, who is the best boss in the world.

it truly does take a village.  Many women can certainly juggle a lot, but it does take a support system. As I mentioned earlier, and you mentioned that as well in one of your answers, is that healthcare is rapidly evolving and influencers and players - not to mention the regulations -  continue to evolve. What are some of the bigger challenges that you face in leading strategy for a large not-for-profit health system today, given those shifts that are happening across the industry?

That's a great question. I would say that one of the biggest challenges that we face is adapting to all of this new competition that's out there.

It's not just hospitals and health systems in the healthcare marketplace anymore. It's Amazon, it's Apple, it's Walmart. It's a lot of different competitors coming at the healthcare environment from a lot of different angles. And so I think that's going to be a huge challenge and also opportunity for us moving forward.

Another challenge that we have is meeting the consumer on their terms and service is key. We need to be flexible so that we can help those working moms take their kids to appointments after work or on the weekends.  So I think service is key. I also think that strategic partnerships are going to be essential. We can't and should not go at this alone as a health system. There are other organizations out there that do things and they do it better than we ever could. And so I think there's a lot of opportunity for strategic partnerships, both on the not-for-profit side and the for-profit side.

There are also lots of new indicators of growth. And so if I have any planners listening, it's not just inpatient market share anymore, we are looking at our competitive position from all different angles - from the outpatient perspective, from the share of wallet perspective, from a new patient perspective - and so we're really shifting from these traditional indicators that we've had for so many years into looking at our competitive position in a new way and through a different lens. I'd say finally tracking the spend of the healthcare dollar. I think this is a huge opportunity and a challenge for my organization and for others out there in terms of following patients through the healthcare continuum and making sure that we're meeting their needs and how we can deliver, whether it's us as a health system or with our partners. How we can deliver the best quality care at the lowest cost.

We do a lot of work as a firm on joint ventures between, let's say there's a for-profit, behavioral health care company that partners with the not-for-profit health system, or you talk about long-term care or home health hospice, there are experts out there with these very specific services and providing the clinical services that really bring in their expertise. And I think those systems that are open to having those conversations and to say, you know what, like we are not all things and let's bring in the experts and let's partner up and work together to provide the best care are going to be the best positioned.

And, on the flip side, I've worked with health systems or hospitals that are resistant to that. We want to go it alone and independence is the most important thing and I think in this current environment, those organizations that are willing to be proactive in those conversations and not be in a position where you're having to react quickly. And it's hard to come up with a solution when you're really stuck in that place. And so it sounds like you all are really forward-thinking in what's coming next as opposed to reacting to the current day situation from a different perspective. What excites you most about healthcare today?

 In particular, have there been any shifts as a result of COVID? COVID has certainly forced healthcare providers to really think about the way things are done from an operational standpoint.  Anything from COVID though that you think are welcome changes that are maybe here to stay?

Annie:  I think that COVID has pushed us out of our comfort zone in many respects. The one that I observed the most was ripping off the Band-Aid on telemedicine and our visits to our physician offices skyrocketed because we were able to accommodate those visits. So I think that's really exciting that something like a pandemic would actually bring some good to healthcare regarding, back to that whole patient service aspect and how can we bring services to patients in a more convenient way? And staying on that theme of convenience pharmacy, we talked telehealth in terms of physician visits, in terms of telehealth, connecting with our community hospitals so that patients don't have to travel. All of these virtual IT-related things are very excited about what they're going to bring on the horizon.

Morgan:  I have spoken to a couple of people as part of this series that are in deal-making type roles where they may be in a development role or even in an integration role where they're bringing in new practices into their group. I'm curious because a lot of them have mentioned that it obviously has impacted the way that deals get done.  I would imagine regardless of your role and your focus area, that maybe there are some efficiencies too, just in terms of the speed at which you can get things done because you're not having to go from one facility to another to have meetings and you can only have two meetings in a day versus now in this world, it's hop from Zoom to Zoom and five (or) six of those meetings in one day. So have you seen it in the work that you do?

Annie:  100%. Yes. And there is a new definition of meeting fatigue when you are in front of a camera all day, and I'm sure you and your listeners would agree. I am exhausted after a day of four or five hour-long video conferences, but I get to talk to more people than I ever did before. It's pretty remarkable.

 And I would say that we're - as a strategy department - more productive than we've ever been.

Morgan:  Yeah, I have to agree. I think that's similar to what, again, regardless of your role or your responsibilities, it has certainly brought a new level of efficiency and productivity.  So as a female in a male-dominated field, what advice would you have for other women who might want to pursue a role in hospital administration?

Annie:  I might not be the best person to answer this, but I will absolutely answer it. When I grew up, I was one of the guys just because of my situation. I went to a really tiny little school and we had bullying and my friends turned out to be the boys. And so I've always been one of the guys, but you're right, when I look up at my meetings around the table- more times than not -  I am either the only female in the room or one of two. So I would say to women out there wanting to elevate their careers to progress: You have the exact same seat at the table that they do. Don't be afraid to speak up for yourself. And, you bring just as many wonderful qualities to the table as they do.

Morgan:  Yeah, absolutely. Yeah. I think it's the same in healthcare as it is in a lot of different professions. I've spoken to some women who prior to being in their current roles at an investment bank or something on the finance level. And that's another area where, oftentimes, you are the only woman with a seat at the table. I think by having those examples, too, and seeing that there are women that are doing it, I think the next generation and my hope is that we will continue to see those numbers that shift and that the ratio will shift as well.

So did you have any mentors who influenced your career along the way? Whether or not those are informal mentors that just happened organically, or a lot of organizations also provide a mentor and it's more of a formalized program. Either way curious if you have mentors who have really helped shepherd you along in your career,

Annie:  I would not be where I am today if it weren't for my friends and mentors along the way, hands down.

So absolutely I've had mentors that have helped me along the way. I would say they span across professional mentors, educational mentors, and then also personal mentors too.  None of them were ever matched through a program although I know that a lot of professional societies do that now.

And I encourage people to absolutely take advantage of that, especially now where maybe you can't go to a networking event because you can't be in person. Definitely take advantage of those. But my mentors are my former bosses from Health Strategies and Solutions that we mentioned earlier. I would say my current boss is absolutely serving as a mentor to me. , He has something that I can only describe as organizational wisdom that I soak in as much as I can and it's really amazing to see him and how he operates. I would say in terms of education, my professors have been mentors along the way, for sure.  Not only in terms of educational aspect, but also helped me decide my career path and, way back at St. Joe's, did I want to pursue an MBA or not. And what was healthcare administration at that time? And then also I can't say enough about local professional societies. I'm a member of the American College of Healthcare Executives and I'm also a member of the Healthcare Planning and Marketing Society of New Jersey and through volunteering on the committees putting together educational sessions serving on the boards, those people that your working side-by-side with also can serve and did serve as mentors for me. I can't thank all of them enough.

 Morgan:  As you were talking, it made me think, particularly right now, and the degree that you're pursuing, I imagine you're exposing yourself to those who are at work in different industries. And even if you plan to continue to concentrate on the healthcare industry, I would imagine there's a lot to learn in those different perspectives and participants.

Annie:  That's why I chose the doctorate in business administration over the doctorate in healthcare administration, because I wanted those perspectives from all different industries.

Morgan:  I think this is such a great thing that many organizations are continuing to invest and grow their diversity, equity and inclusion initiatives. Does RWJBarnabas have a DNI initiative that's impacting the way you hire, promote and retain women in leadership roles?

Annie:  Yes, we absolutely do. And that is in large part from our CEO Barry Ostrowsky, who is amazing by the way. He can articulate and bring people together in a way that I have never experienced before. And I've experienced a lot of CEOs along the way during my consulting days.

This has been a journey a long time coming, but he recognized that our health system needed to do a lot more to strengthen its commitment to equity in New Jersey. If you're not familiar with New Jersey, we have pockets of very high payer mix, as you would assume being outside of big markets like Philadelphia and New York City, but we also have large urban cities that have a lot of healthcare needs and we really want as to, as a health system, improve those outcomes and eliminate health disparities. So right now we're working on a journey that's really renewing the focus on diversity, equity and inclusion. And we have a name for it. In fact, it's called Ending Racism Together and it focuses on patient care at the community, our system operations and our workforce. So back to your question about the workforce.

In my role in system strategy, I'm making sure that as groups are coming together to decide what the future vision is for a particular service line, for the medical group as a whole, I make sure that this ending racism together theme is front and center so that we can ensure that all of our strategies that we implement are keeping this very important issue in mind. The whole initiative is led in part by our human resources team so they have a major focus on this initiative as well for the hiring aspects of it that you mentioned earlier.

 Morgan:  So I have a question for you. The health system was in the news last week regarding the COVID vaccine and requiring that of employees. Tell me more about that decision.

Annie:  The way that I look at it, it's like the flu vaccine and we are all required to be compliant every year to either receive the vaccine from one of the hospitals or areas in our health system or to report where you got it. Now that the research is out there, it's not a surprise to me at all. And they're starting with the leadership, so that we can set the example that this is how we need to operate moving forward.

 Morgan:  And I'm sure that there will be many health systems that follow in your footsteps on that.

 Anything else that we've not covered that you want to mention to our listeners?

Annie:  Yes. I am often invited to speak at undergraduate and graduate classes or in my professional societies. And so in terms of early careerists I would mention to them: never stop learning. Don't ever be afraid to stick out your neck and be bold. That's how I ended up where I am.

So I got my first job. And, I think that's probably the best advice that I could give an early careerist. For the mid-careerists - for those out there at my level of experience hang in there, I think that we are the future of this industry, and there's so much opportunity for us to improve the lives of the communities in which we serve and for us to improve our roles as healthcare leaders.

So just keep the eye on that and we will make this industry great.

And then for senior careers  - whom I look up to - remember what an impact you have on those first two groups- so the mid-careerists and the early careerists  -  and make sure that you take the time to mentor and share all of your knowledge with us as well.

Morgan:  That's a great insight. And I love that you've segmented that out, because I think depending on the stage in your career and oftentimes I think particularly your early careerists think, oh, there's no impact that I can have here or, I've got to do the grunt work and that's certainly a part of, I think, you got to learn being in the trenches and sometimes you're in the weeds when you're early in your career, but sometimes they can offer, unique perspective or asking a question about why is it that we do things a certain way can spark a conversation and even force the more senior folks to really pause for a second and say I don't know why it is that we do that way. Let's have a conversation. So I think just little things like that and asking questions and playing a role early on provide for more opportunities as you develop in your career.  I've really enjoyed this conversation. 

Annie:  I really enjoyed it too. Morgan. Thank you so much.