HIStalk Interviews Cindy Dullea, SVP of SCI Solutions and Rear Admiral (Select) of the United States Navy

I only knew Cindy Dullea as my sponsor contact at SCI Solutions. We swapped the occasional e-mail about advertising reports or graphics, that sort of thing.

Memorial Day of this year, I made my usual "fly your flag in honor of service men and women" pitch in HIStalk. Cindy e-mailed her thanks for that comment, confiding that she holds an additional role that she doesn't talk much about. Cindy is Rear Admiral (Select) of the United States Navy.

Of course I had to interview someone that interesting and accomplished. Thanks to Cindy for agreeing to be interviewed (and for her service to our country, of course).

Let’s start with your civilian career. What do you do for SCI?

I am the senior vice president of marketing. I’d been with John Holton in the original 25 folks that started Scheduling.com in 1999 as VP of marketing. It was a great opportunity for me to create a brand and launch something from the ground up. I have an MBA with an emphasis in healthcare marketing and information systems. I had the opportunity to create the brand now known as SCI Solutions.

I left in 2002 and came back two years ago when John bought the Efileshare product. John and I had lunch together and it was a really great time to bring me back to re-brand the organization and figure out how to put the Scheduling.com product and Efileshare product names in perspective. We looked at that for seven months and re-launched about year ago.

I do all things marketing as well as being a nurse by background. I do a lot of client relations things, visiting clients and understanding how they use our systems, using my healthcare consulting background to see how they can improve their use of our product line.

What’s new with the company?

We have lots of new product functionalities coming out with Order Facilitator and our scheduling products. We had a record quarter last quarter in sales. Things keep getting better and better. We have wonderful ratings in KLAS. I couldn’t be more pleased, as I know John is, with progress of the company, from ratings to sales. We’re on a roll and have great momentum.

How does working for a relatively small HIT vendor compare with the big ones you’ve worked for?

It’s an opportunity to work, first and foremost, with some really bright people who have been around the company for awhile. In big companies, you get siloed and may not know what the division or department beside you is doing day to day. In a small company, you rely on each other. We’re all in it to make the company better. We’re high energy, multi-tasking types of individuals who are happy to step outside of our bounds to help the overall company and the individual departments meet our goals.

I like to multi-task and to be a part of multidisciplinary teams and high-energy team efforts. We can accomplish this by being very virtual. Of our 65 employees, over half are virtual, working from home offices. All our sales and marketing as well as implementation employees are home-based.

As a vendor marketing executive, how do independent blogs like HIStalk fit into the big picture?

We at SCI think it's great because it gives us an unadulterated view of what going on in the industry. Most, if not all, of our executives read HIStalk. It gives us an idea of what the target market is thinking.

In the beginning when I came back, my group was focused on how to take the SCI Solutions brand and make it better to reintroduce it. We accomplished that in terms of creating marketing collateral and so forth to support the deployment of the new brand.

We switched over and said, “What are we doing for sales lately? How are we going to help our salespeople prospect better?“ It’s hard to fill your funnel and tool chest with qualified prospects to talk to. We said, “Where will we focus our marketing activities to help our sales organization?”

We became a prospect marketing organization. We looked at ways to do that and where to focus our advertising dollars. HIStalk was #1 on our list. That’s where the majority of the healthcare arena will get their information, not from reading trade journals. There’s no bang for the buck there.

We do Webinars, go to trade shows where buyers will be, and focus on getting clients out there speaking. We do a number of activities, but we advertise only in two places: HIStalk and on the NAHAM [National Association of Healthcare Access Management] website. That’s it.

You’re a board-certified informatics nurse. Is that a career path you’d recommend?

Absolutely. It has really caught on the past five years, especially among those nurses who have been at the bedside for 10+ years and can take their knowledge of how care is conducted to the information systems piece. It’s a great career path that’s catching on. CARING [a nurse informatics organization] is an organization that has grown tremendously.

Tell me about your military responsibilities.

I’ve been Navy nurse for over 27 years. I spent 3 ½ years on active duty as a full-time Navy nurse. I got off active duty, spent four years in the inactive Reserves, and have been a weekend warrior for the past 20 years.

I was just selected to be the next Navy Rear Admiral for the Reserve Nurse Corps. I’ll put on my star October 1. It was just confirmed by the Senate. It’s a done deal now [laughs]. I guess they found nothing bad in my background.

I’ll be over 4,000 Navy nurses, both active duty and reserve combined. I’ll be the #2 admiral over them. A two-star, full-time admiral is the #1. I will be there depending on the needs of the Navy. It could be up to 180 days a year on active duty. That’s one part of my Admiral job.

I’ve also just been named the Deputy Regional Commander for Navy Medicine National Capital Area. Navy Medicine is divided into four regions, each with a commander over Navy hospitals in their region. The National Capital area covers the National Navy Medical Center in Bethesda, Great Lakes Naval Hospital, and several others.

What are your responsibilities?

That’s unknown for me at this point. I believe it will have some level of governance over all components of Navy Medicine in the Capital region.

It will probably involve the integration of Walter Reed with Bethesda, which has lots of moving parts to think about. It’s no different than when two health systems merge. Beyond who has which toy and who does what, the cultures are different. It’s all military, but each component truly has their own culture, and with that comes small details. A Navy Corpsman is not the same as an Army Medic. Training is similar, but their patient care duties vary. How do you handle that on a patient care ward? You start going through the building blocks to bring the cultures together.

The Navy Surgeon General is the top doc, the top Navy person for Navy Medicine. The Surgeon General is a three-star Vice Admiral, the only three-star in Navy Medicine. I had the opportunity from 2000-2003 to command a unit at Navy Medicine headquarters that reported to the Navy Surgeon General. My unit worked with the strategy and goals of Navy Medicine. Everybody reports to the Surgeon General. I was probably closer because a lot of what we did was under the direction of the Surgeon General and his top team.

Is your military job affected by politics and bureaucracy?

Oh, yes [laughs]. Any time you get in a big organization, especially one that tries to stay apolitical, there’s always politics involved. Nothing happens with Navy Medicine unless it’s at the direction of someone pretty high up in politics. For example, we can’t just decide that we’re going to deploy a hospital ship when a tsunami hits. The Navy Surgeon General can’t just send out his big white ship. It has to come from Congress.

Do the armed forces do a good job taking care of soldiers?

Absolutely. There is nothing even comparable to the military’s ability to treat combat casualties. We’re seeing casualties in this war unlike anything we’ve seen in wars past. Service men and women who would have died in Vietnam and maybe Desert Storm I are living. We get to them quickly, stabilize them, and move them to Landstuhl, Germany. That’s great.

I think our challenge in the military arena – and probably Walter Reed has felt that more than other services – is post-critical time of care. One of the things we’ll get really good at doing is case management. What happens when you release that service man or woman from your facility back to their communities or bases? Each service does that continuity of care differently. Some hiccups have to occur. We’re learning from it. I’m convinced everybody knows that long-term case management has to be done very well.

You helped design the Navy Reserve’s personnel deployment system. How does it work?

It used to be that all reserve medical personnel came under the authority of big Navy Reserve, which owns every Navy Reservist. They were great at administratively taking care of us, but when it came to mobilizing us, they fell short because they didn’t understand the idiosyncrasies of physician and nurse specialties. You might be a med-surg nurse, OR nurse, or ICU nurse. You have to know what kind of nurse.

In 2000, the decision was made that the big Navy Reserve would pass over the day-to-day authority and operational control of Navy Reserve Medicine to the Navy Surgeon General, who would own his or her own assets, including reservists as well as activity duty. They had a better picture of what I call part-time staff, those several thousand reservists. We built MEDRUPMIS, which gave us the ability to drill down into fine detail about each reservist - corpsmen, nurses, doctors, dentists, and medical service corps. We could see not only what they were and their designator , but also see down to the granular detail, like the doctor is a board-certified orthopedic surgeon and is credentialed to practice.

We did a search query capability. You can pull up all med-surg nurses in a list of states and tell a military treatment facility like Bethesda how many med-surg nurses are in their area that they might be able to mobilize or have come in for their annual two weeks of training.

We were scheduled to do a Beta test scenario in which the hospital ship USNS Comfort was deploying for an emergency and we had to backfill Bethesda. I was there on September 11, 2001 as the senior officer, watching the screen as it matched requirements. The planes hit the towers and the Pentagon. What was supposed to be the Beta test became reality. We used the system, not knowing if would work to backfill 250 staff into Bethesda for staff deployed on Comfort to New York. Since then, it’s been used to mobilize for tsunamis and into military theaters around the world.

Having seen clinical information systems in both the military and private sector, how would you compare the two?

The commercial clinical systems are much better than what started out as CHCS I, created by SAIC and now AHLTA or CHCS II. I would say that some of our in-theater product lines are very good. Where the military is still lagging behind is in looking at those civilian systems and trying to understand, building on something that’s reached its life cycle, to see if there’s something out there. Systems aren't building that EMR that we need to get to in the military. The case management aspect and knowing where service men and women are going will play into that.

What military leadership practices do you use in your job with SCI?

I absolutely give credit where credit is due. I wouldn’t be where I am today without the military. First and foremost, it’s understood early on the military that, as you move up into additional ranks, you are expected to take on increasing levels of responsibility. That taught me not to fear taking on bigger and better and more complex issues.

The military allowed me to lead not only small groups as a junior nurse over maybe 20 people, but up to 700 people over six states. It challenged me to think outside the box, to redefine my leadership skills, to try to not be afraid of trying different things and giving myself permission to fail.

I’ve taken those fundamental thought processes to SCI. John Holton lets me do that, strategizing what I want to do. In some ways, it’s very much like senior officers I’ve worked for in the military, using him as a sounding board. I enjoy that collaboration.

There’s much more organizational structure on the military side. Everything is extremely chain-of-command oriented. You wouldn’t pass over your immediate supervisor to get to someone else. When I come back from military duty, I have to think about which environment I’m in. I can be more relaxed and open about what I can say. I’ll use acronyms and John will tell me to stop [laughs].

You’ve known a lot of people in the industry. Which ones were most memorable?

I certainly would say, on the military side, I had opportunity to work for Vice Admiral Mike Cowan, who I understand is now CMO for BearingPoint. I learned a lot from his style. I’ve worked with John Holton twice, so there’s a testimonial there. Steven Russell from QuadraMed gave me my first break in the industry back in 1992 and hired me almost sight unseen, setting my path at Compucare for the first five years. 

There have been lots of great people along the way who have allowed me to do different things. On the Navy side, Chip Rice, president of the Uniformed Services University. And, his chief of staff, Steve Henske, who was my commanding officer 12 or 13 years ago. I was selected as his #2 person, his Executive Officer, which began my leadership movement in Navy Medicine.

Any other thoughts?

I’d like to give a plug for any healthcare professional who has considered looking at a career with the military. For those who are patriotic, who want do something for our country, and who have the skill set, I’ll give a plug for the Navy Reserve.

For me, one of the most enjoyable things that I cherish over the last 20 years as an active reservist is the quality of the people I meet. Wherever I go, I’m in awe of the types of people who are out there and who set aside their lives for two days a month and two weeks a year to do something for the military. Some of them are health system CEOs or senior consultants or nurse anesthetists in business.

It’s incredible the kinds of folks I’ve had the chance to meet and get to know. If you’re looking for a new challenge, I would highly encourage you to consider service to your country. It’s a great opportunity and there’s a lot of self-satisfaction that can come with it.

I’m very blessed in that I’ve had the opportunity to have this alter-part of my life and able to maintain it, thanks to lots of folks who have supported me along with way on the HIS side. I’m blessed to be able to maintain both sides. I’m honored that SCI Solutions and its employees have been supportive. More importantly, when I speak with them, I feel there’s a lot of respect and a celebratory feel that it’s cool that I’m one of them. It’s like family at SCI.