The man behind the U.S. Army Medical Department’s massive IT effort is 47-year-old Colonel Barclay Butler, a soft-spoken techie/senior manager whose tech responsibilities could easily keep a dozen CIOs awake nights. Butler runs a worldwide operation that ranks among the top two or three healthcare systems in the world, and that supports approximately a $70K to $85K staff and millions of patients strewn across continents—a level of responsibility that makes you wonder just what he did to earn his present position.
Butler joined the military following college graduation. The military lifestyle is so ingrained that he speaks unconsciously in codes and acronyms. Throughout his 20-year service stint, he has steadily moved up through the ranks, compiling an impressive resume.
Not too many people hold five degrees, as Butler does: a Bachelor of Science in biology/bioengineering; three master’s degrees (one in signal processing, a second in bioinstrumentation, and a third in military arts and sciences); and a Ph.D. in biomechanics.
With credentials like these, why did Butler choose the military sector over private industry? Butler says the decision was partly related to his childhood as an "Army brat," with a father who was a colonel. But actually, Butler was looking for a way to foot his impressive education tab.
“The Army said they would pay for graduate school,” he explained, with the payback being four years of service. “They had me,” he chuckled. He opted to stay on past that initial stint, as he enjoyed military life and saw incredible opportunity, he said.
Tech is just one part of the job
His first assignment was as CIO of the 44th Medical Brigade deployed to Haiti, where he was responsible for setting up all the communications and systems for the medical forces there. “It meant setting up a small hospital, AIRVAC battalion, medical logistics company, area support, and a continuum of care which included primary through surgical care,” he explained.
Serving a politically “uncertain” (dangerous) country also meant toting a 9mm revolver and wearing body armor. While Butler was a top-level techie, he was also a military officer, well trained in operations.
From Haiti, he then moved on to a two-year assignment as CIO of the 18th Medical Command, running a community hospital and 10 primary-care clinics throughout Korea. One of his many achievements was deploying a sophisticated integrated hospital information system, he recalled.
The next assignment brought him back to the United States, where he took on the role of CIO of Walter Reed Army Medical Center in Washington, D.C., the Army’s largest academic medical center. Simultaneously, Butler also served as CIO of the North Atlantic Regional Medical Center, responsible for 10 hospitals in a 13-state region.
He was promoted to his current position just over a year ago. In addition to all the tech expertise he’s accumulated over the years, he’s also a skilled parachutist, Army Ranger, helicopter pilot, and combat medic. And, of course, an expert marksman.
Military tech life a bit different
The disciplined Army life promotes endurance—both as a serviceman and tech professional, and bodes well for the 18-hour days that often start at 4 a.m. and end about 10 p.m. Yet, somehow, Butler found time to have a family of five children.
The biggest difference between serving as a military CIO and as a civilian CIO is “diversity,” said Butler.
“A civilian CIO’s job is difficult enough, but I was lucky enough to manage the technology and communication for an entire medical system, and develop an integrated delivery system,” he explained. “Besides working with a large military staff, I deal with contractors and civilians as well.”
One of Butler's current projects involves setting up a single clinical data repository—one clinical system across all of the organizations for which he is responsible.
“We’re integrating and coordinating the regional hospital information-management offices to get them focused on a common strategic direction,” he said.
Surprisingly, the Army medical system is more federated than hierarchical. “The commander of a hospital has a lot of autonomy,” explained Butler. “It is not complete autonomy, but it is more than most people realize.”
Not surprisingly, bureaucracy runs deep throughout the extensive military ranks—including the tech environment. But Butler defends the bureaucracy, as he views the systems and procedures as essential for managing a massive, worldwide workforce.
Yet he acknowledges that the bureaucracy can be frustrating as well. For example, the typical acquisition process can be agonizingly slow.
“It can take a year and a half to buy an aircraft carrier or an IT system,” said Butler. “It slows things down when you want to get them done quickly. A [civilian] company can get a technology process approved and in the marketplace in six months. We just do not have that luxury.”
Despite the long hours, and the bureaucracy, Butler clearly enjoys his life. “I love the quality of the military folks and the camaraderie,” he said. “I also admire the work ethic because there is a great deal of support at every level.”
As a tech leader, Butler said he works hard to build that support. “I make my expectations and priorities crystal clear. I negotiate timelines and then hold the staff to them. But, I offer flexibility when the mission allows it,” he said. “I define the lines of responsibility for my staff and then rely on their expertise and good judgment. And then I communicate, communicate, communicate.”
So, what’s next for Butler? Well, when his Army career ends, he’s considering joining the civilian tech ranks. “I don’t think it would be difficult taking what I learned and applying it to a company,” he said modestly.