Dr. Francesca Leithold of Epro: “Understand your domain and do your homework”

Understand your domain and do your homework — I think that is valid for every sector, regardless of where you work, but it’s one that is often missed. Tech and STEM companies are still dominated by men, and in some instances it is necessary to prove oneself more than one’s male counterparts. It’s always better to know […]

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Understand your domain and do your homework — I think that is valid for every sector, regardless of where you work, but it’s one that is often missed. Tech and STEM companies are still dominated by men, and in some instances it is necessary to prove oneself more than one’s male counterparts. It’s always better to know in detail what you’re talking about.


As part of our series called “5 Things I Wish Someone Told Me Before I Began Leading My Company” I had the pleasure of interviewing Francesca Leithold, Chief Operating Officer at Epro. Originally from Germany, Francesca has lived across Europe, came to the UK in 2014 and joined Epro, a clinically-led digital solution for healthcare professionals and organisations. Francesca looks after the operations team at Epro and manages the client delivery of the product suite from start to finish, to deliver safer patient care and a paperless NHS across the country.


Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

So many people enter the workplace knowing exactly what they want from their role: I wasn’t one of those people.

It may be surprising, but I think that it’s actually quite common. I was completing my Masters degree in Information Management and thinking about my next step, and all I knew was that I wanted to keep my ideas broad. That’s why I continued with a PhD at Munich School of Management, examining software ergonomics, usability, and performance factors of distributed teams using digital means. Something that’s been quite handy in the remote working world we find ourselves in.

I took a sabbatical after my PhD and travelled around the world, ending up entirely serendipitously in England working at Epro, where I have been ever since.

Can you share the most interesting story that happened to you since you began leading your company?

Very early on after I joined the company, we visited a customer where we had implemented clinical correspondence. My aim that day was to complete the benefits study, so I spoke with staff who were using Epro after transitioning from analogue audio tapes.

Before Epro had been implemented in their trust, they told me, there had been so much paperwork in the office that they had been unable to manage keeping it on their desks. So much in fact…that they were faced with building piles of patient case notes on the floor, just to avoid having to send them elsewhere for long-term storage.

That meant medical records people spent their days not reviewing medical records, but chasing around the hospital, wandering from office to office, ward to ward, in search of urgently required case notes. This would take them hours, wasting both clinical and patient time. Sometimes of course the medical files had been placed in a satellite site, in which case a medical records individual would have to walk, get a bus, or a taxi/courier to retrieve notes so that an outpatient clinic could go ahead. The impact in terms of time and cost is considerable.

It was an untenable situation. In one incident, a secretary fell over a pile of case notes and sprained her ankle, requiring hospital care herself! It really hit home for me that our software was making a difference not just to patients, but to staff too!

In the years since that visit, I have been to hospitals throughout the country, visiting secretaries and admin staff offices. In those offices I have seen the walls of paper, the frustration of the staff there, and the resulting risk for patient care. It reaffirms each time how proud I am to be part of the team which helps deliver the paperless NHS (and probably saves one or two trees, too!).

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

Adam, the company owner and I were travelling on the motorway from a customer onsite meeting, and it was late in the afternoon. The day had been long, and we stopped at a services station to get a break from the journey and some food. The service station was a massive bridge over the motorway, and you have (the same) shops on both sides, with a restaurant in the middle. After we’d eaten, I went to the bathroom and we agreed to meet at the carpark. Coming back, I went in my head over the day’s meeting, which was an important one, and then waited patiently at the entrance for Adam.

He never came.

After a while, I started searching for the car. There was no car either. It was definitely the right car park, all the right shops were there, and all the signs were correct. It was one of the most surreal moments — I genuinely felt that either he had driven off without me, or the service station bathroom had somehow warped in time and I had ended up in a parallel universe.

I called Adam, and he stated he was in front of the entrance to the service station. So was I. I didn’t understand. After much confusion and what had the potential to become a major panic, I decided that sitting it out inside in the hope for a miracle might be the best action, which is when I realised the bridge and what had happened. Never experienced so much immediate relief at a service station ever again! A story I cherish up to this day. The learning: don’t multitask on the way from the bathroom.

What do you think makes your company stand out? Can you share a story?

Epro is a company like no other. No two days are the same and every day is fast paced, but that doesn’t mean we compromise on excellence. While customers are focused on using our services and tools, we’re focusing on updating and improving things in the background. We’ve built a team of hardworking individuals who don’t go home when the job isn’t done, which is something I appreciate. We’ve worked hard at creating a culture of real commitment and connection to your team.

But of course, there are light sides to our attention to detail. When we had our office redecorated, we didn’t just hand over the money and leave them to it: we showed them what we wanted, worked hard to get it right, and were happy to change things and even redo work to make it better. Whatever it took to get it right. Looking back, it’s almost the same process with our Trusts — they tell us what they want, we work hard to get it right, and if we’re only 99% of the way there, we’ll still look at improving.

Are you working on any exciting new projects now? How do you think that will help people?

A project I’m really proud of is our integration of the electronic prescribing and medicines administration (EPMA) as a project at one of our GDE (global digital exemplar) Trusts, Wye Valley NHS Trust, in partnership with Better.

EPMA integration and interoperability are crucial factors for safer patient care. Some of the most negatively impactful errors are made in drug prescribing, and they have a disproportionate effect on patient safety. Our implementation of EPMA into our comprehensive EPR light product suite has enabled the Trust to take another step closer to achieving paperless patient care.

The difference we as a partner to the NHS can make by digitising large parts of inpatient and outpatient care is considerable, and it doesn’t just sound good: it leads to leaner, faster, and safer NHS care.

Of course, I’m not completely altruistic. Our partner Better is based in Slovenia, a country that is 40% covered in mountains. What more could you want?

What advice would you give to other C-Suite executives or founders to help their employees to thrive?

Of course, things have changed over the last eighteen months. We have experienced that a large proportion of the workforce can deliver their workload while not being located physically in the office. This opens the door for more flexible workplace arrangements, enables wider recruitment, and lifts local restrictions on hiring the best candidates. Businesses can cut utility bills and rent, and benefit from employees who did not get up at 5am to commute into the city, just to find their office parking spot occupied by someone else.

Over the years I have worked with many different people at Epro, and I know that the best results are always achieved when we have a defined task, understand, and choose to work well together.

If you work with a cross departmental team, reporting lines need to be really clear, so your team members know who they can expect leadership and line management from. The two don’t have to be the same, obviously, but you need to start with that agreement.

Last not definitely not least, don’t over-engage. It’s tempting to micro-manage: don’t. Trust your team to deliver on the project they have been given, and to know when to come to you for advice if they get stuck. Give them room to shine!

How do you define “Leadership”?

Give ownership and accountability, and consider organising a larger team into smaller units. We are not machines — there is only so much management one person can do!

Empower people to make decisions for themselves and their projects, and trust them to make them well. It’s a well-known principle of project management that the larger your team or a project gets, the more need there is for management by exception.

This doesn’t mean you don’t have regular checkpoints with each team member so you don’t lose track of what’s happening on the ground. If you don’t understand what a person is working on, ask them. Sit with them. Take time out of your day to listen and learn. You never know what you might find!

Most importantly, if you commit to something, deliver it. Leadership is as much about reliability and trust as anything else.

What advice would you give to other C-Suite executives about the best way to manage a large team?

Delegating work is not something that you should consider, it should be a part of your working habits. Put simply: if someone else does the work, you don’t have to do it yourself. Perfect!

Jokes aside, distributing the workload and empowering people to make decisions for their own specialisms is an essential part of business, and without it we simply couldn’t operate. It doesn’t make sense to leave all the decisions in the hands of just a few people. It creates single points of failure which is obviously undesirable, and it makes the business inefficient, because people await instructions, rather than owning a task or project.

No matter what industry you are in, you are hoping your business will grow. As you do, not just the amount of work but the complexity of those tasks will increase. There’s just one way to solve that: break larger projects into smaller chunks of work and then allocate individuals who can become accountable for them.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

Believe it or not, when I was a child, there weren’t computers in everyone’s pocket! Computers were expensive and complex, but I was fortunate. My father, an engineer, took me frequently to his workplace — he was the exec of a sand and gravel plant — during the school holidays and gave me exposure that few children ever had.

That means that some of my earliest memories include being in the great repair hangar for the machinery, watching people work. From welding, soldering, drilling, to assembling, the smell of motor oil and petrol is still one of my favourites. The education didn’t stop there: at home, my Dad engaged me in every DIY project he was working on. When I was a bit older, he actually taught me how to weld! He’s given me two unshakeable beliefs: a) the screws I drill in are the tightest, and b) if a task can be done, there is no reason (gender, age, race, or anything) why you shouldn’t be doing it.

My mother is a very outspoken feminist and women’s right supporter, my grandmother worked all her life while raising three children, my aunt’s career was as a business leader… I had great examples growing up. Now that I’m ‘all grown up’, at Epro, Adam has been my close mentor over the years. There are many things I admire about him: his thinking, the way he approaches a situation, how he breaks large, convoluted problems into small, rational chunks. I still have a little way to go, but his example of excellence, focus on detail, and critical thinking has been invaluable to me.

How have you used your success to bring goodness to the world?

It may sound obvious, but when I started at Epro, many NHS hospitals were still largely paper-based, and supporting the move to a paperless NHS has been an aspect of my work I’m truly proud to be part of.

Previous workflows in outpatient clinic appointment settings meant that on the day the clinic was booked, a clerk with a trolley would wander down into the depths of the medical records department, requested sets of case notes for that clinic’s patients, then wait patiently for the medical records people to search through their archives of paper notes.

In cases where records could not be located, the clerk would return the successfully located records to the clinic, then go on a treasure hunt for the case notes in places where they were most likely to be found — in secretaries’ offices or with medical staff from the previous appointment. It was a hit and miss system, exacerbated by an increasing backlog of letters waiting to be transcribed, thus requiring the audio tapes to be in the secretaries’ offices together with the case notes.

If patient case notes are not present in the clinic, some appointments cannot take place — some clinicians will not see a patient without them on principle, and therefore appointments simply cannot proceed for safety reasons. The NHS estimates about £100 for a missed outpatient appointment, so the cost of wasted appointments can be staggering!

What are your “5 Things I Wish Someone Told Me Before I Became COO” and why.

  1. Understand your domain and do your homework — I think that is valid for every sector, regardless of where you work, but it’s one that is often missed. Tech and STEM companies are still dominated by men, and in some instances it is necessary to prove oneself more than one’s male counterparts. It’s always better to know in detail what you’re talking about. No one expects you to be a programmer (unless you are!), but it is expected that you understand what you are delivering, especially if you are representing that project. Men get away without having read the project scope and plan before the meeting. Women might not, and it is paramount to avoid a situation where people expect you to be the expert, and you aren’t, but only because you haven’t done your homework.
  2. You don’t have to have all the answers. — This might appear slightly contradictory (sorry!), but it isn’t. One is about being prepared, the other is about being organized. For example, I know how our software works and the architecture behind it. No one would expect me to start debugging java runtime exception errors, yet I had situations in meetings (largely male dominated, which is an industry-wide issue) where people try to catch you out on this. Be firm. Stand your ground. Know what your job is, and what isn’t, and don’t be afraid to point out the difference.
  3. Be authentic. — I think, as women in high performing jobs, we feel the need to prove ourselves all the time. Trying to be someone else is never going to work long-term; whoever you work with can usually tell. Very early in my career, while teaching at university, I was extremely nervous (teaching a class in front of 200 people can do that to you) and tried to overcompensate by preparing absolutely every single question I was worried might come up. I was hyper-alert. I dressed extra-formal. I stuck to a rigid schedule. Not surprisingly, the experience was terrible for both the students and me, and you know what? My evaluation results reflected that. I learned (no pain, no gain!), started to relax myself and my teaching, and loved it. Thankfully, so did my students.
  4. Don’t compare yourself to others. — It’s fine to check from time to time how other people from your graduation year, your networking events, your friends in similar positions, or simply colleagues on the same level as you are doing their job. Human curiosity is natural! If you end up in turn questioning whether you are really doing your job all that well, whether you have really achieved enough, whether you start getting up at 4am, run 10k twice a week, only have smoothies for breakfast, take language lessons, learn a new skill, and do a masters’ degree in your free time on top of doing your day job…it’s time to stop. It is great to drive for better, but not to drive yourself into exhaustion.
  5. Listen to and empower your employees — Here at Epro, we talk a lot about the ‘so what’ factor. I feel strongly that if people understand why they have been given a task, they will complete it better, and listening back to your employees questioning tasks and ensuring everyone is on the same page will help with that. Build a relationship of Trust with your team and help them own the project and be accountable. Though distributed ownership can work, over the years I have seen more evidence of it being like a deer in the woods. You know it’s there, but difficult to track down with a spotlight.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

Down with crisps.

If I could have my own way, I would remove crisps from being a part of meal deals in supermarkets, and I would like cafes and snack shops to consider the choices they make by offering meal options. I still can’t believe that in the UK crisps are more often a part of lunchtime meal deals than fruit and vegetables, which are so much healthier for you. The way nutritionally empty food is on display and made available normalises their presence on the lunch menu. Why can’t we remove half the crisps and put cucumber, red pepper, and hummus pots? As if that wasn’t bad enough, crisp bags are NOT recyclable!

To encourage this, I’d like those meal deals which are less healthy to be more pricey. I don’t think the extra pennies should line the pockets of supermarkets, but should be used to fund early prevention programs for childhood obesity. The perfect mixture of dis-incentive and additional funding for the health sector.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

I thought this interview was going to get easier! It’s hard to think of one quote that can summarize life, but if I had to pick one, I would choose “vivamus atque amemus”. It’s from the first line of Catullus’ poem 5, written 54–85BC. It means: “let us live, and let us love”. I think the most romantic translation is by Richard Crashaw, a translator from seventeenth century England, changing it to: “Come and let us live my Deare / Let us love and never feare.

Love isn’t just looking back, it’s about living in the moment. Leadership is about planning of course, and learning about the past, but you can’t ignore the present.

Some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them 🙂

Though she may have a few other things in her diary, the German chancellor, Angela Merkel, is my choice. Her leadership, both in Germany and in Europe, has continued for over a decade and I haven’t seen anyone more inspiring. Can you think of anyone else who has been so clear, calm, and dedicated to the populace they have served? We have as a world been through challenging times, yet she has maintained her place as one of the most influential women in politics.

As well as many others, I look to her for inspiration. She has proven conclusively that a woman in leadership should be as normal and natural as a man. I admire her inclusivity and clear global vision, especially within all the escalatory rhetoric of politics of these times. So if you’re reading this, Mrs Merkel, the world needs more women like you!

How can our readers follow you on social media?

You can connect with me on LinkedIn, and follow Epro on Twitter and LinkedIn.

Thank you so much for joining us. This was very inspirational.

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