There’s no doubt that the role of technology is accelerating in healthcare and ushering in massive changes. Along with that, the role of the CIO is evolving as well.
In fact, Black Book Market Research raised some eyebrows with its 2018 study that found healthcare CIOs losing influence in IT purchasing to departmental managers. According to the survey, only 21 percent of CIOs said they believed they were meaningfully involved in market-facing innovations and strategic departmental IT selections. More ominously, only 15 percent of CIOs surveyed (down 55 percent from the previous year) said the role of health system CIO was becoming increasingly strategic.
So, what do these changes mean for CIOs?
Healthcare CIOs Embrace Collaboration with Business Leaders
It’s not all bad news. Collaboration between business leaders and IT leaders is increasing, says Doug Brown, managing partner at Black Book.
“The successful CIO is adapting to be the orchestrator of multiple IT support functions, not the IT purchase decision-maker,” he says. “The new CIO must make sure he or she is recognized as the go-to person for help on integrating technologies, ensuring they meet corporate policies and getting the right price, rather than the leader of complex vendor selections for specific business units.”
However, the broad distribution of decision-making power around the acquisition, deployment and management of digital technology is a huge challenge for CIOs because business units want independence, Brown adds.
Hospital CEOs Look to Forge Digital Innovation, Automation
What do CIOs think of Brown’s analysis? David Chou, vice president and principal analyst at Constellation Research, recently left a position as CIO and digital officer at Children's Mercy Hospital in Kansas City, Mo. He agrees that many CIOs run the risk of being overlooked as strategists in their organizations.
“A lot of organizations now have two roles: They have the CIO, who has been there for a long time, and a chief digital officer, who has been brought in by the CEO to focus on digital transformation. That is the writing on the wall,” says Chou. “The CEOs are trying to drive a different type of thinking, and they see that the traditional mindset is not working.”
In fact, Chou says he included the word digital in his title because he thought the traditional CIO title seemed focused only on back-office infrastructure.
“Adding digital to the title reflects an interest in creating new business models by using technology,” he explains. “While it may not change the organization 100 percent from the start, it creates a different impression, because in the next generation, CIOs will have to take it upon themselves to be digital leaders. Technology has become more of a commodity. Now you have to help business units utilize the technology to the greatest level of efficiency.”
Besides focusing on EHR optimization, organizations see automation as a way to become more efficient and cut costs, Chou adds.
“They are looking at ways to improve things like supply chain automation and revenue cycle and billing automation, so there are not as many manual interventions. The CIO or CDO plays a big role in putting that together. They also are trying to figure out how to create the next-generation patient experience using technology.”
IT Infrastructure Remains Top of Mind for CIOs
Despite the changes, Dr. Daniel J. Nigrin, senior vice president for information services and CIO at Boston Children's Hospital, believes the role of the CIO has only grown more important.
“It has become more of a strategic position within the organization simply because more of the operational systems we depend on in the hospital are automated and powered by IT systems,” he says.
In terms of routine operations, the IT infrastructure is critical, and the role of the CIO in overseeing that shouldn’t be minimized. But even more important are the forward-thinking opportunities that make themselves available, Nigrin added.
“CIOs are no longer delivering functionality on request. They are proposing new and innovative ways of running the organization,” he says. “The word digital is used everywhere nowadays, but it reflects the fact that healthcare as an industry is trying to catch up to the rest of the world, where there is consumer enablement and self-service functionality, putting data into the hands of patients and families. Facilities are looking to technology to push those along.”
Decentralization vs. Centralization in Healthcare IT
There was a time when consolidation, aiming to eliminate shadow IT groups, was one of the larger drivers in IT, Nigrin says. He agrees that an awareness of everything that is going on in IT across an organization is critical. But Boston Children’s has also realized that a central focus can cause the organization to miss out on potential opportunities.
“A team like our digital health accelerator can be nimbler in evaluating new technologies,” he says. “I do think it is helpful in some ways to allow ourselves to become a bit more decentralized than we have been in the past, to allow some of these groups to focus on target areas. But we absolutely have to make sure we are all working collaboratively and communicating nonstop.”
Chou believes the key is to create a governance structure that involves IT oversight, but gives departments the freedom to use the technology they want to be more efficient.
“It is a juggling act,” he says. “The trend toward decentralization will continue. I don’t see 80 percent of the buying power moving outside IT, but if IT is not providing good service, that percentage will grow higher and higher.”
How CIOs Can Evolve to Fit a Changing Health IT Landscape
Mary Finlay, director of the Harvard T.H. Chan School of Public Health’s Leadership Strategies for Information Technology in Health Care program, works with IT leaders who want to reach beyond the traditional role in their organizations.
For several years, CIOs focused on implementing EHRs and meeting Meaningful Use requirements, she says. The emphasis now has shifted to three main areas:
1. Optimizing the EHR to improve clinician productivity
2. Helping the provider or health system organize and make the best use of its data
3. Learning about emerging technologies, such as artificial intelligence or blockchain
There is a risk for CIOs of being perceived as too focused on infrastructure and not enough on business transformation.
“That is one of the things CIOs worry about quite a bit,” she says, noting that in her course she works with CIOs on how to ensure they are a strategic partner, working alongside other leaders in the organization. “A big part of that is establishing credibility and demonstrating you are a strategic thinker so that you don’t find yourself in a situation where people find a way to work around you.”
Finlay also suggests that CIOs should not view a chief digital officer or chief innovation officer as a threat, but rather treat that person as a new partner.
“It comes down to building those relationships and determining how you are going to work together to bring value to your organization,” she says. “The CIOs don’t have to come up with all the ideas themselves. Innovation happens throughout the organization. You want to figure out how to foster and support that.”
For example, Nigrin’s IT department works closely with Boston Children’s innovation and digital health accelerator program.
“Sure, it helps to have a distinct group focused on innovation, but to have it operate in isolation, separate from the operational IT arm of the organization, is an exercise in futility,” he says.
Often, if there are silos, promising projects can stall. The key to pushing innovation through is to partner early and stay closely connected to the innovation group. That way, hospital CIOs can ensure that the operational arm is engaged early, Nigrin says, “and when you hit upon that promising new idea, you can deploy it for real, scale it and get it into hands of clinicians or patients.”