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The No. 1 CIO Challenge


By Zack Martin, Managing Editor March 2007
Being a health care CIO or information technology leader is challenging on multiple fronts. Implementing cranky software on a shoestring budget is a challenge numerous CIOs have had to face during their careers. Dealing with staffing issues and inflated boardroom egos also creates a great deal of angst on a regular basis.

But when asked about the greatest challenge they face at the office, many CIOs don't mention technology as the stickiest wicket in their I.T. initiatives. The No. 1 challenge to being a CIO, they say, is getting clinical and administrative staff to actually use, on a regular basis, the I.T. that CIOs and their staff have installed.

Results of a recent survey by Health Data Management back up that point. The No. 1 challenge cited by respondents - CIOs and other I.T. leaders - was gaining staff buy-in for I.T. implementations.

Twenty-eight percent of respondents said staff buy-in was their biggest challenge, followed closely by systems integration (27%) and funding (24%). The online survey, completed by 150 respondents, was sponsored by The Quammen Group, a Winter Park, Fla.-based health care I.T. firm.

These challenges are not new to health care CIOs. But the increased focus on software for clinical staff and the need to tailor those applications to fit clinical workflows have moved getting staff buy-in to the top of the list, says Becky Quammen, founder and president of The Quammen Group.

"All three challenges continue to dominate our dialogue with health care organizations as we partner with them to implement solutions to fit, support and improve clinician workflow," she says. "It's also a continuing challenge to each software and services provider in the industry to truly understand the processes that are being automated-without that understanding we will continue to get it wrong."

Funding issues, for example, used to be the biggest challenge for I.T. leaders. But health care executives for the most part have recognized that automation plays a crucial role in the drive toward financial and clinical success, and have started to loosen the purse strings to fund I.T. initiatives.

The Health Data Management survey, for example, found that 63% of respondents expect their I.T. budgets to grow by at least 5% this year; 27% say their budgets will increase more than 10%. Only 1% of surveyed CIOs and other I.T. leaders expect their budgets to decrease.

Do you speak doctor?

At the University of Miami Miller School of Medicine, I.T. funding isn't a big challenge for Elizabeth Rockowitz, executive director of business and clinical information management systems. Her most difficult task is working as a translator between clinicians and hospital management to ensure both sides get what they need, she says.

"I am often the go-between for these two groups," she explains. "I am working on closing the gap that exists to make sure the product is what the physicians need and that it's not something that management decided to purchase because they heard it was the best thing for the clinical staff."

To help her tackle that challenge, Rockowitz hired a nurse and a physician's assistant to help decipher what physicians need, and why.

"They help me understand what happens if we don't get technology that fits their workflow," Rockowitz says. "We have to remember that the physicians are the ones who are responsible for clinical care-and liable if something goes wrong-and are in closest contact with the patients. Sometimes it's hard for non-clinical staff to understand that relationship."

For example, the university recently deployed new picture archiving and communications and radiology information systems.

Refining the clinical workflow of the PACS and RIS so it was intuitive for physicians was challenging. Explaining to hospital executives why it took so long was just as hard. "If something doesn't go in as scheduled, there's a tendency on the part of some executives to think that physicians are being high maintenance," she notes.

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