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The Nurse As CIO


By By Howard J. Anderson, Executive Editor October 2007
Capitalizing on their insights as front-line caregivers, many nurses are rising up the administrative ranks of their organizations, with a handful even taking on the role of CIO. These pioneering RNs bring a new perspective to the role of leader of the information technology team.

"It's really easy to forget why you're here when you're not taking direct care of patients. I remind my I.T. staff daily that they have an effect on patient care even if they are not at the bedside," says Lisa Bewley, R.N., the CIO at 184-bed Regional West Medical Center, Scottsbluff, Neb.

But nurses who become CIOs frequently must rely on the technical expertise of their I.T. team, she adds. "One thing that has served me well is that I say, 'I'm a nurse, so you need to speak English and draw me a picture. Our I.T. staff is happy to do that."

Nurses bring unique knowledge of the clinical impact of technology to the role of CIO, says Dedra Cantrell, R.N., who is CIO at Emory Healthcare in Atlanta, which owns three hospitals. "The I.T. department needs to better understand the impact of technology on end-users as well as patients," she says.

Experience in nursing is valuable when leading an electronic health records implementation, adds Joanne Sunquist, R.N. She's CIO at 400-bed Hennepin County Medical Center in Minneapolis. "I understand the clinical workflow," she says. "I have a fair amount of credibility with the clinical users."

Nurses who have held supervisory positions are excellent candidates for the role of CIO, says Betsy Hersher, president of Hersher Associates Ltd., a Northbrook, Ill.-based executive recruitment firm. For many nurses, the path could start with involvement in one software installation, paving the way to move up to director of clinical information systems and, ultimately, CIO, she says. "We're pushing R.N.s as CIOs," she says of her company's efforts. "They can juggle more than one ball at a time; they're skilled at constantly prioritizing; they know how to manage a team of caregivers; they manage their time well; and their experience trains them to be good decision makers."

Starting the Journey

Just as Hersher described it, Cantrell's journey to CIO began with involvement in a groundbreaking project.

The CIO at the hospital where Cantrell was nursing director of a surgical unit in the 1980s asked her to lead a clinical systems implementation. "I said 'I don't think so,'" she recalls. "A couple of months later, he asked again. But as I talked to others I began to realize that this was a tremendous opportunity to further the nursing profession by bringing a clinical perspective to technology."

That full-time I.T. project eventually led to Cantrell becoming director of nursing informatics. Later, she became an I.T. consultant to hospitals before joining Emory, a three-hospital delivery system, in 1994, where she served in a series of I.T. roles that ultimately led to her becoming CIO in 2000.

Along the way, Cantrell relied heavily on self-study and practical experience to build her I.T. expertise. "Really the most important piece of it was learning on the job and getting the experience of going through an implementation," she says.

For Bewley, the journey toward an I.T. career shift began after she went back to school to earn a master's degree as a pediatric nurse practitioner. As part of that program, she visited one software vendor to learn how an application for her specialty worked. She was intrigued by the technology, and her CIO asked her to take a role in the hospital's implementation of new software.

At first, she tackled the job of full-time clinical applications project manager, later splitting her time between nursing and managing a software project. "When our CIO resigned, they chose me as her interim replacement," she recalls. "I had no intention at that time of taking the job permanently." But after interviewing candidates for the CIO job, "I realized I didn't want to give up the role," she says.

Going back to school also was a transition point for Sunquist. Back in the 1980s, she became a director of nursing projects and systems at a Minneapolis hospital after earning a master's in nursing administration. "I was a liaison to the information systems department when we were going through the process of choosing the very first clinical information system for the hospital," she recalls. She later became a director of nursing at a New York hospital, working closely with a consulting firm on a wide variety of projects, some of which involved I.T. That was followed by an eight-year stint as a consultant. "I never considered myself as a techie. I was always the person on the project who focused on workflow or change management," she says.

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