IT execs encounter myriad new roles in organizational leadership

As healthcare systems try to catch up in digital transformation efforts, those responsible for IT systems will find new internal partnerships to serve and interact with.


Chief data officer, chief digital officer, chief innovation officer, chief transformation officer, chief strategy officer, chief experience officer, chief consumer officer – the list goes on and on in healthcare.

The number of senior executives with whom today’s chief information officer now interacts has grown in recent years. The titles may vary depending on the hospital or healthcare system, but the expanding list of these emerging executive roles is changing the dynamics for IT executives. CIOs may serve over, alongside or under one or more of these new titles – or they may even be promoted into one of them.

“The role of the CIO has morphed,” said Aaron Miri, who assumed the newly created position of chief digital and information officer at Baptist Health this year after serving three years as CIO at the University of Texas at Austin, Dell Medical School and UT Health Austin.

After devoting years if not decades of their careers to building infrastructure and implementing electronic health records systems in hospitals and healthcare systems, many health IT execs now are being tasked with helping to turn the vast amount of data into useful information that can improve patient care and the performance of their organizations.

Healthcare reform, the shift to consumerism and an increasingly competitive healthcare environment have added an urgency to digitize healthcare.

“Whether you call them subspecialties of the CIO or you call them separate verticals that work in tangent with the CIO, what we are seeing is there is so much work to be done,” observed Liz Johnson, who wore several hats in her career at Tenet Healthcare, including chief innovation officer and CIO of acute care hospitals and applied clinical informatics.

“We don’t want to see the CIO being relegated back to the person who runs all the big servers and data center,” said Johnson, who is now retired. “They are a person who sees into the future and looks at the ways we can use technology to give us a market advantage, to make us a better competitor, to better support care, those kinds of things.”

Healthcare is playing catchup

Healthcare lags behind other industries in its digital transformation, according to Ed Marx, serving as chief digital officer at Tech Mahindra Health and Life Sciences, and former CIO at the Cleveland Clinic. CEOs and boards are expanding parts of the C-suite in hopes of catapulting the industry into the digital age, he believes.

Edward Marx

“We keep hiring a lot of chiefs … I think it is symptomatic of a larger challenge that we face in trying to understand what digital transformation is and how do we make it happen in healthcare,” he said. “It is really important that CIOs realize what is taking place.”

While some organizations are well along in their digital journey, “in many places, there is a sense of frustration,” he explained. “We are not moving fast enough; the CIO is not doing what they need to do. They (CEOs and boards) may not say that, but it is implied messaging.”  

What can CIOs do to position their organizations, and themselves, for success, particularly as they partner with those in new, emerging roles? According to healthcare executives at the forefront of digital transformation, getting on the right path involves having a strong foundation, good communication channels through a collaborative approach, and an appreciation for the business.

Maintaining a solid foundation

Although the top IT role in most organizations has evolved to become a strategic leadership position, the CIO is still responsible for building, securing and maintaining the technology infrastructure. Healthcare systems have become increasingly reliant on data, making any flaws or downtime in tools like the EHR crippling for patient care and the business.  

“You cannot talk about strategy, you cannot talk about transformation, you cannot talk about making leaps when your foundation is dwindling,” said Omer Awan, chief data and digital officer at Atrium Health and the former CIO at Navicent Health, which merged with Atrium in 2018. “That is the No. 1 responsibility for the CIO, to make sure you have a stable, dependable, consistent IT environment.”

A strong foundation sits on both robust technology and a robust workforce. Tivity Health, which promotes healthy living and fitness solutions for seniors, hired Sarah Richardson as CIO in 2021 to modernize its digital platforms and capabilities.

Formerly vice president of IT change leadership at Optum Health, Richardson is building what she calls “better faster cheaper models,” using a two-pronged approach: by updating the technology and the skill sets of those who know it most intimately. “If I can retire old technology and upscale the team that is already there, I am delivering new capabilities, maturity and products to the organization,” she said.

The CIO also can provide a reality check for fellow C-suite execs by explaining the capabilities and limitations of IT and digital tools while still supporting the long-term vision. “More importantly, beyond what the tool can do, is how far you can push the envelope,” Miri said.

Baptist Health, for instance, is developing a marketing campaign for flu shot reminders and signups for shot appointments using strategies that complement its EHR, which Miri noted was never meant to be a customer relationship management tool.

Commit to communication and collaboration

Smooth and speedy transformation requires clear and regular communication at many levels, according to IT executives who either are working with or becoming digital leaders.

Richardson recommends first identifying stakeholders to understand their view of the CIO’s role and team, and then establishing regular, frequent meetings to keep communication channels open. As a direct report to the CEO, she meets weekly with him as well as her C-suite peers.

“My closest customer is my COO, because there is a bunch of Cs and Vs (chiefs and vice presidents) as I call them under him, to whom I am accountable as well,” she said. “Even though we all sit in the same pool of peerdom, he is my No. 1 customer internally from the business side. I daily check in to see how he’s doing.”

Richardson also spends regular one-on-one time with her vice presidents and makes an effort to have touch points with IT teams, down to the scrum masters. She encourages them to share concerns as well as report on their progress.

“If you are a true agile or a high-functioning dev team, your scrum masters know everything that is going on,” she noted. “You want to pay attention to them.” For example, she credits those in the front-line IT roles for alerting her to a recent problem early in a process. “It was able to be escalated (in a timely way) because they were seeing the trends across the group from a scrum meeting. ‘Hey, we have a red flag coming.’ They knew it was safe to tell me.”

Awan, who reports to the CIO at Atrium Health, also touches base regularly with his boss. He makes a point of sharing pertinent information from the chief experience officer and other C-suite colleagues with whom he collaborates. “We have a very ambitious agenda,” he said, requiring work on multiple projects simultaneously. “But I make sure the CIO is not blindsided, and vice versa.”

At the institutional level, Awan’s team stood up a data governance framework across the enterprise that helps keep Atrium’s stakeholders informed. “Everything we do is sitting on data,” he noted. “When you have a good governance structure, everyone is plugged into it, and no one is blindsided.”

Richardson and Miri emphasized the importance of being articulate and targeted when communicating, especially at the C-suite level. “You have to be able to explain things in a way that is concise, makes sense and resonates with your partners on the C-suite,” Miri pointed out. “Otherwise, you are discounted.”

Beyond regular meetings with teams and C-suite members, Miri encourages CIOs to seek out opportunities to learn about customers’ needs and goals. “Spend a lot of time listening and talking to folks and really helping them with quick wins,” he advised. For instance, his experience working on the Child Psychiatry Access Network and the Texas Child Health Access Through Telemedicine program when he was in Austin has been useful for a coalition involving Baptist Health that is trying to address the mental health needs of children in northern Florida and southern Georgia.

Understand the business

The tug-of-war for patients has expanded from the hospital or healthcare system down the street to retailers across the globe, many of which have sophisticated data analytics and marketing tools to better understand and court consumers.

Healthcare CEOs are under pressure to not just retain their market share in this hyper-competitive environment but also grow it. They expect C-suite executives to understand the challenges and offer solutions that level the playing field or give them a competitive edge.

Liz Johnson

For Johnson, who began her career as a registered nurse, CIOs must start by understanding patients’ healthcare journey inside and outside the healthcare system, and how the pieces fit together.

“We are in patient care – that is what we do for our business,” she said. “To me, that is what it is all about.”

CIOs also must be healthcare literate, which according to Marx, means well-versed in initiatives like population health and value-based care that are driving change in the industry. “You have to figure out with data and digital tools how you still stay financially solvent within that environment, because that is where we are headed,” he said. “That is going to be on the CEO’s top 10 list.”

Health IT leaders should make an effort to learn the basics of their organization’s business, too – how it runs, how it makes money, how it interacts with customers and payers and other entities in the ecosystem, its stock structure if it is public, and so forth. “Really getting into the mechanics of our business models and our business capabilities so those translate into how technologically we can deliver the best solutions,” Richardson said.

IT and digital projects should align with the healthcare organization’s goals, according to Awan. “Make sure there is a return on investment, there is value, that everything we are doing in the digital space or the IT space is tied to some strategic objective in the organization,” he said. 

Last but not least, know your markets and look for ways to grow. That includes expanding in existing markets or entering new ones, for instance, by targeting underserved areas. Miri encourages CIOs to work with like-minded partners in the C-suite to help them meet their goals.

“To be able to partner with our chief marketing officer – we call it the chief consumer officer – and our chief operating officer and our chief nursing officer and folks who are all oriented in this manner, that is a dream job for me because I am not fighting against the current,” he said. “Everybody is going in the same direction. They are just looking for a riverboat captain to help (guide) the team down the river.”

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