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Inheriting IT Mediocrity

December 22, 2008
by Tim Tolan
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Accepting a new CIO position can be a great opportunity, but taking the job is only step one in a long journey

Welcome to HCI's newest section, a monthly column from Tim Tolan, senior partner with Sanford Rose Associates Healthcare IT Practice. To view Tim's blog, visit /contributors/tim-tolan.

A fresh start as CIO of a new health system can be a very exciting time for most healthcare IT professionals. There is a ‘special feeling’ when humans embark down the trail of uncertainty that motivates some of us, while others tend to cautiously approach a new journey one step at a time. Every new IT leader has the task of assessing their new organization once on board; and often, by then, it's too late to rethink their decision — the train has left the station, and the ink dried a long time ago on the signed offer letter.

No turning back now

CIOs may inherit an IT strategic plan that is well thought out and on target. This can be exciting! The other scenario (despite the promise in the interview process) is that there is NO strategic plan. Ouch! The good news is that CIOs have the ability to make an impact in either of these scenarios.

Other aspects of the organization CIOs inherit may prove to be much more problematic. Did I mention your new staff yet? Didn't think so… I'm referring to the new team. It is incredibly challenging (and painful) to find out that your new staff has too many ‘B-Level’ players. This is especially true if you are a hard-charging CIO that leads by example. Now what? Whatever you do, don't panic or overreact.

Let's look at this objectively

The CIO must do an assessment of each member of the team and validate that their skill set matches the role they have in the organization. It might be time to shuffle the deck. How many ‘A’ players are on the team? Can the new CIO leverage their skills and leadership capability to raise the bar with the rest of the team? Let's not forget the very important role of HR in this equation. CIOs must have a solid relationship with their HR peers to make sure they are compliant with any people changes they plan to make.

The new CIO may ask, “How did this organization become mediocre?” The answer is that old adage: The speed of the leader is the speed of the pack. One usually doesn't have to look far to find out how a ‘B’ organization was built. Sure, it could be that there are holes in the talent pool. However, sometimes it's simply a lack of communication by the former IT leadership. The staff may have no clue of the department's goals and expectations, and the former IT leader may have decided not to clearly communicate the department's mission.

Ambiguity can sometimes be the culprit. Many weak employees love ambiguity. All accountability is minimized or goes out the window if there is no clarity around the mission.

The good news: this is a problem that can usually be fixed. Leaders need to provide clear direction and ensure clarity of their expectations. Talk openly with team members about what the outcome of the mission is (project by project), when it will be completed, and what employees can or should do if they hit a bump in the road.

On the other hand, the problem could be a pure lack of talent. Most healthcare organizations have a stable full of weak employees, and, if given the chance to strengthen their team, they'd all jump at it. The economic market of today should force CIOs to do a better job at assessing their talent. There is far more ability to carry under-achievers during a good economy, and it's far less painful to make mistakes when times are good.

Finally, CIOs should embrace their inherited team with enthusiasm, reality and an open mind. Change is likely on the way. But, change is a good thing.

Tim Tolan can be reached at, or at 843-579-3077, ext. 301.

Healthcare Informatics 2009 January;25(13):53