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One-on-One With University Hospitals CIO Mary Alice Annecharico

October 2, 2008
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A nurse-turned-CIO, Annecharico discusses her transition and her perspectives on CIOs and clinical informatics.

This summer, Mary Alice Annecharico, R.N., became senior vice president and CIO at University Hospitals Case Medical Center in Cleveland, a network that includes six owned and four managed hospitals and 1,662 owned-hospital beds. Healthcare Informatics Contributing Editor Mark Hagland had the chance to interview this CIO, who sums up her leadership philosophy by saying, “I am a CIO who is a nurse. I will continue to keep my credentials and identity.”

MH: What lessons can be taken from your own experience, making the transition from nursing executive to CIO?

MAA: There are so many. Well, first of all, going from a nurse executive position to the CIO position, I came into my current position with instant credibility among clinicians. I had been a nurse; and I was asked to step out of my nursing leadership role and into the role of director of IS to manage the project in the hospital in which I worked. When I left there, one of the things that made me an instantly credible team member was that I understood what clinicians were going through. And one characteristic of myself and of nurses in general is that they dig deeply, they explore, and they’re able to think analytically on the fly. If you can understand where they are and how to help move them to where they need to be, it’s a whole lot easier. The actual nomenclature within a health care environment is different from being in business and industry; and that too was another area that was a successful link for me.

MH: Are there any adjustments you had to make personally in your transition?

MAA: As the director of critical care in a large medical center, I was told by a vice-president, I like the way you communicate, and that’s the kind of person I’d like for an implementation. And I said, ‘Gee, that’s very interesting, and sounds very exciting, but I don’t even know the difference between hardware and software,’ and those are the only words I knew! So I stayed a step ahead all the time and learned quickly. I have revolutionized the person I was, and the role I play now in local and regional and national circles.

MH: Are there any special insights you’d like to offer fellow CIOs into the way the nurse mind works?

MAA: I think nurses are team-oriented, so that’s one of the critical factors to keep in mind. The CIO and CNO or senior nurse executive need to come at things with the desire for a partnership relationship. Nurses themselves listen; that’s how they learn, diagnose, and treat. The CIO who comes to the table with the absolute desire to intentionally listen, will be welcomed by nurses.

MH: What should CIOs understand about the level of IT awareness that nurse executives bring to the table?

MAA: One of the mistakes that typical CIOs make is in assuming that nursing executives have the same level of understanding that they do about how technology will change nurses’ work lives. They don’t see the incredible amount of change management that will have to take place along with, and even as a precursor to, effective clinical IS implementation across patient care.

MH: Is it fair to say that some clinicians are suspicious of IT innovation-facilitated change?

MAA: Oh yes. They have suspicions of the broader objectives when those objectives are not well-articulated. Often, conversations don’t take place around the questions, what can I do for you, and how can I make your job easier? The conservations tend to be around, this is what we’re going to do, and how we’re going to do it. One of the most challenging aspects of working in the healthcare environment is around the drama of change. Change occurs constantly. But when you’re suddenly told that this is a computer and this is how you’re going to work, it revolutionarily changes the way nurses and clinicians will work. And so nursing executives feel some of that suspicion, too, not just floor nurses. They know the direction their organizations must follow, but unless they’ve been actively involved in the discussions around the new technology, it is difficult for them to rally support for adoption. That can be one of the underlying factors in the tension between nurse executives and other executives; so often, the change has been dictated to them. But the smart CIOs engage nurse executives and physician leaders from the beginning, and they’re empowered to take ownership of the change, and the CIO becomes a facilitator.

Note to readers: Healthcare Informatics’ November cover story will examine in detail the subject of CIOs building strategic partnerships with nurse executives in order to ensure the success of clinical IS implementations.