A Time to Shine

Alan Greenslade, CTO at the 968-bed, Dallas-based Parkland Hospital & Health System, summarizes the CTO role as, most importantly, “establishing a sustainable technology lifecycle.” He says the CIO has a more global focus with the applications and overall vision for the organization, while the CTO has to take that vision and make it happen, by finding the right technology to provide a long-term lifecycle for the technological assets employed. For instance, when Greenslade receives a departmental request, he looks two years ahead to determine the sustainability and the scalability of that technology request. “We will focus on that request, however, we will step back and look at that request and see how it fits across the enterprise; and if we don't look at that now, then I am going to end up re-architecting that six months from now or get a whole new solution,” he says.

Greg Johnson wears two hats as CTO and director of IT technology and engineering services at the Richmond, Va.-based VCU Medical Center, which has 779 beds. He notes that the CIO generally operates on the clinical or the customer-facing side, driving adoption of the electronic medical record (EMR), while the CTO “focuses on the strategic direction that the technology is taking in support of the business direction, which is where the CIO tends to focus most of his time.”

One appealing facet of the CTO role, according to Wierz and Hodges, is that the position doesn't have to deal with the level of politics that the CIO‘s does, because the CTO role generally doesn't report to the CEO. Still, even if the CTO might not have to deal with as much political maneuvering as the CIO, the CTO still has to be a true partner of the CIO: a strong manager, project manager, and consensus-builder, according to Hodges. The CTO also has to be able to communicate to the board the technological needs of the organization, while keeping an eye on cost containment.

Nader Mherabi, CTO and vice president for IT product solutions at the 602-bed NYU Langone Medical Center in New York, feels that CTOs can offer healthcare organizations the ability to standardize enterprise architecture and focus on integration at the enterprise-level. CTOs are “also looking out for technology that can overall enhance the use of technology in the healthcare setting,” he adds.

EMRS DRIVE CTO ROLE

The genesis of the CTO starts with his counterpart, the CIO. Originally, the technology head in a healthcare organization was the director of IT or director of networks, but about 20 years ago, as hospitals became more reliant on technology, the strategic CIO emerged as an organizational role. As EMRs has become more widespread during the last 10 years, the CIO's role has become increasingly strategic; and the technological responsibilities of the healthcare organization or multi-system hospital has become too much for one person to handle, providing an entry for the CTO. “As the CIO evolved into a much more senior leader, strategy person, this technology person's role has also been elevated to that chief technology officer,” Wierz says.

Greenslade also notes the development of the EMR as the impetus for the development of the CTO role. “With the push for EMR, you have to have someone who understands how to implement that type of solution sustainable and scalable, and normally the CIO doesn't have the technical expertise to do that,” he says. “They may understand the technology, but when it comes down to the nuts and bolts of it, that's where the CTO steps in.”