First, is change itself. Most healthcare systems, whether they are deploying a new electronic health record (EHR) or dealing with mergers and acquisitions, have dealt with an incredible pace of change in 2012 and voiced a need for leadership that can help facilitate change.  

Second, the bar has been raised. We asked for more from CIOs and we got it. The industry accomplished some amazing results in 2012. Now, rather than slowing, we see IT being approached with more energy and optimism. In fact, many health systems are accelerating IT initiatives. Healthcare leadership expects more from technology.

The third and final driver for the 2013 list is speed. We anticipate healthcare leadership will seek executives who not only foster a culture of change, but facilitate change at a faster pace.  We believe the speed with which leadership can marshal change will be the new strategic imperative, or the ability to change faster.

In short, today’s CIO will be more dynamic, open, and motivating as change becomes the consistent feature in the health IT landscape.

10. Keep Pace with Regulatory Requirements

At number 10, we believe it is a basic requirement that each and every CIO needs to keep pace with the regulatory requirements and the ramifications of those requirements. HITECH requirements opened the door to a greater focus on data mining, predictive analytics, business intelligence, insurance analytics, statistical modeling and big data. Judy Hanover, research director of IDC Health Insights, Framingham, Mass., predicts that by 2015, annual spending on EHRs will climb to $3.8 billion. Regulatory requirements will continue to guide change in the industry and have become a part of the everyday fabric of being a CIO.   

9.  Mitigate Risk

Mitigating risk at the intersection of medicine and technology and has become more complex.  With the rise of EHRs, integration and community-based systems, we have seen an increase in security risks. The ability to maintain a secure environment is cited routinely as a top priority for incoming CIOs, including processes, procedures, and documentation. We see an increase in the scrutiny of disaster recovery programs, compliance, and security. Not all CIOs will personally lead each of these efforts but all CIOs will need to be savvy in each of these areas. 

8.  Create a Culture Receptive to Change

To maintain a competitive advantage, all industries are now focused on adapting technology to keep pace with change. Healthcare is no different. In healthcare, as a traditionally risk adverse culture, the challenge is to create a culture more receptive to change. In “Accelerate!” an article in the November 2012 Harvard Business Review, John P. Kotter, professor at Harvard Business School and co-founder of the Cambridge, Mass.- based Kotter International, offers a new definition of strategy as a “dynamic force that constantly sees opportunities, identifies initiatives that will capitalize on them, and completes those initiatives swiftly and efficiently.” We agree.  The ability to facilitate change is becoming a requirement and we see it as a new strategic imperative for leadership. Creating a culture receptive to change will speed transformations in healthcare. The countdown below helps to get there.

7.  Give New Meaning to Interoperability

In 2012 we saw building teams as an urgently needed skill in order to deploy an EHR. In 2013, the CIO may spend as much time reallocating teams as building teams to accommodate shifting priorities. Creating an organization that can “plug and play” will become a key value in achieving multiple large-scale deployments. An “intelligent organization,” characterized by its collective knowledge, can move more nimbly because it is an organization that is open to sharing and learning from information and, consequently, can work in alignment to achieve goals even if the task has changed. 

Health IT leadership that values and engages the intelligence of its employees facilitates the flow of information and good communication. The team’s ability to share information openly and appropriately with each other and across departments speeds the ability to accomplish key objectives. From the perspective of organizational intelligence, it is better to have people who work well together than extremely smart people who don’t communicate with each other. Just as it is with technology, interoperability is key to organizational intelligence.

6.  Don’t Just Build Teams, Build a Coalition

The industry is still at an early stage in the implementation of EHRs, but EHRs are just the start.  Building health information exchanges (HIEs) or transitioning to an accountable care organizations (ACOs) will create new challenges for CIOs. In the process of achieving any of these large-scale initiatives in a relatively short time, there will be objections to overcome, for instance, to data sharing. To overcome these challenges, CIOs will need more than an IT team; rather a coalition of key stakeholders throughout the healthcare system will be needed to communicate the value. In addition to sharing a vested interest, these stakeholders should have executive support for communicating the key benefits of these initiatives. The CIO who can help assemble this group and encourage them to work as a team, will lay the foundation for a powerful conduit of information. This coalition can be a powerful ally in communicating the role of IT in quality, safety, and efficiency.

5. Establish Strong Partnerships

The nationwide tidal shift to EHRs has broadened and increased the scope of responsibilities for CIOs and, consequently, we see an increase in the leadership roles surrounding the CIO. In 2012 we saw the acceptance of the chief medical information officer (CMIO), as a critical figure in the deployment of an EHR. In 2013 we anticipate that many health systems will embrace the CIO and CMIO as a leadership team to ensure that the impact of information technology on quality of care is understood beyond the deployment of EHRs. We see additional surrounding leadership roles, such as the chief security officer (CSO), the chief technology officer (CTO), VP of business systems, or a chief data officer. The CIO will need trusted partnerships to accomplish the vast array of objectives. Importantly, these partnerships facilitate an understanding of the relationship between hospital quality and efficiency and the critical role of technology as part of that relationship. 

4. Organizational Awareness

Hospitals must be nimble and react quickly to new realities. Whether you are a CIO of a complex healthcare system or a single hospital, you must be proficient at managing change. “Organizational awareness” is critical to managing effective change and making positive performance shifts. Understanding how leadership functions and performs within the organization, its policies, procedures, and understanding the potential of what can be achieved as well as the specific results that are needed and how to navigate the organization to best achieve those results. A highly matrixed organization requires a high degree of organizational awareness. Those organizations that may be involved in mergers and acquisition activities require a high degree of organizational awareness. Leaders of newly merged organizations may find they need new innovative skill sets from health IT leadership. This important skill set will be key as M&A activity is expected to increase in 2013. It is a new, key addition to hit the 2013 list.

3. Communicate a Vision

This skill, at number 3, points to the greater impact IT has on healthcare organizations.  Outstanding CIOs know how to help create and communicate a vision. EHR transformations involve a large number of people and vision is needed so everyone can understand what is driving that change. Communicating and getting buy-in for a vision helps the CIO connect with key stakeholders and then develop a strategy for accomplishing the vision with their support.  This is true leadership. It defines a destination, a defined end-game, that people find worth-while to pursue. This vision helps people work toward something together.

2. Set the Stage for Transformation 

True leadership is needed to create change. Once the framework is laid and all of the pieces are in place, leading CIOs know how to set the stage for the hard work ahead. These CIOs know how to remove obstacles. Creating a clear path for the transformation requires careful listening skills right at the very time many leaders are being asked to race ahead. Creating this clear path sets the final stage for readiness. This is where much needed enthusiasm and energy builds to launch the project forward.

1. Transform 

We are currently living the greatest transformation of the American healthcare system that we will see in our lifetimes, and it is happening right in the CIO’s backyard. Incremental change is within the reach of most, but the exceptional CIOs will springboard their organizations into the future by defining the future state and getting stakeholders to fall in line behind the plan to get there. These individuals will bring tremendous value to their organizations. They lay the groundwork, build the teams, communicate the vision, and when they execute on the vision, transformation takes place. These are the CIOs who lead and serve as role models for the industry.

Pamela Dixon is managing partner and Steve Nilsen is general manager of SSI-Search, Atlanta.