New leadership traits and skills will be required for CIOs to thrive in tomorrow's healthcare, according to Russell P. Branzell, president and CEO of CHIME, and others, who presented at the CHIME Lead Forum-New York on Sept. 28.
Branzell delivered a strong presentation on setting vision and strategy in a dynamic time in healthcare. The keynote was the second one of the day on health IT leadership at CHIME Lead Forum-New York, co-sponsored by the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME) and the Institute for Health Technology Transformation (iHT2—a sister organization to Healthcare Informatics under the joint umbrella of the Vendome Group, LLC). The CHIME event serves as a lead-in to the iHT2 New York Health IT Summit, set to take place on Sept. 29th and 30th. The first keynote on health IT leadership was given by Rodney Dykehouse, CIO of Penn State Hershey Medical Center and College of Medicine, whose presentation looked at current and future healthcare and organizational trends, challenges and drivers impacting provider organizations, and the role of the health IT leaders.
Both Branzell and Dykehouse emphasized the "new normal" and what skills and leadership qualities are now necessary for the emerging "CIO 3.0." At a CHIME Boston event earlier this year, Branzell, as reported by HCI Editor-in-Chief Mark Hagland, discussed in depth the evolution of the CIO role. Per Hagland's story on that session, Branzell said: “Pre-CIO, IT operations directors were technical managers, and their role was advisory. The “CIO 1.0” was a supportive role, focused on being an application purveyor. The “CIO 1.5” is an enabler role as a knowledge purveyor. The “CIO 2.0” role is a driver role, with the CIO functioning as a service broker, project advisor, and venture capitalist. Most patient care organization CIOs, he noted, are struggling to move into and through the “2.0” role phase; his view is that only 10-15 percent of CIOs are”2.0s,” in his view, while 40 percent each are “1.0s” or “1.5s.” What does the “3.0” CIO look like? The handful of true 3.0 CIOs are truly driving change and transforming their organizations, he said.
Similarly, here in New York, Branzell again mentioned how most CIOs are not that close to the "2.0" level. Skills of the CIO 3.0 include operational management 2.0 and strategic senior management leadership, rather than just be in charge of IT. Additionally, Branzell noted, change leadership, innovation, talent management, information governance/knowledge management, and relationship management are all needed for the changing CIO role. "The expectancy of downtime is now zero. The pressure on CIOs is that they're now expected to come in and fix all of an organization's problems," Branzell said.
To this end, Penn State Hershey's Dykehouse said in his presentation that "Every time [CIOs] think that we are out in front of something, something else changes." Expectations of the CIO 3.0, Dykehouse said, include a drive towards health information exchanges (HIEs), certified electronic health records (EHRs), patient portals, data warehouses, complete data integration, data analytics, population health, a world-class IT team, an accountable care organization (ACO) system, and much more. As such, oftentimes CIOs have to deal with not having perfect clarity for policy mandates such as meaningful use and ICD-10. “People want black and white answers, but we are living in the fog and gray, so you need to get your teams ready for the unknown,” Dykehouse advised.
What's more, Dykehouse and Branzell said, you cannot be a back-office CIO anymore, but instead you need to be embedded in leadership with IT and business being aligned strategically. "Leadership is not being an IT director, it's about being a business leader," Dykehouse said. Now, he continued, CIOs should leverage their relationships and credibility as a true business partner focused on business value. The new normal means demonstrating the value of strategic and operational planning to be agile and effective in meeting changing requirements, he said.
Branzell agreed, going as far to say that business acumen is now even more essential than ever. “To be an institutional leader, the CIO should be a member of the executive team. Those who are below the 2.0 level align themselves with the IT team, where 2.0s and higher align themselves with the executive team,” he said. “You need to understand and be prepared to manage the business. Build bridges with clinicians. Anchor your thinking in process improvement and measurement,” he said. With CIOs at a 2.0 or higher level, Branzell added, most of how well they are doing has almost nothing to do with IT, but instead about organizational performance such as well-defined clinical operating and patient satisfaction metrics.
To this end, Neal Ganguly, vice president and CIO of the Edison, N.J.-based JFK Health Systems, and Shafiq Rab, M.D., vice president and CIO of Hackensack University Medical Center, also in New Jersey, touched on developing relationships with physicians during their presentations on developing talented and effective teams. Specifically, Dr. Rab said that helping physicians with little things in the beginning, such as updates to their iPhones or computer problems, at a time when they are available, rather than later on in the day, could go a long way to building relationships that last forever. Nonetheless, Ganguly felt there is still too much a disconnect between technology people and users. “To a doctor, an extra click on something could mean one less patient for them to reach their numbers,” he said. “More clicks could mean dollars out of their pockets.”
Dykehouse also stressed that having a strategic plan for the years ahead is essential, pointing to NASA's vision for getting to Mars. "NASA was looking 20 years ahead with their strategic plan that started in 2010. 2035 is their goal to land on Mars, and they need the strategy and technology in place to make that happen,” he said. “It’s important to note that the question is no longer what planet are you from, but instead, what planet should you be on and how will you get there?” he said.
Branzell also referenced another industry, noting that while people like to compare healthcare to the finance sector and compare technology in healthcare to ATMs, in reality, many ATM transactions are still being done manually. “It took 38 years for ATMs to work across the country. Many ATM transactions are still manually processed to this day. We started this [healthcare] transformation eight years ago, so the good news is we have 30 years to get it done,” Branzell joked, adding that in reality, healthcare leaders have nowhere near that much time.
Branzell recalled hearing someone saying that the best CIOs are actually “chief invisible officers,” meaning that the greatest thing a CIO could do is make sure everything is happening in the right way, and then stepping away so people can do their jobs. “People want to get credit and recognition, but it’s not about that,” he said. “You don’t go to the opera for the conductor, you go to hear the music. A great CIO is the a conductor of music,” Branzell said.
CHIME’s CEO finished his presentation by going over the rules of being a revolutionary leader. First, he said, is don’t accept the stats quo. Also, always be flexible. Next, he went on, is understanding that plagiarism is not a crime, but rather a skill. “People always want to talk about innovation, but most likely someone else out there has done the innovation already. Steal others’ best practices and share what each of us is doing great in a different way. Master CIO 3.0s are the greatest thieves in the world. They are giving their organization a competitive advantage,” he said. Next, he said, is don’t evolve, but instead revolve. “Are you on target with your vision? Make sure everyone is moving in the same direction,” he said. Finally, he told the audience to “make someone mad today. Changing the status quo alone makes people mad. If you do all of these things well, you will make somebody mad daily.”