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A Leading Role

October 1, 2007
by Mark Hagland
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CIOs at large health systems may have larger budgets, but they also have larger constituencies to keep happy

Stephanie Reel

Stephanie Reel

What does it take to put together and run a top-tier HIT shop? Stephanie Reel has a ready answer. "The first thought that comes to mind," says Reel, vice president and CIO of the 1,564-bed Johns Hopkins Health System in Baltimore, "is that they would in fact be a team, and would be able to meet the needs of the users and their organization in a collaborative way, with a capital 'c' on the words collaborative — all with the goal of serving the needs of the customer and the enterprise."

Larry Ferguson

Larry Ferguson

Further, she says, "The most important skill they need to have is very effective listening; and the respect they need to earn comes from honing that skill and developing credibility and competence, as a team."

Reel is not alone in her assessment. Indeed, CIOs from across the country and industry observers generally agree on the core characteristics needed by highly successful, high-performing IT teams in hospital organizations. The foundation for any top-performing team, they say, is qualities of personal leadership, communication skills, competence, and a can-do attitude, from the CIO on down. All the other elements support, but do not substitute for, those qualities and characteristics.

In fact, CIOs and industry experts say, honing those core skill sets and characteristics will be more important than ever, as pressures on IT departments grow daily in hospital organizations.

Top-tier IT teams, including their CIOs, must "communicate, communicate, communicate," emphasizes Larry Ferguson, CEO of Long Beach, Calif.-based First Consulting Group. "And it's a two-way channel," adds the Charlotte, N.C.-based Ferguson. "They have to be forward-facing and communicate" with every important constituency in the hospital organization, from the medical staff to the business office, through day-to-day participation in formal meetings and a host of informal interactions.

The need to be outward-facing and communicative, to engage all the internal stakeholder groups in their organizations, and to be as strategically focused and oriented as possible, will be tested more than ever in the coming several years, as hospitals and health systems implement more and more complex technology. This is particularly true for CIOs, says Charles Fred, founder and CEO of The Breakaway Group, a Denver-based consulting firm.

"There's so much technology coming into healthcare, that the default is to have the CIO position become a purely technologically oriented one," says Fred. "The really top-tier CIOs are respected by their clinicians, and yet can go back and have an intelligent discussion with their staff."

Ironically, Fred says, the fact that there are so many implementations, including complex systems such as CPOE, has resulted in some wrong-headed hiring these days. "There are some high-level CIO recruiters who aren't even thinking about patient issues; they're looking at technical skills," he reports. "But the top-tier ones are moving in the opposite direction. Some have actually instituted patient-experience methodologies for revenue cycle work and in other areas, or are having deep-level focus groups with clinicians."

Responsiveness to clinicians is critical

If there's one area in which there is absolute agreement, it is on the issue of clinician relations. Almost every CIO and industry expert says that no healthcare IT team can be considered top-tier unless it can demonstrate outstanding relationships with, and responsiveness to, its organization's independent medical staff, physician and nurse executives, and frontline clinicians.

Ernie Hood

Ernie Hood

"Those are my partners," says Stephanie Reel, when talking about Johns Hopkins' top clinician leaders such as the chief of medical staff. "But the people that I need to serve are the faculty, the clinicians and medical staff who are day to day taking care of the patients. To be very candid," Reel says, "I spend far less time enhancing my relationship with the head of the medical staff, because he and I already work together a great deal. My responsibility is to ensure that the guys in the foxholes, dealing with the day-to-day challenges of patient management and patient care, who really need my help the most, get it. And I worry much more about my ability to meet the needs of the young investigator or clinician working his way up in the organization."

Reel's colleagues from across the country agree that responsiveness to the clinicians in the trenches, and tight ties to clinician leaders and executives, are key. "The chief medical officer and chief nursing officer are my two key relationships in that regard," says David Muntz, senior vice president of information services and CIO at the 13-hospital Baylor Healthcare System in Dallas. In fact, says Muntz, "We are clinician-centric in our approach." at Baylor, he says, as well as being a clinical data-driven organization that is strongly focused on furthering patient safety and care quality.


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