The secret's out. Leading healthcare CIOs don't just rise to the top because of luck. They do so through effective management and skilled communication. And while savvy CIOs make huge decisions about implementing technology, technical savvy is not enough.
"The days of the bits and bytes person are gone," says Judy Kirby, president and owner of Snelling Executive Search in Altamonte Springs, Fla. "They have to understand technology, but they need to rise above it." In addition to basic IT know-how, healthcare CIOs need business, clinical, leadership, administrative and, most importantly, communication skills.
For healthcare CIOs to distinguish themselves, they need to be "people who kind of 'get it' from the business of IT — from the budgeting, the measurement, the communication skills," says Glenn Galloway, CEO and co-founder of Healthia Consulting in Minneapolis. "You know, the up, the down, the all-around."
According to Stephanie Reel, CIO and vice provost for IT at Baltimore's Johns Hopkins University and vice president for IS for Johns Hopkins Medicine, it's really not complicated. "It all boils down to basic behaviors," she says. "The one single thing that seems to rise above the rest is communication." After all, "You can teach people the technical aspects of the job, but if they don't have the core, that's what matters." For Reel, that core means making sure people are talking to each other and listening to customers.
Breaking in and breaking bread
When Reel first joined Johns Hopkins, she learned of a group of physicians that held a monthly dinner to discuss the department. Interested in being included, Reel asked if she could join them. However, instead of an, "Of course, we'd be delighted," Reel got more of a, "Sorry, no."
Reel didn't give up. She proposed an exchange: a dinner invitation for her picking up the tab. Twelve years later, the rest is history. When it comes to strategic planning, Reel says she doesn't have a silver bullet. What she does have, though, is a monthly Tuesday night dinner group headed by the chair of anesthesiology to help. "We talk about what's important. We review ideas about new technology, and we walk out with a great sense of what the institution needs."
For Vincent Caponi, CEO of St. Vincent Health in Indianapolis, Ind., communication comes more in the form of interpretation and translation. "At least in healthcare, a CIO has to be pretty diverse and play both sides of the equation," he says, emphasizing the CIO spot as being a conduit at the healthcare table. A successful executive, he says, is the "face that sits down with all these clinical people and understands what they need."
At St. Vincent's Hospital in Birmingham, Ala., that face is Tim Stettheimer's. To Stettheimer, who came to IT after leaving a Ph.D. clinical psychology program, communication is scalable and must be adjusted accordingly. It's not for only one type of venue, he says. Communication needs to be for the "one-on-one, the crowds, the board room." It's even important at the Pentagon where Drexel DeFord worked prior to becoming CIO of San Diego-based Scripps Health. DeFord insists that CIOs must be excellent storytellers, armed with insightful analogies, as they are the "interface between the briefcases and the pocket-protectors."
Jane Maskus, CIO of Lawrence Memorial Hospital, Lawrence, Kan., is focused on linguistic style. So much so, that she insists staff "lose the technical jargon" before they speak to other departments, like clinical or financial. Maskus is quick not to let employees hide behind language or specialization. She says she doesn't "let clinical say, 'Oh, that's too technical,' or technical say, 'Oh, that's too clinical.â€™â€ By inviting departments into meetings when initiatives are affecting them, Maskus fosters an environment conducive to conversation. Simply put, she says, "I make them all sit in the same room together."
Galloway has an on-foot approach to management and communication that he used when he was acting, through a consulting firm, as CIO at Children's Hospitals and Clinics in Minneapolis and St. Paul, Minn. There, he managed the workings of the hospital by making sure he was out in it. He says he misses seeing kids being hauled around in wagons, walking past the statue of Big Bird, and doing rounds with doctors and nurses. "Eventually, people get to know you and eventually learn that you're not just living in the IT glass house."
DeFord, too, manages out in the field. DeFord, who served in the Air Force for two decades, spends a lot of time walking around Scripps Health during off-hours. Since the number of people DeFord can speak to during daytime working hours is limited, he walks around the hospital at 1 a.m., asking nurses about their IT problems and concerns. "Dropping by the data center and the nursing stations in the middle of the night, you find out a lot of things that are going on that you wouldn't otherwise know about," he says. "You'll find out about changes in staff, new leadership and projects. Sometimes, it's an early warning system."
At Johns Hopkins they are walking too, only not in their own shoes. Every vice president at Johns Hopkins was invited to adopt a patient-care unit. Reel chose pediatric intensive care and is convinced she is a better CIO because of it. The experience allowed her to better understand different roles, such as how the pharmacist and the nurse deal with challenges of day-to-day life. Now, Reel has employees adopt their own units and switch jobs for one hour a year in the "Walk a Mile in My Shoes" program. "The hope," she says, "is that if they see a system go down, they'll think twice about it as they'll know how it will impact people."
Effective communication for CIOs includes mentoring and networking with colleagues. According to Sally Goostrey, principal at The W Group, a technology management consulting firm in Malvern, Pa., networking allows CIOs to keep in touch with others in the industry and stay up to speed. "If you're too isolated in your own issues, you lose sight of things," she says.
Several professional organizations offer CIOs networking and development. The Chicago-based College of Healthcare Information Management Executives (CHIME) CIO boot camp has been a meeting ground for many CIOs who later cull relationships and networks of their own. In addition, the Chicago-based Healthcare Information and Management Systems Society (HIMSS), Bethesda, Md.'s American Medical Informatics Association (AMIA), and Chicago's American Health Information Managment Association (AHIMA) are tools CIOs often use.
Russell Branzell is vice president and CIO at Ft. Collins., Colo.-based Poudre Valley Health System, and also program director of CHIME's boot camp program. Branzell has developed important relationships through CHIME, which he joined in 1997. Branzell, who was first introduced to IT in the Air Force, says he has a group of five or six colleagues that he can call for immediate and candid advice. In addition, he has an extended group of 20 or 30 CIOs that he also relies on. Tightly knit groups provide CIOs "the nitty gritty on vendors," Branzell says.
Moving up, moving out, moving on
So, what's the next step for CIOs? Unlike in other industries, CIOs have not flocked to move into the office of CEO, though, according to Caponi, it's not an impossibility. "There is certainly no law against it," he says. However, Caponi says a more likely course is for CIOs to remain CIOs, but take on more responsibility with "less bench-time and more problem-solving, more major system selections and major initiatives."
Thomas Smith, CIO at Evanston Northwestern Healthcare, Evanston, Ill., agrees that not many CIOs have made the transition. "CIO to CEO is a big step. We've seen it in some other businesses, but if you take healthcare where it is today, it's not done too often," he says. "It's done more in banking or in places like Schwab, UPS or FedEx."
Stettheimer also recognizes that in the past the move from CIO to CEO was unlikely in healthcare, but he believes that things are slowly changing. He attributes the shift to several forces, including a greater dependence on technology in healthcare. "Who within a healthcare organization, at the executive table, has to have a view of the entire enterprise?" he asks. For Stettheimer, only two are mobile enough and far enough outside of the silos to have a clear view: the CIO and the CEO.
While the door may indeed be slowly opening, many say they will steer clear. Some may be more in line with Kirby and Maskus who think a COO move would be more logical.
Maskus says, for her, a move to CEO holds no interest. Not only does she like being a facilitator, being CEO would mean she would need to be "too close to the actual patient care," she says and laughs. "I don't want to go into the procedure room." Perhaps because it's a bit unseemly to declare an interest in the boss's job, most say they love what they do, and have no desire to make a move.
No Techies Need Apply?
"I think you have to be the master of dumb questions. You have to be technical enough to understand the building blocks, admit what you don't know and ask a lot of questions."
— Glen Galloway, CEO and co-founder of Healthia Consulting, Minneapolis
"If the CIO really wanted to get down and play with technology, sometimes they're not enabling IT to help the business."
— Sally Goostrey, principal The W Group, Malvern, Pa.
"I could spend all of my time worrying about new technologies."
— Thomas Smith, CIO Evanston Northwestern Healthcare Evanston, Ill.
Us vs. Them
So, is it better to come from outside of healthcare?
"Any time you expand coming from outside the gene pool, you bring in fresh ideas. The problem many face in coming from the outside is that they have trouble dealing in consensus-driven organizations, which healthcare is."
— Ann Sullivan, regional deputy CFO New York City Health and Hospitals Corp. New York
"Healthcare is insular. We view ourselves as unique, and at the same time recognize we are behind the curve when it comes to methodology. There is a conflicting desire to learn from other industries. Maybe it's an ego thing."
— Tim Stettheimer, CIO St. Vincent's Hospital in Birmingham, Ala.
According to Caponi, the key to CIOs flourishing is exceptional interpersonal relationship skills. Ann Sullivan, regional deputy CFO at New York City Health and Hospitals Corp., New York, spent nine years across town as CIO at Brooklyn's Maimonides Medical Center. She nods to good interpersonal skills, and tacks on a passion for detail, hard work and excellence as also essential. "The question is," she asks, "how do you attract all the different types of people — technical people, clinical people?" The answer, she says, is through "good people skills," which foster essential team building. "You're only as good as your staff," she adds.
Having the right skills and the right expertise, though, is not enough, and that's exactly what Reel told an employee just the other day. "You need to demonstrate a passion for what you do," she says.
In successful management, passion needs to be almost contagious. "It's not how much you want to lead, it's how much people want to follow," Caponi says. His eye is always on a CIO who "can inspire people," he says. "If I just manage you, I try to get you to do things, but if I inspire you, you do it because you think it's the right thing."
It's not uncommon for healthcare CIOs to have a technical background, but few have one in clinical psychology. After completing 54 hours of a Ph.D. program, Stettheimer says he "just wasn't feeling it." So he headed for IT, to find a different kind of healthcare. "You have to have a passion for healthcare," he says. "It's hard to be a healthcare CIO without it."