Don’t hire a CIO as your next CIO!

Seems counter-intuitive doesn’t it? Let me explain….

With our changing healthcare landscape, the “old skills” that were valuable to have in a CIO are no longer helpful (and may indeed be counterproductive). With the ARRA and with “healthcare reform” on the horizon, hospitals and physician groups need a “new breed” of CIO–one not steeped in technology, but one with a broader base of skills, encompassing not only technical ability, but business and (most importantly) clinical expertise as well.

Think about it….

Ten or twenty years ago, a CIO had to be technically skilled. “IT” primarily meant “hardware” and getting all the computers configured and networked (along with any communications infrastructure). In addition, CIOs managed technical teams–the guys (and gals) who could sit behind a computer terminal all day, and enjoyed coding and “twiddling the bits”.

Furthermore, corporate executives weren’t all that interested in technology–they knew email had to work and the accounting system had to provide reports at tax time, but as long as things didn’t break down most executives were happy to have a CIO that was able to “just take care of all that technical stuff”.

But somewhere along the way, our industry changed. We became more dependent upon technology–it became more than “just the email”–it became part of our core business.

But we never changed along with it.

For many of our organizations, we still have a technical expert as CIO, and that’s precisely the wrong fit for most healthcare organizations.

What happened?

Technology became integrated with clinical care.

Our physicians, nurses and allied health providers use and depend on technology to do their jobs. EMR, EHR, PHR, HIE, CPOE, LIS, HL7 and many more acronyms are now part of our lexicon, and are as important as a stethoscope and a sphygmomanometer in providing medical care. Simply put, clinicians can no longer provide modern medical care without technology.

And yet for many of our hospitals, the leaders providing that technology–our CIOs–have no clinical background.

Yes, it’s always been that way, and yes many of our current healthcare CIOs have “worked their way up” in the IT group, and yes they’re a “great guy”. They’re technically skilled, and can design a computer network, fix an email problem, configure a router and can manage to solve just about any other of a plethora of technical challenges an organization might face.

But do they understand what a physician does?

And more importantly, can they properly advise an executive team and recommend appropriate courses of action that will have a profound impact on clinical care without understanding how that care is provided or what is involved?

Are they still the “right” guy to help move your organization forward in our modern healthcare marketplace?

In a word–no.

A CIO without a clinical background becomes simply reactive in today’s healthcare environment.

They are not proactive–seeking solutions and understanding where technology can be leveraged to help provide better patient care. Without a clinical background they can only listen to the recommendations of others, be they physicians or others with clinical expertise. Then, without a clinical frame of reference upon which to rely, they must accept those recommendations, and incorporate them into their strategic planning, without the ability or understanding to provide or assess alternative solutions.

They react.

Someone else has to come up with the idea, and they simply implement it.

Indeed I recently had a conversation with a CIO who felt this was exactly his job–he had abdicated all participation in decision making, and wanted “the doctors” to decide on what they wanted, and whatever it was, he’d simply put up the servers and make sure the system turned on. He wanted to be told what to do, and then he and his group would configure the hardware and network, and install the software.

Of course one might argue that a good CIO would recognize this as a weaknesses, and incorporate folks with clinical expertise in his teams (and indeed we are seeing more of this in IT, especially as organizations begin implementing CPOE which requires an exceptional clinical understanding). But even then our CIO still remains reactionary, and has to rely on the internal experts on his team for advice and recommendations.

He’s never written a progress note, never taken a blood pressure, never been in an operating room–he’s never been “on the other side of the mask”.

He simply cannot relate to physicians and nurses, and what they need from technology in order to succeed (and worse still, they cannot relate to him). He cannot proactively help them–he must wait to be told what they need, and what to do.

To be truly effective, a healthcare CIO must have a clinical background.

“But those people don’t exist!”

Yes they do, but we don’t look for them (and of course if you’re not looking for it, you’re quite unlikely to find it!)

We and our HR teams focus on what we used to need–technical ability. We look for Microsoft or Novell certifications, and for someone that’s been a CIO before…but we don’t ask for clinicians. We have job descriptions for CIOs, and all of the characteristics that we think will make an effective healthcare executive.

But we don’t ask for a clinical background.

They’re out there–physicians and nurses that have embraced technology. Maybe they’re already in-house, perhaps part of your informatics group, or perhaps they’re working for a start-up technology firm or EMR vendor, or maybe they’re somewhere else–but they’re out there and you have to find them. We just have to recognize what that’s what we’re looking for, and partner with our HR teams and recruiters to target and find those skills.

A clinical background is simply imperative for today’s healthcare IT CIO.

Don’t place your next CIO without it.