Introduction 

The role of an IT specialist is changing. They are increasingly being viewed as essential members of their organization’s strategic leadership team, providing a long-term vision for technology’s role in the growth of the enterprise. At the same time, they need to ensure that day-to-day technical operations run smoothly.  

Most CIOs straddle the two worlds: those in organizations already engaged in digital transformation have a foot firmly planted in the strategy world, while those in less mature organizations may have only a toehold. Many digital health executives are somewhere in between, looking for ways to strike a workable balance while driving innovation across the organization. 

Tegria asked members of the College of Healthcare Information Management Executives (CHIME) about their changing roles as digital health leaders in 2021. Their insights about how to balance the responsibilities of strategic leadership and daily operations are still relevant today, inside and outside of healthcare, as organizations adopt digital-first strategies and embrace emerging technologies. We captured four key takeaways to help CIOs relieve the burden of daily operations and focus on driving innovation forward.

CHIME President and CEO Russell Branzell moderated the discussion among the following executives: 

• Stephanie Lahr, MD, CIO & CMIO, Regional Health 
• Geoffrey Patterson, North Region CIO & VP of Clinical Transformation, Henry Ford Health System 
• Craig Richardville, Senior VP & CIO, SCL Health 
• Donna Roach, CIO, University of Utah Health 
• Daniel Waltz, Corporate VP & CIO, MidMichigan Health 

The growth of the CIO is in the everchanging maturity of the role, and it is pretty exciting.

Craig Richardville

Understand How Technology Fits Into Your Organization’s Strategy 

The CIO’s responsibilities have evolved over the decades as digital technology has become increasingly integrated into all aspects of healthcare. Many CIOs are trending toward a more strategic role, but the transition is not universal. 

“I think that is where we’re going but not every organization is there yet,” Stephanie Lahr said. “There are still some really big organizations that, depending on the reporting relationship, the technology arena still seems to be less strategic and more to deliver on the methodologies that are necessary.” Organizations with that mindset are likely to struggle to keep and recruit high-caliber IT talent.  

“A lot of people who want to be in this role now look for organizations that have made that transition in their structure,” Lahr noted. “Being part of that senior strategic team is my first job, I feel.” 

Few leaders have the luxury to dwell solely in the high-level strategic world, though. Instead, they must toggle between managing the here-and-now and envisioning a future enabled by technology. The dual role challenges are even more striking when budgets are tight, yet expectations and needs keep growing.  

Extend Your Influence Beyond Your Team 

A 2023 Gartner report found that digital initiatives most often lag because of people and organizational issues, such as siloed behavior, talent gaps, change resistance, and competing priorities. Partnerships within the organization are essential for a forward-looking digital strategy to succeed.  

“The purpose of the IT group as a whole is to enable,” Patterson shared. “But that enablement comes through partnership where we’re trusted with the business and the designs of where we want to go are met with what capabilities we have today.” To that end, Henry Ford Health System created a committee that includes finance, IT, security and human resources, among others, to explore strategic initiatives at a systems level.  

The committee helps create the connections needed to enable strategic initiatives across the organization. “Not to say something is right or wrong,” he said. “But to be that partner that helps define what the future strategy will be in how we enable it and make sure all the pieces are in sync and functioning very well.” Listening and providing feedback help to cement relationships that move the organization forward. 

Roach, who joined Utah Health in late 2020, was immediately paired with their CMIO to develop a digital health strategic plan. In an academic setting, responsibilities and ownership may be scattered across the system. Roach’s approach was to be asked to be present during strategic discussions to help imagine the digital roadmap and juxtapose that with other programs to create a unified vision. “What’s our strategy? What’s our vision? I will support you with the architecture underneath it, whether it’s the technology, whether it’s the infrastructure, whether it’s the connectivity technology,” she said.

It’s exciting because I have a lot of people culturally already behind the idea of this digital health space, but they don’t know how to connect all the dots. I’m helping them connect those dots right now.

Lahr takes the time to educate senior leadership, developing a common language and understanding that allows them to transcend the particulars of a technology or platform and instead focus on objectives, costs and limitations.

Cost Savings and Efficiencies 

Without more resources, digital leaders must find creative ways to implement their digital health strategies. Clearly outlining the options and involving stakeholders within the organization can help, Roach proposed.  

Demonstrating benefits such as cost savings or greater efficiencies can open opportunities, although perhaps not immediately. Like many healthcare organizations, Utah Health shifted IT personnel to work remotely during the pandemic and is likely to maintain a hybrid/remote staffing program going forward. No longer having the IT department occupy three or four floors of office space in downtown Salt Lake City will save the system money and address the needs of the workforce. “The pandemic taught us how to do it (telework),” Roach said. “And it showed us opportunities for improvement. Now I have to make sure I can make it work outside of the pandemic.” 

Technologies like AI and voice recognition software allow for the ability to repurpose the human workload at SCL Health, Richardville noted. “The service is not going away,” he said. “But rather, we’re creating a digital workforce, one that is more efficient and provides more effective and multi-channeled ways for delivery of the service.” 

Creating efficiencies won’t necessarily translate into more resources for the IT department, but it underscores their contributions to the organization and helps to build a case for support in the future, Lahr suggested. Automating some steps in the revenue cycle that expedite billing “doesn’t impact my budget specifically, but it is recognized that my team is the one who created the opportunity for that operational excellence,” she said. “By delivering on that, then there are opportunities. If I can legitimize it, I can grow my team.” 

Making a Case for IT Investments

By developing solutions that lower costs and increase efficiency, digital leaders are creating systemwide value and building a case for investments that will help their organizations grow. Beyond showing that their teams can create savings and efficiencies, digital leaders can make a case that investing in their group is an investment into the whole organization. “What are your contributions?” Richardville asked. “How can you make your division, your responsibilities differentiate your health system from your competitors?”  

Use Strategic Outsourcing to Add Value Across the System 

Digital health executives need to ask what they can remove from their team’s plate that would free up time and labor to invest in higher priority projects.  

Echoing that the pandemic has changed expectations in healthcare systems that embraced digital health, Lahr said, “The toolbox I can use for what I can do differently has expanded because we have taken down some of the barriers and the walls.” For instance, Regional Health’s help desk may go 24/7 with outsourcing in the off hours. “Over time, will that morph to potentially being all outsourced and our help desk analysts will become more desktop technicians because we’re going to be in more places? … I don’t see that as a reduction in force but as a retraining of people and using them to their highest ability.” 

At SCL Health, Richardville is taking advantage of opportunities offered by outside companies to migrate some services to cloud hosting and provide a seamless experience for consumers with software as a service. For large projects, he is making a case for flexing staff to bring in outside support and then rightsizing when the project is done. “There’s a deep skill set that you can get from people in certain target areas,” he noted. “It may be a little bit more expensive per drink, but I don’t have to buy the whole bottle. This allows us to be agile and to increase access to health services while at the same time lowering its cost. That is the true definition of value.” 

He also sometimes looks for outside partners when considering one-time major upgrades and implementations or standard hardware investments.

It really is about looking at the total cost of ownership over time for these investments that you make, and doing it in such a way that you’ve found trusted partners with predictable cost, predictable timelines and predictable outcomes.

Craig Richardville

“Our experience has been that the right partners will deliver on their commitment. In turn, we get the best value that we’re looking for.” 

The bottom line is creating a positive experience for the patient, the panelists agreed. If the experience is good, patients don’t care if services are hosted in the cloud or on premises, or if AI or a person is driving communications, or if maintenance of a system’s EHR is outsourced or staffed internally. They care about getting high-quality service that is timely, convenient, user friendly and accessible. “Whether I’ve outsourced that work or whether my team is doing that work or it’s a blend, if the work’s getting done, and the end product is great, then we can blur all the lines that we want,” Lahr said. 

 Outsourcing tasks like maintaining an EHR or call center, if done without compromising the patient experience, frees the team to innovate and support the strategic goals of the organization. 

Conclusion 

As organizations continue to integrate technology, the role of the IT leader has evolved to become more strategic and collaborative. This is particularly true for organizations with greater digital maturity. The IBM Institute for Business Value reported that organizations with higher technology maturity, effectiveness, and ROI achieved better business performance. To succeed in an increasingly digital world, organizations should bring technology leaders into strategic roles where they can help influence priorities and strategy. In turn, leaders must find new ways to support daily IT operations to enable leaders to focus on the big picture.