When it comes to the CIO’s ability to achieve results, governance structure weighs heavily, according to the March healthsystemCIO.com Snap Survey, which found that 57 percent of CIOs believe an organization’s reporting structure matters “a great deal.”
As mergers and acquisitions become increasingly common, a large number of hospitals are making changes to the reporting structure that are significantly impacting the CIO’s ability to do his or her job — for better or worse. “You need to report to someone who can make a difference,” said one respondent. Another took it a step further, adding, “If the CEO is not getting routine updates through direct CIO engagement, it will not be long before the CIO’s value to the organization will come under discussion.”
Another reason why CEO support is critical? The majority (68 percent) of CIOs polled say they report to the CEO, while 21 percent answer to the CFO. These results mark a dramatic shift from the September 2012 Snap Survey, which found a much more even distribution in terms of who CIOs report to (38 percent answer to the CEO, 26 percent to the CFO, and 18 percent to the COO).
Interestingly, of those who do not currently report to the CEO, 56 percent believe they should.
But no matter who they report to, CIOs want to have a voice, and according to the survey, just over half (54 percent) believe they truly have a seat at the decision-making table. “I don’t necessarily have a vote, but I’m aware, informed, and a participant in all significant organizational initiatives involving IT,” one respondent stated.
Thirty-nine percent of CIOs say they are involved in some decisions, with a few noting that the governance process is a work in progress. One respondent cited positive changes in leadership, noting that regular meetings are starting up again, and communication has improved.
Still, when all is said and done, many believe that it all comes down to the individual. “The reporting structure does lend credibility to the CIO, but in my mind, that’s a minor factor,” one respondent stated. “I believe that the CIO’s ability to lead projects has more to do with their effectiveness in engaging staff and stakeholders to execute and IT plan that is well-aligned with the organization’s strategic goals.”
(SnapSurveys are answered by the healthsystemCIO.com CIO Advisory Panel. To go directly to a full-size version of any individual chart, click on that chart.)
1. Who do you report to?
CEO
- This changed when our new CEO was put into place around 2 years ago. Previously was COO.
- I would suggest for organizations of any size and/or material complexity, if the CEO is not getting routine updates through direct CIO engagement, it will not be long before the CIO’s value to the organization will come under discussion and/or decisions best made by or with the CIO will be made without him/her, leading to sub-optimal results.
- I have reported to the CFO in the past, and I’ll not work that way again.
COO
- It just changed from CFO 2 weeks ago.
CFO
CMIO
Other
- Chief Medical Officer
2. If you don’t report to the CEO, do you think you should?
Yes
- I reported to CEO, then CFO when new CEO came
No, who I report to is just not a big deal
- Although I’m not sure I think it means it is not a big deal; just that at this organization, it works.
N/A
- CIO reporting as a senior leadership/VP-level position has been in place for just the past 3 years.
- I think the reporting relationship varies by institution. In my organization, the CMO is the best place to report when trying to drive adoption of the EHR.
- In our organization it is most advantageous to report to the COO. He links to strategy and he is running the show.
3. Has the reporting relationship at your organization changed in recent years? (If you answer ‘yes’, please elaborate)
Yes
- This has been an evolution. As I gained trust in the organization, the more involved I have become.
Somewhat
No
4. Do you truly have a seat the decision making table or are you informed of decisions after the fact and expected to execute?
Yes, I’m involved in all or most major decisions
- We have strong IT governance and great collaboration at C-Suite level.
- I don’t necessarily have a vote, but I’m aware, informed, and a participant in all significant organizational initiatives involving IT — meaning pretty much everything.
I’m involved some of the time
- There have been many changes in recent months with executive leadership at my organization. I went from reporting to the CMIO (who left and has not been replaced) to reporting to the CFO. The CEO and CFO were meeting in together and coming up with decisions without any other involvement of executive staff members. After 8 months on no executive staff meetings, they are starting up again. It appears that communication may be opening up again.
- This is a product of a new CEO. He is struggling to get/keep his feet under him, and his approach has been to be far less inclusive. The practice has led to results that have cost the organization in material ways. Healthcare is simply too complex for anyone one person to attempt to make unilateral decisions without appropriate consult.
No, I tend to be informed of decisions after the fact
5. How much does the reporting structure affect the CIO’s ability to lead projects and achieve results?
A great deal
- You need to report to someone who can make a difference. It would make little sense, for example, for me to report to the CMIO, who in turn reports to the CMO.
- Although the CIO should not often be the leader of the project; operational leaders and champions are such a key role.
- In the past 5 years we have successfully led (by every measure) some of the most complex projects in the industry, all ahead of schedule, budget and delivering at and above scope. This was with a CEO that fully appreciated the complexities of IT enabled initiatives. The last year, with far less complex initiatives, we have struggled from lack of the same type of engaged CEO/CIO partnership.
Somewhat
- If the role reports to CEO, it is seen as more strategic and influential vs. cost center. But at the end of the day, results matter the most.
- The reporting structure does lend credibility to the CIO, but in my mind, that’s a minor factor. I believe that the CIO’s ability to lead projects has more to do with their effectiveness in engaging staff and stakeholders to execute and IT plan that is well-aligned with the organization’s strategic goals.
Not at all
- For this organization, but I can definitely see where it would be a problem if the CIO was not part of senior leadership team.
Frederick Cox says
“You need to report to someone who can make a difference” are very true words. Projects get done when people work together – towards where they are incentivized.