What I Learned As A Young CIO

Being a young CIO has many advantages and probably even more opportunities — or as some would say, disadvantages. Do you remember the first time you presented to the board or the first time you were nailed by the executives for an issue or maybe even when something failed? What matters is what you do with those opportunities or setbacks.

So what is a young CIO? One could say 45 is young, but how about 25 (which, some might say is way too young)? No matter how young or old you are, being a first time CIO is going to be challenging. There will be as many people wondering if you can make it no matter your age. There will also be many who believe you have the talent; the rest is up to you.

A CIO must learn how to develop relationships — no matter how young or old you are, and also must have mentors. Whether you are 25 or 60, if you aren’t breaking something and learning something, then you must be sleeping on the job, especially these days. A young CIO even has more of a challenge; one is gaining respect. I can remember the first time I was at the executive table and the first meeting they put me on the agenda. I wasn’t prepared for a major issue and about half the room was upset; mistake #1, don’t ever go to a meeting where you are on the agenda and you have no background of those in the room.

I took notes and said, “Let me get to work and I’ll come back with a plan.” I met with the executives individually to get more information on the problem. I met with the departments. I rounded with the staff. I didn’t realize it at the time, but I was on the complaint and listening tour of 2004.

Within a few weeks, I had about 25 significant actions that needed immediate attention. I took those back to my team and we developed a 90-day action plan. Within 90 days, we had 22 of the issues resolved. Lesson learned: listening gains trust. Trust is important for your relationship, and execution is all about gaining credibility. If you do this fast, you will be more successful in the long term. The sooner you do this, the bigger problems you can tackle.

This was a huge step in gaining respect — building relationships and overall problem solving with the executives. While this wasn’t strategic at the time, it was necessary. I later found out that it was probably one of the biggest reasons I gained significant respect from the executive team within a short period of time. I developed great key relationships with the COO, CNO, CMO and a number of key physician leaders. These relationships can make or break a CIO.

The next phase of being a CIO is being a part of a team where you have to take on other assignments. I made sure that I took on additional responsibilities outside of IT. I did physician rounds, case management rounds, and a lot of shadowing in departments and was on several performance improvement committees. It’s about building business acumen. If you don’t understand the business, how can you support it and define IT strategy to drive it further? What I learned is how important ambulatory practices are to hospitals margins.

Then, it was time to tackle what’s next on the agenda — how do you determine what battles to pick? It’s a tough question, and it’s an area where your mentors can really help. You have to decide, especially at the C-suite level, when to stand your ground. For me, it was with the CMO. The physicians were complaining, and I told him that we can’t just let the physicians complain if they can’t explain it and work with us to resolve the issue. It had to be a team sport. The CMO and I had many debates about this, but once we started working on it together as a team, it improved our relationship. We fixed the problems and the physicians had a better respect for the systems and, at the end of day, for us as leaders.

I learned that you can’t know everything; even if you are 55, you learn every day. When you are 25, you have 30 years’ less experience. They say it takes 10 years or 10,000 hours to be proficient at a skill — you don’t have that kind of time in a CIO job. You must engulf yourself with smart people and become a sponge of knowledge.

A CIO always comes with an area of expertise — mine was technical and business management, and so I really needed to learn clinical. I rounded daily with our informatics team, and I even went into patient rooms, watched workflow, assisted in building the system, and processed medication reconciliation and barcodes. You name it, I shadowed it. I was able to learn so much as well as to observe what was broken.

I know that behind the scenes, there are many issues and obstacles. This has provided a better respect for other roles within IT that I might have never bothered with. The more experience you get, the more you think you know, but that might not always be the case. A young or seasoned CIO can learn that focusing on the people and the systems within IT is just as important as working with the business; you have to understand the assets you have so you can leverage them well.

I’ll be writing again soon on other lessons learns related to how to build a team, how to resolve issues, how to prioritize, how to set goals and what is required to influence others.