Doing It All: The CIO’s Dilemma

Two weeks ago, I was in Las Vegas with 50,000 of my closest friends at the annual HIMSS Conference and CHIME CIO Forum. It continues to amaze me how the industry has grown year after year throughout my career — it is certainly true that we live in interesting times. It is even more true that IT is being recognized as one of several enablers of almost every strategic program being considered by health systems across America.

CHIME sponsors focus groups during which its Foundation Members are able to tap the collective wisdom and experience of CIOs who offer 90 minutes of their time to participate. While the ideas and content of these sessions vary considerably, what is consistently valuable for me is the interaction with other CIOs in the industry. I participated in six different sessions last week and wanted to share an observation regarding a major common theme: The Challenge of Doing It All.

It was during an Advisory Board (AB) session on IT trends for the next five years where we got talking about IT Governance Models and the extent to which they were integrated with overall enterprise governance vs. stand alone. Amazingly, a 2013 survey of AB customers showed that 80 percent of respondents described their IT Governance as “stand alone.” One of the senior statesmen in our session commented, “How to do it all has got to be on the list of every CIO in the country.”

It strikes me that given the level of capital and human resources being committed to strategic program enabled by IT, governance models would be more integrated. In the absence of effective integration — clear strategy with all executives in alignment on what we must do, and more importantly, what we will not do — the CIO is in a Catch-22 situation. Demand is insatiable and resources are all too finite. The market is too dynamic to permit the annual capital budgeting process to be the essence of IT Governance. We must evolve to a more integrated model that operates at the speed of the business, or dare we dream, that we get to the proactive edge and bring insight to the business before they ask. I refer to this state as IT 2.0.

Perhaps the next survey will show progress since 2013. We are, in my opinion, experiencing a Meaningful Use Hangover as the capital spent to attain government incentive dollars hits the operating budget with depreciation costs. Margins are low and expectations are high regarding the realization of value from these investments.

With all this considered, we can’t afford to have “standalone” governance.

Currently a ‘CIO in Transition’ working with Bow Tie Consulting Solutions, Dan Kinsella was EVP and CIO at Cadence Health System for 3 years before it was acquired by Northwestern Medicine. He has also worked with Optum Insight, The Revere Group and Ernst & Young, and is cofounder and coordinator of Job Search Coaching Network.