Helathcare CIO’s Feel the Pain

Healthcare CIO’s Feel the Pain

By Fred Kesinger

November 2013

I had coffee with one of my healthcare CIO friends here in the DFW area.  My purpose was to determine her top priority issues and what she planned to do about them.  I was surprised by her comments.

She railed about the demands for IT services at her very large health care system. She said “Some days I don’t know whether I’m coming or going”.  I could sympathize with her and reminded her I had a similar situation back at my old company.

She went on to say that she could not find experienced IT people here in Dallas.  I asked her about her top five priorities.  She looked at me incredulously and started to laugh.  It was a desperate, nervous laugh.  I could hear the skeleton rattling those death knell chains.

“Top five?  How about my top 500 projects?”  By this time the caffeine from the coffee kicked in and she was on a roll.

“I’ve got to meet new compliance guidelines from HIPAA, readmission and mobile apps.   I’ve got security issues with my EMR system.  I’ve got to respond to Meaningful Use and have Phase 1 completed by year end.  We haven’t even started on interfacing with the State’s Health Information Exchange (HIE).    

“A lot of my doctors like to bring their own end user devices, such as iPads, iPhone’s, Androids, Blackberries, smart phones, etc., and so now we’ve got to provide some sort of standards and policies to support BYOD.  Nobody yet has thought about the privacy and the security of doctors and physicians using wireless devices to capture patient data.”

“Even though we capture and store a lot of data in various formats, we don’t have any storage file room in our data centers and we need to add more than 100 TB storage in our data center”.

“This is all over and above needing to upgrade our IT infrastructure “.  Now I’m not feeling so funny when I see the stress in her face and hear the frustration in her voice.  There were a million other questions I wanted to ask her (we never did get to cloud computing, predictive analysis, 2014 needs and telemedicine).

“Besides all that—-I have used up my capital budget for the year and my operating expenses have raised drastically in the last 18 months.  Now, I have to go back to the Board and ask for more money.”  I decided it was time to change the subject.  This conversation was depressing.

I asked her how her family was and she notably perked up when she told me her son and daughter were doing well.  We said our “goodbyes” and went our separate ways.  As I was driving home I reflected on her predicament.  Glad I retired several years ago.  But I couldn’t get this picture out of my brain. Nothing I can do to help her today.

Next morning I got up and wondered how other Healthcare CIOs were doing.  I wanted to obtain some additional inputs so I could compare the two conversations.  So I called another healthcare CIO I know.  He said he didn’t have time to talk to me today, but he would have some time in a few weeks.  I graciously thanked him and told him to call me when he had a few minutes.

A month and a half later, he called me.  “You got time for lunch?” Yep, I always have time for lunch.  The appropriate lunch arrangements were made and we hung up the phone.  I waited patiently for our lunch appointment and occupied my time with my other corporate duties.  Several days later I got a message that says my friend has left his role at the hospital.  What a surprise!  So I sent him an email addressed to his hospital email address.  It bounced.   He’s already gone. 

Then I called his cell phone.  No answer and left a voice mail message asking him “What is going on?”

The following week he called. He and his wife Jackie had taken a week or ten days’ vacation to Baja, Mexico.

He said he left the hospital on his own accord and held no hard feelings.  Apparently he got some sort of severance.  At an officer level of his company, I suspect he was well taken care of. 

What are you doing now?” I asked.  He said “I’m trying to decide what to do.  Do I want to pursue another CIO position, or do I want to start my own company.”  I decided to wait until our lunch meeting to gain the rest of the story.

The appointed date and week came and we met at the restaurant. After we placed our order, I asked him “What’s going on?”

He looked at me somewhat sheepishly and said “I just got tired of the bull________.”

I waited for the flood gates to open.  I didn’t have to wait very long.

“I could never satisfy the demand for IT services.  Nobody was happy.  We spent a lot of money.  We had major security issues in some of our older hospitals.  And doctors, nurses and care givers were all asking for wireless access.   Our Chief Security Officer would not allow anyone to have remote access.  Not from home, smart phone or iPad”.  He went on to say that his current IT infrastructure has major obsolescence issues.  There was no Disaster Recovery/Business Continuity.  And the CFO would not approve outside contractors or consultants.

He went on…I gave him all the opportunity and talked continually as we ate lunch.  We closed; I wished him well and asked how I could help him. He said he would think about it.

Now I had enough data from two reliable sources that would crystallize my understanding of what today’s healthcare CIOs are dealing with every day.  

Here’s my take:

1. Overwhelming demands for IT far exceed in-house ability to supply reasonable IT support.
2. There is a widespread feeling in the health care world, e.g. doctors, nurses, caregivers, that IT is a cost center and they see IT spend rising substantially each year,  and don’t see the value these IT initiatives provide.
3. Healthcare executives don’t look to the CIO for innovative solutions to today’s health care issues. 
4. Healthcare CIOs in general have not seriously considered cloud computing or managed services to offload part of their IT burden.
5. IT providers feel they can run and operate their own IT infrastructure better than an outside provider, and with better security.
6. CIO’s have not effectively built trusted relationships with key users.
7. Company employees are not aware of the value IT provides the organization.

Based on what I heard from my two CIO friends, I can offer the following recommendations:

1. Establish a senior executive level IT Steering Committee to drive priorities, budget, direction and project approval.  Designate the CEO as chairman of the group and allow the CIO to work the details. 
2. Seek (target) the CIOs most recalcitrant user and invite him or her to lunch.  Start the relationship building and keep it going on all fronts.
3. Measure and report (via an Executive portal) IT performance from operations, projects and policies, e.g. Mobile devices, compliance, budget and value added.
4. The CIO must use technology to convey the IT “Message” through employee portals, white papers, and employee meetings.
5. The CIO must spend more time on the user turf and less time on the IT playground. 
6. New technology-stay attuned to any new technology advances that may be a breakthrough for your company.
7.  Try to anticipate new regulatory requirement s and get “ahead of the curve”.
8. Interface with other CIOs, both inside and external to the healthcare sector.  

If healthcare CIOs wish to be successful in the 21^st century, they will have to become more of a proactive business person and less of an IT guru.  Colleagues, customers, stakeholders, partners, providers, alike want to see a proactive, innovative leader at the helm of the IT ship.