Technology: Piercing the Inner Circle

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For more analysis and a look at the complete survey results from all sectors, please visit our HealthLeaders Media Industry Survey 2009 Web page, which features downloadable reports covering CEOs, finance, technology, quality, marketing, health plan, physician, and community and rural leaders.

The role of the CIO—and his or her place in the healthcare organization—is evolving. And as our survey indicates, perceptions of that role, and how well the department is doing, also vary—considerably.

In a concurrent survey of CEOs, our HealthLeaders Media Industry Survey shows that the CIO is at the outer edges of the chief executive's inner circle. Only a quarter (25.23%) of CEOs count the CIO as a member of the senior executive team. That's just ahead of the chief marketing officer (24.92%) and the service line director (18.62%).

But when we asked CIOs about their level of input in the organization's leadership structure, 39% see themselves as a "key leader who contributes to overall organizational strategy." Another 39% see themselves as an important operations leader. One in five CIOs say they are "not very influential in senior leadership."

"The role of the CIO within the senior executive team has such a wide degree of variation within healthcare that I'm not surprised you would have that kind of feedback," says Mac McClurkan, vice president and chief information officer with HealthEast Care System, a four-hospital system based in St. Paul, MN. In some organizations, the CIO's role is the same as that of the senior vice president, who is mentioned in the same breath as the chief operating officer. At other organizations, the CIO doesn't have a seat at the table at all.

However, the days of the CIO simply being considered part of the back office function and not considered part of the executive team are numbered, McClurkan says. "Just as the healthcare industry has tended to be a little bit behind the curve in terms of technology adoption, healthcare been behind the curve in what the role and function of a CIO is. Though it's changing, there can be some real fits and starts, and often a healthcare organization has to go through some painful experiences before leaders recognize that maybe they do need a senior-level executive to help make sure they don't screw this up again," says McClurkan.

More indications of a difference in perceptions are revealed in comparing the CEO and the CIO components of our cross-sector industry survey. We asked each to rate the quality of the organization's information technology. Very strong, say 22% of CIOs. Very strong, say just 13% of CEOs.

That nearly 10-point spread can basically just be chalked up to human nature, says McClurkan. "As CIOs, we are closer to own operations, and we see all the hard work that keep IT functions moving forward day after day," he says. "There is so much competition for the CEO's attention that chances are when an issue bubbles up to the CEO, it's more likely that something has gone wrong. When things are running smoothly, there's no reason for a message to get to the CEO saying, ‘Hey, everything's going fine down here in IT.'"

Interestingly, when we asked technology leaders for their one wish to fix healthcare, very few called for technology-related solutions. The highest-ranking answer at 20.83% of respondents was for a reimbursement solution. Second, at 19.44%, was a call for universal health insurance/healthcare (funding not specified), and 10.42% wished for universal single-payer (government-funded) coverage. Of the 144 answers to the question "You have been granted one wish to fix healthcare. What is it?" only 7.64% named something technology-related. Examples of those wishes related to technology included free HIT, functioning electronic medical records, and funding for infrastructure, hardware, and computerized physician order entry software.

For the next HealthLeaders magazine story in this package, visit For complete, detailed survey results, visit

—Kathryn Mackenzie

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