rock-roadblockToday, on the HIMSS LinkedIn forum, someone asked this simple question, “is the CIO the biggest barrier to healthcare improvement?”  He sees his CIO as having the “if it ain’t broke, don’t fix it” syndrome, and a nay-sayer to opportunities for improving patient management.

CIO – have you ever been accused of being the roadblock?

Below was my response to him.  What he is experiencing may be painful – and accurate.  I outline reasons for what he may be seeing, and the solution.   CIO – it may be worth consideration.


Richard – I have seen what you are talking about.  As one who has worked within healthcare IT for 14 years and understand CIO challenges, may I give you some thoughts on what is going on, and the road to resolution?

CIOs are pressured from all sides:

  1. they are pressured to keep things up and budgets down – unfortunately, it often consumes them
  2. every department wants improvements and specific-to-them functionality – and they ALL have good, sound reasons – therefore, a CIO begins to avoid these opportunities with a simple “we can’t. we have too much going on.”
  3. government mandates constantly force changes and upgrades
  4. tight revenue makes it hard to increase staff or update/expand system infrastructure
  5. everyone wants their data to be shared and usable and yet secure – and the government and other groups increasingly mandates it (e.g., HIPAA, PCI)
  6. with growing dependence on technology, any downtime can cost tens of thousands of dollars or even cost lives – and high availability costs money and time to get and maintain
  7. with all this growing pressure and complexity, any improvement/expansion/innovation project must be managed more carefully and with a broader group of stakeholders
  8. most CIOs do not have routine, consistent adaptable project management skills and processes in place in their departments – therefore, wasted effort, rework, poor quality, failed projects and duct tape and baling wire rob a CIO of maximizing his staff’s project capacity
  9. most IS/IT/CIS groups are overloaded with projects and operations with little or no “air traffic control” to determine reasonable timelines, resource expectations or clear project expectations – the loudest VP wins!  There is no predictability.
  10. most CIOs do not have adequate visibility into the state of all of their projects – all they know is that their people are overloaded and there are problems with projects that they must attend to.  They seek to resist new projects anywhere they think they can.  Their lack of visibility makes it nearly impossible for them to be proactive and strategic in how they work with other executives on defining and slotting important projects.

BOTTOM LINEmany see the CIO as irrelevant or an impediment – a manager over a service area that is more about failure and nay-saying than strategic growth and empowering the organization.

A SOLUTION? Transform the CIO from a service provider to a strategic partner.

A CIO needs to be able to sit at the table with other VPs and be able to help define the possibilities when a department like yours has a perceived need.  He needs to be able to determine what it will take and if it can be done, and when it could be done and how.  He needs to be able to discuss priorities and risks so that the VPs make INFORMED strategic decisions, not mere knee-jerk reactions.  The only way a CIO can do this, is if he gains:

  • VISIBILITY – he needs to know what is going on with all projects – what they are and their status.  He needs to know what the schedule looks like and know what any given change (new project, delayed project, changed project) will do to the schedule of projects.  He needs to be able to give options to the VPs, not just NOs. And the VPs as a whole need to know what a project ACTUALLY is before approving it.  A CIO’s team should be key in this process of defining projects for VP consideration.
  • PREDICTABILITY – he needs to develop people and processes to make sure projects are done well and with quality without bloating timelines and staffing.  Adaptable and consistent processes to manage the schedule of projects (the portfolio/program) and to manage each individual project will give the CIO confidence when giving options to VPs
  • CAPACITY – he needs to ensure that staff are not overloaded and that projects have all that they need to be successful, and he needs to be fostering key leadership skills around managing and executing projects.  Along with visibility and predictability, a CIO will maximize capacity by eliminating poor requirements, poor quality, wasted rework, and failure.

BOTTOM LINE – A CIO will now have the needed information and confidence to help the executives make strategic decisions.  And where your project is clearly a priority to all, the CIO will be your greatest help and champion.

Is this pie in the sky thinking?  NO.  I have helped to make it happen at two hospitals, and am working on a third.


If you can relate to this frustrated healthcare professional, or if you are the misunderstood/frustrated CIO, maybe we should talk.

Go to to see the entire interaction.