Improving Strategic Engagement for Healthcare CIOs with Five Key Questions

Healthcare CIOs risk becoming marginalized from other members of their organization’s leadership when they focus too narrowly on technology and don’t engage with their peers’ strategic goals. As technology continues to grow and shift as healthcare adopts new tools and strategies around value-based payment goals, CIOs must stay engaged beyond the IT level to lead their services to their full potential. For some CIOs, however, engaging in nontechnical conversations doesn’t come naturally. Guidelines can help them start dialogues to better understand their organization’s strategic goals and how to optimize IT to meet them.

This article poses five fundamental questions for healthcare CIOs. The questions aim to help IT leaders engage in nontechnical conversations with their leadership peers and grow their roles beyond technology to engage on an organizational strategic level.

Learning the Value of Strategic Engagement for CIOs

Early in our careers, as young professionals who constantly challenged the status quo, Ryan and I often looked at the established men and women in our field as obstacles to progress. But now that we are among the more seasoned members of the IT and healthcare leadership fields, we hope not to inhibit our younger colleagues’ forward thinking. Our goal is to instead leverage our experience and constantly engage in the strategic investments of technology to help the healthcare industry get the most out of every dollar it spends on IT services. One important focus of this objective is to help CIOs engage strategically on an organizational level.

We’ve each been fortunate to work with many gifted technologists on some breakthrough projects, which are often as challenging as they are exciting. For example, one project that fundamentally shaped Ryan’s thinking about strategic engagement dealt with electronically interfacing lab results and other clinical documents from my health system so he and team could store them natively in affiliated providers’ ambulatory EMR systems. This electronic interfacing service eliminated the need for faxing and expensive, time-consuming manual processing by hospital and clinic staff to get the information to these clinics. What used to take from hours to sometimes days, and was often error prone, now took seconds with virtually no errors. In addition, the electronic process automatically linked the result or document to the correct patient in the clinics’ EMRs and also natively embedded critical clinical information in the providers’ electronic workflows.

Not only was this initiative a leapfrog capability to answer the competitive threat of competing laboratory businesses, it also strengthened the relationship between our health system and these affiliated clinics, satisfied the physicians, and was a service improvement for the collective patients. It was truly a win-win all around, but it didn’t have the full impact with extended leadership Ryan and team aimed for.

Effective IT Initiatives Must Be Strategically Relevant

Despite the positive outcomes, the health system invested only a small portion of the savings and increased revenue generated by the electronic interface initiative into expanding the platform (which would have enabled community providers to electronically send lab orders to the outreach lab). In addition, leadership did not select the primary provider outreach expansion proposal for further investment.

This was one of Ryan’s first experiences with organizational leadership not perceiving the strategic value of a technically proficient initiative and the beginning of his drive to ensure that his IT initiatives were strategically relevant to the organization. Additional experiences have contributed to both our understanding of strategic relevance. We have had several jobs leading IT organizations inside and outside healthcare, which have involved demanding, technologically enabled, strategic-change efforts.

Along this journey, we’ve learned, as playwright Eugene Ionesco wrote in Decouvertes, “It is not the answer that enlightens, but the question.” For healthcare CIOs, great answers for less important questions don’t do much for the organization; however, asking great questions almost always triggers a process of discovering the right answers. Furthermore, we have found the right questions asked of the right people serve to align us with executives in an organization

Five Questions for Healthcare CIOs

We have found the following five questions are critical for CIOs who want to engage in their organization’s strategic conversations. The questions enable a team discussion and education:

  1. Whom do we serve, and what do they (those we intend to serve) want/need/have to do?
  2. What services do we provide so that those we serve can do what they want/need/have to do?
  3. How do we know we are doing a great job?
  4. How do we provide the services?
  5. How do we organize?

Often, when we share these questions with other IT leaders and tell them that this is the heart of what we do as a CIOs, they look at us with a “that’s it?” expression. We typically respond by suggesting they try to answer the questions themselves and with their team.

In our experience, when first-time team members answer the five questions and share the answers with one another, an enlightening and educational discussion inevitably ensues. Each question aims to develop critical strategic discussions and understanding:

  • The first two questions (whom we serve and what services we provide) are central to an organization’s value proposition. Alexander Osterwalder’s Value Proposition Canvas (a tool to design, test, and build a company’s value proposition) is an excellent tool to help answer the first two questions.
  • Question three (how we know we’re doing a great job) is the test of a value proposition in that it clarifies how to know if you are headed in the right direction. If you need more than five to seven types of metrics to answer this question, then you probably don’t have clear answers to questions one and two.
  • Question four (how we provide the services) focuses on processes by which you can create, deliver, and sustain value for those you serve.
  • Question five (how we organize) clarifies organizational accountabilities, governance, resource allocation, and other structural issues

We have found these questions useful when describing our own jobs, as well as the departments for which we might be responsible and the organization as a whole. We have used these same questions in organizations large and small, in for-profits and not-for-profits, in start-ups and long-established organizations.

In addition, the five questions can be asked in two ways: “do” (for diagnosis, as above) and “should” (for design). Here is the design version:

  1. Whom should we serve, and what do they (those we intend to serve) want/need/have to do?
  2. What services should we provide so that those we serve can do what they want/need/ have to do?
  3. How should we know we are doing a great job?
  4. How should we provide the services?
  5. How should we organize?

Understanding the Heart of the Healthcare CIO’s Role

If you are a CIO and you want to become a part of your organization’s C-level strategic discussions, start asking these questions of your peers. You will learn a lot, and so will they.

These five questions are the foundation of the healthcare CIO’s responsibilities. While some leaders might think the questions don’t capture the breadth of the CIO role, when they try to answer them, or work with their leadership teams to answer them, they understand the real significance of these five questions. They serve to align the CIO with their own IT organization and their colleagues throughout the enterprise.

We invite you to ask your IT leadership team to answer the five “do” questions and share their answers. We are confident it will be a learning experience. As you get more comfortable with the questions, start asking some of them of your executive peers across the enterprise. We would love to hear what you learn.

Additional Reading

Would you like to learn more about this topic? Here are some articles we suggest:

  1. The Missing Ingredient in Healthcare Analytics: The Executive Sponsor
  2. The Best Way to Maximize Healthcare Analytics ROI
  3. The Best Approach to Healthcare Analytics
  4. Transforming Healthcare Analytics: Five Critical Steps
  5. Outcomes Improvement Governance: A Handbook for Success and Achieving More with Less
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