A healthcare CIO’s role can demand such an intense focus on technology that IT leaders may struggle to find natural opportunities to engage with their C-suite peers in non-technical conversations. To bridge the gap, healthcare CIOs can answer five fundamental questions to better align their programs with organizational strategic goals and guide IT services to their full potential: Whom do we serve? What services do we provide? How do we know we are doing a great job? How do we provide the services? How do we organize?

1. Improving Strategic Engagement for
Healthcare CIOs with Five Key Questions

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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.
Improving Strategic Engagement for Healthcare CIOs

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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.
Improving Strategic Engagement for Healthcare CIOs

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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.
Improving Strategic Engagement for Healthcare CIOs

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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.
Learning the Value of Strategic Engagement for CIOs

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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.
Learning the Value of Strategic Engagement for CIOs

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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.
Learning the Value of Strategic Engagement for CIOs

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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.
Learning the Value of Strategic Engagement for CIOs

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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 hours to sometimes
days, and was often error prone, now
took seconds with virtually no errors.
The electronic process automatically
linked the result or document to the
correct patient in the clinics’ EMRs
and natively embedded critical clinical
information in the providers’ electronic
workflows.
Learning the Value of Strategic Engagement for CIOs

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This initiative was 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.
Learning the Value of Strategic Engagement for CIOs

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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, techno-
logically enabled, strategic-change efforts.
Effective IT Initiatives Must Be Strategically Relevant

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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
Effective IT Initiatives Must Be Strategically Relevant

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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:
Five Questions for Healthcare CIOs
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?

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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.
Five Questions for Healthcare CIOs

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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.
Five Questions for Healthcare CIOs

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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.
Five Questions for Healthcare CIOs

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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.
Five Questions for Healthcare CIOs

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Question four (how we provide the
services) focuses on processes by
which you can create, deliver, and
sustain value for those you serve.
Five Questions for Healthcare CIOs

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Question five (how we organize)
clarifies organizational accountabilities,
governance, resource allocation, and
other structural issues.
Five Questions for Healthcare CIOs

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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.
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.
Five Questions for Healthcare CIOs

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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:
Five Questions for Healthcare CIOs
1: Whom should we serve, and what do they
want/need/have to do?
2: What services should we provide so 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?

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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.
Understanding the Heart of the Healthcare CIO’s Role

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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.
Understanding the Heart of the Healthcare CIO’s Role

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For more information:
“This book is a fantastic piece of work”
– Robert Lindeman MD, FAAP, Chief Physician Quality Officer

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Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Ryan is a recognized healthcare IT executive and leader for aligning business and technology strategies.
His focus is on establishing strong relationships with business and clinical leaders throughout the
organization and across the industry. He understands how to effectively bring key leaders into the
strategic planning process and encourage collaboration and cooperation across divisions and operating
units. He fosters business understanding of the value that information technology presents in achieving
superior customer satisfaction, driving bottom line efficiencies, and enhancing the operations of health care
organizations. He is often sought out by health care systems nationally to help them understand the role that IT
plays in improving the value of organizations to their internal and external constituencies. Ryan has 20+ years of
experience as a results-oriented leader with strong business and technology delivery, and execution experience. He
is a hands-on leader who understands the CEO vision and how to make it work throughout an organization. He has
an exceptional ability to understand and communicate technology to the “C” suite in health care organizations. He
has played a key role in defining strategic initiatives for improving physician relationships through innovative IT
services. He has served in multiple technical and business leadership roles, with experience spanning strategic
planning, organizational alignment, focus on best practices, online services, IT operations and infrastructure,
information security, and clinical information systems. His strength is in defining and aligning business and
technology strategy. Specialties: Senior technology and executive business management skills, business strategy,
consumer digital strategy, data management and analytics, online services, healthcare IT, architecture, product
development, and IT operations management.
Ryan Smith

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Other Clinical Quality Improvement Resources
Click to read additional information at www.healthcatalyst.com
Health Catalyst is a mission-driven data warehousing, analytics and outcomes-improvement company
that helps healthcare organizations of all sizes improve clinical, financial, and operational outcomes
needed to improve population health and accountable care. Our proven enterprise data warehouse
(EDW) and analytics platform helps improve quality, add efficiency and lower costs in support of more
than 65 million patients for organizations ranging from the largest US health system to forward-thinking
physician practices.
Health Catalyst was recently named as the leader in the enterprise healthcare BI market in
improvement by KLAS, and has received numerous best-place-to work awards including Modern
Healthcare in 2013, 2014, and 2015, as well as other recognitions such as “Best Place to work for
Millenials, and a “Best Perks for Women.”