At the seven-hospital, eight-facility Orlando Health System, Vice President and CIO Rick Schooler doesn't just encourage his reports to focus on professional development; he creates opportunities for them. Schooler, who manages a team of 282 IS professionals (plus nearly 500 FTEs across several divisions), advocated for full CHIME memberships for his three direct reports two years ago, a time when non-CIO memberships in the Ann Arbor, Mich.-based organization were the exception, not the rule.
Schooler was able to get his CMIO, CTO and chief applications officer (CAO) into the CHIME CIO Boot Camp workshops that the organization offers twice a year, sessions that this year were opened to CMIOs and to chief nursing informatics officers (CNIOs). (For more information, see sidebar, p. 46).
As a result, Steve Margolis, M.D., Alex Veletsos, and Drew Cobb, Orlando's CMIO, CTO, and CAO, respectively, attended the Boot Camp sessions, and all report having very positive experiences. More broadly, all three say, Schooler has made it clear that ongoing professional development is important, both for his staff members' current positions, and for any future positions. Indeed, Cobb, who has been at the health system for two years, says he'd like to become a CIO at some point; and further, that he came to Orlando Health specifically to work for Schooler, because of his well-known mentoring capability.“Working in healthcare IS, you learn about the various CIOs around the country,” Cobb says. “And I had heard of Rick Schooler before coming here as a consultant. When he was looking to fill this chief applications officer position, I talked to him and eventually was hired. But I had specific goals in mind. He's very good at governance in IT; and he's put together fabulous structures around IT here. And I wanted to learn about IT governance across the system.” Most importantly, Cobb says, “If we want to be CIOs, he wants us to become CIOs.”
For Schooler, this approach comes naturally. “I was raised in the world of athletics,” he explains. In addition to playing football, basketball, and baseball in high school, he also coached his sons when they were younger. “And in that environment,” he says, “I learned pretty early that when you get your shot, you've got to get up and perform. So one of the principles that guides how I work now is that I focus on helping prepare people to get their shot and fulfill their potential. There are times when I have to be on stage as a leader; but what's really important to me is to help others get up on stage.”
And Schooler is just fine knowing that two of his three direct reports aspire to CIO positions. Indeed, he says, when they ultimately obtain those positions, he will take pride in their ascendancy. Schooler makes it clear to all of his managers and executives that they should be constantly reading, learning broadly, and having experiences that are pushing the envelope of their professional development. For Schooler, that's a key element in being an effective CIO.
A variety of approaches
Increasingly, Schooler's approach to management is becoming the norm in hospital organizations across the country. What's more, even getting onto an IS executive team is requiring more formalized education and preparation. Schooler, for example, makes it a requirement that any direct report to him already has an advanced degree. This has become common at hospital organizations nationwide, particularly at teaching hospitals and multi-hospital systems.
There's a clear logic to such requirements, says Tim Zoph, vice president and CIO at the 897-bed Northwestern Memorial Hospital in downtown Chicago.
“Increasingly, advanced degrees for senior leaders in health IT are important,” says Zoph, who prefers that his direct reports either already possess, or choose to pursue, a master's degree. It has become critical, he says, that “the IT leaders of the future have advanced management degrees, not only because the nature of the role is changing and the level of responsibility is increasing, but also because the need for enhanced business capability is important, in terms of understanding an organization and its operations, and in terms of the layering of technology onto operations for adding value into the system. So if you're working for me, I want you to have the capability to someday run an organization as CIO. And I'm in a very good position to mentor young leaders. I've had five people working for me at Northwestern Memorial who have gone on to be CIOs; in my mind, that's a very good thing.”
Strategic beneficence
CIOs, however, aren't developing their reports solely out of the goodness of their hearts (though most agree it's the right thing to do). Other trends pushing forward the coaching/mentoring/professional development trend include the following:
In order to successfully implement clinical information systems (EMR, CPOE, eMAR, pharmacy, etc.), CIOs must assemble very large teams, composed of highly trained and prepared professionals, some with clinician backgrounds and some with traditional IS backgrounds. Leaders of those teams who have clinical backgrounds are going for (or have already gotten) advanced management education and training; those with traditional IT backgrounds increasingly have management education as well, and occasionally also train in clinical informatics.As the CIO role becomes more strategic, those just below that level - CTOs, CMIOs, CAOs and network, infrastructure and help desk directors - are seeing their jobs move to higher operational and managerial levels.
And as the CIO role becomes more defined, so do several positions below that level, including the CMIO and CTO jobs in particular. Not surprisingly, formalized education and training, especially in management, is becoming obligatory.
As a result, say leading IS executive recruiters, formal advanced education is increasingly becoming a must-have for those one and even two rungs below the CIO. “A lot of people are now going for MBAs, if they don't have one yet, because in almost every search we're being asked to do, a master's degree is now required or preferred,” says Linda Hodges, vice president and IT practice leader at the Oak Brook, Ill.-based Witt Kieffer.
Meanwhile, Betsy Hersher, president of the Deerfield, Ill.-based Hersher Associates, reports that those who are already CIOs - primarily at smaller and mid-sized hospitals - are quickly getting MBAs (if they don't have them already).
The position evolving faster than any other is the CMIO job, notes Arlene Anschel, a consultant in Witt Kieffer's IT practice who works alongside Hodges. And the CMIOs who are moving fastest to add to their knowledge of organizational systems and management are those who arrived in that role as “physician champions” of IT, with little or no previous systems or management knowledge, she says.Parsing the CIO-CMIO connection
The CMIO position is also a major focus of professional development from the perspective of most CIOs. Among the reasons is that CMIOs are becoming the key “go-to” people in helping to lead clinical implementations at the day-to-day level, along with CNIOs/vice presidents of clinical informatics. Indeed, says Orlando Health's Margolis, who came to the organization with an MBA and years of consulting experience, the CMIO is becoming a change agent in hospital organizations, as they leverage EMRs and other systems to improve patient safety and care. Thus, Margolis has been training in Lean Six Sigma techniques in the past year, and expects to receive his master black belt by the end of the year.
And regardless of whether they see themselves as CIOs someday (Margolis says he does not harbor that ambition), CMIOs agree that continuous professional development will be important. “It's going to have to be a part of the job,” says Julio Silva, M.D., associate vice president and CMIO at the 613-bed Rush University Medical Center in Chicago. “In particular,” he says, “as many organizations get beyond implementation, they're going to be looking at the value they can gain from their information systems, so it will shift the focus” of the CMIO role towards leveraging that value.
Of course, there are already a handful of former CMIOs nationwide who have become CIOs. Among them is Dick Gibson, M.D., Ph.D., senior vice president and CIO at the six-hospital, 1,200-bed Legacy Health System based in Portland, Ore. In fact, he has three advanced degrees - a medical degree, a doctorate, and an MBA.
Gibson, who practiced for a number of years as a family physician and emergency physician, obtained a Ph.D. in informatics at the University of Utah in Salt Lake City, before working as a consultant, then becoming a CMIO. He then came to Legacy as CIO in April 2007.
Gibson credits the encouragement of Rick Skinner, who was CIO of the five-state Providence Health System (based in Portland, Ore.), while Gibson was CMIO (and was among the first crop of full-time CMIOs in hospital organizations, he notes). Most of all, Gibson emphasizes, regardless of title or position, the most important thing is to figure out, “what your passion is.” The CIO can be a key mentor for the CMIO in that journey, regardless of to whom the CMIO reports, he emphasizes.
The relationship can also work both ways, according to Patricia Skarulis, vice president and CIO, and David Artz, M.D., medical director of information systems at Memorial Sloan-Kettering Cancer Center (MSKKC) in Manhattan. “I would say we mentor each other,” says Skarulis. “That's particularly true since we both came here around the same time” (Skarulis has been at MSKCC for seven years, Artz for six). Meanwhile, Artz, who has an MBA, agrees with Orlando Health's Margolis that such education will become more important for CMIOs, as the focus turns to quality and performance improvement. “My role is already very strategic and advisory,” he notes. “And I'm already involved tremendously in all our quality initiatives and solutions.”
For those looking for education and training, there are many healthcare-specific options (see sidebar, p. 46), in addition to the traditional MBA and other programs. Still, many CIOs agree that practical experience can often be the best teacher. Like Orlando Health's Schooler, John Glaser, Ph.D., senior vice president and CIO of the eight-hospital Partners Health system in Boston, recommends that executives who are working on self-development have someone in the C-suite observe them. “You can ask the CIO specifically, or someone else from the C-suite, to give you feedback,” Glaser says.
Always learning
As for CIOs, they can ask for the same kind of observation-based feedback, whether from the CEO or another C-suite peer, Glaser notes.
And of course, there's always the possibility of further education, even for CIOs. Larry Stofko, senior vice president and CIO at the 14-hospital St. Joseph Health System, based in Orange, Calif., is “halfway through” a master's degree in medical informatics, via a distance-learning program sponsored by Northwestern University (Evanston, Ill.). Why? “I just think that continuous learning is very important, whether for myself or for my staff,” Stofko says.
Sidebar
Education Options: From Boot Camps to Traditional Programs
Healthcare IT executives have a wide range of options when it comes to educational paths. Of course, there are standard degree programs, such as MBA, MHA, and traditional degrees in information sciences, programs that CIOs and executive recruiters encourage individuals to take.
However, there are now many specialized programs available to meet the needs of executives looking for enrichment and learning in various areas. At press time, the Web site of the Chicago-based HIMSS listed 40 academic programs (http://www.himss.org/content/files/EducatorsSIGdirectory.pdf). Below are a few examples:
In the fall of 2007, the University of Illinois at Chicago (UIC) went live with a new online health informatics master's degree program. According to the school, the program is one of only three online master's degree programs to be approved by the Commission on Accreditation for Health Informatics and Information management education (CAHIIIM). For more information on the UIC program, go to: http://www.healthinformatics.uic.edu
Another program of this type is sponsored by Northwestern University's School of Continuing Studies. The Master of Science in Medical Informatics program offers on-campus and online options. For more information, go to: http://www.scs.northwestern.edu/grad/medical-informatics/
Another program is an online certificate program in healthcare informatics offered by St. Petersburg College in Seminole, Fla. For more information, go to: http://www.spcollege.edu/program/HCINF-CT
Meanwhile, the major associations around healthcare IT offer a variety of programs to address different educational needs. HIMSS offers live and online courses (http://www.himss.org/ASP/educationHome.asp), ranging in scope from classroom programs to webinars, in addition to its Sunday symposia at the annual HIMSS Conference. And the Chicago-based American Health Information Management Society (AHIMA) offers a variety of distance-learning programs, most focused on that association's core HIM audience, but some of which relate directly to HIS as well (see http://campus.ahima.org).
The best-known educational resource for CIOs and those just below the CIO rank is the CHIME CIO Boot Camp (http://www.cio-chime.org/events/ciobootcamp/index.asp). The Boot Camps are offered at least twice a year, and are now open to both CIOs and their direct reports. To date, over 515 executives have graduated. The Boot Camp concept, which arose out of discussions among CHIME leaders early in its history (including, among others, Northwestern's Zoph and Partners' Glaser), has evolved over time, confirms Keith Fraidenburg, vice president, education and communications, at CHIME. Initially, 100 percent of Boot Camp attendees were CIOs, Fraidenburg says; now, about 50 percent are, as CIOs encourage their direct reports to attend.
Northwestern's Zoph says, “I've taught in 10 Boot Camps now, which means 400 emerging leaders. And what we're trying to do at the Camps is to create a trusted environment, to help young leaders learn what's needed in terms of leadership. We make it practical, and we have trusted open dialogue; and we also want to create an ongoing network. So we reinforce the idea that building and establishing relationships in the industry is an essential tool for you in the industry as you grow professionally.”
Sidebar
Paying It Forward
The course has attracted a mix of CIOs, some senior-level IT managers and directors, project management professionals and data analysts, and some international students, Noga says. And, he adds, the progression to formal teaching has been a natural one. “Mass General has an MGH Leadership Academy, and I've done a lot of guest-lecturing there and in various graduate programs in the Boston area, so this was a natural next step,” he says.
Meanwhile, the benefits are many. “With each class I teach, I learn as much from them as I provide knowledge to them,” Noga says. For example, he says, “They have to do some RandD and write-up, so I always learn a lot reading their mid-terms.” Finally, he says, “I enjoy teaching. It's also a means of paying it forward, too.”
Sidebar
Takeaways
While most current CIOs and the majority of direct reports to the CIOs of larger hospital organizations already have advanced degrees, the need for ongoing professional development continues.
Those who are in executive positions are looking to fill gaps in knowledge via a variety of traditional and non-traditional learning venues.
Industry-leading CIOs are providing their direct reports with a wide variety of experiences, including support for both formal and non-traditional education, as well as more targeted learning experiences.
All the healthcare IT executives and executive recruiters interviewed for this story agree: lifelong professional and personal learning will be required for healthcare IT executives at all levels.
Sidebar
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