Cleveland Clinic CIO Ed Marx Urges the HIT Summit Audience to Take Risks and Lead Proactively

The success of healthcare IT leadership in the coming years is going to be based very strongly on the degree to which CIOs and other senior healthcare IT leaders show leadership in their organizations, Edward Marx told attendees Tuesday morning at the Health IT Summit in Cleveland, sponsored by Healthcare Informatics. Marx, the CIO of the integrated Cleveland Clinic organization, is one of the best-known CIOs in U.S. healthcare, and has served as CIO or senior leader of numerous nationally known patient care organizations.

Presenting the opening keynote address—entitled “Time to Lead: Identifying and Executing Business Strategies”—at the Summit on Tuesday morning, Marx told his audience, gathered at the Cleveland Downtown Hilton hotel, that CIOs and other senior healthcare IT leaders face a constellation of challenges in the coming years, as policy-, payment-, regulatory-, business-, and technology-related changes shift the landscape of healthcare IT executive management. And he challenged his audience to rethink how they’re leading their own organizations. “Somewhere in the last 10 years, we gave up our authority, and no longer took up our leadership positions—across a huge range of titles,” Marx said. “We’re all leaders in our organizations. And somewhere along the way, we gave up our leadership position. One result is that in some organizations, the shadow IT is as large as the regular IT,” he said. “Another issue is around the rise of the title of chief digital officer, which in some organizations is now as important as the CIO.”

A key element in all of this, Marx told his audience Tuesday morning, is that CIOs and other senior healthcare IT executives in hospitals, medical groups, and health systems, need to be proactive in their leadership, not passive. “Why aren’t we at the table?” he asked. “The message is, you just have to take the lead. You can’t sit back. I’m very much into mountain climbing. And I know that sometimes, it’s easier to sit back and let someone else take the lead. But that’s not we’re called to do. And in mountain climbing, the leader of a particular expedition may be tired and need someone else to take the lead. I’ve had that happen to me, and also have taken the lead from someone else who was tired.”

Seeking opportunities around leadership is essential, Marx said. “Maybe there’s a digital void in your organization? Are you just sitting back, waiting for someone else to take the lead? When you take the lead, you have success and reach summits. And I would argue that IT is one of the top two or three most strategic assets in a patient care organization.” And he showed the audience a slide that articulated the return on investment in IT, in healthcare organizations. “This slide shows 600 percent ROI on investment in IT—and it’s more than five years old,” he noted.

Considering future scenarios

Urging his audience to consider diverse future scenarios in their operational landscapes, Marx told a bit about the story of what happened with a bridge in Choluteca, Honduras, several years ago. As the Wikipedia article on the subject notes, “The new Choluteca Bridge, also known as the Bridge of Rising Sun, was built by Hazama Ando Corporation between 1996 to 1998 and became the largest bridge constructed by a Japanese company in Latin America. In the same year that the bridge was commissioned for use, Honduras was hit by Hurricane Mitch, which caused considerable damage to the nation and its infrastructure. Many bridges were damaged (including the old bridge) while some were destroyed, but the new Choluteca Bridge survived with minor damage. While the bridge itself was in near perfect condition, the roads on either end of the bridge had completely vanished, leaving no visible trace of their prior existence. More impressively, the Choluteca River (which is several hundred feet wide) had carved itself a new channel during the massive flooding caused by the hurricane. It no longer flowed beneath the bridge, which now spanned dry ground. The bridge quickly became known as ‘The Bridge to Nowhere.’ In 2003, the bridge was reconnected to the highway.”

The key point about the story, Marx told his audience, is that, “They invested in this bridge that would connect the two parts of the country. And they hired Japanese architects to build this hurricane-tolerant bridge. And the bridge survived the next hurricane, but the river moved. So the lesson is, we have to move with the times and not be stuck in the past.”

Meanwhile, Marx asked his audience, “What does it mean to be a post-modern leader? How come IT didn’t take the lead on social media? How come you and I didn’t? So, at Texas Health, we actually led our social media efforts, and then handed that off to others. But we created a lead in the Dallas-Ft. Worth market.”

There are countless opportunities to help lead innovation forward in one’s organization, Marx noted. “Are you personally known for innovation in your organization?” he asked. “For being the digital expert? For some aspect of leadership that takes technology and applies it to healthcare? I would guess that the majority of people would say, no, I’m not known for that. But wherever you are in your organization, you can lead; you don’t have to be a CIO to lead.” Meanwhile, he said, “Here’s an area of opportunity: who’s leading artificial intelligence in your organization? Augmented reality? And are you the first place your CIO looks to when they ask, what are we doing in machine learning?”

Another element in all of this, Marx told his audience, is that “You are what you measure. The number one thing we measure” at the Cleveland Clinic organization, he said, “is quality and safety. And if there’s a never event, a serious safety event, everyone comes and reports. We find out what happened and why and what we’re going to do about it. We do the same thing in IT,” whenever a “never event” occurs. What’s more, he said, “If you report on an incident, you gain credibility.”

All of this also requires some level of humility, Marx told his audience. “At the end of the day,” he said, “none of this works if you’re not humble. At the same time,” he added, “Leaders bear the burden of visibility; you have to be seen.” In fact, he noted, “I’ve rarely had an office in the jobs I’ve been in. I was always out with my customers. That was true in both New York and Texas.” And real leadership requires creativity, and the willingness to take risks, to be a risk-taker.

And, he said, it’s important to think about a metaphor around plants. “Are you potted or planted?” he asked. “A potted plant is temporary; a planted plant is permanent, with deep roots.”