What’s Keeping Hospitals and Health System CIOs Up At Night?

In part 2 of our series that looks at the challenges healthcare faces, we wanted to share the hospital and health system perspective. Similar to part 1 where we got responses from medical practices, I sent a number of CIOs the following two questions:

  1. What are the major areas that are keeping practices up at night?
  2. What challenges are coming that practices aren’t paying enough attention to?

Here are the responses I received:

David Chou (@dchou1107) is a healthcare industry leader in the digital space. He is currently the CIO for Luye Medical Group which is the joint venture with the Cleveland Clinic on building 2 hospitals in Shanghai. Chou has held executive roles with the Cleveland Clinic, Children’s Mercy Hospital, University of Mississippi Medical Center, AHMC Healthcare, Prime Healthcare, and is also advising many academic medical centers and healthcare startups.

What are the major areas that are keeping CIOs up at night? (CIO Challenges)

In recent years, spending in the healthcare industry has been dominated by expenditures on the electronic medical records for every hospital and health system. This has led to a neglect of back-office enterprise resource planning (ERP) software, and, as a result, almost every healthcare provider organization now faces choices regarding whether to stay with current vendors and upgrade to the latest cloud product offering or evaluate the market for a new solution.

Health systems have been under-investing in information security for a decade, some even longer, but the threat landscape has now reached a critical point. Hackers are sophisticated and have access to the same cutting-edge machine learning technologies that security teams use to protect their data. Information security is about more than just avoiding data breaches; it’s a patient safety issue, and a social responsibility.

What challenges are coming that CIOs aren’t paying enough attention to? (CIO Neglect)

The lens for a CIO to lead innovation needs to widen in healthcare. Why? Organizations succeed at incremental innovation but massively struggle with turning an idea into reality. There is someone in MIT, Stanford, and other organizations working in a basement that is going to get $50 million and is working to put us out of a job. It is ok to focus on keeping the lights on, but CIOs must lead the innovation initiatives.

Sue Schade, MBA, FHIMSS, FCHIME, LCHIME (@sgschade), is a nationally recognized health IT leader and Principal at StarBridge Advisors providing consulting, coaching and interim management services.  She has served as CIO and Interim CIO at multiple healthcare organizations.

What are the major areas that are keeping CIOs up at night?

No one size fits all but I’d say the most common ones these days are cybersecurity, cost reduction, digital health strategies to more effectively reach and service patients, analytics to fully utilize all that data, and interoperability especially with all the mergers and acquisitions. Not sure the entire list is that much different than in 2018 when I wrote a blog called “What keeps you up at night – the wrong question”.  There are clearly common themes but every organization has a different focus depending on what major initiatives are already behind them, what the financial situation is in their organization, and whether they are dealing with mergers and acquisitions.

What challenges are coming that CIOs aren’t paying enough attention to?

The one I’d highlight is talent management, retention and developing the next generation of leaders. With so much focus on delivering systems and services, CIOs may lose sight of their most valuable asset – their people. It is incumbent on CIOs to continuously invest in their staff, create solid succession plans, and ensure that the culture is one that people want to work in.

Thank you to CHIME for helping us with these responses. I’ll be interested to hear more CIO perspectives on these two questions at the upcoming CHIME Fall Forum in November.

My response to this question would be slightly different from those above. For most hospitals and health systems, I think they’ve overwhelmed with two major things. First, how do they get value out of the EHR. That includes things like optimizing the EHR, doing updates, analytics, etc. They’ve all made hundred million dollar to billion dollar investments and there’s a real need for it to show it’s value as an investment. Second, is managing all the legacy software and equipment. This is overwhelming for most healthcare CIOs and is a big challenge that’s just made worse by all the mergers and acquisitions that are happening. Ensuring you have a good strategy for this is key to freeing up your time to do more innovative efforts.

What did you think of these responses?  Is there something missing from the above that you think is challenging for hospitals and health systems?  Which of these challenges do you think is hardest?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • I am the little person in all of this. I work in a lab. I work hard. I try to put the patient first. I try to put out an excellent product: test results. With the corporation pouring millions into the EMR, which I gather they need to do, the little person is being squeezed to the point of ridiculousness. I watch every purchase, every hour of over time and am denied the basics to process testing: lab contracts, basic centrifuge replacement, replacement of failing analyzers, and now the focus is the BUDGET. They watch every cent. Delays, analyzer failures, lack of supplies, provider dismay at length of lab turn around testing…doesn’t matter. I am ashamed.

  • Thanks for sharing this perspective. I think it’s something we don’t often realize. If you spend a few hundred million to billions on an EHR, then you’re probably going to start penny pinching other places.

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