Is stepping away from the CIO role the key to becoming a stronger leader? It may seem antithetical, but for Beth Lindsay-Wood, Chief Informatics and Technology Officer at Moffitt Cancer Center, the strategy proved quite effective.
“When you’ve been in a single place for a while, you don’t really have the perspective of what else is going on and what other people are doing,” she said in a recent Town Hall: Road to Flourish episode with Erica Williams, Regional Technology Officer-Texas, Ascension Health. During the interview, Lindsay-Wood reflected on her career journey, including her decision to break from the CIO post, she discussed the qualities she finds most valuable in team members.
Beth Lindsay-Wood
One of the seminal moments of her career came in 2013 when she faced a major crossroads: whether to remain in the CIO seat or pursue what she believed would be “a great opportunity” to pursue an advisory role. Ultimately, “I made the pivot to be partner at a consulting firm,” she said, which wasn’t an easy decision considering she had amassed 27 years of experience on the provider side.
However, it proved to be the right move, as she “learned more about the operations” of the organizations where she served in interim roles – including Stanford Medicine and Atlantic Health – and how tasks are prioritized. And while that particular chapter offered valuable insights into the industry, it also provided clarity in terms of her career direction.
“It was a great experience, but I missed being part of the provider side,” said Lindsay-Wood. “I wanted to be part of a team.” And so, after 7 years in consulting, she transitioned back to the hospital environment, assuming the CIO role at Moffitt Cancer Center, then spending a few years with City of Hope before returning to Moffitt in June, 2024.
Not surprisingly, she has been able to draw upon the knowledge gained from working in an advisory capacity, especially when it comes to prioritization. “Being a partner is important to me, as well as working with the board or senior leadership to move the needle from within,” she recalled. “That can be hard to do, but once you’ve seen it a few times in different organizations, you can get some ideas on how to approach the problems we all have.”
At Moffitt, where she has oversight of clinical informatics, IT, digital operations, and cybersecurity, her team is approaching those common problems through a series of initiatives. One of those is CancerX, a digital ventures arm that identifies technologies that can improve patient and provider experiences and incorporates them into the workflow.
Moffitt is also rolling out an integrated ERP system and launching a new strategic plan that will leverage transformative technologies such as GenAI to boost clinical outcomes. “We’re looking at how we tie all of that together using AI,” she said. “We’re on a path to do a lot of exciting things.”
For Lindsay-Wood, that “path” hasn’t always been an easy one, and getting there has meant being willing to take risks and embrace career gaps. “I’ve had setbacks just like everyone else,” she said. “Sometimes you’re going to part ways with an organization because it’s not working.”
When that happens, it’s important to use those gaps “as a time to reflect on what you really want to do,” she added. The next step? “Get back on your feet and start to look at different opportunities. Look around and think about what makes you passionate.” Of course, some situations are more difficult to navigate than others. But no matter the circumstance, it’s critical to “dust yourself off and keep moving forward,” she said. “You need some internal and intestinal fortitude to do that. Remember, the end is usually a better place than where you came from. It’s a great experience to move into a new role where you feel valued and can make a strong contribution.”
The challenge for many, she noted, isn’t in identifying the next career step, but rather, positioning themselves to take it. This is where career coaching can play an enormous role. “We’re all in the business of sales in one form or another. We have to do that for ourselves too,” LIndsay-Wood stated. “You need to make sure you have a brand” and that “people see the best of you.”
By investing in coaching, individuals can learn about opportunities that are available and position themselves as viable candidates, she said, noting that networking and staying engaged are also critically important, especially in the current landscape. “It’s a little bit of marketing, and that can be hard, but having that confidence in yourself is critical.”
Finally, she encouraged both leaders and staff to be open to feedback – even if it isn’t positive. “Those conversations can be hard, but we all have things we need to work on,” Lindsay-Wood added. “There’s no golden ticket. It’s hard work, but your career has to be a priority.”
With most IT initiatives, “it can be very tough to put a business case together.” Determining whether it’s going to save on labor and increase revenue, in fact, “is extremely difficult 80 percent of the time,” according to Chad Brisendine, VP and CIO at St. Luke's University Health Network.
But there is an exception: enterprise imaging, which, compared to other projects, is a downright “easy” sell because of the revenue directly associated with it. During a Keynote Interview with Bill Russell, Brisendine discussed his team’s plans for an integrated platform, which he believes will help boost efficiency and patient satisfaction by freeing up more appointments.
Chad Brisendine
“Access is one of the key things we’re working on,” he noted. “It’s a capacity and a constraint issue,” and one that will become increasingly important for organizations like St. Luke’s that have experienced significant growth.
Since his arrival in 2009, the Bethlehem, Pa.-based system has grown from 4 to 13 hospitals, and continues to expand “vertically” within those facilities. Being able to serve more patients, many of whom are baby boomers, has meant expanding virtual capabilities as well, which his team is doing through tele-sitting, physician consults, and other means.
In the interview, Brisendine discussed his strategy for supporting growth without compromising service, how this will likely translate into the hospital of the future, and how to find the right place on the adoption curve.
Before diving into any initiative, whether it’s enterprise imaging or self-scheduling, leaders have to know just how deep they want to go. “It’s knowing when to get in, when not to get in, and how much to innovate,” he said, admitting that he often “struggles” to make the right call. What he has found, not surprisingly, is that “a lot of what we learn isn’t about technology, but operations – how do we actually get this thing implemented and make it work in an environment? How do we get people to champion it, drive change and actually use the technology?”
The adoption piece, he said, can’t be understated. “The strategy can look great on paper, but the execution won’t happen if engagement is low, and no one wants to drive a solution if they don’t see value.”
This is where CIOs can have an enormous impact by not just understanding the problem that exists and the solution that could potentially solve it, but also whether that tool is the right fit. According to Brisendine, the most effective way to do that is by getting in front of users. By doing so, “you get to see a lot in terms of how things work,” he said, from design to execution. “You’re then able to take those learnings and bring them into those structures.”
Rounding, he believes, offers a unique window into how technology is – or is not – being utilized. By observing cardiovascular procedures and speaking with surgeons and other providers, he has developed a “really good understanding of the challenges.”
One of the challenges facing his own team is envisioning what the “hospital room of the future” looks like, and how to best prepare for it. To that end, they’re looking at which “high-level capabilities” are needed, such as AI voice recognition, to enable virtual observation and physician consults.
And it’s always flashy; rather, sometimes the focus is on details surrounding sound and video quality. “All of those things matter when we're trying to get adoption and engagement by our providers,” he said. And while they have seen high levels of usage so far, Brisendine’s team knows full well that emerging technologies are a moving target.
“It’s a lot of strategic thinking and a lot of conversations and dialogue,” he said. It’s also allowing for modifications and realizing that AI could look very different a few years down the road. For CIOs, it’s looking at the curve and determining where your organization should be.
According to Brisendine, it all comes back to the business. “What we see is the momentum behind it and the business need,” he said. “That tends to determine whether we want to jump out early and have a strategy that's a little bit more agile,” realizing that there are risks involved, and that it could entail multiple reiterations.
No matter what, it’s making sure teams are aligned and are moving toward a shared goal.
“There’s a lot of stuff coming down the pike, especially with AI,” he concluded. “There are some huge opportunities, and we need to make sure that we’re out in front of it.”
One of the worst things that can happen, according to Matt Christensen, is for a firehouse to burn down. And yet, that very scenario can unfold if the right steps aren’t taken, he said. During a conversation with Drex DeFord, he cited a structure fire that resulted in millions of dollars’ worth of damage because there wasn’t an effective alarm system in place.
It’s the same behavior that can put health systems in danger when it comes in investing in cybersecurity measures, noted Christensen, who serves as Senior Director of Cybersecurity at Intermountain Health.
Matt Christensen
“In cybersecurity, we can’t let the firehouse burn down. It has to be programmatically sound,” he said. “There are non-negotiables that you have to build into a program. Otherwise, you’re going to have incidents.”
That “sound” strategy requires several elements; and while data protection tools are critical, they’re just part of the picture, said Christensen. In an Unhack the Podcast interview, he broke down the most important components of a successful cybersecurity strategy.
Systemic risk
First and foremost, the focus needs to be on systemic risk, rather than individual vulnerabilities or vendors, particularly given the increasing reliance on third parties – and the dangers that poses to data security.
“Our world was broken open last February,” he said of the Change Healthcare breach that rocked the industry. “We all saw the downstream effect.”
It’s precisely why organizations like the HSCC Cybersecurity Working Group (in which he participates, along with Intermountain CISO Erik Decker) are “honing in on the ecosystem” of care delivery, rather than trying to protect one vendor.
It represents a major shift in thinking, Christensen said. “It’s going to upend the way organizations, specifically in healthcare, approach risk management.”
Revamped training
Another change that’s needed? More emphasis on the human element of cybersecurity, which he believes is often overlooked. “It blows my mind that asset number one – which is you and me – doesn’t get the level of attention commensurate with the risk.”
Despite the fact that 90 percent of breaches “start with breaking a human,” most frameworks prioritize inventories of systems and applications, he said. “The bad guys know this – that’s why they’re successful.”
Cybersecurity leaders, however, have an opportunity to gain some ground in the battle by improving their training tactics, said Christensen. One way is by eliminating repetitive content – which may prompt users to gloss over crucial information. “We’ve seen it so many times,” he said, particularly those required to do quarterly training. “It becomes, ‘how quickly can I click through this without getting in trouble?’”
Behavior over metrics
Another way is to simplify the content. For example, “the average employee probably doesn’t even understand the term ‘social engineering.’ And so, if you blast your content filled with these technical terms, it’s going to go right over them,” he said. On the other hand, “if you can break it down into, ‘this is how a helpdesk call can go wrong and how it can impact the service that you provide,’ then you’ve got their attention.”
It’s also important to ensure training is having the desired effect. Doing so, however, doesn’t have to involve metrics, according to Christensen, who prefers to measure changes in behavior. “I want to see what good behaviors people are doing more – or should be doing more, and what bad behaviors they’re doing less. That, to me, is a far more effective way of actually measuring progress.”
Speak the language
Of course, all of this requires an investment, which means cybersecurity leaders need to feel comfortable communicating with senior executives – something that may not come naturally to everyone. Christensen’s advice? Don’t rely on data; make it relevant and relatable.
“The easiest way to garner the support from a board member is to speak their language,” he said, encouraging leaders to start by identifying a system that’s core to the business, then running through scenarios if it were to go down for a prolonged period of time. “How are you going to run the business? What does it mean if we have to completely rebuild? How do you continue to deliver care, versus having to divert?”
The ability to speak at that level – not just theoretically, but about how to execute plans in a way that doesn’t impact patient care – has become a critical piece in keeping data safe.
And keeping the firehouse from burning down.
Before any potential vendor can partner with St. Jude Children’s Research Hospital, Keith Perry has one requirement: a road trip. Perry, who has served in the CIO role for nearly 10 years, wants vendors to tour the Memphis, Tenn.-based organization and learn about the mission before any negotiations start.
Keith Perry
“I want them to understand what we're trying to do and what we're trying to accomplish, and I want them to see it firsthand. I want them to walk the hallways and see the kids and see the families,” he said. “Put yourself in their shoes. Then, we can talk about technology and the problem we’re trying to solve.” Any partner, Perry emphasized, needs to “advocate internally within their teams on our behalf and come forward with ideas that help us.”
Everything centers around the mission of eradicating catastrophic pediatric diseases through both top-notch patient care and a strong focus on research, according to Perry. During a Keynote interview, he spoke about how his team is working to leverage AI and other tools to create “the pediatric exam room of the future” without adding to the complexity and tech debt that can hinder progress. Perry also offered professional development advice for current and future leaders.
Envisioning the future
When it comes to AI and other advanced technologies, there’s no doubt about the potential they have to transform care. The challenge comes in determining the best path forward, noted Perry, adding that “future-proofing” technology that’s already in place isn’t going to cut it. “We’ve spent an inordinate amount of time envisioning what that exam room of the future is going to look like.”
One of components, he believes, is ambient listening, which some organizations are already leveraging to improve care coordination and delivery. “We’ve done models looking at how that flows today, but we know that's going to be evolving as we introduce different types of tests and what they mean. It’s been a really fun endeavor thinking through what tomorrow looks like.”
Keeping families together
For some use cases, that ‘tomorrow’ isn’t too far away, said Perry, whose team is looking at innovative technologies that can improve processes such as pre-surgical blood collection. Although St. Jude’s is able to cover the costs of care for patients, along with transportation, housing, and meals, reducing the burden on families, the organization isn’t stopping there. And so, rather than having patients and their families leave the hotel or housing facility and travel across campus to draw blood on the morning of an appointment or procedure, they’re looking to “push that challenge to housing,” he stated. While there are “technical challenges associated with that, it has been an exciting opportunity to rethink and reimagine how we can improve the delivery of care to our patients.”
Tech debt
This type of innovation, however, has to be approached deliberately, according to Perry, who cautioned against the “downstream complexity” that comes with any technology initiative, from protecting data and digital assets to ensuring applications are operationalized to support clinicians. “It’s part of the transition and evolution of an IT organization,” he noted. “Once you’re able to put something in place that reduces the complexity of the technical stack and the technical debt that you have, it allows your team to think differently.”
The GenAI piece
Another area that requires new thinking is GenerativeAI, which has “exploded in terms of allowing us to rethink how we can use this new tool in a thoughtful manner that helps advance our mission,” said Perry, noting that the transformation has been “fun to watch.” Like many organizations, especially in the pediatric space, St. Jude is monitoring several use cases for GenAI across administrative, clinical, and research areas, and has established governance to determine how to utilize it in various settings.
And as CIO, it’s critical that Perry can serve in an advisory capacity. “That’s part of my role to help the organization look through the window of technology and see the possibilities, but also understand there are other windows and considerations,” including risk mitigation. “It’s working through that and helping the organization to see the opportunity that’s in front of us.”
The reluctant CIO
Perry speaks from experience, as the ability to see opportunities has proven pivotal in his career. Interestingly, his initial interest in technology was rooted in being able to avoid “talking to people,” but pursuing an MBA in Business Administration helped open his eyes to a possibility he hadn’t considered: healthcare.
Shortly into his tenure with HCA, Perry had fallen in love with healthcare – specifically, “the opportunity to be somebody who is focused on technology and how we can give back and help the healthcare industry save lives,” he said. Landing a role with MD Anderson Cancer Center, where he served for 13 years, further cemented his desire to conquer cancer and “make it my life’s work to serve that segment of catastrophic disease,” one that robbed him of the chance to get to know his grandparents.
Serving the mission
Being recruited to join St. Jude’s as CIO was the icing on the cake for Perry, who was impressed by the dedication to service. “That's something that you pick up on quickly when you come to campus and you'll see us go out of our way for a patient and their family,” he noted. For example, when food trucks arrive on campus, it’s quite common for staff to encourage patients and families to “cut” the line. “They’re time is more valuable – that permeates the culture here.”
As CIO, one of his key priorities is to ensure that spirit is reflected in the IT strategy. “We want to make sure our technology is serving the mission” by providing the tools and support needed to provide quality care. Doing so, however, doesn’t mean saying yes to everything, which can be detrimental. Instead, the goal is to “make sure you're doing the right thing for St Jude’s – not just today but a year from now, five years from now, ten years from now,” he said. “It goes back to our core values, which is to work collaboratively to make others successful.”
Career advice
It’s a philosophy that has guided him well throughout his career. Of course, it didn’t develop overnight, according to Perry, who offered words of advice for those who aspire to leadership roles.
The first is to seek higher education. “One thing I tell people who are strong technologists is to branch out into the business,” he noted. By obtaining an MBA, for example, leaders can “make yourself valuable in the room when they're talking about the business.” Another smart move is to expand clinical knowledge, which can help individuals add value to conversations with physician and nursing leaders.
Finally, he emphasized the importance of gaining diverse perspectives. “Don’t be afraid to move around,” said Perry, whose previous experiences include managing networks, data centers, telecom and client servers. “I’ve done basically every job in IT and healthcare,” he added. “That prepares you for conversations with your peers and leaders because you know what systems they need, and you know the challenges they're trying to work through. That just further prepares you for growth and your career journey.”
One of the biggest misconceptions around cybersecurity leadership is that it’s all about breaches. Although the goal is indeed “to reduce the likelihood of a breach as much as we can,” according to Duc Lai, CISO and VP of the University of Maryland Medical System, that’s only a piece of the puzzle. “We also need to think about resiliency – how quickly can we detect, respond, and recover from a cyberattack?”
The biggest piece, he has found, is around risk; more specifically, the ability to accurately communicate it to the board and senior leadership and secure the funding needed to ensure healthcare organizations are constantly improving their cybersecurity posture.
Duc Lai
“In our industry, it doesn’t take long before the status quo becomes obsolete and outdated,” noted Lai. “What we’re doing may be good enough today, but how can we continue to make it better? What else should we be doing?” The ultimate objective is build enough resiliency to be able to minimize the impact of a cyber event and facilitate a quick recovery. “That’s the mindset and the challenge we have.”
During a recent Keynote, he discussed the most critical challenges facing cybersecurity leaders – including the human element, and how the valuable lessons he learned both in the military and his early career helped shape his philosophy.
One of the many hats security leaders need to wear is that of evangelist, according to Lai, particularly around cost. “I like to say that security is a tax that we all have to pay and we all have to contribute to for the greater good,” he said. Providers, however, often already feel taxed with everything on their plates, whether it’s entering notes or looking up patient records. The last thing they want is to deal with security measures. “We need to think about how we as security practitioners can accommodate for that workflow with compensating controls.”
Much of that, he has learned, comes down to a simple, yet critical concept: keeping an open mind.
“You have to understand what your providers, your users, your employees, and your team members are trying to accomplish,” he said. “You have to work with them to be and be flexible and agile in your security controls. That’s going to help you find the balance.”
But it doesn’t come easy. Maintaining that balance is a constant effort that requires a great deal of creativity, according to Lai, who cited a recent example in which employees (especially those working long shifts) requested access to personal webmail. Although they had reservations, Lai’s team worked to find a solution that enabled employees to communicate with family members in a secure manner.
“To me, that was rewarding because we were able to reduce our attack surface while still allowing them to stay in touch with their families,” which in turn can lead to higher satisfaction and productivity.
It’s a compelling example in and of itself, but it’s also part of a larger philosophy that has guided Lai throughout his career – and was put to the test early on. After serving in the U.S. Army (as a West Point graduate) and studying engineering, he took on a role architecting a security program for a financial institution. His agenda, however, quickly shifted when the company was hit with a security attack during his first week.
“I was thrown right into the fire,” said Lai, who immediately locked down the firewalls and installed more advanced antivirus software. Despite the rocky start he remained with the organization for 13 years; at that point, “the security program had matured to the point where we had all of the proper controls in place,” he recalled. “I felt that what I was leaving behind was impactful and would endure. For me, that was a defining moment in my career.”
Like many leaders with military experience, Lai was drawn to healthcare’s mission of serving the community and being part of “something that’s bigger than yourself.” And as he has progressed in his career, it has become increasingly critical to ensure he’s making a positive impact.
“When I think about my legacy, am I leaving behind a security program that can endure and live beyond my tenure?” Viewing it through that lens, he added, can provide leaders with a valuable perspective.
“It changes the way you look at decisions that you have to make, because then you look at the long game and focus less on the immediate fire that you're trying to fight, which we all do every day,” he continued. On the other hand, by focusing their energy on implementing initiatives, improving processes, or strengthening partnerships, leaders can enact changes that can lead to a more secure environment. And that, in turn, can improve providers’ ability to care for patients, which is “the ultimate mission in healthcare.”
For an aspiring leader, an unfavorable evaluation can be devastating – especially when it isn’t expected, or even warranted.
But, with the right attitude, it can also be a game-changer.
Chani Cordero
That was the case for Chani Cordero, CIO at Brooke Army Medical Center and a Colonel in the U.S. Army. During the inaugural episode of Town Hall: Road to Flourish, she spoke with Erica Williams (Regional Technology Officer - Texas at Ascension) about her sometimes bumpy career path, and how she was able to turn a difficult situation into a growth opportunity.
Long before she landed at Brooke Army, a 425-bed medical center that boasts the Department of Defense’s only Level 1 Trauma Center, she experienced her share of challenges. One of those was a supervisor with whom she “didn’t gel very well, and ended up issuing a less-than-stellar performance review. “I thought it was a career ender,” recalled Cordero, who had enlisted in the Army after high school, eventually earning an ROTC scholarship and a degree in chemistry from St. Mary’s University.
What that education didn’t provide, however, was the knowledge needed to navigate this particular situation.
“I didn’t know how to approach it,” she said. “I would get an anxiety attack that hit me in the pit of my stomach.” When she did finally receive an explanation, it left her even more baffled. “There was no good reasoning or rationale other than, ‘I don’t like you.’”
Cordero’s mistake, she admitted, was letting the resentment fester – and, as a result, prevent her from moving on. “When you’re in it, it’s hard to see past it and it’s hard not to take it personally.”
Fortunately, she was able to look past it and seek professional development opportunities, one of which was a speaking engagement with CHIME. And despite it being her first stab at public speaking – and her fear that it didn’t go well – it was a success. The audience found her delivery to be both “relatable” and “real,” and it led to more invitations.
The key, according to Williams, was in Cordero’s ability to view a stumbling block as a stepping stone. “We have these red lights in our lives and careers that are really pivotal moments,” she noted. And although they can be difficult at the time, those experiences help people to “head down a different path that takes you where you wanted to go and where you needed to go.”
The other critical lesson she learned? Seek guidance. Rather than let her entire career become derailed as a result of the negative evaluation, Cordero approached one of her superiors and asked, “how can I earn opportunities or demonstrate that I am very capable of getting selected to the next rank?” The key, she noted, was being “very open and candid,” and of course, being willing to go the extra mile. “Some of it wasn’t fun, but those opportunities allowed me to do very well in that position.”
And, like a true leader, she has made it a priority to pass along that knowledge and experience to the next generation by creating a group focused on coaching and developing women in IT. “We meet once a quarter and talk about anything from time management to career building, resumes, and even the importance of credit and investment opportunities,” she said.
No matter the format, what’s critical is ensuring that mentorship is available at every step along the way, because the need for guidance doesn’t stop at the top. “At the C-suite level, there’s a different type of culture and environment that you have to navigate,” Cordero noted. “And at every point of your career, it changes. What made you successful in the beginning part or the middle part of your career will not necessarily make you successful or sustain success at the senior level. And so, having someone that you can bounce ideas with and also help you navigate is very important.”
For healthcare organizations, transitioning to the cloud is no longer a pipe dream; it’s a core strategic objective. “This is where the future is going,” said Andrew Rosenberg, MD.
And that means not only “building out a robust, wide-area network with a lot of redundancy,” as Michigan Medicine has been doing, but also fostering transparency with vendor partners. “The level of comfort with communicating uncertainty has to mature even more,” he noted. During a recent Keynote, Rosenberg – who has served in the role since 2016 – broke down his cloud strategy, shared key lessons learned, and discussed how the current M&A environment can influence decision-making.
Rosenberg speaks from experience, as Michigan Medicine merged with Sparrow Health in 2023, further adding to the health system’s scope, and putting him on course with a large percentage of healthcare leaders.
Andrew Rosenberg, MD
“The contemporary healthcare CIO was defined mostly by the EHR implementations from the 2010s to about 2018,” he recalled. “Then we had Covid and the disruptions that came with it. Now, with consolidations, you’re seeing a lot of new Epic implementations as consolidated health systems are trying to rationalize their EHRs or they’re integrating along strategic applications, platforms, and infrastructures.”
Michigan Medicine, of course, is no exception. “We’re deeply into that work right now,” he said.
One of the challenges for CIOs in his shoes is in reaching consensus among the different entities, and striking the difficult balance of empowering local practices while also cementing their place as part of a larger organization.
Achieving that, he noted, requires more than just technical knowledge. “Technology, and especially IT within technology, is only a component of how the business needs to shift the way it works,” Rosenberg said. The person leading that needs to understand how tools like ambient listening can help relieve the administrative burden. They need to understand the nuances of a nursing flowsheet, and the difference between physician notes written in the OR versus the clinic.
In short, leaders must understand the business and where opportunities exist that can help improve efficiency and increase satisfaction. “They have to understand where they work has to change.”
One change his team is eager to make? Getting out of the data center business, which includes several steps: develop a redundant architecture (in partnership with AT&T) and working with Digital Realty on data center services and co-location. And although they have landing zones with AWS and GCP, Microsoft Azure is the strategic partner that will help drive the migration.
And that’s just part of it.
“We have identity issues to work through. We have security, we have software-defined networking issues, all of which are new to us, and we have upskilling of our talent,” Rosenberg said. Because there are so many pieces, his team is moving at a deliberate pace, one that he feels they can continue. “It’s not cloud-first. It’s a contemporary, strategic enterprise platform. Our challenge is to figure out what we need to do, and do it as efficiently as we can.”
What that requires is more focus on tactics than strategy, according to Rosenberg, who shared some of Michigan’s wins. The first entailed an “unusually detailed service design document,” which they developed with Deloitte and NetApp to support the level of granularity needed by hyperscalers to provide actionable data.
Not an easy road, but one he believes is worth taking.
“The amount of effort we put in to get those levels of detail actually slowed down our process by probably a year, but I suspect that level of pre-work will pay off,” he said. “The level and details of our service design document should leapfrog us by at least a year,” while also providing a model for other organizations – at least, those who are Epic customers.
Another critical piece of the puzzle is cultivating more transparent relationships with partners, according to Rosenberg, who, like most (if not all leaders), craves the brand of honesty he has seen from Epic in recent years. “They’ve been showing us where they are, where they know they'll be in a year, and what they're thinking about, with no expectation that what they're thinking about will happen on time.” That, he believes, is “an example of a co-maturation,” as well as a step in the right direction. “I believe that as we go more and most hosted, the hyperscalers are going to have to mature to a level of discomfort to say, ‘here’s our best estimate. We’re not going to be held to it, but we’ll give our best effort.’”
Finally, he advised CIOs and other leaders not to focus solely on the finances of cloud migration.
“I didn’t lead with, ‘We want to save money, so we’re going to the cloud,’” he cautioned. “That's absolutely wrong, because if we don’t do it right, we could easily spend more money.”
The true driver, Rosenberg added, should be business continuity, particularly given the alarming number of cyberattacks and outages in the past few years – some of which have proven extremely costly. Even if ransomware victims are back up after 6-8 weeks, they’ll still feel the effects of the attack for months, he noted.
This is where having solid partnerships can make a significant difference. “We’re going to have outages. What it comes down to is how fast they correct it versus how fast we would. That’s going to be really important.” For leaders, that means doing due diligence around not just the strategic vendors, but also the redundant and WAN architectures that can provide a significant upgrade from on-prem solutions – if organizations are willing to invest dollars and sweat equity.
“I was skeptical about the cost of cloud,” he said. “Now, I’m much more reassured that it’s probably going to be neutral at worst, and I think we have opportunities to distinctly show where we can add savings.”
Appearances can be deceiving.
At first glance, healthcare appeared to be relatively stable in 2024, as operating margins showed sustained improvement and the major ratings agencies issued neutral outlooks for not-for-profit hospitals and health systems in 2025. But a deeper dive showed a different story.
According to a Kaufmann Hall report, the percentage of transactions involving a financially distressed party hit a record high in 2024. What’s more, 45 of the 72 transactions (62.5%) involved a divestiture, marking a significant spike from the previous year.
One of those organizations is Steward Health Care, which filed for bankruptcy in May and announced plans to sell off the 30 hospitals it operates nationwide. It’s not an experience any leader wants to go through; but in today’s world, it’s becoming more common.
David Colarusso
“Unfortunately, we’re not the first or the last hospital system that’s going to go through this process,” said David Colarusso, who spent nearly 12 years with Steward, including five years as CIO. During a Town Hall interview, Colarusso – who has since started a new role as CIO at HSA – spoke with Sarah Richardson about the challenges of leading through difficult times, why such a large portion of the team stayed throughout the transition, and the worst thing a CIO can do.
Like many organizations with a high mix of Medicare and Medicaid patients, Steward was hit hard by the Covid-19 pandemic – as costs for labor and supply chain increased, reimbursement rates sank lower. “It became impossible to not run the hospitals at a breakeven,” he recalled. “We tried really hard over that time to find a way to overcome the challenges in front of us, and it was very difficult. We didn’t want to get on the road that we’ve gone down.”
However, as was the case with Community Health Systems, Ascension, and others, it was determined that divesting was the best path forward. And so, Colarusso and his team switched gears and turned their focus on care continuity, working with courts and state government agencies to find new operators for the hospitals.
“At the end of the day, we’re generally in healthcare IT because we want to feel like we have an impact on our patients,” he said. “And so, it’s difficult to transition from giving doctors the tools they need to care for our patients or giving our patients the tools they need to care for themselves, to finding a way to safely transition their care and their records to a new operator.”
It was a switch that needed to happen – not just to enable continuous care, but also to prevent disruptions in workflow. But despite the shift in priorities, his team never wavered in their pursuit of these goals.
“It speaks volumes about the staff that they still worked hard to ensure that patients and providers had access to their records,” said Colarusso. “Each one of them had to look at themselves and determine what's important to them and why they should stay.” What he found was a common thread of ‘if not us, then who,’ which further demonstrated the character of his team. “It’s important to put yourself in the place of the provider, in the place of the nurse, the place of the patient, and say, if the IT group abandoned us, what would happen? The reality is that the hospitals would shut down.”
The majority of the staff, he recalled, stayed on through the transitions because “they understood that they have a direct impact on the patient and on the provider at the frontlines,” he noted. “If they walk away, that’s just one more nail coming out of the door that’s holding everything together.”
The question, of course, is how leaders can build and maintain teams that embody those qualities. It starts by cultivating an environment that fosters innovation and encourages individuals to take initiative, while keeping the overall goals in mind.
A prime example came during Covid, when the lockdown threatened to derail Steward’s ambitious strategy to roll out Meditech Expanse across all acquired hospitals.
With timelines tight, the staff pushed for a remote go-live, at which Colarusso initially balked. “I’m very old school in a lot of ways,” he admitted. “I believe in face time. I believe you should be on the floors, working hand-in-hand with nurses, doctors, lab techs, pharmacists – that presence means a lot.”
But so did staying on schedule, which was made possible by leveraging virtual communication platforms – and being willing to bend.
The result? “We brought them from the start of the project to live in nine and a half months for 17 hospitals, in the middle of a pandemic,” Colarusso said. “It forced us to do things in ways we never expected. It forced me, actually, to come out of my comfort zone.”
And in fact, the team received better feedback than they had in the past, “because we had a larger group of people that could provide support,” and help was available instantaneously. “With a traditional go-live, if they couldn't find a person on the floor, they had to call the helpdesk or get back to the command center and find someone.”
What was most notable, however, was the fact that the idea came from the team. “That’s probably one of the things I'm most proud of,” he said. “They felt comfortable pushing it with me and telling me I was wrong. I’ve never been so happy to be proven wrong.”
That willingness to listen and consider different perspectives isn’t just important for leaders – it’s imperative, and will only increase as the CIO role continues to evolve. “IT is such a vast field of knowledge requirements that you can’t know everything,” Colarusso said. “My cybersecurity guys know way more than me. My network guys know way more than me. My storage and server guys know way more than me. The minute I think I know better than them is when I’m going to fail.”
Another critical aspect of the role? Being able to communicate the criticality of cybersecurity, network and server continuity to the executive suite. “That’s a skillset,” he noted, along with keeping those teams moving in the same direction “so that we can get some of the things we want to do accomplished.”
Finally, it’s imperative for leaders to check in on teams regularly and ensure they’re feeling challenged in their roles. “If they’re feeling stale, or that they’re just coming in every day and keeping the motors running, they're going to move on to something else,” he advised. “They want to be doing something cutting edge. They want to move the organization into a better direction. And if you’re not constantly feeding that desire, you’re going to lose that staff.”
On the other hand, leaders who are able to “keep that innovative spirit alive” will be able to keep good people, even during difficult times.
As health system leaders dive into a new calendar year – and a new list of priorities – one item that should be at the forefront is data, according to Myra Davis, EVP and Chief Information and Innovation Officer at Texas Children’s.
“Data is becoming the new asset,” she said, particularly for organizations the size and scope of Texas Children’s which have amassed terabytes of information. “We have a big opportunity and somewhat an obligation to leverage this pot of gold that we have and make something meaningful of it.” And with droves of digital natives entering the workforce, it is becoming increasingly important to provide a seamless experience.
During a recent Keynote, Davis shared insights on how her team is leveraging AI and advanced analytics to enhance user experience and improve outcomes, the approach she is leveraging to triage innovation, and her unique role as Chief Information and Innovation Officer.
Myra Davis
For Davis’ team, the driving force behind every initiative is to “get smarter, faster” by harnessing data more effectively. “We’ve continued to move the dial in areas like leveraging data, performing advanced analytics, and bringing in our own internal instance of large language models so we can do more there and really be disruptive,” she noted. The objective? To gain meaningful insights, in partnership with the organization, to the “insurmountable amount of data we have” and use it to “help our organization get smarter faster.”
To that end, a key area of focus is the enterprise data warehouse, which holds data from 70 distinct source systems, making the search process quite onerous.“Imagine being able to sift through key data in those databases to bring to light patterns of learning that the models have identified and share that information with leaders across the system,” she said.
Doing so requires a solid focus on AI governance. At Texas Children’s, a group was established that’s co-led by data and analytics executives, and incorporates input from compliance, finance, and clinical in addition to IT. Having that presence, according to Davis, helps guard against both hallucinations and unintentional bias as they look to provide actionable insights.
“There will be no limits in terms of where we can go and how we can help pockets of the organization get smarter faster, or how we can create efficiencies for a clinician who’s performing wash-rinse-repeat processes and make that better.”
That’s also where innovation comes into play – but only if it’s approached thoughtfully. In fact, when it was added to her title in 2019, Davis embarked on a listening tour to gauge the organization’s understanding as to what successful innovation entails.
What she learned is that it needed to be a true group effort. “We have a lot of smart people in this organization, and so we want to make sure it’s a unique idea that we should explore,” she noted. To that end, they developed a hub and spoke model whereby ideas are presented to the innovation team and put through some rigor, starting with: “Is it really a problem? And has that problem already been solved? We want to make sure it’s an idea we should actually explore.”
If it meets that criteria, an idea then progresses to the discovery, design, and development methodology.
That collaboration, Davis added, is critical. “It’s really important to make sure the IS team sees themselves as a part of the innovation. You do not want an ‘us against them’ mentality, or ‘they get to do all the cool things and we get to take care of everything,’” she said. “The innovation team works hand in hand with the rest of the IS team.”
The challenge is that there’s no shortage of “cool things” that teams want to push forward. This is where governance can play a significant role. “Having strategic imperatives affords us an opportunity to hone in on the right projects in partnership with leaders across the system, as well as the physician community,” she noted. “Articulating your problem statement, identifying whether we can leverage technology we already have, and documenting the output measures allows us a scorecard to say, is this the right initiative we should focus on? Clearly, we want to focus on initiatives that drive great performance, enhance the experience, and also improve the bottom line.”
And despite the fact that Davis has ‘two I’s’ in her title, the onus doesn’t fall solely on her or her teams. “At the end of the day, innovation is everybody’s responsibility.”
“We know what we’re after. It’s not the implementation of a tool; it’s the pursuit of value.”
For Mark Zirkelbach, the mission has always been the same, starting with his first foray in healthcare and continuing to his present post as CIO at Loma Linda University Medical Center. Focusing on value has served him and his teams well, and he believes it will become increasingly important going forward.
Leaders, he said during a recent Keynote with Sarah Richardson, have an opportunity to “transform the way things have been done” and “leverage digital capabilities much more readily than we have in the past.”
Mark Zirkelbach
And while technology certainly plays a critical role, it isn’t just about swapping out one tool for another. Rather, true transformation starts by asking a few simple questions: “what value are we after that we’re not getting today? What’s going on that needs to be different?” he said. “That’s a very different conversation than ‘I need this system’ or ‘I want this system.’”
At Loma Linda, the conversation started about two years ago when the leadership and operations teams developed “a new way of working” that didn’t rely on “keeping up with what the business wanted to do,” Zirkelbach recalled. “We needed to provide value at the speed of market. And so, we simplified our governance,” and began working closely with operations to determine which tasks are most important and how much value needs to be generated.
A critical aspect of that strategy is agility, he said, noting that Loma Linda has moved away from the traditional cycle of product selection, go-live, post-go-live, and stabilization. “It’s probably not a good way to do things because we’re reacting to the market and not focusing on whether it was a good implementation.”
And in some cases, a project that started out strong may lose steam or prove unsustainable overtime, which is why it’s critical to adopt an agile mindset and be willing to take action “if a solution isn’t providing the value we need.”
The challenge – particularly for those who, unlike Zirkelbach, lack experience in consulting – is in determining how to quantify the value of a solution or initiative. His recommendation? Create two separate buckets for direct and indirect savings. The former can be measured by dollar savings, including reductions in resource or labor costs, while the latter is a bit trickier to calculate. “It’s not necessarily about reducing total time, it’s about simplifying the work,” he said, which can be shown through intangible measures like eliminating steps.
Again, it comes down to value. “That, to me, is the sweet spot for automation – having those nuanced conversations to know this is going to make a difference,” he noted.
As part of that philosophy, Zirkelbach believes automation shouldn’t just be about reducing. “It should be more about, can we make it easier to do the right thing or get the right outcome?” he remarked. “If you only focused on automating manual steps, you might be missing an opportunity to be more holistic and understand the situation and what really matters.”
Another important aspect is proactively identifying value, which his team does in collaboration with the business, to stay ahead of the curve. “Submitting a request to IS is probably too late to be market competitive,” Zirkelbach noted. On the other hand, “if conversations are occurring in real-time, where we’re piloting some technology or process to see if we can make a difference on this proactive pursuit of value and move at the speed of market, that's big.”
To that end, Loma Linda has put structures in place to monitor market trends. They’re also “trying to understand what’s going on, networking more, and spending time looking at what our core vendors are doing with their development roadmaps and starting to map it to our value proposition.” Doing so helps them to remain proactive, while also ensuring alignment with their vendors.
It’s just as crucial, however, to make sure internal roadmaps are in sync, he said, noting that all roadmaps are developed “collaboratively,” with input from both the service line and IS. Together, the organization is able to “organize around getting the roadmap done” and focusing on the things that “bring the most value.”
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