Recruiting IT Executive Positions


How has recruiting for IT executive positions in the healthcare industry changed in the last 5 years? Please provide some thoughts and observations.

Answers from Melinda Costin

There has been a dramatic change in recruiting for IT executive positions in healthcare in the last 5 years. There were the days, even as recently as 5 years ago, when the CIO was considered the "technical expert" for the organization.

Traditional Role of the CIO

This position was the one other leaders in the organization expected to understand the current technologies--hardware, software, storage, interfaces, connectivity, redundancy—and to predict the next technologies to be considered and implemented as appropriate. In addition, this role was responsible for leading their direct reports, understanding their technical, organizational, and even clinical knowledge, and their ability to perform their responsibilities in a way that kept the healthcare organization running smoothly, from an IT perspective. The CIO was also the master at setting IT policies, negotiating contracts, creating an Information Management infrastructure, and representing IT at the executive level.

Technology to Services

Well, all of this is still true today, but with a great deal of additional responsibility. With the advent the Electronic Health Record, ARRA Meaningful Use, and the emergence of technology as one of the major competitive arms of the healthcare organization, the role of the CIO, and other IT executives, is greatly expanded. Note that even the department name is more often referred to as IS (Information Services) rather than IT (Information Technology) as the understanding of the role of technology in the organization is much more aligned with the overall services that can be provided to meet the goals of the healthcare organization, rather than just the supporting the technology.

Key Characteristics

When recruiting for IT executives today, here are some key characteristics required in addition to those discussed above:

    • Does this individual have strong overall knowledge of the operations of the healthcare organization? Do they understand how the departments relate to each other and can affect the clinical and financial outcomes of the organization? Can they hold their own when speaking with the other operational executives and with the Board of the Trustee for the organization?
    • Can the individual present information, both verbally and in writing, to the executives and Board, in a convincing and easy to understand manner?
    • Has this individual participated in overall operational strategy for a healthcare organization, understanding the competition in the marketplace, as well as the effects of healthcare reform? Can they associate current and emerging technologies that could contribute to the success of the operational goals? Can they bring innovative ideas to the table that might move the organization ahead of their competition, or allow them to perform beyond their anticipated goals?
    • Are they strong personal leaders that can maximize the performance of their staff and can incorporate use of technologies such as VDI (virtual desktop infrastructure), cloud computing, and mobility, in such a way as to minimizing the costs of IT while maximizing current and new capabilities to address overall operational goals?
    • Can this individual relate to the clinical needs of the organization? Do they understand how technology can support patient safety, clinical decision support, quality reporting? Do they understand the need for real-time data analytics and how to aggregate that data in a meaningful way for operational users to utilize in their day-to-day operations?
    • As more and more clinical data is being collected and the former paper "medical record" has become the "electronic heath record", the IS executive role has become even more involved in the areas of Security, Privacy, and Compliance. It is often a very thin line to walk between meeting these needs while addressing the requirements for the clinicians to have effective and efficient communication of patient data. These issues have been compounded by the technical and legal requirements around Health Information Exchanges (HIE's), Accountable Care Organizations (ACO's), and understanding the requirements for patient population outcomes reporting.

As these more C-Suite oriented responsibilities have emerged for the CIO role, many organizations, have created the role of the Chief Technology Officer (CTO) who has assumed responsibility for the more technical knowledge and operations of the IS organization allowing the CIO to operate at a more executive level.

Answers from Melinda Ed Marx

Healthcare experience no longer required

Two trends that will continue to grow happen to be juxtaposed. On one hand, you have the advent of the clinically experienced IT executive gaining more traction and notice. On the other hand, we are also seeing increased interest in candidates who are complete outsiders. No healthcare experience at all. They both have a place in today's rapidly changing and technology enabled enterprises. Increasingly, we are seeing recruiters looking for both types of backgrounds.

We will see more and more searches contemplate non-healthcare experienced professionals. Healthcare experience is no longer required. This is an emerging trend and will become dominant moving forward. 5 years ago someone from outside of healthcare could not break into our industry. One of the reasons why we are a few years behind other verticals in terms of maturity and innovation is because we have largely been insular, only hiring from within. This is changing. It has to if we hope to see the kinds of transformational improvements required for accountable care and significant quality of care enhancements.

I have recruited for two executive IT positions in the last 5 years. Both times my preferences have been to have someone from outside of healthcare come and compliment my existing team. I can accelerate a candidates learning and have them become familiar with the nuances of our industry. It is much harder to accelerate an internal candidates understanding of the utilization of technologies in other industries if they have not experienced it first-hand.

Clinician Leaders

Another trend will be leaders with clinical backgrounds. 25% of my overall team is certified clinicians of one type or another. 40% of my direct reports are clinicians. While not a certified clinician myself, I know I have immediate respect from clinicians we serve when they learn of my background as a combat medic, ambulance driver and finally, anesthesia aide. I have seen more executive hires in the last few years with clinical backgrounds and it is easy to understand why.

As work with recruiters and review resumes to fill my officer level openings, a candidate with "RN" or "MD" certainly stand out. If the role calls for an individual to work closely with clinicians, clearly they have immediate street cred and can more easily meld the concepts of technology and clinical practice. They bring authority and applicable knowledge saving time on the learning curve. Some of my best leaders have been nurses and physicians.

If you are not a clinician and have spent your entire career in healthcare, I believe you will find it increasingly challenging to land that dream executive position. There are still opportunities out there, but given the trends I have seen the last 5 years, they will be difficult to come by going forward. Dependent where someone is in their career, it would not be unreasonable to consider going back to school for a clinical degree or, take a position outside of healthcare for a few years and then come back. Either one of these routes will make the candidate very marketable in the future.

January 2013