The vanishing chief digital officer

Is the hospital chief digital officer vanishing almost as quickly as it appeared?

Amid the pandemic, many health systems created the new C-level position to help facilitate the shift to virtual care. But in recent months, some big health systems have eliminated or opted not to fill the position. Some major systems never created one in the first place.

At the same time, as artificial intelligence proliferates, some big health systems have appointed their inaugural chief AI, analytics or data officers.

"Digital is still the broadest term that encapsulates what I do (by example, IT, AI, innovation, analytics, and consumer experience)," Jeffrey Sturman, senior vice president and chief digital officer at Hollywood, Fla.-based Memorial Healthcare System, told Becker's. "The industry is certainly grappling with how to define AI and digital still. I think this largely depends on the unique needs of a health system as to what roles are believed to be needed and what they are called."

Digital leaders' responsibilities often vary by health system, adding to the confusion. "There is no clear or uniform way health systems are using a chief digital officer," said Tarun Kapoor, MD, senior vice president and chief digital transformation officer at Marlton, N.J.-based Virtua Health.

Dr. Kapoor said there are three aspects of digital: digitization (converting analog to digital), digitalization (adapting processes), and digital transformation (business creation). His position falls under digital transformation while Virtua's CIO focuses on digitization, and their roles meet somewhere in the middle.

"If a health system has a CDO, I think it's important for that system to be clear if the CDO has responsibility for all three phases of digital, and if so, how does that intersect with the CIO role?" he said.

Digital chiefs depart

Health system digital chief departures have accelerated in recent months.

In 2022, Nick Patel, MD, the chief digital officer of Greenville, N.C.-based Prisma Health, left and has not been replaced.

Earlier this year, in a span of five months, Angela Yochem, chief digital and transformation officer, and Amber Fencl, chief digital health officer, both exited Winston-Salem, N.C.-based Novant Health. No replacement has been named. "These changes were part of a restructuring, and we do not have additional information to share at this time," a Novant Health spokesperson said.

In July, Maia Hightower, MD, chief digital and technology officer of University of Chicago Medicine, vacated the role a year in.

Then in September, Karen Murphy, PhD, RN, chief innovation and digital transformation officer of Danville, Pa.-based Geisinger, moved into a part-time advisory role to that health system's CEO. Digital transformation will continue "under the direction of other leaders throughout the organization," a health system spokesperson told Becker's.

The recent moves are likely a combination of digital strategy realignment and rightsizing those responsibilities for the organization's needs, said Jim Feen, senior vice president and chief digital and information officer of New Bedford, Mass.-based Southcoast Health. But he doesn't foresee the chief digital officer going away. At least version 1.0 of it.

"If anything, the lines will continue to blur for this role with the more traditional roles in operations," Mr. Feen said. "I see more digital dyads (or even triads) emerging with COOs and CMOs, etc., the same way CIO and CMIOs were married over the last two decades. The names of these evolving roles aside, the bigger question in my mind is how this change will disrupt the traditional org chart, as we all face pressure to continuously do more with less."

Other sectors are experiencing this shift as well. CEOs across industries brought in digital leaders during the pandemic, but it often caused tension with CIOs, Gartner analyst Janelle Hill said at the IT consultant's recent conference covered by the Wall Street Journal.

"And so, most of the people that were hired in to be the chief digital officer were out within two years and the CIO was somewhat elevated to lead digital transformation," she said in the Oct. 17 story.

When health systems created the chief digital officer role, they made two oversights, said Kathy Azeez-Narain, chief digital officer of Newport Beach, Calif.-based Hoag. For one, many didn't carve out space for developing new care models that wouldn't be tied down by operational constraints. For another, they didn't build the positions with AI, data and analytics in mind.

"Without them, there is a risk of developing 'cool' tech that doesn't solve key patient and consumer problems," Ms. Azeez-Narain said. "Successful health systems will not only focus on evolving these roles but also ensure that their entire executive team is committed to spearheading the transformation."

'There are a lot of chiefs'

Many health systems — including a few of the most prestigious — don't have chief digital officers, relying on good old-fashioned CIOs. For instance, Johns Hopkins Medicine CIO Richard Mendola, PhD, oversees all the IT and digital functions for the Baltimore-based health system. "There are a lot of chiefs," Dr. Mendola told Becker's earlier this year with a laugh.

"It depends on the organization's strategy and what kind of leader they are looking to advance technology and analytics maturity," said Praveen Chopra, chief digital and information officer for Green Bay, Wis.-based Bellin Health and La Crosse, Wis.-based Gundersen Health System. "With that said, separating digital, analytics and IT creates confusion. It also dilutes the focus within the organization as people start to compete for resources rather than collectively work towards unified enterprise strategy."

Meanwhile, many health systems give the "digital" title and responsibilities to their IT leaders. Other organizations have assigned the duty to marketing or strategy chiefs.

"Digital health is becoming more integrated into all aspects of healthcare and can't run as a silo outside of IT," said Zafar Chaudry, MD, chief digital and information officer of Seattle Children's. "Part of a larger IT strategy shift is that health systems are combining the CDO and CIO role into a single CDIO role."

Terri Couts, RN, senior vice president and chief digital officer of Sayre, Pa.-based Guthrie, said chief digital officers play a "pivotal role" in shaping overall IT strategy.

"The collaboration with other C-suite executives aligns all digital initiatives with the organization's broader goals and objectives," she said. "Their specific duties and strategies are tailored to meet the unique needs of individual health systems, making them both vital and adaptable within the healthcare landscape."

The ideal chief digital officer?

Health system chief digital officers serve as "business transformation evangelists" and have a totally different role from CIOs and other leaders, said Tom Kiesau, leader of the digital transformation practice at healthcare consultant Chartis.

Without clearly defined responsibilities, appointing a chief digital officer can just create a "turf war" or "fiefdom battle" among leadership and set up the executive to fail, Mr. Kiesau said. He said many chief digital officers are C-suite in name only and don't have the power to make real change, sitting below other leaders such as CIOs or CFOs on the organizational chart. Ideally, he said, they would report directly to the CEO.

Some health systems that have left chief digital officer roles unfilled have had financial challenges and perhaps viewed digital transformation as superfluous, at least in the near term, he said.

"I think they would all say that over time, digital enablement of consumer experiences and digital enablement in operations — things like automation, robotic process automation — will be important," he said. "Online scheduling utilization is still staggeringly low in a lot of health systems and has huge benefits for consumer preference and cost management."

Some health systems have also had trouble filling the role either because of its specialized skill set or factors like salary and geography. "There'll be others that — by the nature of spending three quarters of a million dollars in compensation to get this role filled and build the team around them — will say we can't afford it," Mr. Kiesau said

Like several other systems during the COVID-19 crisis, University of Rochester (N.Y.) Medical Center created a standalone chief digital health officer position, appointing Michael Hasselberg, PhD, RN. Dr. Hasselberg joined the health system in 2014, spearheading several technology projects along the way. He reports to the chief executive.

The health system felt chief digital health officer and CIO were two different, full-time roles — the former in charge of digital strategy and transformation, the latter tasked with keeping IT systems running, EHRs and cybersecurity, Dr. Hasselberg said.

"If you can have a CIO who can do both of those at the same time, fantastic," he said. "But what we're finding is both are really important jobs. They work synergistically with each other. And you've really got to dedicate the resources to it if you want to be successful to make that transition, or that transformation.

"That gets down to system specifics, and I suspect it's multifactorial: What's happening in your market? What is your current financial state? What is your level of change acceptance within your organization from the frontline clinicians all the way up to executive senior leadership?"

Dr. Hasselberg said his role initially focused on virtual care, online scheduling and mobile apps, but as those have matured he envisions it evolving into more of a chief strategy or transformation officer, encompassing innovation, venture capital investment and competing (or partnering) with disruptors.

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