The health system CIO’s portfolio now spans cybersecurity, infrastructure, digital strategy and, increasingly, AI. A number of large health systems have responded by splitting top technology leadership between two executives.
At Becker’s 11th Annual IT + Revenue Cycle Conference in Chicago, Robert Frieden, CIO of Hutchinson (Kan.) Regional Healthcare System, was asked whether one CIO can still meaningfully oversee all of it.
“The short answer would be no,” he said.
Mr. Frieden, who has been a healthcare CIO for nearly 30 years, said the role has already been carved up over time as health systems created chief technology officer and chief digital officer positions, making it naive to think a single person still controls everything.
At Nashville, Tenn.-based HCA Healthcare, for instance, digital doesn’t sit with the CIO. Michael Schlosser, MD, who became executive vice president and chief clinical officer Sept. 1, continues to lead the company’s digital transformation and innovation organization, alongside CIO Chad Wasserman.
University of Rochester (N.Y.) Medicine has gone further, with two executives sharing CIO duties. Chief Technology Officer James Forrester and Chief Applications Officer Lisa Nelson, PharmD, have co-led the Information Systems Division since 2021, and both joined Mr. Frieden on the September panel.
Mr. Forrester said the model depends on deep trust. Before launching it, the pair met with the CEO to work out how they could hand work to each other without getting defensive or territorial. Each has defined areas of accountability, including staff and budgets, but he said the people IT serves rarely notice who owns what.
“They just want to know that they’re getting their thing done,” he said.
Ms. Nelson said the two often decide case by case who takes an issue, depending on workload and relationships. With University of Rochester Medicine acquiring several smaller hospitals, she has taken the public-facing lead on those deals while Mr. Forrester picks up other work.
The biggest downside, Mr. Forrester said, is that employees who let something slip can claim they didn’t know whom to contact.
The panelists said shared authority needs firm guardrails. Mr. Frieden said one office should control vendor contracts and decide who can read from and write back to the enterprise EHR, which limits shadow IT and duplicate AI vendors.
Mr. Frieden also argued for keeping the tech C-suite small. Health systems haven’t split the CFO or COO role, he noted, and he believes technology should likewise have a single point of authority at the top.
Still, paired leadership persists at some of the biggest names in healthcare. Rochester, Minn.-based Mayo Clinic has both a CIO and a chief digital officer. Yale New Haven (Conn.) Health’s CIO works alongside a chief digital health officer. And Bloomington, Minn.-based HealthPartners splits work between a chief technology officer and a chief data, AI and digital officer. At Dallas-based Baylor Scott & White Health, the CIO and chief product officer have previously both reported to the CEO.
Others are consolidating. Houston-based Memorial Hermann Health System had a senior vice president-level CIO and chief digital officer until Eric Smith retired as chief digital officer in late September. CIO Desiree Gandrup-Dupre now oversees both IT and digital.
Kern Medical in Bakersfield, Calif., is also unwinding a split. Sandra Bakich, one of its two co-CIOs, told Becker’s the arrangement, with her leading the application side and a partner leading the technical side, began as a temporary fix that leaders expected to last about six months. It continued for three years. Kern is now recruiting for a single CIO.
Asked where IT leadership is headed over the next five years, Mr. Frieden predicted a sole officer-level role overseeing a distributed model, possibly under a different title. Ms. Nelson was more open to multiple technology leaders, saying executives bringing different perspectives push one another to be better. Mr. Forrester said the successful CIO will lean heavily on the leadership layer below, but someone still has to answer for the whole portfolio.
“At the end of the day, there does have to be a single leader that’s accountable,” he said.
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