Meet the health IT department: Chief technology officers

With the digital shift in healthcare well underway, IT leadership roles continue to evolve. That includes chief technology officers, a position that has existed for years but has recently taken on different responsibilities.

Becker's reached out to health system CTOs to ask how what they do differs from other IT executives. Here are five who responded.

Note: Their responses have been lightly edited for clarity.

Chuck Christian. Vice President of Technology and CTO of Franciscan Health (Mishawaka, Ind.): What I tell everybody is if it's broke it's my fault. I started out having just infrastructure, which is the networking, all the computers, the data centers, data closets, the phone systems. But now I also have service delivery, which is the service desk, in-the-field desktop support, the networking team, and which includes testing and a few other things.

At large organizations like Franciscan — we're a 13-hospital system — you need somebody who's an air traffic controller. When we do an enterprisewide project, it's huge. And I've done several of those. I have a radiology background, and one of the first things I got involved with was an enterprisewide [picture archiving and communication system] implementation — replacing a couple of older systems. And then we started tackling enterprisewide phone system replacements. So there are about 33,000 phones, or what we call profiles, at about 350 locations — some small, some very large. And then we've done an enterprisewide replacement of wireless access points.

I'm the executive sponsor for those kinds of projects. I have 11 direct reports who manage those various areas. So a lot of my job is managing the managers, making sure that they're getting what they need and removing the barriers for them to be successful. I'm also the face for vendor relationships.

I also have a team of architects that looks at future infrastructure needs. We started that right after I joined and we made some investments into quite a few things that when COVID hit, if we had not had them ready to go, we would have been really in a bad place. We were able to move about 6,000 people to work remotely at home in about 2 1/2 weeks. It was a logistical nightmare. But the team pulled it off, and I'm very proud of them. A large majority of those folks are still working remotely today.

I have responsibility for a lot of what I call the plumbing and wiring of the organization. We redesigned the network to make it more resilient. I have responsibility for the data centers, and our remote hosting and cloud strategies as well. I'm responsible for almost 50 percent of the entire expense budget. And, in looking at the last couple of years, the grand majority of the capital budget is mine as well. But really and truly my teams and those managers are actually doing the real work. I just get to show up and offer an opinion and help design what the future is going to look like.

I wouldn't say the CTO position is rare. It depends upon the size of the organization. For organizations the size of ours, the CIO can't focus on the technical and tactical approach to things. Some do, but most of the ones I know at organizations our size, and even some a little smaller, have CTOs. And when I was at two different community hospitals, I filled both roles.

Even in the 3 1/2 years I've been here, the focus of the role has changed somewhat from just the technical and the computers and the wiring to more trying to design "what do we need to have for the future" and being aware of what's going on in the industry.

Vish Anantraman, MD. CTO of Mayo Clinic (Rochester, Minn.): At Mayo Clinic, CTO is a strategic role. The office of the CTO helps define the long-term technology roadmap for the organization to align with long-term business objectives. It also provides enterprise architectural leadership for key technology initiatives. The office of the CTO identifies emerging technology trends and finds the right opportunities for the adoption of such technology.

Christian Lindmark. CTO of Stanford Health Care (Palo Alto, Calif.): The chief technology officer and their team play a key role in helping healthcare organizations achieve their overall strategic goals. Typically reporting to the CIO (as it is at Stanford Health Care), the primary role of a CTO is to ensure reliability, resiliency and security of all information systems, data and devices across the organization. There are hundreds, if not thousands, of applications in use across a health system, and the CTO is responsible for creating an infrastructure stack — both on-premise and in the cloud — that is quick to deploy, secure, fast to access and cost-effective for all these applications. The CTO needs to build strong and collaborative teams in infrastructure, engineering, networking, data center, identity/access management and end-user devices to accomplish this.

Secondly, CTOs are innovators, creating and implementing transformative technology offerings to improve the experience of our clinicians, staff and patients. Clinicians continue to rely more and more on technology in their clinical workflows, yet these technologies can often be cumbersome and frustrating if they're not easy to use and not always available. The CTO needs to innovate, simplify and secure the technology environment and user experience while working hard to ensure these systems never go offline.

Lastly, but just as important as the other two, CTOs need to develop relationships with clinical leaders, hospital administration and other stakeholders throughout the organization. Having firsthand knowledge of the goals, challenges and vision of these individuals and departments is critical. The CTO role has typically been less clinically focused; however, partnerships with key clinical leaders across the organization are vital, especially as the CTO role in many organizations, such as Stanford Health Care, has expanded to include clinically facing systems such as biomedical engineering and clinical communication technologies.

The CTO role is different from the CIO or chief digital information officer role in that a significant focus for the CTO is on managing and driving technology in support of clinical operations, as opposed to technology that is directly clinical-facing or clinical by nature. The CIO role is the leader of the healthcare IT organization, responsible for ensuring all the IT teams are working closely together and aligned around the organization's strategic goals. They are not only responsible for the scope under the CTO, but also the clinical/business applications, analytics and security teams, and ensuring the relationships between these teams and key clinical and hospital stakeholders is collaborative and driving toward the organizational strategic goals.

The CIO role has a seat at the executive leadership table within the healthcare organization and directly provides input and feedback into the organization's strategic goals, while the CTO usually does not. The CIO provides the framework for success and removes obstacles to allow IT teams to succeed. There is no question that CIO and CTO have a mutually dependent relationship, as do the CIO and other IT leaders, but a great CIO makes all teams within IT successful, as well as ensures the organization sees IT not just as a cost center but as a partner in its success.

Jeff Olson. Vice President of Information Systems Technology, CTO and Chief Information Security Officer of Legacy Health (Portland, Ore.): The CIO in our organization oversees the overall technical, application and informatics portfolio. The CTO, a key leader providing counsel to the CIO, is focused on evaluating external technology trends and evaluating them with the engineering teams. The ultimate goal is to ensure reliable, modern and secure IT platforms. The CTO leads a diverse organization of technology disciplines, which provides service delivery for the present while focusing on architecting and improving service delivery for the future. The CTO's leadership team also has the responsibility to manage large IT vendor contracts and the associated complex licensing conditions.

Steve Eckert. CTO of Cook Children's Health Care System (Fort Worth, Texas): At Cook Children's, my role as the CTO is much more strategic than purely technical. Indeed, technology underpins how we operate as an organization — it enables connections with our patients and families, allows caregivers to practice and collaborate, and allows our stakeholders to function in various capacities. But a critical component of what the CTO does is designing how these connections occur.

As a CTO, I spend a considerable amount of time developing strategies and roadmaps to improve the IT service for our customers. I am focused on enhancing our customers' experience by understanding the outcomes they hope to achieve and ensuring that our products and services align with business goals.

I am responsible for some critical aspects of IT:

  • Project management office
  • Enterprise architecture
  • Customer experience — including IT service management operations
  • Technology and systems engineering
  • Platform engineering
  • Disaster recovery
  • Our path to the cloud

I'd say that my role differs from the CIO in that the CIO spreads across the enterprise more widely, while my focus is more narrow (yet deeper in areas). While we work as a team, my job is to support the strategic vision she sets for IT. I focus on how technology supports the vision, and develop solutions to meet the demand.

A chief digital officer is focused on seeking solutions to provide closeness with customers. While we don't have one at Cook, I work closely with our digital team to ensure that our technology can deliver the envisioned digital experience.

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