The Life of a Healthcare CIO: CIO of the Year Ed Marx

An interview with Ed Marx, CIO of Texas Health Resources.

In collaboration with CHIMEBecker's Hospital Review'snew "Life of a Healthcare CIO" series features leading hospital and health system CIOs from across the country who are sharing their experiences, best practices and challenges.

To recommend a CIO to be featured in this series, please contact Helen Gregg (

An interview with Ed Marx, senior vice president and CIO of Texas Health Resources, based in Arlington. Mr. Marx was recently awarded the 2013 John E. Gall Jr. CIO of the Year Award by CHIME and HIMSS. (Interview has been edited for length and clarity.)

Question: You've been CIO of Texas Health Resources for almost seven years, correct? How has your job changed since you began? 

Ed Marx: I've been here for exactly six years, three months and 31 days. [Laughs]

[Editor's note: This interview was conducted on Jan. 31, 2014]

And the job has definitely changed in that it's more strategic now. I'm now on the senior leadership council; I wasn't when I started. Because everything we want to do as an organization has its underpinnings in technology, it's trying to figure out how to best leverage technology to achieve superior outcomes. Everything needs technology.

I was actually asked this question earlier today — [at a speaking engagement] they asked me, "What are your top three IT initiatives?" Instead of the three top IT initiatives, I responded with the three top health system initiatives — and all three of them need IT to make it happen. Basically, in the past [the CIO role] has been very operational and translational; today it has a transformative focus.Ed Marx

Q: In your time with Texas Health Resources, what has been your biggest accomplishment? 

EM: The development of leaders. In order to be transformational, it can't be all about one person, it can't be all about me. It needs to be about the team. I've spent a lot of time developing both myself and other leaders so any one of us can be a strategic visionary and help guide the organization.

As a result, we were able to implement our electronic health record beautifully. Which is very rare, to do it beautifully. We recently won the [2013 Enterprise HIMSS] Davies Award, which recognizes health systems that have implemented EHRs and gained benefits from it. We're really impacting the quality of care at our organization. Part of the reason it is increasing is through leveraging technology.

Q: What do you see as your biggest misstep or mistake?

EM: This could make up the bulk of the article. [Laughs]. I learned from Ronald Reagan, and the hard way, to trust but verify. Early on, I trusted but did not verify and got burned.

I haven't always made perfect hires, for one. When I recognized I hadn't, I took the appropriate action, but still, I've had my share of mistakes.

Q: Looking back over the past month, what has taken up the majority of your time?

EM: Two things. The first is strategic alignment. We're in the last three years of a 10-year plan. I've been spending a lot of time with the business and clinical folks to make sure we have that strategic alignment. You can't just throw out objectives. There's lots of meeting and lots of testing. I have to make sure we're marching up the same mountain.

We use a metaphor, Transformation Mountain, for our 10-year plan. Right now, we're leaving base camp two. When we started I had asked the other officers how many of them had actually climbed an actual mountain and understood real, technical climbing, and therefore understood the metaphor. Not many had, so every year we pick a mountain and climb it. Not everyone attends, it's completely voluntary, but in the past four years we've climbed 20 mountains.

So now, everyone understands what it means to be leaving base camp two and climbing to the summit. It takes twice the effort to go from base camp two to the summit as it does to go from base camp one to base camp two. To be successful, you have to lighten your pack, and so we at the organization have to take some things out and be hyper-focused to be successful and achieve our vision.

The second thing is leadership development. I'm such a big believer in it, and therefore I spend a lot of time on it.

Q: What is the biggest challenge you're facing right now?

EM: Things change so rapidly, the technology changes, strategy can change, the environment changes, there are more mandates from the government and a lot of different new things. So keeping IT ready to pivot in any direction is very important. While we need to ensure organizational stability and run a first-class operation, we also need the ability to pivot.

It's challenging enough to be operating at a high level, which we are — 94 percent of our physicians are satisfied with IT, and 85 percent of all our customers are. But we also need a level of readiness to be able to pivot to meet new demands. It's a two-part challenge, we have to be able to adapt to changing business environments, like a new payer relationship, while maintaining a world-class level of service.

It's also about trying to see into the future. While we need to care about today and have the ability to pivot as needed, we also have to think one to three, or five, years down the road to what will be needed then.

For example, six years ago we realized the need for data analytics. So five years ago, we started working on it, and now we're ready for the future. Another example is social media. Six years ago, we said, "That's how we will be engaging patients." So we made plans for it, and when [social media] really exploded four years ago, we were ready.

From an enterprise view, some of the biggest challenges we're facing are about living in both worlds regarding payment reform. We still have traditional fee-for-service, but more and more of our business is in accountable care organization arrangements now. It's a challenge to live in both of these worlds. We're doing it, and we're ready for the new world, but it's still a challenge.

Q: What is one lesson you've learned during your tenure you'd like to share with other CIOs?

EM: There's a couple. One is that everything rises and falls on leadership. Therefore you need to think more about talent than skills [when hiring employees]. Skills are taught, talent is caught. Talent is what I look for, and it's what I would encourage others to think about. Look for passion, customer service, drive, if they're action-oriented. If they have those things, they can pick up any skill. Too often we think about if they have the 10 years of experience we want, but what's more important is talent.

[CIOs should] also dive deep into strategy and learn the business if you don't know it already. I personally spend a lot of time with clinicians to learn their workflows and challenges. It's the same on the business side. I hang with the financial folks to learn billing and their business. I require my IT division to do the same. Too often we stay in the silo of technology, and when we do that we make ourselves somewhat impotent. I would admonish people to get out there and spend time with people.

The other thing is somewhat heretical, but this is a faith-based organization so I can get away with it. You need to be aware of people's body, mind and soul. We had five employees die here in the last five years, and I can tell you it brought home to me the way leaders have to live by example. I'd encourage everyone to think about your staff's mind, body and spirit because leadership bears the responsibility to help people with what matters in life to them. We have to encourage people to live well and be healthy. This will have an impact in the workplace, but it's more about ensuring everyone has a well-balanced life.


More Articles in the "Life of a Healthcare CIO" Series:

The Life of a Healthcare CIO: Community Hospital Anderson's Joey Hobbs
The Life of a Healthcare CIO: Hawaii Pacific Health's Steve Robertson
The Life of a Healthcare CIO: Summa Western Reserve Hospital's Pam Banchy

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