Donna Roach has a simple way to measure whether a health system CIO has built the influence the role now requires.
“The most successful CIO will be the one who has the relationships with their executive peers,” said Ms. Roach, assistant chief digital and information officer at University of Utah Health in Salt Lake City, during a panel at the Becker’s 11th Annual IT + RCM Conference in Chicago. “Do you have their cell phone number, and when you text them, do they respond back and call you?”
Ms. Roach said she has every executive peer’s cell phone number and that they call her back. More importantly, her peers know she reaches out only when there is something that warrants it and she needs a response.
The test is informal, but the idea behind it reflects a broader shift in how senior technology leaders are defining success. Health system CIOs are entering a more disciplined phase of technology strategy where the ability to build organizational relationships and drive enterprisewide decisions matters as much as any technical capability.
Luis Taveras, chief digital and information officer at Philadelphia-based Jefferson Health, has come to the same conclusion through 26 years as a CIO. He frames it as a fundamental reframe in how technology leaders think about their own function.
“Don’t think about being a technologist,” Mr. Taveras said. “You have to be a general manager that happens to specialize in technology, but you have to be a general manager first.”
The distinction carries consequences for how technology leaders spend their time. Mr. Taveras said that close to 80% of his focus goes toward things that are not strictly IT. At Jefferson, a 33-hospital system with a university, a health plan and a medical school that he said will be the largest private medical school in the country within six years — that breadth is not incidental. He said he sits on the committee planning the medical school’s expansion into Delaware and the Lehigh Valley, and that his presence at that table is precisely the point.
“Nothing can happen at the organizational level that you’re not going to be involved in as a CIO,” he said.
Ms. Roach agreed. When a new supervisor came on board at University of Utah Health, he expanded her scope significantly, adding oversight of IT for all the health sciences schools under the university, including medicine, nursing, pharmacy, dentistry and health science, as well as the health sciences library. What followed was not a technology project, but a year-long negotiation.
“It’s not as easy as you would think,” Ms. Roach said. “You can’t have somebody dictating that kind of structure without it pretty much falling apart before your eyes.”
Ms. Roach built a federated IT structure that centralizes services that should be shared while respecting the autonomy of departments with specific, specialized needs. Getting there required a listening tour across deans and department chairs, making a case for the value of the model rather than simply imposing it.
“It’s really a negotiation,” she said. “It’s actually relationship building much more than it was ever anything about technology. It’s just, this is how we’ve always done it, and getting people to see a different way to do things.”
The federated model is still evolving. The groups aren’t accountable for their own budget yet, but the structure she built has given her insight into how that spending flows.
Both leaders pointed to AI as a domain where the general manager framing has become especially important. Mr. Taveras said he hired a senior vice president for AI who is not a technologist — an emergency physician with a background in clinical operations and consulting. The goal was to have someone at the table who understood how the organization functions, not just its technology stack.
“AI is an organizational focus that we have to have, not an IT focus,” Mr. Taveras said.
Ms. Roach added that the CIO who steps back from that organizational role, who lets AI remain an IT conversation rather than an enterprise one, leaves the most important work undone. Not everyone understands how AI can help them create even simple projects, like resorts or spreadsheets. Closing those gaps required her to step into rooms she might previously have left to others.
“You have to think much, much broader than the technology piece,” Mr. Taveras said. “That’s what you represent as a CIO.”
