Soon after Scott Arnold landed his first job working in aerospace, he realized he had a knack for managing technology and technologists.

This passion has led to a successful career, including IT leadership roles in telecommunications and healthcare. Scott joined the team at Tampa General Hospital in 2010. He currently serves as their Executive Vice President and Chief Digital and Innovation Officer.

Tampa General Hospital is a private, not-for-profit hospital with 8,000+ employees and one of the most comprehensive medical facilities in Florida serving a dozen counties with a population in excess of six million.

Key Takeaways

  • Build a strong partnership with your CEO by being direct, honest, and authentic. Focus on building trust, solving problems, and removing obstacles to drive the organization forward.
  • Make talent retention a leadership priority by setting target attrition rates, investing in leadership training, and fostering open communication. Regularly share information with your team to keep them engaged and encourage their input.
  • Stay ahead of emerging technologies like generative AI by understanding their potential applications and establishing appropriate governance. Focus on leveraging these tools to assist and empower team members, rather than replacing them.

Q&A with Scott

Judy Kirby: Scott, when did you realize that a technology leadership position was of interest to you, and why?

Scott Arnold: I think it was organic, or accidental, or both. I went to college because I wanted to fly airplanes, build airplanes, or work on the technology that makes them fly, and I did that for the first part of my career. But what was also interesting to me was managing the technology and the technologists, and their brilliant personalities. I just fell in love with it, first in aerospace, and again while working at a telecommunications software company. Being able to translate between clinical and business and technical is a special skill that is hard for many people, but I guess it came easy to me. That’s how I ended up on the technology leadership path.

JK: What were some lessons learned in aerospace that you brought with you into healthcare?

SA: Aerospace, aviation, and healthcare are actually very close cousins, because they have human factors involved. People can die if you don’t do your job right. I didn’t realize the parallels around safety until I got into healthcare.

Years ago I had conversation with someone from Mercy in St. Louis who wanted me to take a leadership role in their technology division. I told him that I didn’t know anything about healthcare, but he said, “We need people from aviation and aerospace, to bring some knowledge with safety and human factors. Frankly, aviation has a better safety record than healthcare does, so we’d love to have that perspective.”

I said OK and took the job because I’m always willing to learn, and he was right. I was fascinated with healthcare from the start and I’ve been in love with it ever since. Even though I love flying and aviation, healthcare technology is the most favorite thing I’ve ever done professionally and what I have spent most of my career doing.

JK: From where I sit as a recruiter, new CEOs are perhaps the biggest reason for CIO turnover. But you have survived and thrived under a new CEO. What has made the CEO transition so successful for you?

SA: First, we get along great. The CEO, John Couris, and I see the world through the same lens. We’re different people, and we do see things differently sometimes, but our styles and the way that we approach things are somewhat similar. He’s a far better communicator, and he really gets people, so I am learning a lot from him. I think he’s the fourth CEO that has been here since I joined Tampa General 13 years ago, and I’ve learned something from each and every one of them. I think John would tell you he is learning from me too, so when you have great chemistry and authenticity, it just works!

JK: You’re skewing the bell curve on CIO tenure after a change of CEO. What advice would you have for other CIOs for getting on the same page as their CEO?

SA: My advice is to be direct, honest, and authentic. Be someone the CEO can trust. You may not have all the answers because that’s impossible in the healthcare technology. The surface is just way too large. But even if you don’t know the precise answer, you have to instill confidence with the leader that you have put together a team that will know or can get you the right answer.

Do not be an obstacle. That’s a simple formula that has worked for me. Help your CEO solve problems and help them remove obstacles.

JK: Your CEO seems to be very invested in technology.

SA: That is a blessing. Some people might say it’s a blessing and a curse. Sometimes John is hard to keep up with, but I like it that way. He has incredible vision, understands people and inspires team members like no other leader I have seen. He also understands the power of technology and technology’s role in getting the best out of people. That makes my job easier.

JK: How do you partner with the CEO to drive results and ROI from technology investments?

SA: John is skilled in terms of growing the company, and investing in things that either have a benefit that’s accretive, creates an ROI, or is just the right thing to do for the community. We’ve created this mutual trust where we’ll weigh these things together, and then we’ll try something. 90% of the time we’ll successfully move the dial on quality or cost.

JK: Can you talk about your dual role of innovation and CIO, and your involvement in the company’s investment arm?

SA: Innovation means many things. Innovation and research go hand in hand, and we are doing a better job of connecting research, innovation and venture together. That’s new for me. I’m not an expert but I’ve hired some people in our group who manage the venture side and are cultivating innovation in our organization.

I do lean on our team that runs the venture side to know that business, how an opportunity pipeline runs, how to put together the right deals, how to recognize good founders, and what to look for in investable startups. The one thing that has taken the most focus is adjusting our strategy with innovation and investing, not looking for bright, shiny things. What are the problems that we actually need solved, and what are the white spaces that aren’t already covered by enterprise systems that we own, because we want to get the most out of those investments. Then, if there’s anything out there that we haven’t done really well, those startups or emerging tech companies can potentially be a fit for us.

I think I’ve hired well on the innovation side. On the IT side, most of the leaders in my group have tenure over 10 years, so we’ve cultivated an awesome leadership team that loves this community. And we’ve done that while dealing with explosive growth. We’ve grown our health system from $1.3 billion to almost $3.5 billion in the last 5 years. I know I’ve hired well, and I am blessed to be surrounded by some really smart, engaged people.

JK: How did you get involved in the venture capital arm, TGH Innoventures?

SA: Prior to having a venture fund in pursuit of innovation, it sometimes felt like I was gambling with our operating money, which is not how you want to do things. If you make the wrong gamble, that money is gone. It was CEO John Couris’ idea to create a TGH venture fund. We started by setting aside $15 million, which is not a lot for venture, but it was a lot of money to us. But if you’re going to be in the innovation business, you’ve got to put your money where your mouth is and go out on the edge.

In the beginning, John wanted to stay very involved. He took the lead on it and we worked together to get the right person installed to run TGH InnoVentures.. After about a year and a half, he said, “You know what? This really should be yours, Scott, because there’s so much overlap.” Even our venture leaders felt it was a better fit and we can move faster together.. I’m honored that it was bestowed upon me, and we’ve been making a go of it. It helps with great leaders in place.

JK: What are some keys to success leading a venture fund?

SA: It’s understanding what you don’t know, and hiring people that do know that space. Understanding intellectual property, warrant deals, and identifying investible candidates and founders, and then understanding what we should be solving for and what technologies will fit well in our ecosystem. Between the innovation / venture leader and I, we’ve got that covered pretty well, so I feel really good about that.

JK: Is there any company you’ve invested in that you can point to and say, “Here are the positive results for Tampa General?”

SA: One thing that I’ve had to learn is that these investments have a long tail. We’re still fairly new so it is a little too early for me to answer that question. We have not invested in any sort of unicorn, but we’ve invested in some things that have done really well and solved a lot of problems for us. DexCare, HealthSnap, and ModifyHealth are some real neat ones that are really just getting some legs now. It’ll be a lot of fun to watch them and be a part of their success.

JK: Recruiting and retaining top talent has long been a challenge in IT, even before the pandemic. What is one of your most effective recruiting or retention strategies?

SA: We make retention a priority for our leaders. We agree together on a target annual attrition rate. It is the responsibility of every leader to achieve low attrition. But it starts at the top. The senior-most leaders have to make sure they have the right people in place who are able to make jobs a bit more joyful than just work. We invest a lot in our leaders, in their training, we set these goals together, and we are always looking for ways to knock down obstacles for one another.

Also, people can come talk to me anytime. Any one of the 400-plus people in our division can get online with me at 7:15 every morning, and if there’s some issue, they can just ask me directly. I make myself available.

I just got some numbers the other day. Last quarter, we had a 1% attrition rate, which I’ve never had in my entire career. Now, that is just one quarter, but annually our attrition rate has been in the single digits. When I started 13 years ago, it was like 25% or 30%! But let’s not fool ourselves. Having great leaders supports retention and Tampa, Florida is a great place to be, and that really helps!

JK: How do you see the CIO role evolving over the next three to five years, and what might some new responsibilities and job qualifications be?

SA: I think this inflection point we are at with generative AI is going to create new CIO responsibilities, new governance, and new skill sets needed for interrogating data sources. The CIO or chief digital officer role, whatever you want to call yourself, isn’t going away anytime soon. Really smart organizations are going to get as far ahead on emerging technology as they can, to understand what things like generative AI can do to lift administrative work off of nurses, off of revenue cycleteam member, off of any team member that has an administrative burden.

That’s the space for generative AI. The work ahead for CIOs is making sure we don’t misapply it, that we don’t create some sort of cybersecurity or safety issue. It needs to be governed well. Nobody has this figured out yet but it will be our job to figure out what we can do with this assistive technology, not to replace people, but to make them more efficient and effective. Because frankly, most of the people that we support would rather be doing higher order things. There aren’t enough resources available, so we should do everything we can do to put machines to work.

JK: I hear a lot of concern about the lack of up-and-coming IT leaders ready to fill healthcare CIO positions. What are your thoughts around this void, and what are you doing about it?

SA: I feel very strongly about the depth of our bench, the “heirs and spares.” If I won the lottery tomorrow, there would be up to five replacement candidates already in-house that are tuned in to both the culture that we’ve built together, and that have the depth and the training.

JK: Looking back at your own journey, Scott, what career advice do you have for rising technology professionals interested in becoming a CIO one day?

SA: My advice is to learn about people, how to get the best out of them, and how to hire and retain talent. If you want to be in an elevated role in IT, your success depends on it.

JK: How have you created the culture you have, a culture that keeps people?

SA: I think that’d be a great question to ask some of the team members here, but here is what I think. As a leadership team, we keep each other informed and in the know. For example, when I come back from a CEO council, or a board meeting, I immediately share what was talked about with my senior team. In fact, sharing of information is a standing agenda item in our regular meetings, and they will then share it with their teams in their meetings.

So, we’re in this continuous loop of keeping the whole division in the know about what’s going on, or what we’re thinking. And what I’ve learned is that sometimes I’ll be wrong on something, and I’ll hear an even better idea from one of our team members. It’s a win-win cycle that way. If you’re going to have a successful team, you want to keep them in the know. It’s absolutely foundational.

JK: If you hadn’t become an IT leader, what other career do you think you were cut out for?

SA: I would be flying in the Air Force.

JK: Do you still fly at all?

SA: I do. I’ve been flying since I was 18. I can’t describe the feeling of the wheels coming off the ground and being at the controls of that flying machine. Aerospace and aviation have always been a passion of mine, but now it’s more of a hobby.

JK: What else do you love to do with your spare time?

SA: Travel. My wife and I travel all over the world, and we’re trying to do it while we’re still young and ambulatory. There are just parts of the world that you can only get to if you can climb, like in the Greek islands. We travel all over the planet when we can.

JK: How many countries have you been to?

SA: I’ve lost track. Most of Europe. I worked in Australia for three years, so Australasia got covered. The Middle East, Israel, the United Arab Emirates, the Maldives. There are still a lot of places I have not been to, like India, so that should be on my list soon.

JK: What’s been your favorite place so far?

SA: Bora Bora, hands down.

Soon after Charlene Wilson landed her first job working in human resources for a healthcare organization in El Paso, she knew she had found her calling. Charlene’s passion has led to a long and successful career, including HR leadership roles at Loma Linda University Health, Vidant Health, and Rochester Regional Health, where she became CHRO in May 2023.

Rochester Regional Health is a physician-led integrated health services organization serving Western New York, the Finger Lakes, St. Lawrence County, and beyond, offering comprehensive care from more than 400 locations, including nine hospitals.

Key Takeaways

  • HR leaders need to understand how to connect with the younger generation of workers and future leaders. We are obligated to ensure they are prepared to run this business in the future.
  • AI is going to play a major role in the talent acquisition space. Some worry that this could lead to unintended discrimination, but Charlene is reassured by what providers have shown her. A far bigger concern is the talent shortage.
  • An emerging challenge that CIOs are going to be faced with is enabling a virtual clinical workforce, such as virtual nursing.

Q&A with Charlene

Judy Kirby: When did you realize that an HR leadership career was of interest to you, and why?

Charlene Wilson: My journey has been a little different. I went to law school and then decided that I was not going to be Perry Mason like I thought I would. Then I entered a master’s program at Villanova University, and for my internship I worked at the Housing Division of the City of Philadelphia in their human resources department. And that was it! I had found my calling and my passion! My husband was in the military, so when we moved to El Paso, I got my first job in human resources at a hospital system and this the only career I have known, HR in healthcare.

JK: You’ve done this for a while, so maybe you have given thought to how the CHRO role will evolve over the next three to five years. What might some new responsibilities and qualifications be?

CW: Since I started my career, the expectations of the workforce have changed drastically. Leaders can no longer afford to take a command-and-control approach to leadership. They’ve got to learn how to inspire, how to motivate, and build a culture of trust.

Human resources leaders of tomorrow really need to understand how to connect with the younger generation, the up-and-coming leaders, in a very profound way that is different from how my managers connected with me. As we confront the whole retention and commitment issue in both clinical and non-clinical positions, we must be able to relate and lead in a much different manner.

JK: How are you doing that today?

CW: I’m now more of an executive coach to the senior leadership than I was before. 10 years ago I was doing very tactical, traditional HR, building compensation models, building total rewards, talent acquisition, et cetera. But the majority of my time now is spent coaching the C-suite. HR leaders of tomorrow must be very strategic. Every facet of the workforce in healthcare is now leaning on HR for answers that they didn’t necessarily ask for a decade ago. “Charlene, how do I create these tools to help me deal with this younger generation?”

JK: How have you learned to deal effectively with the younger generation of workers?

CW: I learned very early that they are smarter than I am. They have access to information very quickly. They are barraged with data constantly. That wasn’t my career experience. We had to search long and hard for answers, but they know it instantaneously. But what they don’t have is wisdom.

So, I feel that my calling is to share my wisdom so that, coupled with their expertise, coupled with their knowledge, I can rest assured that the young leaders I have touched know how to run this business.

You have to do a lot of introspection and be okay with being vulnerable with this new generation. But at the end of the day, you need to take responsibility for preparing them for tomorrow.

JK: Succession planning is the responsibility of all senior executives. Can you talk about the status of your succession plan and the approach you’ve taken?

CW: As you know, I’ve been here just five months, and we do not have a succession planning framework or model as of yet. I am currently working on developing that as well as an appraisal system to complement the succession plan. There is a three-year commitment for me to get an enterprise succession plan done.

JK: What tools or frameworks do you rely on, especially when it comes to hiring great leaders, and retaining and developing them?

CW: Gallup’s Strength Finders (now called CliftonStrengths) gives you the ability to understand the strengths of an individual, which is good to use not only when you’re hiring, but also for succession planning and career development opportunities for people. Where are their gaps? What do they need to be strengthened in? How do their strengths complement or clash with your current team? There’s another tool by David Lapin, which takes a different approach to understanding what your strengths are. He looks at it through the lens of your values. That is another tool that could be used to help navigate with the individual.

JK: How do you think generative AI will affect you and your team over the next few years?

CW: Oh, I believe that AI is going to play a major role in the talent acquisition space. Based on algorithms, we will be able know whether a person has the potential to do really, really good work in our healthcare system. Some will argue that this could lead to unintended discrimination, but the algorithms in the system I saw recently at Workday’s annual conference in San Francisco have been tested and validated. So, I’m not as concerned about that as I am about the talent shortage. I’m excited about what AI can do in terms of helping us find and manage talent. We will be implementing the Workday AI solution probably in 2025.

JK: What does a really strong partnership between the CHRO and the CIO look like?

CW: I’ve always had a very close relationship with IT, but it’s a little different here. Rochester Regional Health adopted Workday in 2013 as the HR platform, but IT has nothing to do with it at all. HR runs the platform, we monitor it and we manage it, which has been a change for me. Our connection with IT is really about bringing folks into the IT team and working with the CIO to develop career paths. The IT talent market is so volatile and hot due to intense competition for good people.

JK: Over the course of your career as an HR leader, how have you partnered with the CIO to improve the culture of IT?

CW: This new generation of workers is seeking more. They’re seeking more purpose, they’re seeking more flexibility, they’re seeking more opportunity to grow and develop. They’re no longer expecting to come into an organization just for the job. They expect to come in and see a career progression.

My work with our CIO is about building job profiles and complementing them with the career progression from the very beginning. Therefore, when he’s hiring or presenting our company to candidates, they know right from the start that they’re not in a dead-end job.

I’m working with Rochester Institute of Technology to help me develop that career progression and we are going to test it out on some RIT students. We’ve got this well-known, renowned technical school right here in Rochester, and so why not test it with them? I’m working very closely with the CIO on this now because that is what he’s going to need from HR the most over the next couple of years.

JK: What other work have you done to help strengthen the culture in technology, especially with remote and hybrid work?

CW: The real trick is ensuring that people are engaged. Not with just the work, or the work product, but engaged in the IT community here. Gone are the days when we believed that if you’re present, that means you’re engaged. No, it doesn’t.

You could have a leader who is a director living in Kansas. How do you create the atmosphere so that that director can lead and still live in Kansas? I am helping the CIO to utilize different tools to make sure that his people are engaged with one another.

I’m excited about it, about being able to see in my lifetime such a major seismic shift in the workforce, and being able to contribute to it.

JK: The virtual workforce has been a major focus for CIOs I speak with.

CW: Let me tell you about another challenge that CIOs are going to be faced with: the virtual workforce on the clinical side, like virtual nursing. We’re getting ready to launch virtual

nursing internationally here. When you call your credit card company, or get software support, you’re often talking to someone that isn’t physically located in the United States. We’re going to start using that same approach to providing our clinical services. I think we will see more of this due to the nursing shortage.

JK: Looking back on your own journey, what career advice do you have for rising professionals interested in becoming a CHRO one day?

CW: My advice to them is to remain relevant, and that means understanding not just what’s going on today, but to also what the workforce is going to need tomorrow. CHRO leaders must accept the fact that they need to serve. If they have issues with being servants, if they have issues with leading not because of the job title, but because being a leader is sacred, I don’t think they’ll be successful. This is all due to heightened expectations of the workforce I have mentioned. We need to position ourselves in such a way that people see us as serving them in a manner that is sacred and purposeful in healthcare.

JK: When you are not working, what do you like to do with your free time?

CW: I love to travel. I’ve been to more places and more countries than I could ever imagine. I’m also a vegetarian, pretty much vegan, and I love to cook. That’s a stress release for me, so when I am heading into a tense time, like when I’m getting ready for a board meeting, I go cook a whole bunch of stuff. And reading also.

JK: What do you like to read?

CW: I like to read things that are inspirational. Right now I’m reading Trust and Inspire, the book Stephen Covey wrote after The Speed of Trust. I also like to read John Maxwell’s books because, as I said before, I believe that my career in HR is based on a calling.

JK: What has been your favorite country to visit?

CW: My favorite one was Dubai. The countries where I could actually live would be Germany or Korea.

I have a question for you, Judy. What do you see on the horizon for healthcare talent and recruiting?

JK: One concern of mine is the mergers and acquisitions. The organizations are getting so big, and I’m not sure the leadership is prepared for the scaling, where suddenly you have a CEO or a CFO in a much larger organization. Are they prepared to really lead that large of an organization and bring the cultures together? And do they have the money to really hire the talent they need? For a long time, technologists in healthcare didn’t have the skillset to take to jobs in other verticals, and now they do.

CW: You can’t compete, not financially.

JK: And now we’re having nursing and physician shortages, which are going to continue. As all the aging baby boomers need more healthcare, Charlene, where are they going to get it? How are we going to pay for it?

CW: And that impacts the workforce, Judy. We now have five distinct generations in the workforce because the older generation won’t retire if they can’t afford the health insurance they need. They’re living longer and they are working longer, and that creates this very interesting situation here where you’ve got the younger generation needing to move up, but the older generation deciding to work until they are 70. That’s something we’re dealing with.

JK: How are you dealing with quiet quitting, and individuals who aren’t performing?

CW: I’ve implemented what are called human resources strategy partners. They’re really working with operations on strategy and we’re changing the way in which we collect and analyze feedback. Instead of just once a year or every 18 months, we go in for interviews after the first 90 days, and very regularly after that. The data points us very clearly to where our gaps are. Workday has a robust analytical component for looking at employee survey data. We can slice and dice the data any way you can think of to understand where gaps are and where my strategy partners need to work with the leaders to deal with this culture issue.

This edition of “C-suite Conversations” features Vicki Hildebrand, CIO of Blue Cross Blue Shield of Massachusetts.

After many years in engineering and IT leadership positions in the for-profit sector, and much to her surprise, Vicki was attracted to a federal government opportunity due to the importance of the mission. As CIO of the Department of Transportation, her budget was $3.5 billion. Success in that role eventually led her to the healthcare industry, which she feels is the best place to be if you are passionate about driving transformation.

Key Takeaways

  • As a CIO, you must learn to have patience. Change is still hard for many people and many organizations, particularly in the healthcare industry.
  • With digital transformation initiatives that no one has ever done before, on time and on budget are not measures that provide a lot of value anymore.
  • In IT there is always money being spent on things that are of low value. That is where you can find the budget to fuel innovation.

Q&A with Vicki

Judy Kirby: How did your career in information technology get started?

Vicki Hildebrand: As a student, I always gravitated toward math. My father was an engineer and he encouraged me to try electrical engineering in college. There weren’t very many women in that field then, but I’m a risk-taker, so I did it and I loved it. I had dreams of joining NASA, but by the time I got out of college, NASA was winding down and personal computers were booming, Silicon Valley was going crazy, and I wanted to be part of that.

When I first moved to Silicon Valley, it was really humming and full of people just out of college, so that’s where I started my career. I was an engineer for a long time, and then this IT industry kind of cropped up. I’ll never forget one day getting a message from HR, saying, “You are now in the IT function.”

JK: You have led IT in multiple industries. You spent a long time at HP. Then you were CIO at the U.S. Department of Transportation. From there you became CIO of Blue Cross Blue Shield of Vermont, and now Blue Cross Blue Shield of Massachusetts. Can you talk about those industry transitions?

VH: I was in the for-profit sector for a very long time, and I learned a lot, but after some time and experience, I wanted to do something that was more mission oriented. Then the opportunity to join the Department of Transportation came up. Never in my wildest dreams is that something that I had planned for, but I thought, “Why not interview for it?” After all, the mission of that department is the safety of the American people. And I got the job.

After a few years it became clear that I needed to be closer to home in Vermont. My parents were aging, I was flying to D.C. every Monday, spending four days there, and then flying home every Thursday night, me and Senator Bernie Sanders. Then I got a call from Blue Cross Blue Shield of Vermont, and I thought, “What better place to apply digital transformation capabilities than in healthcare?” Because healthcare, to me, is still behind other industries in the digital space so I was eager to see what I could do to help.

JK: Most organizations struggle with change, and they struggle with digital transformation. What have you learned from your experience that would be helpful to other CIOs?

VH: One of the things I have learned is to have patience. There are enterprises out there that are anxious to pursue digital transformation, while others might eye it suspiciously. “What is this transformation? We take good care of our members today; we’ve got high regulation we have to deal with. Why is it we need to do these things?”

I have been driving this model of equal accountability for our partners and the technology team for speed to value, really driving value to our members. But not everybody embraces that. Change is hard for any company, including one that’s 80-plus years old and successful. Change is hard if there’s no burning platform.

I’m a driver. I’m eager to get things done, but I have learned that it is patience, high EQ, and learning from what’s working and also from what’s not.

JK: What have you accomplished so far with digital transformation at Blue Cross Blue Shield of Massachusetts?

VH: We have a very modern data fabric. I can’t take a lot of credit for it because there was momentum before I started, but I have been a big advocate of it, and I am trying to accelerate it. You know, people are all talking about generative AI, but their data can be awful. You’ve got to start with a solid data foundation. Data is what differentiates us. We have really rich member data, and we’re in a unique position to help them on their health journeys with AI.

Another accomplishment is the CX practice the company is building and we are supporting. Before, customer experience was more about how to resolve survey complaints, now we’re pivoting toward journeys, a “no wrong front door,” and a digital-first approach to things, while ensuring that members still feel a high touch. You don’t want to go so digital that they feel like they’re remote from you.

JK: And what would you say have been the keys to success with those two initiatives?

VH: Changing the accountability. On time and on budget are not measures that provide a lot of value anymore. There is some science and some art to all of these initiatives, and there’s not one person who has ever done any one of these initiatives before. So, why should we know exactly how long it’s going to take and exactly how much money it’s going to cost, and exactly how many resources? We don’t know the answers, and if we take guesses, we will disappoint people 365 days a year.

I’ve created a “two-in-a-box” relationship with our partners. The technology folks are told, and must embrace, that they are equally accountable for the success of our enterprise. We’re trying to create models where the technology leader can finish the sentences of their business partner, and the business partner is learning a ton about technology, and the two of them are operating so quickly and so collaboratively that they’re driving decision-making and progress really fast. We estimate how long things are going to take, and how much money things are going to take. But it’s not a punitive environment, where, if you miss your date, you’re in trouble, because in that situation everybody pads their numbers. So, I’ve tried to change that to, “As fast as possible, drive that minimum value so that we can actually move the enterprise forward, and do it in a collaborative way.”

JK: How do you get your CFO to go along with this practice of not necessarily defining a budget, and a cost scenario that is fluid?

VH: I am a CIO who believes that we have to have an efficiency arm of transformation. It’s one of the first things I did when I walked in the door. I set up an efficiency initiative because there’s always potential savings. There’s always money being spent on things that are of low value. That’s where you find the money to fuel your innovation.

I am not a CIO who keeps going back to the till, asking for more, more, more. I’m a CIO looking for where we are spending money that is not delivering value, and how I can reinvest that in the innovation that we need. So, I have been out there driving efficiency. That means in the workforce and in being brutal with my vendors. If a vendor is not going to work with us on the costs, we’re leaving. Even if they’re strategic, we’re leaving. In this environment where some vendors are asking for 30% upcharges, we can’t do that. It’s not sustainable. I’m always looking to drive efficiencies and I think CFOs appreciate that.

At the Department of Transportation, the biggest splash I made in the government was when a reporter asked me if I was going to take advantage of a new law that added additional funding to IT departments. My response was, “Absolutely not. I have a $3.5 billion budget. Why would I need more money?” And it spread like wildfire across Washington D.C., “CIO, Department of Transportation says she needs no more money.” I even got a little backlash about it. But I had a $3.5 billion budget for a mid-sized department. How could I justify needing more money?

JK: When you came to Blue Cross Blue Shield of Massachusetts and started changing things, you had to bring your team along. How were you able to engage and excite them?

VH: We set up an initiative called MOVE, which stands for Modernize, Optimize, Value, and Empower, and branded it. Then we tried to make sure that we focused on those areas so that people understood what it was we were trying to do and would rally around MOVE.

No transformation initiative is going to be successful just being driven by technology. It has to be enterprise wide. So, I did that to get my team going, and then we used some of those seeds of change to bring our partners along. But we had to focus on expectations and consider that we were not all starting from the same place. I was probably moving too quickly on some things, again, going back to the importance of being patient.

Transformations don’t have an end game. There’s no end state, no “Voila, I’ve arrived.” It’s all about constantly iterating, changing, and reflecting. What are our impediments? What could we do better?

JK: Looking back on your career journey, what advice do you have for technology professionals interested in becoming a CIO one day?

VH: Learn, learn, learn. I had a fabulous boss, who is now the CEO of Xerox. His name is Steve Bandrowczak. I think he now has upwards of 20-plus CIOs that have come out of his organizations. Steve always used to say, “Every day, spend some time learning. Learn your business, learn what’s going on out there in the world, learn new technologies.” To that advice, I would also add, “be a risk-taker.” Just lean into things, go explore, and open doors.

JK: How have you navigated the technology talent shortage, and what advice can you give for hiring in this environment?

VH: We haven’t had a lot of trouble because we’re able to recruit people to the mission of the organization. We’re obviously not going to be the biggest compensators, nor are we the lowest. Healthcare is very complicated, and it doesn’t always serve members as well as it could. There are people out there who really want to help solve that and support our company’s mission. In addition, I’ve been upscaling the organization, and people are reaching out to their colleagues saying, “Be part of our merry band.” I think we’ve got some momentum going here that people are excited about. If you’re passionate about what you’re trying to accomplish, that comes across to people.

JK: You said you are upscaling your organization. Can you talk a little bit about how you’re doing that?

VH: When I arrived here, I inherited a very large PMO. They had years of experience with the waterfall approach, but I knew we needed to adopt the Agile methodology for technology development. I recognized that this would require a significant evolution, starting with our own team. I quickly introduced the mantra “speed to value”, and we took a close look at our processes to identify steps that aren’t necessarily value-add. We were able to eliminate some steps and streamline the approvals process. We also encouraged people and teams to be less risk averse while constantly learning and recognizing what questions to ask. Many of the changes we made are now enabling us to get more hands on keyboards so we are ready when our business partners come to us. Even if it’s not on the fiscal quarter or the year, I want us to be able to work nimbly.

JK: Succession planning is a responsibility for all senior executives. Can you talk a little bit about your approach to succession planning?

VH: I know that at a lot of organizations, technology aptitude is the top of the list, but leadership is top of the list for me. We spend a fair amount of time on training, grooming, and growing people in their leadership skills, and we do have succession plans. It’s part of the discipline that we have. We’re also a little bit more rigorous than other organizations on our performance calibrations. We’re thinking about where this person is going. What do they need to learn? How can we help them improve and develop their skills? I always view it as a real compliment when someone is promoted out from underneath me to do something new, because growing people is such a high priority for us.

JK: The buzzword for the year is generative AI. How is that impacting your organization and the company’s strategy?

VH: We’re certainly incorporating it, but despite the fact that I usually want to be out in front on new technologies, this is one where I don’t want to be the leader. We are doing some proofs of concept with GenAI, but we have to be very careful with people’s personal health information. Security is very high on our list. Right now, we’re seeing generative AI helping us in the back office, inside the firewall. But we’re going to stay very current on the technology, and we’re going to be watching and learning as we go.

JK: Many organizations right now are touting sustainability, but I hear less about it in healthcare. As CIO, are you involved in any strategic initiatives around sustainability?

VH: Yes, sustainability is a priority for us. In fact, we recently won the Social Impact award from We’re always looking for ways to reduce, to automate, and reduce paper, to make sure that we’re using resources efficiently. It goes back to the efficiency I was talking about earlier. We do build sustainability into our initiatives. We ask ourselves, what can we do here that will really help with sustainability goals?

JK: If you hadn’t gone into IT, what other career do you think you were cut out for?

VH: I have always loved business and academia, and I always thought that if I’d pursued a Ph.D. that I might be interested in running a small college or university. The other thing, if I really followed my passion, is that I probably would want to run U.S. Figure Skating. I was a competitive skater as a kid, and I was a coach for many years. Then I transitioned from coaching into judging, and now I’m on the board of U.S. Figure Skating. The popularity of the sport is declining somewhat, and since I am all about transformation, I wanted to join the board and lean in to see if I could bring some of the excitement around U.S. Figure Skating back to viewers.

JK: It doesn’t sound like you have a lot of free time, but when you do, how do you like to spend it?

VH: My problem is that there are a lot of things I love to do, but I have a lot of energy. I am on some boards, and I really enjoy that work. I love being outdoors. I love skiing, hiking, kayaking, and biking, and that’s what saves me on weekends, just getting outside and having decompression time. I also love to cook, and I love to read.

JK: What is a good book you would recommend to others?

VH: I am a very big fan of Mark Schwartz. He is at Amazon now, and before that he was in government at U.S. Citizenship and Immigration Services. That’s how I met him originally, and he is based in Boston now. He really understands modern technology. I just reread his book, A Seat at The Table. I’ve read it many times, and pages are starting to fall out, but every time I read it, I learn something new, and I’m very energized.

The next healthcare executive featured in our interview series is none other than Tressa Springmann, SVP & Chief Information and Digital Officer at LifeBridge Health, a large comprehensive healthcare provider in the Baltimore area.

Before joining LifeBridge Health as CIO in 2012, Springmann served as CIO of Greater Baltimore Medical Center for 14 years.

Here, Springmann shares her thoughts about huge changes coming to the healthcare industry, how to keep the IT leadership pipeline strong, and why some of her best hires have been people she took a chance on.

Key takeaways:

  • For many IT positions, a candidate’s empathy and EQ are just as important as their technology credentials because there is a lot of PTSD in the healthcare ecosystem since COVID.
  • The challenge of succession planning is balancing the needs of the organization with the professional goals of the IT leadership team, meaning it is a continual conversation.
  • A CIO who is too busy to pursue interests outside of their work should make changes in their lives. Time away from work is essential fuel for what this role requires, and it makes you a more approachable leader.

Q&A with Tressa

Judy Kirby: How did your career as an IT professional get started?

Tressa Springmann: My undergraduate degree was in the sciences. I found myself at Johns Hopkins doing protein chemistry research and very quickly realized that I was in a career I wasn’t very excited about.

When we were automating a lot of the physical chemistry process in the lab, I raised my hand for the work and found that I really loved deploying IT. I was more excited about overseeing and bettering the process than I was about doing the scientific process.

Back then, Hopkins had a fantastic tuition reimbursement program, so I pursued a Master’s in management of technical professionals. Eventually, this led to a role at EDS in systems engineering, which was the real start of my career in IT.

JK: How do you think the CIO role is going to evolve over the next three to five years in healthcare? Do you see new responsibilities and new job qualifications?

TS: We continue to see waves of new innovation that, as an organization, we want to leverage and take advantage of for the benefit of our patients and our companies. As this occurs, we see various areas of functional focus inform the CIO choice for many organizations: the physician as a CIO, the head of marketing as the chief digital officer, etc. But at the end of the day, I think there are certain leadership competencies that have been critical and will continue to be critical for the CIO. One of them absolutely is technical competency, not as a doer but as someone with sufficient analytical and reasoning skills to support the work. It is not just a relationship role. Perhaps a new area of appropriate focus would be change management in this dynamic time we now find ourselves.

JK: One of the concerns you and I have talked about before is a lack of up-and-coming IT leadership able to fill the void as healthcare CIOs retire or move on. What are your latest thoughts on this?

TS: My biggest concerns right now are around continuing education and professional development, not just for IT leadership, but for healthcare IT professionals as a whole. HIMSS has always been a constant resource where clinicians can become more immersed in information services, or folks brand new to the industry can get some exposure. As HIMSS has sold their annual conference, it makes me wonder about the potential professional development gap for HCIT staff.

I think that we are all experiencing a workforce shortage, in a variety of ways. Most organizations, including mine, are making sure we’re firing on all cylinders for our clinicians, whether it’s retention plans, or team educational relationships, and keeping that talent pipeline moving. As our organization has had to attend to some of these clinical workforce constraints, many very creative ideas have surfaced that my leadership team is considering.

Technology companies have deeper career ladders and they have different compensation capabilities, and technologists will never be the priority workforce support area for a healthcare company where care delivery is the mission. So, it’s a big deal. On the other hand, people choosing a career in healthcare typically do so for a purpose: they can see their own contribution to the improvement of their communities. To many, this is what matters most in their professional pursuits.

At the end of the day, healthcare is a team sport. We need to have a succession plan and recognize and acknowledge the strengths and weaknesses on our current team. And it’s an ever-evolving team. The areas where we have drawn from in the past are not necessarily the areas that will seed our bench in the future, and we need to be open to that.

JK: Recruiting and retaining top talent has long been a challenge in IT, even before the pandemic. What is one of your most effective recruiting or retention strategies?

TS: Well, top talent is super subjective, right? During my career as a leader, my most intelligent, responsible, and loyal team members have been people we’ve taken a chance on. There are a lot of people who are very credentialed and have X years of Epic experience, or Infor, or Oracle, and so on. But as leaders, we’ve all been in circumstances where, despite all that book knowledge, they alienate their customer, or they’re disorganized and can’t deliver.

I always advise my team to employ situational interviewing, because we can support new team members as they get certifications and credentials. But there are basic competencies around empathy, teamwork, learning, and positive attitude that are much harder to educate on.

JK: When you are employing situational interviewing, as you recommend, how do you test for something like empathy?

TS: Empathy is probably the most underdeveloped soft skill and is something everybody’s talking about. There’s been a lot of PTSD in the healthcare ecosystem since COVID. A lot of people were called for what was essentially combat duty, where it was life and death, really high-stakes stuff. Somebody who will be in customer service situations every day in our service center needs to exhibit different competencies than, say, a senior network engineer.

Most of my situational interview questions start with, “Tell me about a time when…” and I’ll play out a scenario. Then I will ask them to talk about their choices. What did they do about it? How did they feel about it? What did they learn from it? Their answers help me understand whether they have depth of both EQ and IQ, and a desire for continual improvement. I am listening for what they think they could have done better in that situation for the other people involved. Are they self-aware?

You can’t downplay someone’s self-awareness. When I interview an individual whose answers lead me to believe he or she doesn’t have a sense of self, I proceed with caution.

JK: You mentioned succession planning before. Can you talk a little bit about the status of your succession plan and the approach you’ve taken?

TS: First, it is very important for leaders to look outside of their own ranks for their future leaders and successors. It is myopic not to do that. Secondly, it is really important to have more than one idea in mind – to always have a number of options in play. I learned this early on in my leadership journey when my identified successor took another role and moved on. I realized that there was a single point of failure in the succession plan that I’d come up with. So, I strongly recommend that, just like with any system implementation, you have a number of contingency plans.

In professional development conversations with my team, it’s very important for me to understand the things that they would like to accomplish in their careers and in the next professional development period. But it’s equally important for me to pepper in learning, industry experience, and assignments that position them potentially, should I step away, or should another leadership role open up on my team. I need to balance the organizational risk with the professional goals of my leadership team, meaning that this is a continual conversation.

JK: As CIO, are you involved in any strategic initiatives around sustainability?

TS: I am thinking a lot about organizational sustainability, given what is going on in the industry. What are we doing as an organization to make sure that we remain relevant and that we continue to be able to care for the communities we serve? We are, as we speak, knee-deep in a very provocative strategic exercise contemplating all of the external factors that have been at play, some prior to the pandemic, but many as a result of it. With the regulatory environment, with non-traditional disruptors, with the advent of the “payvider,” and data telling us that the cost of healthcare has gone up in the United States while quality has not.

Through a strategic dialogue facilitated by a partner, we’re challenging some basic assumptions that made this organization what it is today. There are probably four or five scenarios that we could see over the long run. One scenario might be that there are far fewer hospital companies, and the only thing they manage are the highest acuity and most complex care. Because this type of care is so expensive, you want to get really, really good at it and, with all of the virtual care and other technologies to keep people well, or care for them at home, this type of care should become a much smaller part of any individual’s own healthcare journey.

We are playing through some scenarios and challenging ourselves as part of the strategic process about exactly what our community needs. This community in Baltimore needs us, and they need us in a variety of different ways. So, as we combine what’s happening externally with what we believe the community we serve will need in the future, that allows us to be better positioned for the decisions we’re going to have to make around sustainability. We’re engaged in this work because we do believe that the future is going to be very different.

JK: What other possible scenarios may there be for the future of the healthcare industry?

TS: Is there a more effective role we can play serving our community in the wellness space? We aren’t reimbursed that way today, are we? Most things that make our lives more valuable and more comfortable every day don’t happen in a physician’s office. For example, if someone has a sleep disorder, there are all these different devices and treatments available which are hard to sort through. Do they have anything better than just Google to help understand which one is efficacious?

JK: Looking back on your own journey, what career advice do you have for young professionals interested to become leaders?

TS: I’d love to say something incredibly inspirational, but I believe that if you find something you really enjoy and become good at it, everything else will fall into place.

I did some informational interviews with college students recently, and they want to be the President or CEO of a corporation, they want to be the CIO, they want to launch their own startups, etc. While I think it is important to start with the end in mind, the advice I often give these young people is to look closely at the elements of what they want their workday to be like, what they want their story to be, and what they want their impact to be, as they evaluative measures of success, as opposed to a job title.

My other advice is to stay open-minded and raise your hand for opportunities to try new things. Having a variety of different professional experiences, large and small, will help a rising professional understand what he or she is most passionate about as a person. The sooner they figure that out, the sooner they can get on a career path that allows them to do their most inspiring and rewarding work.

JK: Outside of work and spending time with friends and family, what do you love to do with your free time?

TS: Some would say that CIOs never have time outside the office, but we do. If someone doesn’t, I challenge them to go and figure that out, because taking time away from work is essential to fuel what this role requires, and certainly makes them a more approachable leader.

Around 10 years ago I really started getting into wine. So, I went through a program at Penn State on wine production that included wine chemistry – not the sommelier stuff, like how to taste, or how to understand the aromatics, although the program did include some of that, but literally the chemistry and nuance that contributes to the production of a quality wine.

I am also a second-year beekeeper. I got turned on to all the antibacterial and antiviral properties of honey and pollen, and I just wanted to understand how it worked. Professionally, I’ve been an ideas-to-outcome architect, and I think as a person, when I fundamentally get intrigued by something I just want to know how it ticks. By the way, I’ve killed a lot of bees, and some of my wine has been really horrible.

JK: You make your own wine?

TS: I do periodically, but more often I rely on others in the business who have access to quality varietals from elsewhere (Maryland is NOT known for its high-quality grapes) and all of the appropriate equipment.

In fact, at the end of October a group of us began the year-long process of making what we hope will turn out to be a lovely red wine from grapes harvested in the Lodi AVA (American Viticultural Area) in California. It sounds quite a bit like our role as technology leaders – we get involved with something based on our own interests and abilities, and then surround ourselves with others who have better access, talent, products, and ideas.

JK: I can’t wait to hear how that turns out!

TS: I will let you know, and of course, if it is any good, I’d love to share some with you.

We’re starting our new series, “C-suite conversations”, with an interview with my good friend, Jonathan Manis, SVP & CIO of CHRISTUS Health.  

Jon has spent over 20 years in healthcare IT roles, including Sterling, Advocate, Provena, Sutter Health, and CHRISTUS, which he joined in 2018. CHRISTUS Health is a Catholic, not-for-profit system comprised of more than 600 centers, including long-term care facilities, community hospitals, walk-in clinics, and health ministries. It has 55,000 employees. 

Please watch this space for more pieces featuring experienced healthcare technology and business leaders sharing secrets from their transformation playbooks, advice for rising healthcare executives, and forecasts for where the role of the CIO is heading.  

Enjoy this Q&A with Jon! 

Key takeaways

  • Healthcare must change. We need to become technology companies that provide access to healthcare services when, where, and how it’s most convenient for consumers. 
  • Many technological developments have changed business and the role of the CIO, but generative AI will change our world. 
  • Labor shortages and burnout issues in healthcare can be solved with better technology utilization. We need to let computers do the work they are designed to do.

Q&A with Jon

Judy Kirby: Thank you for joining me for this series, Jon. When did you realize that a technology leadership career interested you, and why?  

Jonathan Manis: I did not pick this career; this career picked me. I’m a Florida boy and became a ground combat officer in the US Marine Corps. For some unknown reason, the Marines sent me to Norway, north of the Artic Circle where I was freezing to death. One day the Captain came into the officers’ tent and asked, “Does anybody want to go to graduate school?” All of us lieutenants just looked at each other. One of the junior officers finally asked, “Where’s the graduate school?” The captain said, “California,” and I immediately said, “I’ll go!” The captain then asked, “Don’t you want to know what you’ll be studying?” to which I replied “It doesn’t matter. I’d like to go to California.” When I got my orders, it was for computer science and information systems management. I completed my degree at the Naval Postgraduate School at Stanford University, was assigned to the Pentagon for a payback tour, and I have been doing technology leadership ever since.  

JK: You have had an incredible career, including over 20 years as a CIO in healthcare. How do you think the CIO role will evolve over the next three to five years?  

JM: I was once quoted as saying that the CIO role would not exist in three to five years. It would have been more accurate to say that the CIO role as we know it would not exist in three to five years. I think that was true then, and it’s certainly true today.

Most of us don’t really notice the role changing because constant change has become our new normal. The emergence of the IT function out of the basement changed our role. Virtualization and cloud computing, and the rise of nomadic devices and smartphones changed our role. The internet of everything and the evolution of networks changed our role. Consumerism, ease of use, and consumer expectations have changed our role. Digital technologies have changed our role. And I think soon the connectedness of everything will change our role yet again.   

Social networks, Amazon, eBay, Netflix – they’ve all changed our role. The one that feels very different for me is artificial intelligence: generative AI, machine learning, and very soon, artificial general intelligence, which is algorithms and applications having broad general knowledge and the ability to accomplish intellectual tasks autonomously — machines thinking and doing for themselves.

Those kinds of advanced technologies are certainly going to change our role yet again. But I suspect that they may also change our world, more so than just the CIO role. The way we live, the way we work, the way we play. I believe that our lives will be dramatically impacted in ways that we haven’t yet imagined and don’t yet comprehend. That prospect is both extremely exciting and absolutely terrifying.  

JK: How does all this affect the CIO’s job responsibilities. Are there new job qualifications? 

We need to understand those technologies, certainly, but we also need to be able to identify use cases and opportunities to apply them, and we need to be able to communicate a compelling case for investment in them.  

Perhaps most importantly, we need to be able to moderate expectations, something that we haven’t done well in the past. We need to dispel that primal fear that comes with any technology as powerful and potentially threatening as artificial intelligence. It’s scary for many people. It’s scary for me! And look, we can no longer separate technology from operations. Technology is operations today. Healthcare has just been slow to realize it.  

I think every company is first and foremost a technology company, and what separates and distinguishes the industries is simply how they leverage that technology to service consumers. It can be retail or manufacturing or hospitality, finance, or healthcare. CIOs need to understand they are not simply leading a support function. In modern, consumer-centric, market-responsive organizations, technology and operations are inseparable; they have become merged.   

In the meantime, boards and executive leaders are struggling to understand the forces impacting and changing the healthcare landscape, and how to stay relevant in an increasingly nomadic, ever-connected, and competitive marketplace. I think the reason you see the proliferation of so many new job titles like chief digital officer and chief transformation officer is because many CIOs are failing to deliver more visionary operational leadership.  

What I mean by that is a new and far more progressive delivery model, enabled by tools and technologies that provide access to services when, where, and how it is most convenient for the consumer of services, not the provider of services. The Googles and Amazons of the world consider themselves technology companies that provide access to services. We need to be the technology company that provides access to healthcare services.  

JK: As a recruiter, one of the concerns I frequently hear about is the lack of up-and-coming IT leaders to fill future CIO positions. What are your thoughts about this void?  

JM: I think there is an element of truth in what you’re hearing, but I am more optimistic than some on this topic. CEOs and boards are looking for more than technology leadership. They’re looking for business leadership. We teach the use of technology, and we develop technical expertise, but the opportunity we’re missing is leadership development – business and operational leadership specifically. How do we develop our leaders? Where do they train and receive leadership experience? For the kind of organizational leaders our industry needs, we must augment our technical competencies and develop our business and operational leadership competencies.  

JK: I agree with you. Can you talk about the status of your succession plan and the approach you’ve taken?  

JM: In the military, we were taught that the most important responsibility of a leader is to develop those who will be required to step up and carry on the mission in the event of the leader’s transfer, retirement, death, casualty, or capture. Professional development is a personal accountability, but I believe that succession planning is a leadership accountability. Here at CHRISTUS Health, succession planning and mission sustainment are extremely important to the long-term success of our organization.  

It all starts with a personal development plan, in which we include training and certifications as necessary. We have a coaching network, a mentorship program, and we encourage opportunities for exposure, like conferences or speaking engagements. An individual’s professional development plan might also include assignments of increasing responsibility, often with cross-functional, multidisciplinary work groups. In some cases, a development plan might include a recommendation that an individual seek graduate education, move outside the IS function, or even to a different organization to assume a position of higher accountability.  

The performance review process is another integral component of our succession planning process. Each leader at CHRISTUS Health has a plan for professional development and for promotional succession.  

JK: Looking back on your own journey, what career advice do you have for rising technology professionals interested in becoming a CIO one day?  

JM: My advice would be to challenge everything, to speak up and to stand out. You know, leaders don’t always fit in. Leaders stand out. Sometimes that can be risky and uncomfortable, but things need to change. The healthcare consumer experience needs to be the same as the consumer experience in every other part of our life. We must enable immediate service and become accessible when, where, and how it’s most convenient for our consumers, not for us. Digital doesn’t care where you are when you access services. Healthcare systems do. Healthcare systems are territorial and geographic by design, and don’t want you going anywhere else for services or going out of our service area for care.   

Our industry must change or it will be changed for us, and we’re already seeing some of that. I would tell any new leader to become intolerant of the status quo and to challenge everything. The modern world moves at a different clock speed.  The pace of change is accelerating and that we need to speed up as an industry. COVID brought healthcare and technology into the spotlight. Digital consumerism is all about data, the connectedness of everything, mobility, and personalization. All of those things are enabled by technology and technology dependent. We should own it and take advantage of this unique opportunity. This is our moment.  

I would encourage any up-and-coming technology leader to be a change agent. In our industry we need more than leadership. We need visionary leadership, maybe even revolutionary leadership, I think that’s the incredible opportunity for the next generation of IT leaders willing to step forward and make a real, positive and lasting difference.  

JK: That is bold advice. Clearly, you are anticipating huge changes to come in the industry. 

JM: I think there will always be hospitals, but I think they’re going to be very different. I think our industry has been slow to realize it, but the future of healthcare, in my opinion, is going to be smaller, and it’s going to be outside the four walls of hospitals and clinics.  The exceptions are likely to be emergencies, intensive care, complex surgeries, and end of life. Look at birthing centers, dialysis clinics, urgent care clinics, “hospitals at home,” ambulatory surgery centers, cosmetic surgery centers, cancer treatment clinics…  I’m not a proponent, but it’s certainly not too far-fetched to expect that we might soon see something like an end-of-life center where people will go to pass comfortably in the most appropriate environment.  

I do think that the hospital, as we know it, will change dramatically in the near term. The old saw is to “give customers what they want,” and the number one thing that our customers want is to not be our customers. Nobody wants to be a patient. So, they want us to predict their disease, help prevent their disease, and lastly, they want us to provide care if they have an accident, develop symptoms, or contract a disease. Isn’t that what we all want?   

We have a clinic right here in Texas that offers any healthcare service for $49 or less. Now, you probably don’t want to go there if you have pancreatic cancer. But, if you have a sprained wrist, need stitches, have a sunburn, an earache, a runny nose, a sore throat or whatever, they will see you for $49 or less. You couldn’t touch that price at most large health systems. If we don’t respond with a different care model a lot of business is going to be taken away from traditional provider systems by new entrants offering substantially similar services at a substantially reduced cost.  

In short, the current traditional care model is both challenged and likely unsustainable. I do see big changes ahead for our industry, and we will be left doing the things that nobody wants to do, specifically emergency services, complex surgeries, end-of-life, intensive comorbidities, and intensive care, the things that are high-risk, low-margin. The high-margin, low-risk services we use to offset those other services are being taken away from us. Healthcare is a retail industry. It just doesn’t know it, and that is what’s hurting us. 

JK: Speaking of sustainability, other verticals are working on environmental sustainability initiatives, but I haven’t heard much about it in healthcare. As a CIO, are you involved in strategic initiatives around sustainability?  

JM: Absolutely. Maybe this is because we are a Catholic organization. The Catholic Church is very, very concerned about sustainability, efficiency, and the environment. It’s part of our mission, and we are absolutely committed to sustainability. “Reuse, Recycle, Reimagine, Repurpose” is part of our mantra. We have targets for conserving resources, and we have to prove it, so we actually have a quarterly report on what we’re doing to advance sustainability. In fact, we just built a new corporate office that has been recognized nationally for its sustainability and green footprint. 

From a technology perspective, we work with our vendors to secure the most environmentally friendly products and services.  We look at everything from packaging to disposal, including power consumption and recycling.  We encourage remote consulting and online training, and we have initiated carbon reduction goals.  Finally, our movement to cloud computing and remote hosting provides both value and operational efficiencies and also helps address our environmental concerns by reducing waste and leveraging available compute efficiencies.    

JK: We have a physician shortage and a nursing shortage. How do you see robotics and generative AI filling in the gaps?   

JM: The truth of the matter is that we have technology that would enable us to do with a lot less labor. I’m not sure we have a labor problem as much as we have a technology utilization problem. Make no mistake about it, AI is a very different and very powerful technology, and I think it’s going to change everything, and I believe it will certainly help us address both the labor shortage issue and the concerning clinician burnout issue.   

As a technologist, I believe we should automate everything that can be automated.  We need to let the computers do the work they are designed to do. Leveraging available and emerging tools and technologies – smartphone apps, mobility, connectivity, data, generative artificial intelligence, virtual/ augmented realities, drones, robots, etc. – will help us decrease costs, eliminate friction, address labor shortages, reduce response times, improve convenience, and enhance the consumer experience. We also need to leverage technology and monitoring tools to help our physicians, nurses and other clinicians manage by exception. We reduce clinician burnout by helping to identify only those individuals and patients that truly need to be seen by a clinician. Monitoring, tracking and trending technologies can help us to do just that. 

My graduate thesis at the Naval Postgraduate School at Stanford was on artificial intelligence. Honestly, I never expected to be where we are today in my lifetime. And AI development is accelerating. This is a very interesting time.  When have you ever seen any business sector or industry asking for federal regulation and oversight? This tool, this technology, is just that powerful. And there’s tremendous potential value here, but also tremendous potential for risk and disruption – business risk, financial risk, political risk, societal risk. Institutional trust and job security are likely to be challenged. And it seems to have caught us by surprise. Every CIO I’ve talked to is asking, “Where did that come from?”  

JK: So, what do you do about it as CIO? 

JM: Here at CHRISTUS, we’ve excluded ChatGPT from our network, at least temporarily. I provided our board and our executive leadership with a primer regarding ChatGPT, so that they know what it is and what it’s not. We formed a committee to monitor developments and recommend use cases, and we’ve volunteered to participate in controlled trials with several of our vendors, including Microsoft, Nuance, Epic, and others.  

I think the greatest near-term opportunities for us with AI will be in repetitive tasks and back-office work. I’m thinking of our opportunities to realize value in dictation, scheduling, billing, purchasing, supply chain, service desk, all of which are labor-dependent and maybe a bit less newsworthy than computers diagnosing and treating patients.   

JK: If you had not become an IT leader, what other career do you think you were cut out for?  

JM: The truth is I have always envied the artists, the poets, the painters, the musicians, writers, and storytellers. I’d probably write songs or tell stories. If I could do it all over again, I think I would have learned to play the guitar and maybe become something of a traveling troubadour. You’d probably find me somewhere in the Florida Keys, singing songs and telling lies to a bunch of tipsy, sunburned tourists. At least I like to imagine myself somewhere singing songs and telling stories.  

JK: Outside of work and spending time with family and friends, what’s something you love to do with your free time?  

JM: I grew up on Cocoa Beach, Florida, as you know, and that Florida lifestyle is still in my blood. I love to sail and scuba dive. I prefer to be out on or in the ocean.