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.  

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.