During my career in healthcare IT dating back to the early 1980s, I have seen one major change in the executive leadership in hospital IT. This was the creation of the chief information officer (CIO). Prior to this time, the key IT position in hospitals was the HIS manager who reported to the CFO. This was logical because the major functions of the HIS (hospital information system) at that time were billing and tracking patient admissions and discharges (i.e., patient management systems). About ten years later, hospitals began to appoint chief information officers (CIOs). This change roughly coincided with the deployment of what we know today as EHRs for which the CIOs were responsible and which thrust them into the clinical domain.
The next major change in hospital IT leadership we are now seeing is the appointment of hospital Chief Digital Officers (CDOs) (see: Memorial Sloan Kettering taps former CVS Health, Aetna exec as chief digital officer). Other major health systems are following suit (see: Kaiser Permanente taps Prat Vemana as first chief digital officer). Below is an excerpt from this first article:
Memorial Sloan Kettering Cancer Center has tapped Claus Torp Jensen, Ph.D., as the organization's first chief digital officer and head of technology. Jensen joins MSK from CVS Health and Aetna, where he served as chief technology officer and head of architecture for the past four years. In that role, Jensen led technology innovation, business transformation incubation, architecture planning and design, and digital integration, the New York City-based cancer center said in a press release....Jensen's recruitment follows an expansive national search to identify a leader with the vision and experience to lead MSK’s digital transformation, according to the organization....As the cancer center's new chief digital officer and head of technology, Jensen will oversee the integration of data and technology resources across MSK and develop the data and digital platforms that will enable the organization to meet critical patient care and research objectives. He will also direct the operations of MSK’s departments of information systems, health informatics and data products, as well as other core components of MSK’s information technology ecosystem, comprising some 800 employees. Reporting to MSK’s Chief Operating Officer, Jensen will work closely with leaders across MSK to design, create and optimize digital solutions that will benefit patients, researchers, clinicians and administrators.
I have blogged frequently about the explosive growth of digital health. (see: What Trends Can We Anticipate as Digital Capitalism Reshapes Healthcare?; What Is Digital Health and How Does a Health System Get There?; Consideration of the Organizational and Personal Digital Health Managers of the Future) Without question, the future of healthcare lies in the digital realm. These newly appointed CDOs will play a major role in this transition. I have the following observations about this new hospital executive officer:
- I believe that soon there will not be much room for current CIOs with a CDO in place. At the very least, the CIO title no longer seems apt, particularly if CDOs are given the additional title of Chief Technology Officer. What then is the fate of the current CIOs in large health systems? I suspect that some of them will continue to manage the EHRs but report to the CDO.
- The only place to recruit all of these new CDOs in healthcare will be the private sector. They largely don't exist in healthcare. Their appointment is thus another step in the increasing corporatization of healthcare (see: Majority of Physicians Now Salaried Employees of Health Networks; Blurring of Definition of Big Medicine; Corporatization of Healthcare). There will now be even less daylight between large health systems, expanding health insurance companies, PBMs, and large retail drug companies like CVS.
- One of the major challenges for CDOs will be to deploy AI and algorithms to increase the quality of care and decrease the cost. This will be achieved largely though the use of analytics. This will mandate that CDOs develop close relationships with Big Tech and new health AI start-ups that will have most of the fresh ideas, unencumbered by the traditions and restraints of Big Medicine.
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