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CIO Unplugged 10/7/15

October 7, 2015 Ed Marx 3 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

If It Ain’t Raining, It Ain’t Training

One week prior to the Duathlon Long Course World Championship this September, I meandered out for my last long training bike ride. I met with a group of cyclists with whom I share the same coach.

As we tuned our bikes to ride, it began to rain. No worries. I lowered my tire pressure, threw on rain gear, and was ready to roll.

As a member of TeamUSA, I finished in the top 100 at last year’s World’s. My goal was to stay there and help our team’s score. I needed this last ride before the long haul to Switzerland in what is the most difficult course on the circuit, a 150 km ride through the Alps with 16 percent grades and 5,000 feet of elevation change bookended by trail runs of 10K and 30K.

We began our training ride cautiously, given the rain and slick streets. My tires were new and that made the situation that much more risky. As we passed the two-mile mark, I began to feel increasingly comfortable, but wary. I thought about turning around and training indoors, but the words of my ROTC instructor, Sergeant Major Samuelsson, echoed in my mind as it had so many times prior:  “if it ain’t rainin’, it ain’t trainin’.” So there I rode near the front of the pack, confidence building.

Samuelsson’s exhortation served me well my entire life, especially as an Army combat engineer officer. When in training mode, it was so tempting to cancel or postpone construction, bivouacs, or drills whenever the weather turned dour. But we knew that could kill us. If we were called into combat, we needed to have trained under the worst possible conditions so we would be ready for anything.

The same principle applies in the civilian work place. If you avoid adversity, you won’t be ready to perform well when you find yourself in less than ideal circumstances. How often have we lost golden opportunities because something did not go as planned and we were unrehearsed in our response?

I am comfortable working through challenges in real-time and don’t panic because I know it makes my team and organization stronger. I have led through countless application and technical go-lives where we had success because we had persevered through adversity in the buildup. It is part of growing up.

That day in the rain, we were making a hairpin turn and our peloton slowed appropriately. Before I could react, I took my first cycling crash. Down. Hard. I braced myself for impact from riders behind me. Thankfully, everyone avoided or skidded around me.

I was pretty shaken as I listened to my body for damage and inspected my bike. We were both injured, but well enough that I limped back to my bike shop. My bike repaired and my body bandaged, I gave thanks that neither bike nor body were irreparable in time for World’s.

The weather forecast for Zofigen called for rain. While the days preceding the event were warm and sunny, race day was wet and cold. The first hour was mostly uphill, so the slick streets weren’t too much of a concern. Once we crested the highest point of the course, a steep, technical, narrow, alpine descent beckoned us.

While I questioned my judgment for riding in the rain one week prior to World’s, it all became clear. I was thankful for the experience, fall included. I was better prepared to handle my bike under extremely dangerous conditions. I was confident, albeit cautious, in my approach.

The rain dissipated in time for our second and third laps of this 50K loop and slick roads were no longer a factor. There were many accidents that day on this hill. I am convinced that without training in the rain, I would have ended up a statistic on the pavement and not have fared as well as I did. I fell out of the top 100 duathlete in the world category that day, but remained proud to help TeamUSA.

Whether in sport or profession, it is critical to train under all conditions. Don’t take the easy road and cancel or modify your path because circumstances are less than ideal. Just deal with it as is. You never know when the real world is going to throw you a storm or two, but when you’ve trained for it, you will remain confident. Dealing with adversity will be second nature. Not only will your odds of success increase exponentially, but you will build confidence in the people around you.

Raining? Awesome! I wouldn’t want it any other way!

Ed encourages your interaction by clicking the comments link below. You can also connect with Ed directly on LinkedIn and Facebook and follow him on Twitter.

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October 7, 2015 Ed Marx 3 Comments

CIO Unplugged 9/2/15

September 2, 2015 Ed Marx 4 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.


I am often asked what the difference is between a manager and leader. In simple terms, it comes down to this. Leaders replicate themselves; managers don’t.

This may seem offensive because many who would consider themselves leaders are actually barren in a professional sense. They have not replicated themselves to cultivate children in leadership. They are managers. There is nothing wrong with being a manager — you just have to be honest about it.

If you think you are a leader but no one follows in your footsteps, you are a manager. But the greatest joy of a leader is to raise someone up and see him or her succeed.

I have been blessed with two children. We were deliberate in how we raised them. From an early age, they were taught to be independent adults who would add value to society. Parenting success was largely based on our ability to mentor and model how to be an adult. I am thankful that both children are of upright character and morals, graduated from college, have noble professions, and moreover, are adding value to society in numerous other ways.

That is what leaders do — replicate. They serve as models. They mentor. They call forth the seeds of leadership within their teams, nurture them, and protect them until they can protect themselves. Then they let them go. Yes! Let them go.

I learned this early on as I observed leadership roles in my classrooms, on the playground, in Cub Scouts and Webelos, on the soccer pitch, and as an altar boy. It was all about identifying potential leaders, nurturing them, and helping them grow and—eventually—letting go.


I learned last week that another one of my former direct reports became a CIO. I cried just like I did when I let my kids go. We invested so much energy and resources into Brandon and Talitha over the years, and as hard as it was, we let them go.

Oh the pain and joy. I feel it fresh as I write. But that is what leaders do — replicate themselves. Joey was my 12th CIO. Most of the 12 serve in healthcare today, but I had one who left for the Cleveland Zoo. He said that there were many similarities with academic medicine. I believed him. Like a proud papa, I let him go.

If you are not barren, then perhaps you’ve got it down and can add fresh ideas in the comments section that might help others.

If you are barren but want to start producing children in leadership, here are some ideas that may help:

  • Self-reflection. Ouch. Yes it starts with you. Are you worthy to be replicated? Do people seek you out and want to serve you ? If not, be honest about it and figure out why. I self-reflect constantly and sometimes, I don’t like what I see.
  • Mentor. Establish a mentoring program. These can be formal or informal. You will have more success if you develop a formal program and enlist others to help.
  • Hand-offs. I still recall an Army mission where we were on patrol for three days straight. The company commander approached me early one morning and said, “Congratulations Marx, you are in charge. Take us back safely.” No time to prepare or rest. Man, I grew on that mission. My boss knew how to force me to grow. Throw surprises at your team. That is how you accelerate growth.
  • Commission. Speak life into your people. Most are beat down by the circumstances of life. Stuff happens and life and career can be hard. Counteract the negativity with an opposing spirit by encouraging those you serve. Tell them what they need to hear, but don’t believe about themselves and their abilities – that they are leaders and have what it takes. That they can be CIO. That they are better than you. That their lives matter.
  • Listen. The biggest compliment you can give is to ask for input, listen to those you serve, and take action on it. Insecure leaders are afraid and don’t listen, but doing so builds the confidence of those around you. Confident subordinates are future CIOs.
  • Model. Always lead the way. Don’t just talk about rounding floors—actually do it and take people with you. Grab them spontaneously and say, “Let’s go visit with some of our team” or “Let’s go to our hospitals and talk to clinicians directly.”
  • Opportunity. Look for opportunities for your team and pass them along. Kick them out of the nest. If you hear of a great opportunity, tell them about it and help them prepare. Leaders help locate opportunities for those they lead.
  • Legacy. Look, we should all ask ourselves what on earth are we here for. We ask ourselves those deathbed questions about legacy and if our life mattered now. What better way to leave a legacy than to have dozens of leaders out there you helped develop who are saving lives? Wow. That is something to live and work for.
  • Time. Your time is not yours. You owe everything to your team. Spend social and work time with them. Laugh, cry, reflect, vent. The reason my kids are successful adults is directly proportional to the time we gave them. If you don’t give yourself to your team, they will never escape adolescence and grow into the leaders they have the ability to be.

What are you going to do with this challenge? Are you a leader with offspring … or are you a manager? What will you do to move from manager to leader? What will you do to increase your impact in this world?

One is too small a number for greatness (Maxwell). You need to multiply yourself if you desire to be a leader. Let’s do this.

Ed encourages your interaction by clicking the comments link below. You can also connect with Ed directly on LinkedIn and Facebook and follow him on Twitter.

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September 2, 2015 Ed Marx 4 Comments

CIO Unplugged 7/29/15

July 29, 2015 Ed Marx 6 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Paradox of Power

Power corrupts. Absolute power corrupts absolutely.

Do you want more influence at work and life? The key to increased power is the opposite of what most of us do. Most of us hoard power. But here is the truth: the more power you give away, the more influential you are.

There are two primary reasons most people hoard power: pride and insecurity. With power we can easily become arrogant. It feels good and makes us feel important. (Maybe more important than others around us?) It begins to shape our identity and invades our ego. We become addicts reliant on a power fix to make us feel good and ignore pain.

Yesterday’s fix does not satiate today’s appetite, so we need more and when we don’t get it, we lose our security. We are no longer thankful for the opportunity to have influence. It becomes an addiction. We all know people who once were rational and lovely but became unrepentant tyrants. It’s all pride and insecurity.

I recall the difficulty of moving the “IT Agenda” forward in a specific organization. Originally technology stragglers, leadership was quick to allocate resources to any other area but IT. Clearly there are multiple approaches to overcoming this common situation and we employed many. Embracing the paradox of power was the single biggest strategy we adopted that enabled our organization to move from laggard to national leader in a very short time.

I served with a gifted CMIO who reported directly to me. Our relationship was amazing and extended far beyond the workplace. We didn’t want our friendship to change, but knew we needed broader influence, so we expanded his reporting relationships. At first it was a dual reporting relationship to the CMO and then ultimately grew to a triad reporting structure to the COO as well. This approach was so successful, we severed his reporting relationship to me entirely. We eventually took a similar path with the CNIO. The results? Laggards to leaders.

Think about it. When it was time to prioritize budget items, I had the power of a singular vote. Now, I wasn’t the only believer in the power of technology to transform how we delivered care, there were two others of the same opinion. The IT vote was essentially tripled. This is one example but you can see the principle in action. The more you give away, the more you receive. This method is effective in play, at home, and at work.

In contrast, the insecure leader tries to tighten their grip on influence. No sharing. Hoarding takes hold. Command and control. No longer viewed as a team player, the leader’s power slowly and painfully erodes and is no longer respected. Key people resign, leaving behind equally insecure “yes” men and women. In an effort to replenish and build power, energy is diverted and the insecure leader begins to self-destruct.

Not only does the leader lose, but the organization loses as well. It is an avoidable tragedy. Imagine an organization where leaders seek to share power with one another. That is where I want to serve!

The biggest blocker of giving away power is insecurity. You must be secure to give it away! Insecure leaders are easy to spot—they do the opposite. They grab for power and hold on for dear life. They protect power. They actually believe they are becoming more powerful by controlling people. Controlling reporting relationships. Controlling information. Controlling culture. Another paradox? The more they try to control, the more they become controlled, imprisoned behind bars of fear. The cellblock does not have a lock. None is required.

What is the message? Give it away. Yep. Give up your power. Give up the control. Give up the grip.

An interesting dynamic happens when you walk in the opposite mindset or what I tag “freedom.” The chains are loosened and eventually broken. As this transformation occurs, you see results that serve as motivation to give away even more. Not only did this approach help us transform healthcare delivery, but it also felt good and was fun. Insecure leaders hoarding power—not fun.

This paradox is active in every aspect of life. I had this experience with money way back when. We did not have much and everything we did have, we hoarded. We did not share. And things stayed about the same financially. One day, we started to give it away. We noticed that the door to our cell had no lock and eventually we walked out free. More money started coming in. The more we gave, the more we received.

A few years ago I posted about softball. I was the best on the team, but we were mediocre. I swallowed my pride, gave away my position and batting spot, and boom, we won every game. We went from mediocre to champions.

I could give you similar examples in love as well. Don’t argue with me until you try it. If it does not work, then let’s talk! You want more power, more love, more success, more of anything? Give away more and let the cell door slam shut behind you!

Ed encourages your interaction by clicking the comments link below. You can also connect with Ed directly on LinkedIn and Facebook and follow him on Twitter.

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July 29, 2015 Ed Marx 6 Comments

CIO Unplugged 7/8/15

July 8, 2015 Ed Marx 6 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

The Opportunity and Danger of Influence

Following my farewell speech, several of my team approached me to say personal goodbyes. Waiting in the back, and the last person to step forward, was a manager. He confided that while not active in terms of volunteering at or attending social events I’d hosted, he was deeply impacted by my leadership. Since this was the first time he expressed such feelings, I looked him straight in the eye and asked him, “How?”

He stated that because of my personal emphasis on upholding responsibility for my well being and my active modeling, he’d decided to lose weight. In fact, over the last two years he had lost 185 pounds! Standing before me was a svelte man. I shared how proud I was of him. He went on to say that he observed how I shared and lived my faith and decided he wanted the same as well. A year prior, he’d found faith as a Christian.

My point is this: I never once spoke to him personally about well being or Christianity. But he watched, adopted, and changed. Transformed.

Last week, I attended a funeral and visitation for a former employee. He was not a vice-president, director, manager, or lead, but I knew him just the same. After seven years at the same company, I’d made it my priority to know everyone. I was no longer his leader, but refused to miss this visitation.

That day, I met his wife for the first time and introduced myself. She responded, “Oh, I know who you are. Eric spoke about you all the time.” “What, he spoke about me?” I thought to myself. “What for? What about?”

Eric loved to laugh, so I took a chance and made a subtle joke. His widow and I broke out laughing, then hugging, and then crying—as if we’d known each other as long as I had known Eric. People go home and tell stories—good or bad—about their leaders.

Yesterday, via LinkedIn, I had a message from an operations manager at one of my former hospitals. She shared how impressed she was by the training that one of my staff received through our internal IT program. She ended up taking the course herself and it changed her personal and professional life. She was so impacted that she switched careers and became an instructor for the course.

Your influence has repercussions beyond the immediate.

I could tell you more stories, but you get it. As leaders we wield significant influence. This influence can be for harm as well as good. We must be very careful and aware. It does not matter what you say, it is what you do. Our actions speak louder than words and they have the power for good or evil. Scary.

Choose life.

Ed encourages your interaction by clicking the comments link below. You can also connect with Ed directly on LinkedIn and Facebook and follow him on Twitter.

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July 8, 2015 Ed Marx 6 Comments

CIO Unplugged 5/28/15

May 28, 2015 Ed Marx 11 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Time for Me to Fly

Speculation swirls as to the reasons for my departure from my Texas employer on April 20, 2015. It is really simple and drama free. The organization I served was awesome. The most amazing place I have ever worked. Loved it. What I can share with you is my resignation speech below.

I called you all here this morning to share something important with you in person. Most of you know what happened to me in January on my ascent of Aconcagua. I had every intent of summiting that beautiful and rugged peak, but it was not to be. I had to abandon my climb, although my team would successfully summit 10 days later.

In the same way, I won’t make our summit climb with you. But I know you will be fine without me. You are trained, you are equipped, and you know the path. The climb was never about me. It was about all of us fulfilling our calling here. You will climb to the top without me and continue to save lives.

It was exactly seven years, six months, and one day ago. I drove with my family down from Cleveland through Kentucky and Louisiana. And there it was — the vast flatlands known as east Texas. As we crossed the state line, a Ford 350 pulling a flatbed trailer carrying 20 head of cattle pulled in front of us in our yuppie Lexus.

My daughter was spinning the radio dial looking for travel music, but every station was playing Nascar or college football. Suddenly we were hit by a dust storm. No wait, that wasn’t a dust storm! We were being pelted by cow dung that exploded on the asphalt highway into shit shrapnel penetrating the wax of our freshly washed veneer. Welcome to Texas!

I showed up here not sure what I was getting myself into. Tumbleweeds? F150s? Country music? Cowshit? WTH!

I knew it would not be forever and I am thankful for the precious time I had to serve with you. My last day will be April 20. Seven years, six months and 20 days. Five years and 20 days longer than some of you thought I would last, or at least hoped for.

I am not leaving for another opportunity too good to be true. I am not unhappy here — quite the contrary. I am not looking for more time with my family. I am not trying to fulfill a promise made.

A leader knows when it is time to move on. Give others a chance to fulfill their leadership calling.

I am giving myself some time for reflection.

We have an amazing leadership team and you are part of it. I am so proud of all of you. I brag about you all the time. You are the envy of many.

My only frustration in leaving now is you don’t know how good you are. How good you have become. Those of you who have been to the CHIME CIO Boot Camp know what I am talking about.

What have we done together? What storms have we weathered? What challenges did we overcome? What have we innovated? How much did we grow? How much impact did we have? It is overwhelming to think about.

Trust me, I have focused on this the past 30 days. Sigh. When I think about us, I think about all our “one anothers.” You know, as in, “We served one another,” or, “We upheld the promise with one another.”

  • We labored with one another.
  • We danced with one another.
  • We did obstacle courses with one another.
  • We hopped on 3 a.m. severity one calls with one another.
  • We drank with one another.
  • We stayed up 24+ hours with one another.
  • We cheered and experienced joy with one another.
  • We engaged with one another.
  • We elevated with one another.
  • We excelled with one another.
  • We passed out with one another.
  • We cared for one another.
  • We rounded at every hospital with one another.
  • We got tattoos with one another.
  • We played soccer with one another.
  • We played volleyball with one another.
  • We played softball with one another.
  • We took grief from clinicians with one another.
  • We sang carols with one another.
  • We debated with one another.
  • We challenged one another.
  • We loved one another.
  • We broke bread with one another.
  • We listened to Ralph’s SEAL Team stories with one another.
  • We made meals for one another.
  • We took care of each other’s families with one another.
  • We read books with one another.
  • We supported go-lives with one another.
  • We did karaoke with one another.
  • We did way more than IT for our customers with one another.
  • We survived audits with one another.
  • We bared emotions with one another.
  • We rebounded with one another.
  • We were mesmerized by Ferdie’s chants with one another
  • We broke silly rules with one another.
  • We cried with one another.
  • We survived (name removed) with one another.
  • We endured Dale Carnegie with one another.
  • We discovered and learned with one another.
  • We worked from home with one another.
  • We climbed mountains with one another.
  • We preserved through RIFs with one another.
  • We celebrated weddings with one another.
  • We had all our expense reports rejected with one another.
  • We climbed ropes with one another.
  • We played jokes on one another.
  • We achieved the highest levels of physician satisfaction with one another.
  • We prayed with one another.
  • We laughed with one another.
  • We enabled the dignity of death with one another.
  • We won Davies with one another.
  • We visited many bedsides with one another.
  • We worked out with one another.
  • We held hands with one another.
  • We consistently achieved world-class customer satisfaction with one another.
  • We attended Leadercast with one another.
  • We lovingly tolerated security with one another.
  • We bar crawled with one another.
  • We improved business outcomes with one another.
  • We were with the family of Stacy with one another.
  • We were with the family of Dale with one another.
  • We were with the family of Fred with one another.
  • We were with the family of Renee with one another.
  • We were with the family of Carole with one another.
  • We spent time in my home with one another.
  • We received way too many texts from Jim with one another.
  • We yammered with one another.
  • We created TEDx with one another.
  • We suffered through ITSM classes with one another.
  • We improved clinical quality with one another.
  • We improve patient safety with one another.
  • But most of all, but most of all, we saved lives with one another!

@#%$@ I watched so many of you blossom into amazing leaders that enabled these one anothers!

The future is awesome. The summit is in your sights. You have what it takes. You are leaders, you got this! You will become stronger without me But be assured. I will be watching you. You better not @$#%!@ up!

Jeremiah 29:11 says, “I know what I am doing. I have it all planned out. Plans to take care of you, not abandon you, plans to give you the future you hope for.”

I have tried to live my life embracing the following verses. I fall short, but share it with you nevertheless. It is aspirational. I pray this for you.

I Corinthians 9:24-27: “You have all been to the stadium and seen the athletes race. Everyone runs; one wins. Run to win. All good athletes train hard. They do it for a gold medal that tarnishes and fades. You are after one that is gold eternally.

I don’t know about you, but I am running hard for the finish line. I am giving it every thing that I got. No sloppy living for me. I am staying alert and in top condition. I am not going to get caught napping, telling everyone else all about it, and then missing out myself.

I will miss you. #@!&&^% I will always love you. You have no idea the depth of the pride and love I have for each of you.

We will always be about…one another…and saving lives. That’s our legacy.

I then went one by one to every VP, director, and manager and laid hands on them and spoke to their soul. I knew my people. I asked God to give me the words to encourage each one. I gave each one a specific word.

And when the last person left the room. I wept.

Today I have the privilege to serve the people of the world’s greatest city working in public health. Through an arrangement with The Advisory Board Group/Clinovations, I am part of the NYC Health and Hospitals Corporation IT leadership team. I could not be happier. Perhaps a future post I will get into more details.

And yes, I still have my eye on my Texas colleagues.

Ed encourages your interaction by clicking the comments link below. You can also connect with Ed directly on LinkedIn and Facebook and follow him on Twitter.

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May 28, 2015 Ed Marx 11 Comments

CIO Unplugged 3/11/15

March 11, 2015 Ed Marx 8 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Why IT Governance is Impotent

Every CIO I speak with struggles with IT governance. Despite everything written, numerous conference sessions, and creative processes, IT governance is a quagmire. 

I  wrestle with the “why.” I write extensively about it, give sessions, and publish creative models, but have not yet hit the mark. The literature is full of theory and process flows, but none seem to pass the test of time and stress. IT Governance remains a struggle for the majority of organizations across industries.

This riddle won’t be answered with new models. Innovation and creative models will inevitably fail unless we address three key factors. If accounted for, these influences will help ensure It Governance success: culture, leadership, and identified outcomes.


It does not matter who sits on the IT Governance committee or what model you use. When I switched organizations a few years ago, I transferred in what was a reasonable model. But what works in the North may not work in the South. It is a mistake to believe that models are portable, yet that is our focus. We keep thinking the answer is in the model.

You can leverage any model to achieve effective governance. Let’s stop copying other organizations models and start homing in on and adopting the principles that run through the few working models out there. Build these values in your IT Governance fabric and you will find success.


CIOs forsake our IT Governance leadership responsibility. Consensus is the enemy of collaboration. In an effort to appease key stakeholders, we no longer walk in our authority and thus the entire process has become deluded, rendering us impotent.

If you are not making people mad, you are not leading well. Stirring up contention is not the point. But when you lead with authority, not everyone will like your decisions. If our goal is to not upset the apple cart, our produce will eventually spoil and nobody will be happy.

So make the tough calls. That’s what you are paid to do. Don’t give it away and shortchange your organization. You, not a committee, are responsible for IT.

When will you know IT governance is successful?

The answer to this question will drive your model and principles. Collaborate with organizational leaders to establish desired outcomes.

If a focus is leveraging IT resources to do more strategic initiatives, then adjust your model accordingly. Set targets and then measure and report on them. Use these to prioritize requests. What percentage of your resources should be spent on strategic versus tactical? Know this answer and lead accordingly. Make adjustments to hit the outcome.

An outcome might be financial, related to establishing and defending budgets. I always have clinicians and executives as co-chairs in my models. Practically, I gain three times the influence, as they are surrogate CIOs when it comes time to acquire or defend resources. Adoption and usability are no longer on my shoulders, but rather the responsibility of all stakeholders. I retain authority by sharing it. Yet I remain accountable.

Strategic alignment is a valuable outcome. Ensure that everything you do is aligned with organizational objectives. You can build this into your process. Establishing alignment as a measurable outcome is one of the most effective ways to ensure the continued allocation of scarce resources. Moreover, you are demonstrating that your focus is not IT, but the greater good of helping your organization fulfill its mission and vision.

Focus less on the model and more on culture, leadership, and desired outcomes and the odds for effective IT governance increase exponentially.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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March 11, 2015 Ed Marx 8 Comments

CIO Unplugged 1/28/15

January 28, 2015 Ed Marx 13 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Beyond the Summit

The follow-up exam confirmed the base camp physician’s initial diagnosis. My eyes welled as the valley echoed with a familiar roar of the medevac chopper engines making the treacherous flight to reach the high ridge.

We had barely arrived at Base Camp Plaza Argentina, a mere 4,200-meter elevation, when the fickle finger of HAPE touched my lungs. I had to abandon my bid for Aconcagua well short of the summit. The fact that I’d summited peaks higher than this base camp did not matter.

Six years ago, I’d started climbing, and since then, I’d summited 20-plus peaks. I realized mountains ago that the true prize was never in conquering the actual summit. If I really listened and reflected, each climb embodied a much deeper lesson. An epiphany. I wrote about this a few times. Kilimanjaro, Rainier and, most recently, Elbrus.

Where I’d always connected these lessons to my success in summiting, I was now perplexed by Aconcagua.

Our team had formed and stormed for a couple of days in Mendoza, Argentina. The age range spanned 30 years. Germans, Scottish, Brazilians, and North Americans. Singles, one couple, friends, and in my case, climbing partners composed this diverse team. All were surprisingly equal in abilities, well prepared, fast, and strong. And of course we had talented guides who took us places our passports could not.

Once on the trail, we traveled 8-10 miles each day. We climbed 2-3,000 feet elevations before making camp each night. One day, we even outpaced the mule team carrying half our gear. We reached Plaza Argentina swiftly and efficiently.


We set our tents on the Plaza and all of us dealt with typical altitude issues. The few hours before dinner, we rested. As I laid my head on my makeshift pillow, I heard gurgling noises when I exhaled. My experiences and training said this was a telltale sign of things not good. Our lead guide Zeb did a pulse ox. Dropping under 90 was reason for concern—I was 65! My heart rate was 80 (my normal resting heart rate is 42). Obviously, it would go up in altitude, but this was twice the norm and my breathing was already labored. I suffered a major headache and my BP was out of range.

Given my climbing résumé, we tried to fix things with drugs to accelerate acclimation. Nothing worked. My oxygen saturation stayed dangerously low. HAPE had won.

If you’ve never experienced High Altitude Pulmonary Edema, taste this. The night before my medevac chopper ride, the physical misery was indescribably frightening. Water invaded my lungs as if to drown me alive. The lack of O2 getting into my veins rendered me lethargic; every step stole my breath. I had zero energy.

After I got the final diagnosis that morning, I had to tell the team that the incoming chopper had come for me. I approached our mess tent where my companions were eating and I started bawling. I stopped and took deep, labored breaths to compose myself. I said 10 words and my emotions overwhelmed me again. I touched my heart, eyed each of them, and then left to be alone.

Frank (Tucson Medical Center CIO) helped me gather my belongings. He and I were tight, having shared many tents in the past. He’s like a brother. He provided comfort. I took what I needed to get by for the day. My bags would come down by mule later that evening.


Frank and Zeb stood with me as I waited to load the bird. I don’t bawl often, but overwhelmed with sadness and inadequacy, I convulsed. Another climbing buddy Adriane came over. A sister, we also climbed together previously and enjoyed singing. A mother and teacher, she consoled me. One by one, my team came to the helipad. We shared hugs and tears. They stood there waving as I lifted off. On the bright side, they no longer had to groan at my puns or hear me sing.

Five months prior to this climb, I ranked top 10 at the world’s highest triathlon. Four months prior, I completed my second Ironman in record time. Three months prior, I was the top 100 duathlete at the World Championships. Two months prior, I was flirting with a 90-minute half marathon. One month prior, I was traipsing around local trails, carrying a 50-pound pack or stair-climbing in my Everest boots sporting a backpack full of 50 pounds of water.

Now I could hardly move.

Not to mention all the high-end equipment I purchased. I’d given talks about the 100 percent success rates for my previous climbing teams. My pride had been at stake.

What was beyond this summit?

The flight out was amazing. To gain altitude and overcome hellacious winds, the pilot did three loops in front of Aconcagua. The beauty left me awestruck. The rest of the ride through the Andes was a sight to behold. I made the most of the experience. Chin up. God was teaching me something. Listening to Him taught me what was beyond this summit.

The chopper dropped me off at the staging area, where I waited for my belongings to arrive by mule. Most of my symptoms cleared quickly. Finally, bags in hand, I headed back to Mendoza and made the most of the next couple of days as a tourist.

What did I learn? Humility for sure. But I also took the time to actually hear God. He’d been speaking to me for a couple of years now, telling me to decelerate. Slow down in all areas of life. Pole-Pole (slow-slow) in Kilimanjaro climbing terminology.

I never listened, despite well-intentioned people telling me. Failure got my attention. I had to learn the difficult and expensive way because I’d clearly refused the easier route. So again, it was never about the mountain. It was about an epiphany beyond the summit. This time, very close and personal.

How about you? Do you have ears to hear and eyes to see the real story around your circumstances? What are the peaks and valleys in your life? It’s rarely obvious to the physical eye. You have to seek it with your heart, because your heart sees and hears what your other organs cannot.


The best news: my team went on to summit that glorious peak on January 12, 2015. At their celebration dinner back in Mendoza, they left an empty chair to honor me.

Now for some Malbec.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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January 28, 2015 Ed Marx 13 Comments

CIO Unplugged 1/14/15

January 14, 2015 Ed Marx 2 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Leadership and the Paradox of Shame

Ninety percent of successful business executives are driven by shame. Psychology Today defines shame: the painful feeling arising from the consciousness of something dishonorable, improper, ridiculous, etc., done by oneself or another. It’s an attitude toward self. Nobody needs to look long to see the roots and vines of shame snaking through my life.

Shame is a powerful motivator. I was afraid to being a failure, so I graduated in the top 20 percent in the corps of engineer officer academy. I dreaded being last in any race, so I drove my body until I reached Team USA status. I feared disappointing my parents, so I strove to be a senior vice-president. One boss told me I wore the wrong clothes, so I revamped my wardrobe to keep from being harassed. Shame became my identity.

It begins in youth. We are shamed by parents, educators, coaches, friends, and clergy. If we chose to believe the lies, our identity falls prey to …

The paradox of shame. On one hand, it’s an emotional prison. On the other, it’s a fuel for success.

I was led to believe I was never good enough. Never as smart as my eldest brother and sister. I never could score as many soccer goals as my middle siblings. For every mistake and failure to meet his expectations, Dad shamed me. If a scoop of ice cream slid off my cone, Mom called me an idiot. They labeled my adolescent tomfoolery criminal. They didn’t know any better.

The year I earned my master’s degree and got promoted to Army captain was a big deal for me. Yet my mother exclaimed, “You still have to prove yourself.” Shame was my parents’ subconscious method of motivation.

Following their ingrained model, I leveraged shame to my advantage. I had to prove to men that I was a man. I had to prove to women that I was desirable. I had to prove to the world that I was worthy of accolades. Shame drove me to accomplish some amazing things. In order to feel good about myself, I had to be number one in everything. All false beliefs.

I even used shame in my leadership practice. I’d shame others to get the results I desired. I subtly made people feel bad under the label of motivation. While the intent was OK, the technique was pitiful. I would belittle and criticize others openly. Often, it was not so much what I said but my body language. I would make others feel bad until they relented and did things as I wanted them done.

The day someone exposed my shame, I embraced it. Twisted thinking! I loved the benefit. The power. If I let go of shame, what would happen to my drive? How would I motivate my staff? Would I still be number one? Would I still accomplish great things? Would men still admire me and women find me attractive?

Crazy, right? It’s called deception.

Shame infiltrated my DNA. Can I reverse the curse? Yes! But at what cost? At what benefit? Is it worth the risk? What if I fail? What if I lose the admiration of friends, family and industry? What if it costs me all that I have gained?

I’ve really been searching and examining myself. How do I escape shame? How do I stop shaming others?

It comes down to releasing myself and others to be who they were created to be. If that means I’m not president of the United States, so what? If I don’t make the team, so what? If people no longer seek me out, so what? Easier said than done.

Truth: better to live in freedom than in bondage to a lie. Shame creates a void that will never be filled despite the drive it creates. And for a leader, the higher status you attain, self-deceit can spiral out of control. The only way to escape this vortex of deception is to jump. Forget what others think. It is about you and me being who we really are, despite title.

Then how do we fill the void once we denounce shame? It zeros back to identity. Figure it out and live who you were created to be. To be self-reliant is to dig a deeper hole and still never be good enough. Instead, reach out for help. Continuously explore faith. You’ll be a work in progress, as am I. Messy, yet loveable. Redeemable. Worthy.

Thoughts on work relationships and the keys to escape:

  • Acknowledge shame-driven ways (you might need to ask a friend).
  • Apologize for manipulating through shame.
  • Replace shame with sincere encouragement.
  • Do not tolerate shame from others.
  • Exhort your teams to be all they can be, no strings attached.
  • Tell them it’s OK to be something different than what you may have wanted
  • Surround yourself with truth-tellers who will call you out on shame tactics.
  • Hold fast to your true identity.
  • As you become free, they will become free
  • When you remain imprisoned, so do they.

One more thing. I believe it is probable that by operating in the opposite spirit of shame, your teams will shine brighter than you ever envisioned! They may not look or act like you, but they’ll be free to be their best. Better to be mortal and free rather than super successful and emotionally imprisoned.

Shame is the new “Hotel California.” You can check out any time you want, but you can never leave.

Thankfully, there is an escape route out of the vortex. Break free with me.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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January 14, 2015 Ed Marx 2 Comments

CIO Unplugged 12/31/14

December 31, 2014 Ed Marx 2 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Forever Young

The song ‘Forever Young,” originally recorded by Alphaville, has been covered by numerous artists, most notably Jay-Z. As with many popular lyrics, the meaning differs for each listener. For sure, it’s a reference to the Cold War, during which it was written. But for me, it’s my 2015 anthem.

To live every day with my heart in the moment and only one eye on the horizon.

I’ve missed many heart moments. At age 14, I wanted to be 16 and then I wanted to be 18 and then 21. My first time swimming across San Francisco Bay, all I wanted to do was get out of the frigid waters. I hated it. When I was in college, I wanted to graduate and didn’t give a hoot about absorbing what I was learning. My freshman year, I fell in love, but romanticized the future and focused on getting married instead of developing a solid relationship foundation. When my babies were born, I groaned for the day they’d be potty trained. I missed critical bonding moments between “boring” infancy and tee ball age.

Essentially, I stunted my emotional evolution. Distracted with the stuff of earth, I was so absorbed in what I might gain in the future that I missed the present.

As are some of you, I’m a visionary by design. Without a vision, we go nowhere fast or drive backwards through life’s maze. But if we’re uber focused on vision, we shortchange relationships and forgo eternally valuable opportunities. Both ends of this spectrum are danger zones. When we lean too far toward vision, we lose two critical elements to a fulfilling life. Pain and Joy. And you can’t have one without the other.

“Forever Young” opened my eyes to being in the moment—emotionally.

I want to avoid pain, and relationships are painful. Work is painful. Can’t I just skip all the hard stuff and jump straight to the Promise Land? Why suffer? Let’s introduce new technologies and not deal with required culture and workflow changes. Keep pushing and everyone will eventually accept it as designed. So what if we rub one another the wrong way or talk behind a person’s back? Let’s just pretend that no one ever gets hurt and move on in our grand masquerade. Life is good!

Not really. Really living means we have to touch pain.

Years ago, I suffered rope burns on a challenge course. The skin on my hands was ripped off, exposing flesh. My ER friends could have simply put on salve, a bandage, fed me some drugs, and patted my back as I walked out. But then I’d return in worse condition. Instead, I screamed as they flushed my hand with saline, rubbing Betadine through my wounds and under the remaining skin. Today, you can’t see the trauma because they were willing to touch my wound.

A new year is prime time to change your game. Touch your wounds; touch the pain of those you love. Stop running and put on your big boy pants. I’d prefer putting on an Elizabethan collar (that lampshade thing dogs wear) to keep me from seeing or touching any wounds. Forgive and forget. Pretend nothing happened. Ignore pain. Get over it! I’ll be OK.

No! Pain unresolved only leaves open scars. You’ll feel counterfeit relief for a spell, but emotional scar tissue builds up. Continue to ignore and you’ll never reach your full potential. Every time you run from pain, you deaden part of your soul and become a false you. I am learning to embrace pain. In the moment. “Forever Young.”

Unspeakable joy. Only after you endure pain can you experience true joy. If you skip through the hard stuff, you cheat yourself. Total counterfeit. Superficial. And that’s boring!

The second time swimming the Bay, I stopped in the middle and beheld the San Fran skyline and the Golden Gate Bridge. Not only did I enjoy the moment, I then swam faster than my first time. Climbing some of the world’s tallest peaks, I marvel at the beauty of God’s creation and enjoy the moment. It makes the summit pure joy. I don’t reach the peak without the pain. The same goes for enduring emotional pain. Your soul reaches a new high.

Work conflicts. Not on my fun list. But I won’t run any more, meaning I won’t run away. I’ll run toward it, hoping to put some humanity back into the corporate world—culture shock! Some of my best working relationships will only be born out of pain if I don’t repeat past mistakes.

For example, a while back, an executive director was stuck in his ways and our personalities clashed. We never saw i2i. Did I go through the pain of deeper conversations or opening my heart to him, despite how he might stab me? No. I took the lazy way out. Smiled and nodded then walked out of meetings, rolling my eyes inside. But had we resolved, we could have become a dynamic duo rather than each other’s arch nemesis. We could have changed the future of our hospital. Working through the pain could have led to professional and personal joy.

I’m embracing the pain of my personal relationships. It’s messy! And it hurts deeply with every touch. I have plenty of open scars, and I’ve caused even more. But I have a new vision for healthy relationships, and the only way to achieve joy is to touch the pain. If I don’t change the game, I’ll become so callous I’ll no longer feel.

I am tired of missing moments. Of being shallow. No more counterfeit. Instead, “Forever Young.” I wanna be “Forever Young.”


Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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December 31, 2014 Ed Marx 2 Comments

CIO Unplugged 11/12/14

November 12, 2014 Ed Marx 4 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.


Thanks to a recommendation by friend and peer Pamela Arora, I was invited by the Chinese government to speak about health information technology. Having visited 29 years ago for my honeymoon, I was eager to return. This time, I would not be smuggling in bibles, but freely sharing lessons learned from my healthcare technology experiences.


After a 14-hour plane ride, I landed in Beijing and was greeted by my gracious host, Michael Wang. Michael is an English-speaking administrator at the China-Japan Friendship Hospital, the primary hospital for the city and party officials. We shared much in common and bonded over many meals, discussing our values and ideologies. Heck, we even did Starbucks together! We would later catch up with Pamela, who was also invited as a speaker.

You may be wondering how I survived eight days without Facebook, Twitter, Google, and YouTube. The answer: barely.

I had shared in advance my Top 10 list of sites to visit and they gave me a personal tour guide. It was freaking unbelievable. Although not a fan of Asian cuisine, I promised I would eat and drink everything set before me. Gulp. I managed. Incidentally, sea cucumbers are not ocean vegetables!

We also bonded through the ritual of shared shots. In China, each toast is a three-shot minimum. I, well … lost count of the toasts. What happens in Beijing stays in Beijing.

As you would expect, we toured the magnificent Friendship Hospital. Our guide and senior host was hospital president XU Shuqang MD, PhD. Dr. Shuqang now serves as the Party’s undersecretary of health for emergency management. A very friendly man with a great sense of humor. We connected on several levels, as both China and USA share many of the same challenges in healthcare.

As a big believer in the power of technology to help transform healthcare, Shuqang was personally responsible for the content of this conference. Every hospital in China took part. The equivalent of the ONC sat in the first row. The 2014 Chinese EMR and Hospital Information Management Association Congress was underway. I still pinch myself. Was I really a featured speaker? Humbled.


They employed simultaneous translation, which helped my speech go very smoothly. Until slide 12. Michael had entered the Chinese translation for all of my English bullet points, but for some reason, for every slide after the 11th, the English bullets disappeared.

It gave me pause, but I collected myself and then went on from memory. Thankfully, I recognized the pictures along the way that told a story related to the content. All was good. Who would know?


What did they want to learn about? Meaningful Use, HIE, privacy and security, and HIMSS stages of EHR maturity. Because I couldn’t imagine not talking about it, I threw in a few nuggets on leadership as well. What good is all that other stuff if nobody can lead and execute?

They were ahead of us in some areas such as telehealth, but behind in other areas such as EHR adoption and HIE. We learned from one another and developed a lifelong friendship that transcends political ideology. We are in this to transform healthcare. Indeed, the world is flat.

As I headed home, I reflected. My new friends. The amazing sights and sounds. The beautiful people. I came away with renewed hope. Hope for the world.

What resonated with me most was one of the triple-shot toasts given by Dr. Shuqang. “Despite ideological differences,” he said, shot glassed raised, “our two super powers can collaborate and truly transform healthcare and make this world a better place for the citizens of every country.”

They will be in Texas visiting Pamela and Children’s Health. I aim to catch up on progress made since we first met. I also hope they’re ready for some Texas cuisine!

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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November 12, 2014 Ed Marx 4 Comments

CIO Unplugged 10/29/14

October 29, 2014 Ed Marx 9 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

The Art of Saying Goodbye

How you say goodbye is more important than the first hello.

We only get a chance to make a first impression once. It is hard to recover a blown opportunity at saying hello. When I start at a new organization, one of my top priorities is meeting with as many individuals as I can as quickly as I can. I call this “hit the ground listening.” It is amazing how you can accelerate your adoption in a new company by asking questions and showing genuine interest in others and how things work.

I don’t recall all of my interactions. But I do recall every interaction where the first impression was blown by either party. In fact, those relationships rarely recovered despite reconciliation attempts.

Based on that, how can I assert that saying goodbye is more critical than that first impression?

While the first impression is typically a moment between two people, the last goodbye is often public. People watch, observe, and take note. They make impressions that, like first hellos, leave an indelible mark whose impact is irreversible.

How we treat an associate as they leave says more about the culture of an organization than anything else. We need to perfect the goodbye. There is an art.

There are a variety of valid ways to say goodbye. First, I do not believe that title dictates the extravagance of a goodbye. Why do we reserve champagne just for executives? Often the departing analyst may have had equal or greater impact! A rock star is a rock star.

I recall one farewell reception where a fellow executive who was walking by our festivities was wondering which of our peers was retiring. He seemed aghast that is was just a farewell for an analyst who had been with us for five years. I told him that the impact that analyst had in five years was greater than the impact of some execs who had been there twice as long. It is not about title or length of service, it is about material impact. The greater the impact, the greater the celebration.

Second, make sure you understand how the departing person wants to say goodbye. While I am all about big celebrations, others prefer a sedate getaway. Always do what that person prefers — it is their party! I recall lavishing praise on someone for the amazing work they had done. Afterwards, they texted me that they dislike that kind of recognition. My attempt to bless backfired. When someone prefers an understated affair, I think it is important that this is shared with those observing.

The next time this situation presented itself, I simply let the team know that we really appreciated the person who was leaving, but they specifically asked for a quiet exit and we would honor that. A card or small luncheon may be perfectly appropriate.

There are many ways to say goodbye and this is by no means an exhaustive list. My favorite thing to do is to verbally affirm others. We bless them with a reception full of friends and family, but the thing people have told me time again as having the most significant impact is the verbal praise received from those they worked with for so many years.

As the leader, you start this. You surround the person, look in their eyes, and speak truth. Dependent on their comfort and your relationship, I recommend including touch. You don’t need to prepare a speech — this should be spontaneous. Just speak what is in your heart and perhaps include an anecdote. Try to include something light to counterbalance the sorrow that everyone will naturally feel. As you lead, others will follow.

To be able to say goodbye like this clearly requires something of you. That you have relationship with your entire team. That you know them by name. That the stories are natural to come by because you have shared experiences.

What if the person leaving was a poor performer? All the more reason to celebrate!

And if anyone tells me they have no time to celebrate and say goodbye in an artful, thoughtful way … you need a new career.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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October 29, 2014 Ed Marx 9 Comments

CIO Unplugged 10/15/14

October 15, 2014 Ed Marx 14 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

The Hands of God

“Will I die?”

My nurse checked my vitals on the evening prior to my operation, a surgery to correct a birth defect. Even at eight years old, I was acutely aware of the possibility of going asleep and not waking up.

I’ll never forget what happened after I voiced my fear. Sitting on my bed, the nurse drew me close and wrapped her arms around me. “Little boys don’t die,” she whispered. Nurse Beata’s verbal medicine soothed my anxiety. I woke the next morning confident and excited about getting a new ear.

Nurse Practitioner Pinkerton shed a tear of joy and gave my wife a hug when Julie showed delight upon hearing that we were indeed going to have a baby. As the primary caregiver at the student medical clinic at Colorado State University, Nurse Pinkerton shared that students usually expressed sorrow over an unwanted pregnancy. Julie was the first student that year to be happily pregnant. I was especially pleased that Brandon’s due date was after graduation.

A few years after our son was born, we had a daughter, Talitha. She pent the first eight days of her life the NICU. Our precious baby, her life in the balance, was loved on by nurses’ caring hands.

About a year ago, Tali and I dropped in on them to say hello and let them see the fruit of their labor. They studied the strong woman that frail baby transformed into. Tali had a chance to say thank you to the nurses who had watched over her like angels two decades prior.

Early in my healthcare career, I worked with nurses in the OR. Oh, the things I witnessed! So hard to express in words. The love. Compassion. Humility. The hours and dedication. The passion and the tears. The smiles. The joy. The healing. I hated leaving that environment and culture, but my calling lay elsewhere.

As I became involved with technology, I remembered the nurses. I consistently position nurses on my team and I’m proud of all of them, especially those who have become CIOs. At last count, roughly 25 percent of my teams have been certified clinicians of one sort or another. They understand workflow and the culture. You match this education and experience with technology and boom! I exhort my fellow IT leaders to embrace nurses.

OK, not all of my nurse experiences were positive. My only bad nurse encounter happened when I was 15. While riding my bike to school, I was struck broadside by a truck that pushed my face and body into the asphalt for about five yards. Much of the skin on my face was roughed up.

An ambulance rushed to the ER, and the triage nurse gawked at me and winced. That was not a good signal for an insecure teenager in shock. But to his credit, he did take good care of me and stopped wincing after painstakingly pulling every bit of gravel out of my face. I forgave him.

My point? I’m thankful for nurses. They don’t win Emmys or Heismans. Fearful patients chew them out, yet they extend mercy. They sooth your worries. They help facilitate healing. They make health information technology successful.

One last thing, something we rarely acknowledge. They put their lives and health at risk for us.

They are the hands of God.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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October 15, 2014 Ed Marx 14 Comments

CIO Unplugged 7/16/14

July 16, 2014 Ed Marx 2 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Abdication of Authority and the Poets

I used to write a fair amount of poetry in my early teens. I continued writing for about 10 years, but stopped shortly after marriage and after the birth of our first child. Julie remarked one day that my poetry had lost its romantic flair and creativity, reading more like a stuffy business letter. As I re-read some of the stuff I wrote, she was absolutely correct. “Dear Julie,” I would begin, and then end with something akin to, “With all due respect.”

Actually, even as I review some of my earliest material, I become increasingly critical of my writing. I think of how I might rephrase specific stanzas using today’s vernacular. Then again, sometimes when you mix the old and new, the outcome is not all that much better. I finally came to accept that while imperfect with today’s eyes, the poems of old were indeed perfect for the time in which I originally wrote them. A zeitgeist sort of thing, I suppose.

As I rummaged through old online files, I found several presentations I’d done around IT governance. I was shocked to find myself in disagreement with many of my original suppositions. But, as with my retrospective with poetry, those governance models were possibly the best for that point in time.

Or were they? With this historical vantage point, I noticed a disturbing trend that not only led me into a long-term malaise, but many of my peer group as well. Subconsciously, we ceded more and more control of IT to our customers, unknowingly setting the stage for a silent yet unintended overthrow.

Today, we are scratching our heads and wondering where the power of the CIO has gone. As I’ve said before, many of us are downright impotent, and I’m ringing the bell loudly to awaken the sleeping spirit.

My findings were disturbing. At one point, I want to cry, and then in the next second, laugh. We often blame our customers for uncontrolled IT costs and say crazy things like, “There is no such thing as an IT project.” We load governance councils with individuals who are unqualified to help make technology decisions and yet complain about the insufficient funds for infrastructure. Giving away control only doomed us to the Tragedy of the Commons.

From a historical perspective, the pendulum has swung a full 180 degrees. I applaud inviting others into the tent. Absolutely it was and remains the right thing to do. But somewhere along the line, we left the tent. We maintained our responsibility but abdicated our authority. We abandoned our leadership rights.

Many are now outside the tent looking in, running IT by title only. Not influence. Not leading. Just reacting. Yuck!

Do we want to swing all the way back? No! I suspect for most of us we need to shift more toward center. The governance continuum will vary by the culture, organizational challenges, environmental factors, and ultimately our individual leadership capabilities. We need to appreciate the journey, learn from it, and modify.

Let’s reconnect to our mantle of authority and lead governance. Not be ruled by governance.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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July 16, 2014 Ed Marx 2 Comments

CIO Unplugged 6/11/14

June 11, 2014 Ed Marx 3 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Data-Driven Performance

I have a confession to make. While I am an uber advocate of data-driven performance in healthcare and IT operations, I seldom apply these tools to my personal life. Sure, I look at data when I consider investments and major purchases, but, put it this way, you’ll never see me with a Fitbit!

I am witness to the power of data to shape clinical transformation. Are you kidding me? Serving in organizations with mature electronic health records and advanced business intelligence tools, I see the evidence in our quality reports all the time. Bam! Data-driven outcomes for sure. Evidence-based medicine—check. Ditto on the business side. In fact, my organization is among the first in the country to post our data-driven metrics online. Transparency is a great motivator.

For all my talk on leadership, innovation, connected health, and business intelligence, you might expect me to be a walking wearable. Nope. I’m wired as a visionary. Details are not my forte. I might have a grand idea for a party, but I leave the planning and execution to the detailed-minded organizers.

When it comes to athletic endeavors, I’m about getting to the finish line fast. Forget style and quality form; just get out of my path.

Over the years, the downside of this method caught up with me. Time was no longer my friend. Another confession: my performance had stayed flat for a few years. I wanted to see improvements, so I needed to change.

My friend Ben Levine is a perennial “top doc.” He runs the Institute for Exercise and Environmental Medicine and is one of the world-renowned types who’s been kind enough over the years to help train my mountain climbing teams.


Ben took me through the paces of his research lab. Part of our deal meant I had to be in a study and sport a wearable for a while.

After analyzing all the tests, he told me my body was capable of greater performance. My lifelong conditioning gave me a good base, including a resting heart rate of 40 (occasionally six BPM when asleep). But I had not reached my physiological potential.


I researched and found a triathlon coach to help me get to the next level of performance. Of course, it turned out that Amari of Dallas-based Playtri is a total data hog. She stretches me (no pun intended) beyond my comfort zone with all these wearables and resulting analytics.

In the past, I would cycle in a race and hope for the best by just doing whatever felt good. Now she had me monitoring a combo of heart rate, cadence, and wattage. Speed is secondary. If I focus on the analytics, the outcome (speed) will take care of itself. If I only look at speed, as I did in the past, I might dismount my bike only to find I have no legs left for the run —bonk!

I posted last fall about qualifying for regionals and then for the national Duathlon (run/bike/run) championships. Through grit, I lucked out and secured the last spot (age group) on Team USA. It was not pretty, but I made the team.

With the World Championship on the horizon as well as other important races, the time for data-driven performance arrived. A real life experiment—with me as the subject. Time to walk the talk.

Albeit imperfect in my utilization, Amari’s training formula is completely driven by near real-time data feeds. She makes adjustments based on daily training and race results. I dutifully wear the gear and upload. She parses the data, does meta- and microanalysis, and off we go.

What were the 120-day results?


I am writing this post on the plane home from the World Championships in Pontevedra, Spain. I followed Amari’s race plan, which was all data points: 150-165 BPM heart rate on the first 10K, 270 watts on the bike, never going lower than 165. It was not “outrun the person in front of me,” but to be patient and focus on my data. If I did that, the results would be my friend.

I finished in the top 25. I was the #4 American (an upgrade from #18 last fall) to cross the finish. Data-driven performance! I’m a believer. I can’t wait until I perfect the technology and discipline myself further under Amari’s coaching to see even stronger outcomes.

Personal life imitates professional. We must all push our organizations and ourselves to become data driven.

While being data driven leads to improved outcomes, no data tool could ever create the following. Intrinsic motivation does have a purpose.


The home stretch with .5K to go. I saw the Team USA Manager exhorting us to finish strong. Tim handed me Old Glory as I ran by and said, “Catch two more racers!” I caught my two as I turned into the stadium sprinting to the finish. Waving my country’s flag. Hearing chants of “USA USA USA.” Tears of joy.

Go Team USA!

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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June 11, 2014 Ed Marx 3 Comments

CIO Unplugged 5/21/14

May 21, 2014 Ed Marx 7 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Marching to the Syncopated Beat

Syncopate – to place the accents on beats that are normally unaccented.

At our last quarter IT leadership team offsite, we invited our Business Technology Leadership Academy cohort to join us. As part of the icebreaker, I asked everyone to describe a leadership paradox — philosophies that don’t seem particularly logical on the surface, yet are quit profound and effective. Since the paradoxes are not mainstream, we may overlook some of these leadership gems in search of the quick fix.

Here is what the team came up with. As you read these, ask yourself: do you operate in each of these areas? If not, what if you did? I know I can read lists and say to myself, “Well of course I do all these things.” But when I am intellectually honest with myself, I begin to see my gaps more clearly, which in turn motivate me to action. I don’t want to toil in vain; I want my work to count for something. I know you do as well. Embrace the gaps and work to close them.

  • Serve, not be served. The day we left the assembly line making widgets is the day we stopped adding direct production value to our organization. Therefore, focus on those who do the actual work and seek to serve them instead of seeking to be served.
  • Patients come second. Heresy? Nope. This book, co-written by one of our hospital presidents, speaks about employee engagement as the key factor to higher quality of care and services. When you focus on people first, everything falls into place.
  • Letting go enables influence. Too often we grip everything with an iron fist trying to protect what we believe belongs to us. While we might succeed at protecting our turf, our influence is stifled. Rather, give everything away and it will come back to you threefold, pressed down and shaken together. Our CMIO and CNIO used to report to me. I purposely had them report elsewhere in our organization, effectively multiplying the influence of IT threefold. You do not have influence until you give it away.
  • Love when you want to hate. Admit it. Sometimes people can just beat you down and for no good reason. You are maligned or disrespected or taken advantage of and your natural inclination is to strike back. Instead, double down on your efforts to love on that person. Clearly, they need it. Hate only fuels hate. Love puts out the fire.
  • Turnover is awesome. We used to have these KPI that were, in a sense, perverse. Someone decided 10 percent was the high watermark for turnover. That generated a lackadaisical attitude and atmosphere. Transforming an organization sometimes requires clearing out non-performers. Embrace appropriate turnover, KPI or not.
  • Turn your leaders. Longevity has value to a point, but it also cultivates complacency and inflexibility. I will delight in celebrating the day one of my team resigns after years of serving—but not necessarily serving me or my organization. I’ve enjoyed a greater pleasure watching one of my directs fly the coup and continue on their journey to reach their career goals. I have six CIOs out there who used to report to me. I am a proud papa!
  • Hide your rank. I will rarely introduce myself or say, “I am the CIO.” I actively participate in meetings and rely more on my logic and persuasiveness than on rank. If I relied on rank, the world would not be a better place. People are less inclined to contribute and engage if some arrogant ass is leading them.
  • Build villages, not castles. We all have a set amount of mortar and brick at our disposal. The real action happens in villages, in the town square, among the people. Get out of your castle and live among your people. You will not only better understand how to serve them, but you will experience real joy.
  • Ask for help. Everyone already knows you’re partially incompetent. You can’t possibly know everything. The gig is up. Just admit it, ask for help, and move on. You will earn respect and more will get accomplished.
  • Give credit to the team. Obvious, yes, but hardly practiced. Hello? You want glory? Then take the glory that comes with taking bullets for your team when a project goes sideways. You want the most loyal team on earth that will jump on grenades for you? Protect them. Take the shit when it hits the fan.
  • Embrace challengers. At first, I’ll hate them; but then I’ll love them deeply. They are one of the reasons I’ve experienced success. I grit my teeth and embrace those who challenge me; I glean all I can. They have the inherent ability to transform me more than any who kiss my ass. Ass-kissers feel good. Challengers make you good.
  • Never coast. I have participated in about 125 triathlons now. Coasters never win. They look good for a while, but they never achieve significance. I know people who achieved a level of success and decided to retire while working. When all is said and done, they will be depressed knowing they had more to give but kept it to themselves.

As I review the above list and contemplate the personal application, I see where I have fallen short and need to take another run at them. I know that if I do not continuously look for and fill gaps that I will become the kind of leader I fear most. A complacent leader. An impotent leader. A leader in name only.

Insignificance is not my calling. Nor is it yours.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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May 21, 2014 Ed Marx 7 Comments

CIO Unplugged 4/16/14

April 16, 2014 Ed Marx 6 Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

How Snow White Changed My Life


OK, life change is a stretch, but Snow and some of her peer princesses did remind me of a critical aspect of leadership—creating special moments. In the case of Disney, it’s “where dreams come true.” For my Starbucks aficionados, it’s, “Handcrafted beverages are the secret to making life better.”

Five years ago, I added “create perfect moments” to my personal strategic plan. It’s one technique to help ensure “creating perfect moments” moves from bench to bedside. In the big things of my life, this has worked well, but not the common everyday stuff of earth.

While in Orlando recently, I spent time exploring Disney’s Epcot. Just for fun — and to make my wife and 20-year-old daughter smile — I decided to grab a photo op with Snow White.

Was my pride ever challenged! There I was, sandwiched between animated toddlers and star-struck preteens, in line to take a pic with Ms. Purity herself. Seemed everyone was dressed like a princess except me. I stood close to one toddler hoping passersby would think I was part of her family. Heaven forbid someone I knew might see me standing in line at Disney for a personal princess pic.

My turn came. I sheepishly held my arm out for Snow White. My friend took the pic.

I was ready to run, but Snow would not let me go. Help! She turned, looked me in the eye, and engaged me in conversation. I was pulling away, but she kept me there. It was longer than a moment, but not excessive, maintaining eye contact the entire time. As if someone just discovered my hand in the cookie jar, I was about to break out in a nervous sweat.


I texted the pic to my wife and daughter and they both replied ROTFL. So when I saw Sleeping Beauty, I stepped in line again.

This time, I carefully observed all the interactions between the princess and her devotees. Miss Beauty held eye contact with every fan and engaged in brief conversation.

My turn came, and though I tried to pull away, she clung to my arm until we talked. Awkward, yes, but so enlightening. Ditto with Belle, Cinderella, and last but not least, Ariel. They were indeed making dreams come true for their fans. They made me feel important.

How can we take something as simple and yet profound as a Disney princess engagement formula and put it into practice ourselves? How can we allow this to become a natural part of who we are?

As leaders, we are so rushed. I preach to myself here. We walk past our staff with nary an acknowledgement. When we do stop to talk, we are thinking about the meeting we are headed to.


On one hand, we claim that the right people in the right places are our most valuable assets. But do we give them the gift of our time, fully present, even for just a minute? This proves a contradiction in our leadership.

Since my return from Disney, I’ve been doubling down on creating special moments, this time with my staff. I am making sure every interaction, however brief, is meaningful. Eye contact. Genuine interest. While the other person may be rushed, I will remind myself that my agenda is their agenda, and my role as a leader is to serve them. True, not every person will want the time, but for those who do, I am there.

Before the end of my final day at Disney, I was looking for the next princess. Why? Because I enjoyed the way they made me feel. Special. If a princess can do this for strangers, we can do it for those we serve. Pics or no pics.

Create special moments.

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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April 16, 2014 Ed Marx 6 Comments

CIO Unplugged 4/2/14

April 2, 2014 Ed Marx No Comments

The views and opinions expressed in this blog are mine personally and are not necessarily representative of current or former employers.

Accelerating Workplace Relationships

I inherited the party bug from my parents. I recall that during their parties, Mom and Dad would march us seven kids in to play our instruments and sing. I think we each earned a quarter in exchange for those performances. Not bad for a non-union, late-60s era gig, I suppose.


My parents had many guests over between parties as well. Sometimes my dad’s co-workers, other times just small socials and mixers made up of Mom’s and Dad’s extensive friend network. We had no dull moments growing up!

When an HIStalk reader asked me to comment on how to accelerate work relationships and break down silos, partying was the first thing that came to mind. I’ve carried this tradition into work and home. While Julie is more into hospitality as I am into entertainment, parties and fun times with friends reside in our blood. Hardly a weekend night passes where we are not out dancing or hosting some sort of get-together.


Clearly, there are many techniques to building work relationships. Since you can download a book and get routine ideas, I will focus on methods less talked about yet in my wheelhouse, because I love to party. Yes, I party with my work peers and subordinates. I can hear the naysayers and I respect you. I can assure you from personal experience over the years, partying has made a positive difference in business outcomes as well as employee engagement. Plus, it’s fun. Life is too short to work with dull people!

Here are some ideas. I’d love to hear yours. Please comment below so we can all benefit. Not all will be applicable, but we won’t know if something works unless we try it. Be brave!

  • Monthly after-work socials. Who: managers and above. One Thursday per month, we hit a city (rotate) in our sprawling metroplex and get to know one another in a relaxed setting. Typically, we visit 2-3 venues and the first round is on me. Everyone knows the rules. People are responsible for their behavior during this voluntary social and getting wasted is discouraged. We are so hurried at the office that there’s little time for informal chitchat; this relaxed venue allows for real engagement.
  • Annual cheese, wine, and chocolate party. Who: directors and their significant others. Dress code: a step above casual. We’ve hosted six of these parties at our home. This fellowship has a two objectives, one social and one training. Some of our directors have officer-level career ambitions. This offers exposure to a new culture and a safe environment in which to practice new skills.
  • Annual Christmas party (non-office setting). Who: direct reports with their families. We host this event in our home as a gift to those who serve me directly. December is way too busy, so we schedule this for the first weekend in January. Our white elephant gift exchange has produced some interesting and memorable … stuff.
  • Annual leaders’ family barbeque and swim. We rotate the location of this summertime event at one of our director’s homes. Kids and significant others are the focus. We eat lots of food and chill while the kids—and a few brave adults—frolic in the pool. You want to engage your team? Engage their kids!
  • Sports (all unofficial due to liability.) Soccer teams, Ironman triathlon teams, mountain climbing teams, etc. Not everyone participates, of course. These are simply additional examples of outside-the-office party opportunities. After every adventure race, we have a line for our guest shower before the celebrations begin.
  • Manager and director thank you party. We did our first one of these in January. A gift from Julie and me, it is an opportunity to say thank you to my entire leadership team and their significant others. Email is OK and I love thank you cards, but having everyone over and showering them with love is yet another way to engage at a deep level. My success is largely attributable to their leadership so we are quick to have everyone over and splurge.
  • Special events. As needed. Last year, we won the Davies Award, so we hosted a professionally catered dinner for everyone who made this happen (including significant others.) Additionally, we invited the president of the EHR software company we used to come reinforce the magnitude of the achievement.
  • Personal parties. We have several parties throughout the year and we often include many from work (peers, staff, etc.). These include birthday parties, game nights, and theme parties. We have “The Great Gatsby” coming up next week. I suspect that 25 percent of our guests at personal parties are from the workplace.
  • Recognition events. Directors have access to our home to use as a party venue for their teams. Some of them use our home for team-building events, some use it for parties, and others for special recognition for projects well done. While many of the examples above stress managers and directors, over 50 percent of my entire department has been to my home at least once for some sort of party.
  • Exercise parties. Yes, my entire staff is invited to any of my daily workouts! Sometimes I will hold “office hours” in our treadmill or spin-cycle conference rooms. For some reason, these seem to be the least popular of all the parties …
  • Dallas City Lights. This monthly event involves friends in all of my circles, but again includes about 25 percent from the workplace. I choose a different location each month and we all meet up. February we went country and March we hit the Glass Cactus, where part of the dance floor was reserved for our group. We danced to ‘70s music until they turned the lights off at 2 a.m. In May we hit an infamous ‘80s-only venue. Dancing takes center stage at many of these gatherings.
  • Other peoples’ parties. I accept most the invitations I receive.


Many traditionalists suggest maintaining a big border between work and play. Leaders should not engage or otherwise be transparent with the teams they lead. I disagree. I found great success by being transparent and opening up my heart and home to those I lead.

Together, we have accomplished tremendous things, and I attribute a large part of this because of the level of engagement we have achieved. We know one another deeply. We know spouses. We know children. We know our joys and our hurts. When we know deeply, we care deeply. When one of us is injured or needs help, my joy is seeing many rush to walk with them, even carry them if needed. I’m thankful for the times they carried me.

And yes, when our kids were younger, we marched them out to entertain our guests. There was Brandon the Magician and Tali the singer. Memories!

Ed Marx is a CIO currently working for a large integrated health system. Ed encourages your interaction through this blog. Add a comment by clicking the link at the bottom of this post. You can also connect with him directly through his profile pages on social networking sites LinkedIn and Facebook and you can follow him via Twitter — user name marxists.

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April 2, 2014 Ed Marx No Comments

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