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CIO Unplugged 2/21/18

February 21, 2018 Ed Marx 2 Comments

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

First Days

This is the last in a four-part series on key considerations and action items during your first 120 days in a new job.

They say the typical executive will switch positions 5-7 times during his or her career. How can you ensure a smooth and effective transition? This series is intended to compliment what others have written over the years with some fresh perspective. This post will begin where the last left. A shout out to several peers whose ideas are reflected below.

A summary of the posts in this series.

30 Days Prior. After you have celebrated your new role with friends and family, you have to get to work. This is a challenging transition time as you must first honor your commitments and obligations to your current employer while also carving out time to focus on your pending role. Your primary commitment and loyalty remains with your current employer. If you can find some time to invest in your pending gig, it will pay dividends.

Day 1-30. Your first 30 days on the job are the most critical. The first day can be nerve-racking. You typically head straight for orientation or to your new office and meet your manager. Whatever the circumstance, dress the part and take a deep breath! Remember your first day of school?

Day 31-60. By this time, you no longer need a GPS to find your way around campus. You are becoming familiar with the organizational culture and building foundations of trust with key leaders and team. You are working hard but eating right and getting in rest.

Now we are at Day 60-90. The actions you take from this point forward establish the DNA of your organization. It is challenging to change trajectory as you lead from the base you established in your first 90 days. Final adjustments should be made during this time.

You are mastering many of the basics. You are learning culture, establishing relationships, converting quick wins, and building your team. There will be many nuances depending on your organization and the state of your division, but the following are generally solid areas to focus on.

90-Day Plan

Create and publish a second 90-day plan. This will buy you more time to develop your strategy and complete your onboarding. You have to visibly be moving things forward even while learning your new job. If you have no published plan, colleagues may assume the worse or others may attempt to fill a suspected void. It is best to showcase continuous action. The additional plan contents will also continue to keep your organization focused on getting things done, not waiting for some magical master plan. See next!


Simply put, there are three broad categories of IT strategy: non-existent, aligned, and converged. Your objective should be to reach strategic convergence, as explained below. If there is no strategy, you must create one. If there is an aligned strategy, you should set the stage for convergence.

  • Non-existent. Many organizations have no defined IT strategy. This may be one of the reasons you were recruited. Before you seek to collaborate and create a strategy, make sure that other foundations are firm or else you’ll be building on shifting sand. Ensure governance is in place, as well as a functional project management office. Double down on key peer relationships to ensure the developed strategy sticks. There are many resources and examples available online. Someone once said, “If there is no plan, people will wander.” They will.
  • Aligned. Some organizations have a strategy that is aligned with the business. The fundamentals are popping and much care is given to ensure the IT strategy is in place to support the overall organizational strategy. Super. Make sure you have the right people on the IT governance team and aim to have your CEO co-chair with you. Include a patient for their unique perspective. Publish your plan and report on related metrics. Now focus on getting out of the IT strategy business and setting your eyes on convergence.
  • Converged. When the IT strategy is embedded as part of the overall organizational strategy, it’s organizational nirvana. IT is woven throughout, much as a thread within a tapestry. There are no defined boundaries; IT is just part of the business. There is little reason to call out IT because it is at the same level of all other key organizational functions. It is hard state to achieve and remain, but worth working towards.


It is good to be brutally honest about IT and identify any gaps. Transparency is key. Share openly when things go wrong. Your customers know there are gaps and they know before you do when things are not working well. Go ahead and be proactive, own up, and take action. In addition to highlighting IT-related metrics, show all failures, along with the root cause analysis. It is old school, but there’s nothing wrong with adding one of those “X Days since…our last accident” reminders to keep the importance of high reliability front and center. You are what you measure.


You won’t succeed on your own, so be extremely diligent in pursuing relationships. Not everyone will be warm and welcoming, so it is up to you. It is not that your peers are uncaring; more likely, they are plain busy. It is your responsibility to develop high quality partnerships with your peers.

Vendor Management

I recommend developing a vendor management office and look to segment vendors in order to better manage your time. One method is to divide vendors into strategic, tactical, neutral, and emerging categories. Don’t get fixated on my descriptors as much as the concepts. Your time is precious and you will run out of resources if you try to meet with everyone. I stick with 3-4 strategic partners and 2-3 emerging vendors while my team handles the balance. You should invest time with key suppliers, as they can accelerate your strategy and success.

Professional Organizations

These are your lifeline. Do not ignore. Organizations like CHIME and HIMSS offer so much support through all of their programs and services. I would not be where I am today without them. By all means, give back to the broader community, especially local chapters.

Community CIOs

Another lifeline is your area peers, inside and outside of healthcare. In NYC and Dallas, I made it a point to try to bring peers together. In Cleveland, all area healthcare CIOs are meeting for dinner. I also encourage reaching out to the non-healthcare CIO community as part of onboarding. They can provide valuable insights and direct you to community resources. Asking for help is a sign of confidence and strength.


I’m not sure I can overemphasize this. You must have the right people on your team. We all know this intellectually, but it is a challenge to pull off. Do you keep everyone? Individually, are there issues with competency? Character flaws? Does he or she embrace your vision? Is she or he better then you? (hopefully yes!) Your team alone may not lead to your success or demise, but will be the accelerator of either.


What an amazing opportunity you have as the new leader on board. You have been chosen for a reason and now you have to exceed your end of the employment agreement. To optimize your success, I encourage you to complete a written 90-day plan. Take posts like this and other resources to give you some ideas. Reach out to mentors and others who have gone before you. Write it out and execute.


What other considerations and action items should leaders consider in their first 90 days that I haven’t covered in the First Days series?


Ed encourages your interaction by clicking the comments link below. He can be followed on LinkedIn, Facebook, and Twitter.

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Currently there are "2 comments" on this Article:

  1. I’d like to hear more from Ed about his perspective on the current state of “Professional Organizations” – in terms of their true value and the ability for execs to truly benefit from participating. Beyond local chapters – which by their very nature are limited in breadth of participants – there aren’t many ‘intimate opportunities’ available. Everything seems to be centered around and in bed with HIMSS. It’s just getting too big and too overtly commercial.

    Do execs really benefit from these mammoth organizations and infrequent – sometimes only once a year – opportunities for networking and thought leadership development?

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