Health IT from the CIO’s Chair 2/4/15

Fine print: The views and opinions expressed in this article are mine personally and are not necessarily representative of current or former employers.

IT and the Big Rooms

Talking about change in IT is nothing new, but it feels like less has been written about the changing role of IT in the C-suite and at the board. Since I believe we are in the midst of a new shift, I wanted to raise the topic.

For the most part, the makeup and composition of C-suites and boards defies generalization. Company size, business sector, and stage — combined with the wide breadth of talent and backgrounds that compose these groups — makes them all unique.

But if I were to generalize, I would say that the trait that cuts across most C-suites (and certainly most boards) is the aversion to risk. IT has delivered many successes over the years and certainly in the last decade, but it is still often seen though this lens of risk.

If risk is the language, how can we leverage the opportunity?

Change, Change, Change

In the 1960s, the MIS manager (remember that title?) was a stranger to the big rooms like the C-suite and board. In fact, the common habitat of MIS was in an office in the basement near the IBM mainframe.

In the late 1970s with PCs, networking, and user interfaces that finally were not just green or amber, the groundwork was laid for a fresh look at the governance role of IT as the number of computer users started to grow.

By the mid to late 1980s, the IT executive began to emerge, MIS started giving way to IT, and our first CIOs were anointed. But the real shift in the C-suites, while not yet really inviting IT to the table, began the change to centralize IT budgets and gave large amounts of control to the IT head (MIS manager or CIO, depending on how trendy the company wanted to be back then).

In the 1990s, the big rooms still viewed the discussion of IT to be mainly approving the annual IT capital budget. For the most part, they did not really react much to the explosion onto the scene of little things like distributed computing, the World Wide Web, and the mobile phone.

Then came Y2K. The big rooms now had to deal with not just risk from IT, but material risk. In many companies, this was among the first active involvements of IT in the business conversation. While not thought of at the time, it also laid the groundwork for the IT executive to begin to not just solve operational issues, but to help lead the conversation about what could be next.

As we passed through public financial scandals (Enron, et al.) government regulation came pouring in. IT was seen as the builder of the key infrastructures to support the bevy of new mandates. Again, IT was back in the big room solving operational issues and laying the groundwork and credibility to help lead the business.

By the mid and late 2000s, IT became intensely preoccupied with the complex roles of shifting to the distributed computing era, solidifying IT’s role delivering function through ERPs and other key business applications, managing the still-steady stream of regulatory requirements, and coping with the rise of the Internet.

As the 2010s rolled around, IT risk conversations in the big rooms began to shift from asking “What will be the risk if something bad happens?” to “What is the risk if we don’t act?”

Today, the crazy mix of social, cloud, analytics, and mobile has everyone’s attention. IT firmly has shifted from the 1990s — when only 10 percent of the leading 4,000 companies in the US even had a CIO — to greater than 50 percent of CIOs today reporting to the CEO and having accountability to at least one board committee. IT is in the room.

So Now What?

I think IT has never been in a better place.

The big rooms will still want to manage risk and ask how IT will provide stable, resilient, and dependable systems and infrastructure. But the opportunity is to exceed expectations when answering these questions and use the credibility to pitch for new investments in digital innovations that can underpin growth and expansion. IT needs to present these ideas not in terms of technology, but frame them in terms of revenue (yes, revenue).

The Next Two Big Things

1) The digitization of EVERYTHING

2) The next cyberthreat

The C-suite and board will want to know how they are effectively managing the risk that new competitors and business models won’t wipe out overnight key lines of services delivered today. This creates an unprecedented opportunity for IT to not just be part of the next conversation, but to lead it. As our friends in Silicon Valley warn us that “Software will eat the world,” IT must help our companies not defend against the thread of digitization, but lead an impressive assault forward.

Finally, cybersecurity has marched into a new era. The big rooms — primary the board — will not just ask, but expect regular updates and leadership in this area. If they are not satisfied, it will be achieved through other sources – they will get answers. IT either has to lead or we will see 80 percent of the CISOs that report into the CIO today shift directly to chief compliance or risk officers. Cybersecurity is not a concern, it is a fear.

IT is fully positioned to leverage these great opportunities. The big room is looking right at us and asking us to innovate, deliver, and lead.

Let’s not screw it up!

Darren Dworkin is chief information officer at Cedars-Sinai Health System in Los Angeles, CA. You can reach Darren on LinkedIn or follow him on Twitter.