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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.

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.

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.

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.

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.

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.

CIO Unplugged 3/19/14

March 19, 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.


I spent my early years in Europe, where travel by train was the most efficient form of transportation. I loved the excursions where we bypassed the Autobahn, moving swiftly across the landscape of Germany and surrounding countries.

Returning often as an adult, I became increasingly aware of the differences in how trains were run by country. Even my kids quickly learned that German and Swiss trains were always on time, while the French trains were often delayed or just plain cancelled. We crossed our fingers whenever we had to jump a train for France.

I asked some Swiss operators why the French trains had such a dismal reputation. They blamed it on the culture — their processes were not as sharp as those of other countries.

December 2010, I had a rude awakening that my internal operations, or “trains,” were more French than they were German. I detailed some of the lessons learned in this post. I realized that our culture, unattended, had drifted. We had no logical processes that were detailed except in the minds of one or two key individuals. Not good.

Around 2 a.m that fateful day, one of my team convinced me it was time for a major change and that we needed uber focus on process. Convince me … Nothing! I was desperate!

Since then, I’ve learned that the majority of IT organizations across all industries don’t have formal process plans. Based on historical success or experience, they operate without intention. Some do extremely well with this non-method; others don’t.

We operated well without a plan for years. But given the complexity in this increasingly digital healthcare world, the risk became too great to operate whimsically. We chose the ITIL framework. I’m not endorsing ITIL, but it is the framework we selected for IT service management.

As a result, we’ve seen significant improvements in our operations. Like most frameworks, ITIL isn’t just about operations, but it is the area we chose to focus on initially.

We started with a gap assessment. Yep, we had holes in our processes, and we knew it. Our train tracks were not always true.

We started to close those gaps, reassess, find more holes, and filled them. We were tenacious. It became one of our top priorities.


Three years later, we won a major industry award for the impact of our ITIL journey. Again, it is just an external validation of what was taking place internally. A complete transformation of our operations. This train is going places, reliably!

This is the video that was shown prior to my employer winning this prestigious award conferred by Pink Elephant.

If you find yourself with operations that are more akin to the French trains than German ones, here are some steps you can take to transform your operations:

  • Lead this personally so everyone knows how important this initiative is.
  • Hire someone, redirect a current position if you must, to have someone focus 100 percent on your framework.
  • Have an external review of all IT service management processes.
  • Pick highest risk areas and focus relentlessly.
  • Require IT service management certification as a condition of employment (I was in the first class).
  • Require advanced certification of all your leadership.
  • Everyone takes our classes, including administrative support.
  • As momentum grows, add staff as needed to enable transformation, even if it means repurposing existing staff.
  • Make your maturity level goals part of your key performance indicators to ensure everyone has skin in the game.
  • Invest in an appropriate number of staff to become experts.
  • Annual external assessments to review progress to KPI.
  • Never lose the focus or determination, talk about it often.

Not everyone will be on board. You will experience pushback from your own team. That is part of leadership. Have the vision and execute. Listen to your team and adjust accordingly, but never lose sight on the need to drive this until IT service management is just a part of the culture and folklore.

Our results on our operational areas of focus:

Area Baseline, Year 1, Year 2

  • Service Desk – 2.5, 3.28, 4.04
  • Incident Management – 2.0, 3.07, 3.79
  • Problem Management – 1.5, 3.13, 3.63
  • Change Management – 1.25, 3.10, 3.34
  • Configuration Management – 1.0, 3.10, 3.07
  • Knowledge Management – 1.0, 3.18, 3.69

We met our KPI by meeting a 3 or greater CMMI level of maturity. We now push towards 4 or greater and have expanded our areas of focus.

An example of how this translates into transformation is our rate of unplanned changes (Emergency and Urgent) has been reduced by over 40 percent. We now have a vibrant service catalog. Ninety-four percent of all team is ITILv3 Foundation certified and 95 percent IT leaders have at least one advanced certification. We now have nine ITILv3 Experts.

But the best part is how our focus on running our trains efficiently and effectively has impacted business and clinical performance. I am unable to share our metrics at this point, but the reason we won the Pink Elephant had everything to do with ensuring the reliability of our systems to enable superior business and clinical outcomes. Simply put, we save lives.

Perhaps your trains run well and IT service management is not an issue for your organization. Bravo. I know this was not the case for us. Today our customers can trust that our trains won’t be delayed or cancelled. All aboard….

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.

CIO Unplugged 3/6/14

March 6, 2014 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.

Executive Success – The Secret Unplugged, Part 2


This is the second guest post from my wife Julie. The first one is here. She writes what she feels and it is unfiltered, straight from her perspective. She would not have it any other way! I am thankful to have married a very strong woman.

“No, no! Take your finger off that send button, Edward Marx.”

Yes, I had to stop him before he sang his own praises on this blog. For heaven’s sake, he just finished pouring out his heart in a four-part series on Identity based on humility, and now he was about to shoot himself in the foot.

I confess. It’s tough living with a “celebrity,” especially when his prominence is bigger in his head than it is in the mortal world.

Don’t get me wrong, I’m extremely proud of him for winning the “John E. Gall CIO of the Year” award. After all, how many execs choose to trample their way out of the policy box their organizations try to keep them in? How many execs have disrupted their workplace practices and standards and influenced their peers and followers to change their own organizations?

Ed has a voice that speaks volumes to improving healthcare on the technology side. He draws out leadership talent in people everywhere he goes. He absolutely deserved to win the award.

Ed was equally proud of winning the HIStalkapalooza IT Leader of the Year award.

But I can always hear the tremble in his voice that asks, “Why are these people following ME? What if I lead them in the wrong direction?”

Ultimately, time will tell on the direction part. But my response to the first question would be “vision.” Am I right? We like to go somewhere important and add significance to our sphere of influence.

Now that the 2013 award ceremony is over, my hope is that you show your admiration and appreciation by applying all the spoken and unspoken lessons you’ve learned from the 2013 CIO of the Year and revolutionize your own domain. Don’t live vicariously through Ed’s achievements and settle for complacency in your own world. Seriously, one man can only accomplish so much, but an army of like-minded leaders can advance the IT kingdom beyond its present borders and into a model worth imitating.

Yes, you do have what it takes. For some of you, the secret is to bust the box. And that would be an applause heard around the world.



Julie’s personal highlights from the HIMSS conference:

  • A man came up to congratulate my father-in-law and said, “I want to be just like you.” (Wow! I’ve never met anyone who aspired to be an old German fart. Or a holocaust survivor.)
  • A taxi driver mistook Ed for The Edge from U2 (this is becoming the norm.)
  • A man (name withheld) said, “I appreciate Ed, but Julie always makes me smile.” (Ahh shucks.)
  • Three of Ed’s direct reports (names withheld) serving others who had fallen ill and required medical treatment
  • Taking pictures of Ed posing with Disney princesses at Epcot
  • Argentine Tango at HIStalkapalooza

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.

CIO Unplugged 2/12/14

February 12, 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.

Mentoring 2.0

Next week, I will accept the 2013 HIMSS/CHIME John E. Gall Jr. Award for CIO of the Year. At my table will be three of my mentors. I chose them because these men coached me during various phases of my personal and professional life. Mentoring is everything to me. Everything.

Two-plus years ago, I wrote on this subject. The Lost Art of Mentoring quickly became one of my most popular posts. I have given a dozen speeches around the country on mentoring. I am passionate on the topic because it shaped who I am today and where I will be tomorrow. I want to share with you one method to accelerate the adoption of mentoring in your organization and get you to 2.0.

We started the Business Technology Leadership Academy (BTLA) two years ago. Its purpose is to accelerate and enhance our pipeline to produce business technology leaders at all levels of our organization. The curriculum is designed to prepare candidates to take on positions of increasing responsibility by developing and sharpening their leadership skills. Major props to our People & Culture (HR) division who helped the BTLA vision become reality.


The Academy lasts 10 months during which my direct reports and I serve as mentors.


The Academy meets once per month for two hours. The first meeting focuses on developing relationships and establishing the rules of the road. Student goals are agreed upon based on 360-degree feedback, developmental needs, and career objectives. Both mentor and mentee sign a contract. This covenant identifies the specific roles and responsibilities of both parties, and outcomes are clearly identified.

The next eight seminars focus on the eight BTLA “Success Factors.” Mentors co-teach the specific subject areas along with their mentees. Success factors vary from setting strategy, value realization, leadership, and life balance. The final meeting is run by the cohort, where the mentees present their capstone BTLA projects.

Individual Sessions

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Each month the mentor and mentee meet privately for 90 minutes. There are few rules here, but the time is focused to help the mentee meet defined goals and to talk about real-world situations they face. Some of this time is also used to develop assigned presentations and special projects.

Shadow Opportunities

Students have opportunities to spend additional time with their mentees through shadowing. This provides more time for coaching and gives the mentee a chance to see their mentor in action. Often, the best mentoring is when nothing is said, just observed. At any time, we will have mentees participate in our leadership meetings, offsite retreats, and attend conferences or our own presentations.

Professional Development

Students are automatically enrolled in any special development activities we might have during their course. Examples include high-impact presentation classes and personal development courses.

Special Projects

Students are expected to volunteer for special projects. These will vary and must be agreed upon by both mentor and mentee. A student might help lead our annual TEDx event, while another leads our organization’s annual employee giving campaign. These projects provide real-world opportunities for leadership while under the careful eye of a mentor and are ideal for real-time coaching.


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Selection is a highly competitive process. Every employee is encouraged to apply. We have an average of 100 applications. We open up an online questionnaire consisting of roughly 20 questions. There are no right or wrong answers, but some answers receive a higher point value than others, which remain unknown to the prospective students. The questions, point values, and criteria change each year dependent on our target cohort. Our leadership needs change, so the tool is built to allow us ultimate flexibility in the selection process.

Typically, the top 25 scoring submissions are selected for the next round, which consists of a 360 peer and manager review. Once the results are in, we look at the final 12 or so candidates. Our People and Culture team runs special reports for us based on the questionnaire and 360 to allow us further insight into each prospective student.

With all the data points in hand, my team holds a vigorous debate about which candidates to select for that year’s cohort. We try to ensure a diversity of individuals with respect to title, responsibilities, and gender. After the finalists are decided upon, we debate further to decide the mentor/mentee combinations. Again, we use leadership judgment to make the best matches possible. We have few rules here, but we do ensure that the mentor is not already in that person’s chain of command. The side benefit is significant cross-pollination. For instance, we may have an applications vice president as a mentor to a technical analyst or our CTO may have a governance manager as a mentee.


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Everyone wants to know the specific criteria and scoring formulas we utilize. We purposely do not share these. We do not want candidates applications focused on maximizing point values.


Clearly we are making a material investment in the students. Joining BTLA means the person is making a long-term commitment to our organization. It also means that, when calls for volunteers are made, BTLA graduates should be the first to respond. There is nothing worse than investing but getting no return. Mentors are expected to make their mentee a top priority and are making a significant time and mind investment.


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We have observed tremendous growth in our inaugural cohort. They are more confident and effective. As we continue this program year after year, we will have multiplied the leadership capabilities of our IT organization tenfold.

But here is another reason we do BTLA. We the mentors learn. We may in fact learn more than the students! My hope is that one day a few years from now, one of our graduates will be accepting an important award and their mentor will be sitting at the table cheering them on! Just as mine will be next week.

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.

CIO Unplugged 1/22/14

January 22, 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.

Leadership and Identity—Look at Me! Look at Me! Look at Me! (Part 4 of 4)

We may not admit it, but most of us crave recognition and awards like a drug. Receiving honors gets us high. We love the buzz that says, “I’m better than you.”

Accolades, though fine on their own, can create an identity on which we base our self-esteem and worth. But it’s only a short-term fix, and the satisfaction quickly fades. The buzz wears off. Worldly recognition is a pursuit that never quenches the real need for significance and worth. The new gold plaque merely masks our insecurities.

So we seek after more, something bigger. Perhaps a more prestigious award. Another graduate degree. Another Fellow.

Don’t believe it? Bing the thousands of companies out there that make a living off our need for recognition. Peruse the corporate office walls. Facebook screams, LOOK AT ME!

You want to score a quick hookup? Talk up your target and pour on verbal affirmation and validation. Want to watch a coward become a hero? Entice him with a ribbon for his chest. Humans are complex for sure, but when it comes to our ego’s need for glory, we are single focused, simple minded, and easily led astray.

Hey, I’m stuck there in the “Look at me!” frenzy. I have sacrificed those most important to me just to win that coveted award. I worked longer hours than reasonable just to be ranked number one. I had to add cabinets to store my prizes. Heck, I spent three hours per day in the gym purely so I could outperform those half my age and get a medal around my neck to brag about it.

I know I’m not alone. I’ve watched marriages destroyed because some guy needed to upgrade his trophy wife. It’s madness! And I am determined to stop it in my own life.

Whoa, now, hold on a minute! There is nothing wrong with winning awards and being recognized for great service or whatever. True. But it becomes a problem when we make it the foundation for our identity. How do you know you have an identity issue? Ask yourself some key questions.

  • Are you defensive reading this post so far?
  • Do you perform so you can get your name engraved on a plaque?
  • Do you covet the other guy’s award?
  • At parties, do you brag about your trophies, medals, certificates?
  • When in conversation, can you draw out the success of others without speaking a word about your last honor?
  • Do you set performance targets because they are the right thing to do or because they will gather positive self-attention?
  • Who do your pursuits make more famous, your employer or you?
  • When you receive recognition, do you take all the glory or share it?
  • When you receive recognition, do you display false modesty?
  • Do you live for yourself or for others?
  • Do you always need to be in control?
  • Are you constantly bewitched by the legacy you will leave?
  • When you don’t win what you want, are you ticked off?

If your identity is based on the need for external validation, what can you do?

First, get rid of people who feed you bullshit. You know who they are — the ones who make you feel good because they inflate your ego. Replace them with people who will be brutally honest and have no fear of repercussion. How do you know who they are? They’re the ones who make you mad.

A couple of my direct reports are good at this. I have staffers who are unafraid of me and get in my face. I love ’em! If there is nobody close to you who challenges you to the point of making you mad, you might need an identity reboot. Conflict, not flattery, is what helps build our character.

As I draw closer to the half-century mark, I find myself on a new learning curve. Man, the growth is painful. I’m OK with recognition and awards now as long as they are purely an external validation of an internal (team) reality. I won’t personally pursue them nor take actions for the sole purpose of personal fame.

Recently, I made the biggest mistakes of my life when I forgot who I was and chased false sources of identity. If it weren’t for mercy, I might not be writing this post. I’m committed to discovering who I really am so I never do that again. Finding my true self is painful and ugly, but at the same time, gloriously beautiful. And freeing.

I’ll leave you with this from one of my heroes, Saint Paul:

The very credentials these people are waving around as something special, I’m tearing up and throwing out with the trash—along with everything else I used to take credit for. And why? Because of Christ. Yes, all the things I once thought were so important are gone from my life. Compared to the high privilege of knowing Christ Jesus as my Master, firsthand, everything I once thought I had going for me is insignificant—dog dung. I’ve dumped it all in the trash so that I could embrace Christ and be embraced by him.

During this series, I pointed out that an identity based on what you do, how you look, or your titles and awards will not lead to fulfillment. What I’m learning is truth for me and it’s rooted in faith. I know I am Edward Marx. A follower of Christ. Here to serve and point others towards the pursuit of truth. I might fail, but I will get back up and move forward.

Who are you? Where is your identity rooted?

This concludes a four-part series on Leadership and Identity. The previous posts are Identity and the Leader, I Look Better than You Do, and It’s All About the Title.

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.

CIO Unplugged 1/8/14

January 8, 2014 Ed Marx 5 Comments

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

Leadership and Identity—It’s All About the Title! (Part 3 of 4)

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In our office lobby display case, the theme of the month was “pets.” David had a picture of his beautiful hunting dog, but what caught my eye was the castle ruin in the background. “Oh, that’s Bective Abbey, right across the street from my parents’ home in Meath. The remaining cloisters were used in scenes from ‘Braveheart.’” Jokingly I said, “Beautiful. Let’s go.”

Four weeks later, David and I were standing in the actual spot, walking the castle ruins. Although “Braveheart” was about Scotland, many of the movie shots took place in Ireland, in David’s backyard. To prepare ourselves, we watched the movie three or four times.

“Braveheart” is full of leadership lessons, but the following interchange between Robert the Bruce and William Wallace stuck with me. Here is the script and the video (3:30).

Robert the Bruce: “I’m not a coward. I want what you want, but we need the nobles.”
William Wallace: “We need them?”
Robert the Bruce: “Aye.”
William Wallace: “Nobles. Now tell me, what does that mean to be noble? Your title gives you claim to the throne of our country, but men don’t follow titles, they follow courage. Now our people know you. Noble, and common, they respect you. And if you would just lead them to freedom, they’d follow you. And so would I.”

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The same is true in life. Screw the title, focus on leadership. Title holds significance when it’s earned through performance.

People want to follow leaders, not titles.

Look at the 2013 Time Man of the Year, Pope Francis. Did Francis suddenly transform into the unique leader because he became Pope? No! If you know his history as a Cardinal and Arch Bishop, nothing he does as Pope should surprise you. Did he become Pope because he sought title? Oft called “the reluctant Pope” tells us that seeking title was not on his goal sheet. Serving people had always taken precedence. In fact, look at his warning against careerism.

I am not naïve to suggest this is always the case. We know plenty of people who gained titles by stepping on others, a Machiavellian winning-at-all-costs approach. But I can tell you the most successful leaders never sought titles, they sought to humbly serve. The former are easy to spot and get little respect.

One of my directors — I’ll call her Tracy — was a damn good analyst. She didn’t seek a title. She just pursued her role and responsibility with vigor. She accomplished great things and we gave her more. We saw the results and potential so we promoted her to a director. She is awesome.

In another instance, I was struggling to fill our chief security officer role. One day, I asked this recently retired Marine what his defining moment was. He described how, as a staff sergeant, he stood down a full bird colonel. You see, he cared about doing the right thing despite anyone’s title. That’s moxie. It’s leadership. I hired him on the spot. You think he will stand down from an executive or his manager if our security posture is compromised? Never! Title is secondary to effective leaders.

Do you possess your title or does it possess you?

A good test: Do you ever use your title to get things done or get your way? I rarely refer to myself as senior vice president or CIO. When I am in meetings, I tell people I serve as a leader in leveraging technology to enable superior business and clinical outcomes. I do what I can to not to let title get to my head. Humility is the key. Watch for the slippery slope. It will take your title and life if you are not careful. I know.

Much of what I’m writing is logical and intuitive, but not often practiced. We are driven and ambitious and we seek instant gratification. We toiled well for a few months, so we think we deserve that next promotion. But I tell you the truth, gaining titles before you are prepared is very dangerous to both you and your organization. Stop the pursuit. Focus on being the best at whatever you do. The rest will follow.

Some of you are thinking, “Ed, I do all that. I don’t seek crowns. I seek to serve and the title never comes. In fact, I see others being promoted over me that offer half the value I do.”

I get it. It happens. The world is not fair. Continue to work your ass off and double down on your efforts. Find other ways to increase your value to the organization. Expand. Ask for more responsibilities. Volunteer. But if at some point, over multiple years, you’re doing all these things consistently and still nothing? Yep, time to bail.

Again, I’m a work in progress. Some of the things I write are aspirational for me. I struggle with the same things as you. Pride, arrogance, achievement orientation, instant gratification, etc. But I am slowly catching on to this identity thing. Taken me all of about 50 years. Hopefully it will stick for the next 50.

Damn, this is easy to write but hard to internalize, yet it is truth.

For me, identity is not rooted in title, looks, or what I do. It is who I am and what I stand for, believe in, and practice. I am trying hard to forge my identity in my faith in God. I like the sound of CEO, but His title is what I desire. “I am free. I am new. I am a saint. I am alive. I am all He says I am. I am His own.”

My detractors are right in the sense I fall short of the above list. However, only One’s opinion about me counts—and they’re not the One.

I will wrap up the Leadership and Identity series with, “Identity & Recognition” in my next post. I will specifically identify the keys to identity that resonates with who I am becoming.

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.

CIO Unplugged 12/18/13

December 18, 2013 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.

Leadership and Identity—I Look Better than You! (Part 2 of 4)

Part 2 was slated to just go to commentators of Part 1. But given the collective interest from the original post gathered via comments, LinkedIn, email, Facebook, and Twitter, I decided to expand into a public, four-part series. Here it goes….

You might argue with where the identity journey has taken me, but the fact is, all of us have been a counterfeit to one degree or another.

Does how you see me agree with reality? Do I even know who I am? Really?

Janis Ian nailed me with At Seventeen. Thank goodness I had a supportive family and a slight awareness of the love of our scandalous Creator, because when I first moved to the US as a pre-teen, I dressed unusually. Kids made fun of my German attire. As I came of age, acne invaded my complexion, giving classmates another reason to pick on me. I never got the girls I crushed on. I was ostracized and spinning downward in self-hatred.

Rather than surrendering to a super low self-esteem funk that could jail me for life, I fought for validation and identity via sports. Continual reinforcement from adults and peers convinced me that success on the playing field signified acceptance and popularity. Where a lack of clear-skinned attractiveness stole my self confidence, I made up for it through tennis and soccer. Sheer determination compensated for skill deficiencies.

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My idolized letterman jacket became like pure gold and epitomized my counterfeit identity.

Sports accolades helped establish an achievement-based identity. Extreme achievements gave me a sugar-like high that would in time fuel my adult lifestyle. This placebo-based identity would affect my relationships, both personal and professional.

As I passed through college and into my career, the focus on looks became less important than champion skills. But the deceptive ugly bug still had a grip. I compared myself to other men. I poured significant energy and resource into making myself look better. Excessive exercise, extreme diet, fine clothing, braces—anything to bury the insecurity.

My teeth! I had this Michael Strahan-sized gap between my front teeth, so I put myself through adult mini-hell—braces. The gap’s gone. But then they weren’t white enough. So I got them whitened, and lo and behold, I spotted someone with whiter teeth than mine. Ugh! A close friend complained that I was too hairy. What did I do? Yep, and after that painful process, the same friend said I was too white. Thankfully, I tumbled off the merry-go-round before the first tan session. What the hell was I doing?

Insanity! I’ve even contributed to this appearance ruse! I recall the day some fool cut me off in traffic and almost got us in an accident. Cursing, I pulled up to the person to flip the bird. When I saw she was gorgeous, I just waved. I’m embarrassed to admit that, but I know I’m not alone. When people are given a choice between two candidates, most tend to choose the prettier person.

I’ll never forget my final interview for a Fortune 50 management trainee program. I had made it to the final eight, of which they would select four for this prestigious position. The COO invited me into his office and dismissed the resume and questioning as he said, “At this level, all candidates have the same background . . . a graduate degree, high aptitude and strong skills. So I just want to look at you.” I was thinking, shit, this interview is over. Yep, I no longer “qualified” for the job.

I’s healthy to maintain yourself, look your best, and especially to remain attractive to your partner. But when we nail our identity to our frame and features, we have a major problem. Major! We all know people who are preoccupied with their mirrored reflection. Undoubtedly, as you age, you’ll be displaced by others more attractive.

Neither time nor gravity is on your side. If you try to compete, the number of hours and dollars you spend on your looks will only increase. In the end, guess what? Someone else will always be better looking. You’ll never be satisfied. Or rewarded. Grab some tissue and check out this video on the latest fashion trend.

I’ve awakened from the Hollywood delusion.

As I approach 50, here’s what I’m learning. I need to get out of the false identity trap that says my appearance is so grossly important. I do what I can to take care of myself, but I will no longer be excessive.

Here are a couple of self-tests. If a flare-up of acne determines whether you have a good or bad day, take a time out. If you’re more concerned about people liking your new hairstyle and less concerned about your derogatory comments to others, you have an issue.

The good news is that we can overcome. I am learning to accept myself as I’ve been created. I was meant to be 5’8,” so I embrace that height. If my genes say I’m balding, I’ll stop the ridiculous comb-over. If I am hairy, then . . . well, OK, I have to draw the line somewhere.

Here’s the deal. Allowing shallow people and a fluctuating society to determine my identity creates a lose-lose situation. My identity stems from what’s inside. Character triumphs over a perfect nose job. This cultural issue is nothing new. Two thousand years ago, wise men said:

“What matters is not your outer appearance—the styling of your hair, the jewelry you wear, the cut of your clothes—but your inner disposition.”

“We should be concerned most with the transformation of the inner man, not outward appearances…”

Traits that are skin deep are not worth obsessing over or bragging about. If you’re so vain you think this post is about you, it’s not. It me spilling my guts. But if you’re honest enough to admit to feeling pain while reading this, we might share a common struggle. Our value reaches much deeper.

As a leader on the slippery slope, where are you investing your time, money, and effort? In what’s skin-deep, or in the real you?

Stay tuned for part 3.

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.

CIO Unplugged 12/4/13

December 4, 2013 Ed Marx 55 Comments

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

Identity and the Leader

I vividly recall, at age 17, jumping off the bus at the in-processing station of Ft. Dix, New Jersey, where a drill sergeant greeted me—screaming. By the third day, I was wearing a uniform, had a shaved head, and was organized into a squad and a platoon.

The drill sergeant shouted, “Look to your left, look to your right, and now look down at yourself. In nine weeks, one of you will not be here, because you do not have what it takes to be a United States warrior!” Gulp. He scared the crap out of me.

But looking around myself, I determined I was better than at least one or two of my fellow trainees. Yep, I would be OK.

A couple of weeks after I graduated as Private Marx, I entered freshman orientation at Colorado State University as a poster child for insecurity. I have no recollection of who spoke that day, but I do remember him saying that 80,000+ students had graduated in the past 100 years. I pondered the odds and decided that surely there were other bozos who made it, so I, too could succeed.

Since childhood, the comparison method had been a pervasive mindset. My identity had been in what I was rather than who I was. And I had based my success on what I could create rather than why I had been created. I floundered under that junior-high mentality of “I am significant because you are less significant.”

This warped attitude gave me a false confidence in the workplace. I compared myself to my peers and to those above me. Sometimes I would try to learn from others who were stronger and smarter than I, but more often than not I would pounce on their weaknesses to climb over them and up the career ladder. Sure, my skills and talents have helped boost my success, but I was also counterfeiting my identity and confidence based on others’ deficiencies and weaknesses.

Leaving that mindset behind, I’ve been searching for the real me and trying to live as the genuine Ed—insecurity surrendering to conviction.

After qualifying for the USA national championship Duathlon (run-bike-run) as an average athlete, I had just hoped to finish the darned race. Qualifying for a spot on Team USA was not only about to become a dream come true, but also a test of my desire to be the genuine Ed.

At first, I suffered second thoughts based on my insecurities. The odds for success were not in my favor. In fact, competing at this elite level, I would likely end up embarrassing myself. But there I was already comparing myself again. Yet this was my only shot to compete with the gifted.

When I arrived in Tucson and began the registration process, I started doing what most athletes do—comparing myself to others. That guy has less body fat. Another athlete was clean-shaven all over. The guy next to him had a $10,000 bike. The woman in the corner was sponsored … And pretty soon I stood there mentally defeated with the race a mere two days away. I was still basing my success on how I compared to others, not on who I was.

Damn that warped thinking! I stopped it and chose to walk in the opposite spirit. I decided that what I had—a strong heart, a decent bike, and an OK albeit hairy body—was sufficient. I chose to look forward and not to my right or left. The outcome wasn’t in my hands anyway. As an athlete, what mattered was, how will my stats in this performance compare to my stats in the previous races? Was I improving? Forget the guy racing next to me. If I was meant to represent Team USA at the 2014 World Championships, then that would happen.

Identity is a tricky thing. What is it? How is it formed? How does it impact who we are and our performance? Most of the time, I base my identity on how I believe I compare to others. I suspect most of us are mis-wired to think this way.

I don’t claim to have it figured out; I already proved that. My true identity is squaring who I was made to be and living congruent with this truth. I’m still working on it, but as I approach 50, I’m finally getting close. If these ideas help nudge you in the right direction, I will have accomplished my goal for this post.

Some self-reflection ideas:

  1. Is my life/career mission about me, or about the betterment and growth of those around me?
  2. What do I stand for?
  3. Do my values reflect a desire to see others succeed, or do they revolve exclusively around my personal success?
  4. Does my behavior reflect a value for the human soul?
  5. What’s my gauge for comparison: other people or stable virtues?
  6. Am I able to sincerely rejoice in others’ accomplishments, or do I have to one-up people all the time?
  7. Do I go to bed praying that no one finds out how insecure I am?

Who are you really? And are you happy with you?

To view my full reflections in depth, leave a comment with a request and I’ll send you “Identity and the Leader” Part 2.

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.

CIO Unplugged 11/13/13

November 13, 2013 Ed Marx 16 Comments

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

Grilled Cheese Sandwich, Please

As a new CIO, I spent the first five years volunteering after hours for our health system. They assigned me to the greatest volunteer opportunity available. Each Wednesday afternoon, I went room to room delivering $10 gift shop vouchers to all the winners of our closed circuit TV bingo game. Bingo was the highlight of the week for hundreds of patients and their families. The game normally finished around 4 p.m. I’d pick up the certificates at  5 p.m. and hand-deliver them to the winners.

While striving to take our IT shop from bad to good, I was not always Mr. Popular with my customers. Thus, volunteering became the highlight of my week. It got me out of the office and into our hospitals. Everyone wanted to see me. Everyone welcomed me. Wednesday evenings became a salubrious respite from the work grind I faced the rest of the week.

Observing joy in the recipients’ faces brought my heart pleasure. Think about it. These citizens were stuck in a hospital. Receiving a voucher for a $10 credit at the gift shop meant everything. And their responses had an impact on me. I stopped taking life for granted and started embracing the simple things.

Volunteering routinely also broke my heart, especially those dreaded deliveries to the fifth floor of our children’s hospital. As I scrubbed in before entering the floor, I took twice as long to wash in an attempt to delay the inevitable. I was about come face-to-face with kids the same age as mine, except these children were dying.

I’d knock gently on the door and they would be looking right at me. Expectant. Picturing my own two children in their situation, I’d swallow hard and muster up a smile. But then the joy in these young patients’ faces made the grief worthwhile. Before leaving the floor, I’d stop in the restroom and let my smile fade to a cry.

I learned the value of listening. When I delivered vouchers to the elderly, they always wanted to chat. They cared more about having company and far less about the vouchers. Oh, the loneliness I witnessed! As much as I wanted to hurry the interaction and get on to the next winner, I envisioned my own parents and thought how I would love for someone to spend time with them if I could not be there.

I met many interesting characters. The love I saw between seasoned married couples encouraged me in my marriage. I recall one man holding the hand of his sickly wife. The lines in their faces proved a beautiful testimony of a life well lived and a true commitment through health and sickness.

I’ll never forget the mom who met me in the pediatric ICU waiting room. Before I could reach her child’s room, she said, “Can I use the voucher in the cafeteria?” Although the vouchers were strictly for the gift shop, I took her down there to see what we could negotiate. She went to the grill and asked for a grilled cheese sandwich. “We don’t serve grilled cheese sandwiches,” the cook said. The exasperated mother all but begged. “My daughter just woke up from months in a coma, and her first words were, ‘Mommy I’m hungry, I want a grilled cheese sandwich.’” Tissue, please. The cook made the off-menu grilled cheese sandwich while the woman wept.

Ask anyone who knows me, and they’ll tell you — often with a shudder — that I’m a Type A personality. My wife tells me I’m an extremist, all or nothing. I am wired to compete and win. I can’t climb just any mountain, I have to summit the highest peaks, all of them. Army combat training taught me to kill with my hands, and my kids say when I’m overly focused on a project, I look ticked off at the world (I’m not really, and I’m working on smiling more). But volunteering became my counterbalance. Interacting with the sick, feeble, and dying helped shave the edge off my hardcore design.

What keeps you balanced? When you see a bed of roses, do you stop to enjoy their scent? Or does just the thought of pausing to take in the “life” happening around you ruffle your nerves?

I miss bingo. I miss weekly interactions with patients. The memories still stick with me. The emotions still live vividly. And I’m ready to jump back in and refresh the experience.

Grilled cheese, anyone?

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.

CIO Unplugged 10/30/13

October 31, 2013 Ed Marx 5 Comments

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

Secret to Great Sex…and Other Faux Pas Along My Journey

Skipping the rank of manager, I catapulted from physician relations coordinator to director of information technology. I had worked plenty with a cadre of nurse directors at my former employer, so I expected the same stereotype when I landed at Parkview. Boy, was I wrong!

My first week post-orientation, I attended a mandatory leadership class on counseling employees using a new behavioral technique. After the theory lesson, we were randomly partnered with a peer to practice our newly acquired skills. My partner was the director of surgical services, and she was a young knockout. I had expected someone seasoned in looks and experience, but this woman made me nervous.

I hate to disappoint any readers, but I was struggling. I was afraid that my subconscious might win over my conscious and say something bad. I was coaching myself to not say any word that might even remotely sound sexual or land me in trouble. I recall moving into her personal space, per instruction, locking eyes and going through our training script, fumbling for words. I started to sweat but made it through. Phew! Deep breath.

She then began. She moved in, locked eyes and with all sincerity asked me, “What is your secret to great sex?” She quickly spewed, “secret to success,” but it was too late. Our uncontrollable laughter lasted a good 15 minutes. The instructor moved us to the corner of the room because we were disrupting others. It was the hardest I had laughed, ever. We eventually regained composure, and a great working relationship was born. Adding to the drama, the next morning at 7 a.m., I presented to the surgical committee and she was sitting there smiling, thinking the same thing as I was. I looked away.

Over the years, I created many faux pas or bloopers. Here’s my best:

  • I regifted some chocolates only to learn from the recipient that when they opened the confection, the originating thank you note meant for me was inside.
  • I managed a rock band on the side. Late one night while working at the office, I inadvertently sent the band contract and operating agreement out to the entire IT department. Not only was it full of financial information, but moreover, a code of conduct that was very personal.
  • I replied to an “email” from our CMIO that had been generated inside of our internal collaboration software. He relayed his concern regarding a public posting from another physician that might have violated our solicitation policy. I replied that not only was it a gross violation, but that the doc had frequently done this on my Facebook page as well. About five minutes later, another colleague sent me a note asking me if I knew that my reply was posted to every employee instead of just my CMIO.
  • I was speaking with two fellow officers when a third one joined our conversation. I said with utmost sincerity, “Hey, here is our best hospital president in the entire health system.” As soon as I let that loose, I realized the other two were also hospital presidents.
  • Our COO was wrapping up his closing remarks after an all-day leadership meeting. The technical aspects went without a glitch. I instant messaged the admin who was running the operation when, lo and behold, my IM popped up on the screen on top of the presentation. “Phew, so glad the technology worked for once.” I shrank in my chair as the audience chuckled.
  • I was dancing the night away at an after work party. While I prefer ballroom and Argentine Tango, I can hold my own freestyle. Or so I thought. The people who could clearly “move like Jagger” later told me that I “danced like a white man.” I don’t know if that’s an offensive statement to anyone else, but to me it said that I danced like a dork, or at least that’s how it made me feel.
  • One of my nurse managers had been asking to go out to lunch and I was forced to cancel twice. Finally, my schedule opened up, so I teasingly messaged her “Our time has finally come to be together.” She agreed to meet me in our lobby at the appointed hour. I was shocked when a different nurse manager showed up and realized I had asked the wrong person out. Talk about an awkward lunch.
  • Sexting to the wrong person. I have not done this yet, but know it’s only a matter of time. My wife and I exchange all sorts of texts from “pick up some eggs on the way home” to … well use your imagination. Someday I am certain it will go the wrong person. Hopefully not my HR colleagues.

Over the years, I’ve learned to laugh at myself. My foibles and blunders will be around as long as I’m alive. It’s called being human, and we can’t take ourselves too seriously. Ever. Do you have a work faux pas that needs a good laugh?

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.

CIO Unplugged 10/16/13

October 16, 2013 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.

Thankfulness in Action

During a leadership meeting, one of our chief nursing officers, never nominated for Miss Congeniality, came rushing towards me. Although smiling on the outside, I braced on the inside for the tornado I expected would hit. I extended my hand in greeting, but she went straight for a hug. Not knowing her intentions left me cautious and suspicious.

She released the impromptu embrace. “Ed, you sent me a thank you card for serving in nursing while acknowledging my top 100 nurse recognition, and I was like ho-hum. But what caught me off guard is when I walked into the nurses’ lounge on our med-surg unit. On our community board was another card you sent to one of our floor nurses for her recognition as well. I tracked her down and she was blown away that a non-nursing executive would take the time to acknowledge her contributions in this way. It means a bunch to her, to me, not to mention her peers who all see the card.” Then she chided me for being forced to change her password every six months (j/k).

I’m paperless and proud of it. I have no printer drivers. You’ll rarely find me with a notepad, and I judge people—particularly those in healthcare technology—who still rely on paper. But I have one major exception. I still pen handwritten thank you cards. I always carry blank thank you cards and I send out an average of eight per week.

Here’s why:

Thank you card sales have hit an all-time low. Digital convenience has displaced some of the need, but I think the reason goes deeper than that. I suspect it’s a combination of laziness and lack of training. Growing up in the Marx household, we could not enjoy any gifts received without first having written a thank you card. This became second nature to us kids, and we’ve since passed this tradition down to our kids. I suspect they will do the same with theirs. No thank you cards, no gifts.

It makes a difference. Since handwritten cards are rare, the impact they have is magnified tenfold. People still love to receive snail mail, especially personalized mail. You can open a card and hang it in your office or place it on a desk. You can touch it, smell it, hold it to your chest. As another benefit, thank you cards differentiate you. When interviewing candidates, darn right I pay attention to which interviewee sends a card and which one does not. That little bit of effort speaks volumes and differentiates candidates.

Handwritten thank you cards are a physical expression of the word “care.” Recipients not only see that care, but they feel the effort and time it cost the sender.

What’s the best virtue of handwritten notes? They don’t beg for a response as do email. You send an email thank you, and the person now feels obligated to reply—“Back at ya.” Doesn’t that defeat the purpose?


  1. Carry with you a stash of cards, and when you hear of a deserving act, whip one out. The five minutes you spend writing could bring a day’s worth of happiness to someone.
  2. Write cards with your leadership team. This is a standing agenda item at our weekly meetings. There is always someone deserving of praise. (Not to mention it’s leadership by example.)
  3. When you see or hear of someone who has received honor, send a card. For instance, whenever the top 100 nurse list is published, I target the nurses who work in my organization.
  4. After concluding a meeting during which someone went above and beyond, start writing.
  5. Each Friday, a task pops up on my schedule that says, “Give thanks.” I reflect on the week and decide who to thank.


  • A grumpy finance executive responded to a thank you card via email. “Thank you so much for the card. The timing was perfect. Had a real rough week. Made everything worthwhile.”
  • A physician sought me out. “I have never received a thank you card from administration. This has given me fresh perspective.”
  • I was rounding with nurses in one of our hospitals when one approached me during a break. “Oh, you’re Ed Marx? We’ve never met, but you sent me a card two years ago [emphasis mine] for working with your team on an order set. Thank you for noticing and sending the card.”
  • Employees routinely stop me in the halls to say thank you for the card, some with tears in their eyes.
  • My first platoon sergeant, a tough Vietnam vet, said, “Lt Marx, I was like what the shit, I am just doing my job … and then it hit me, leaders do the little extras. I just sent short notes to my squad leaders.”
  • I sent a note to a CEO thanking him for his leadership and for my privilege to serve with him. “…nobody ever sent me a thank you card for no specific reason other than to say thanks for leading.”

I have a confession to make. I do store some paper actually—a pile of thank you cards I’ve received over the years. I can’t toss them. They carry such meaning. I’d wager it’ll be the same for the people who would receive a card from you. It becomes an oasis in the dessert. A Starbucks red-eye during an all-nighter. It’s salve on a wound and the bridge over a chasm. It can make our toils all worthwhile.

For whom are you thankful? Staff, your boss, a peer? Take action. Grab a card now and share your thoughts with that person. If your handwriting sucks, don’t worry, mine does, too. But no one has ever complained about it, and I doubt they even care.

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.

CIO Unplugged 10/2/13

October 2, 2013 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.

Connecting with Staff

Own up. Once you leave staff and move into management, you cease to add productive value. Staff is the engine; it’s where work happens. Management is overhead and owes any success to staff. Our calendar is now their calendar. They come first. Management second.

Never forgetting my roots makes it easy for me to connect with staff. Back in the day, I started as a clinic janitor, an experience that sparked my healthcare career. Later, after working some god-awful assembly lines and toiling to fill sandbags, I made a commitment to move into management. My goal was to reinvent staff work to make it more meaningful and efficient. After my lousy experiences, I promised myself I would treat staff as I would’ve wanted to be treated. As I worked my way through management, I observed and took notes. Tucking away all the good things from that experience, new inspirations sprouted, and I committed to the idea of remaining connected to staff.

Management that loses touch begins a downward slope towards mediocrity.

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10-2-2013 5-47-34 PM

Even today, I observe my peers and management and look for gems. I actively seek to relate and stay linked. The day I lose touch is the day I become impotent.

Here are some best practices I presently deploy:

  • Major Life Events. Be there. Remember what matters—your presense, not presents.
  • Hands-On Visits. Go experience their work environment. I spend significant time traveling to our various facilities and hang with staff. I worked the service desk. Email and texting are false forms of relationship building.
  • Drop In. I drop by unannounced into various meetings and just listen and answer any questions.
  • Personal Parties. I am always looking for a reason to host a party, especially in our home. We host several annual parties as well as impromptu. We have about 200 staff and family each year in our home.
  • Other’s Parties. I love getting invited to department parties, and I make them a priority. Nothing feels freer than ripping off the suit and let out the real me.
  • Unique Venues. Not everyone feels comfortable coming to my house. So I’ve started picking cities in the metroplex and going bar hopping. We publish schedule to give plenty of advance notice. Remember the beer summit? Well, it’s better than that.
  • Sport. I lead triathlon teams, adventure race teams, and climb teams. These provide tremendous opportunity for time together. Sometimes, I mountain bike with staff. I can’t golf, but I drive a mean cart on the course.
  • Open Door. Staff can view my schedule and drop in whenever I’m around our offices.
  • Meals. When I have free time, I actually publish these offers to see if anyone wants to go to breakfast or lunch. Impromptu meals are a lot of fun.
  • Exercise. We have spin/cycling and treadmill conference rooms and I let staff know when I’m in one. They’ll throw on a pair of tennis shoes, and we talk while exercising indoors to avoid the 100-degree Texas weather. Now that’s efficient multi-tasking!
  • Volunteer. We volunteer together. We’ve served in food banks, Habitat for Humanity, and other various organizations.
  • Town Halls. We do these once or twice per year. Too stuffy for me, but I do them.
  • Department Meetings. Whenever I’m invited, I’m there.
  • Social Media. For sure I connect with any interested staff on Facebook, Twitter, etc.
  • Collaboration Tools. I microblog daily to staff and share what I’m working on plus general, organizational news. Staff can reach out numerous ways to include IM, Txt and Yam. Email if you must.
  • Book Studies. We do these quarterly. Eight-week sessions, one hour each. Great team building.
  • Holidays. My wife and I make a point of serving my Service Desk staff on Thanksgiving and Christmas. We cater in all the food and have a giant feast.

I love my staff. It is a privilege and honor to serve them. They make things happen, and connecting is one way I can add value back to the system.

How do you connect with your staff?

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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