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CIO Unplugged 10/24/12

October 24, 2012 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.

CIO, Wake Up and Lead

Alexander the Great, one of the greatest military generals who ever lived, conquered almost the entire known world with his vast army. As the story goes, one night during a campaign, he couldn’t sleep. He left his tent to walk the campgrounds.

He came across a soldier asleep on guard duty – a serious offense. The penalty for sleeping on guard duty was, in most cases, death.

The soldier began to wake up as Alexander the Great approached. Recognizing who stood before him, the young man feared for his life.

Alexander the Great looked down at the soldier. “Do you know what the penalty is for sleeping on guard duty?”

“Yes, sir.” The young man’s voice quivered.

His features hardened, and Alexander the Great put a hand on his hilt. “What’s your name, soldier?”

“Alexander, sir.”

Alexander the Great studied the young man with a searing gaze. “What is your name?”

“My name is Alexander, sir.” The soldier’s knees shook.

A third time, Alexander the Great demanded with force, “What is your name?”

Breathing heavily, the young man replied, “My name is Alexander, sir.”

Alexander the Great then came face to face with an intense look. “Soldier, either change your name or change your conduct.”

True or not, the story brings out the point that it’s our duty to walk in the authority of our calling. As CIOs, we continually lobby for our voice at the table. We want to be seen and treated as a peer by our C-suite counterparts.

After interviewing several CEOs and CIOs, I wrote a post for Modern Healthcare last summer about this precise dilemma. In our quest to be recognized by the first letters of our title – typically VP (vice president) or SVP  (senior vice president) — we ultimately back down when opportunity presents itself.

A few notable exceptions exist. We all know CIOs who lead business areas of their organizations such as human resources, strategy, finance (yes, finance), and construction, or have gone on to become CEOs. But these are absolute rarities.

Here is a quick pulse check to figure out which one you are:

  • Are you presently leading something outside of IT?
  • Do you speak as a business person or a techie?
  • Do you routinely showcase the business value of IT investments?
  • Are you known to resolve challenges or do you run for cover?
  • Do you frequently say, “There is no such thing as an IT project” and punt responsibility?
  • Do you tell people you “lead from behind?”

Let’s take an example many can relate to. Most CIOs are already on an EHR journey or preparing to embark on one. What an opportunity to lead! Certainly you are not to lead alone, but nor should you abdicate your leadership on this one. And here lies the irony. The majority of troubled EHR initiatives were not led by CIOs, yet the CIO was often the first to go.

Don’t get caught up in my specific example, but rather the heart of the situation described. You might as well take the lead whenever available, because one way or another — despite your best attempt to disassociate — the CIO is integral to almost every action taken by the business. You will take the fall! I advocate that you lead alongside, not in front or behind.

What factors position you so that the coach puts you in the game?

  • Excellence. Ensure your credibility is rock solid based on the operational performance of your team. The trains must run on time.
  • Intentionality. Have a routine in place where you are getting face time with your peer suite. Throw in a mix of one-on-one time.
  • Transparency. Operate and conduct your interactions as openly as possible. Build your own site where peers can get self-help information on what’s taking place in your areas. Publish your budget and show the costs for supporting each business unit down to the application level. Give no one reason to accuse you of hiding anything.
  • Knowledge. Success is predicated upon continuous learning. Read the materials popular with your C-suite peers, not just IT.
  • Potted or planted. Are you and your directs potted in the organization or planted? When planted, it is hard to tell IT from any other business unit because of the purposeful integration. I want the business units to think my directs work for them. If potted, not planted, the plant does not take root, and eventually withers and dies.
  • CEO agenda. Know the agenda of your CEO and your peers and you will start connecting the dots between business strategy and IT. You will become a trusted advisor.

How can you turn to broaden your insights?

  • Networking. Continuous interactions with other business leaders, inside and outside of healthcare.
  • External connections. Leverage other influences by serving on advisory boards and universities. We bring my team together with IT leadership from a non-healthcare organization annually (see a previous post). i.e. Last month we compared notes with Kimberly-Clark.
  • Partnerships. Leverage your organizations partnerships with other companies and vendors. We bring our strategic partners together routinely to learn and grow.

We are all set to lead. Here are some critical success factors to consider:

  • Passion. It is contagious. No passion = no energy, and nobody wants to follow a lifeless leader.
  • Visibility. Be seen and heard. We rotate our leadership meetings inside of all of our business units. Each time, business and clinical leaders are our special guests, and they are excited to see us on their turf.
  • Trust. You know the old adage: do what you say you will do. It’s tough to build trust, yet that trust so easily falls when we stray from the truth.
  • Boldness. Being a CIO is not for the faint of heart. Based on advice from my new team, I stopped an EHR implementation so we could regroup before the project went south. This timeout paved the way for a very successful implementation and enabled the kind of returns we had originally hoped for.

Let me close by asking you: what is your name? Or better yet, what is your title? If you are not leading, then downgrade your title. Either start acting like a vice president or senior vice president or give someone else the opportunity. Healthcare is desperate for strong leaders, especially CIOs.

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 10/3/12

October 3, 2012 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.

Brand, or be Branded!

1997. Reverberating rave music generated a hip vibe. Cameras flashed as the crowd studied the student models.

Attending my first fashion show, I sat at the end of the runway—as one of the judges. The dean of my alma mater had appointed me to the board of the fashion school (long story). I and my fellow judges —all of whom were in the business of fashion models and designers—were responsible for appraising the graduate student champions of design.

Despite my initial excitement over the opportunity to act as a fashion critic, I quickly realized my business skills didn’t match my responsibility. And if you have seen my tie collection, you would understand. I felt as out of place as a punk rocker at a symphony.

But I gained one valuable lesson through that experience. The beauty of a model or her or his clothing design didn’t captivate me. The confidence with which the model walked did. They defined their brand despite the fabric or color.

Whether or not you embrace it, the cold, hard truth is that you are judged daily. Minus your own purposeful brand, your board, executive team, peers, subordinates, and business associates will do the branding for you.

In fact, you already have a brand and you don’t even know it. The work has been done for you. Rather than accept a label that may or may not be accurate, take responsibility and define and project your brand.

Borrowing a truism from my friends in marketing, brand or be branded.

First, do some intensive soul searching and decide on the brand you want. Examine your life. Ensure that your chosen brand is aligned with your core competencies and your personal vision. I posted on this subject several years ago in Taking Control of your Destiny.

Once you’ve defined your brand, here are a few ideas to create and manage it:


Continually expand the breadth and depth of your professional and personal network. Proactively reaching out to others saves you from isolation and becoming irrelevant.


Editors are interested in genuine stories from real leaders. Send queries and don’t give up when initially rejected.

  • Magazines
  • Online services
  • Blogging


Get over your fears. Presenting forces you to nail your subject matter and confront doubts.

  • Professional societies
  • Neighborhood associations
  • Your organization
  • Church, Synagogue, etc.

Get Involved

Jump into the community. Let leaders know you’re interested in adding value.

  • Professional societies
  • Special interest groups


Find regular opportunities, and your network will expand.

  • Internal to your organization
  • External to your organization

Routinely Self-Review

Build in times to review progress and make adjustments. Ask for feedback.


Take the initiative to self-educate. Learn from inside and outside of IT and healthcare.

  • Blogosphere
  • Marketing resources
  • Conferences

Add to the Existing Body of Knowledge

Comment on what others have to say (you don’t always have to be the author).

  • Post to blogs
  • Contribute whenever the opportunity presents

No action will spoil your brand more than damaged credibility. While I’m all about a personal hallmark, it must be built upon a solid foundation of execution and excellence. These are not sequential tasks. Proactively improve performance and brand simultaneously.

Critics will say your brand is created and reinforced by your actions. This holds some truth, but it would be foolhardy not to be deliberate. Please! Take a look at politics for a second as we head into the presidential election. According to this study in The Journal of Personality and Social Psychology, when evaluating others, people prefer the potential of an individual over their past accomplishments. I maintain that this propensity for potential is stimulated by an effective brand.

Keep your brand in perspective, and let it humble you. The value of a stellar brand should reach far beyond you, and its primary benefits should accrue to the people and the organization served. If not, then it’s all about you. Possessing a personal brand, which should never come from arrogance or false humility, is key to success. For without it, you are allowing others to determine your brand and possibly your future.

You’re on the runway — lights flashing, cameras clicking. You may not always be able to select the specific clothes, but you must maintain poise and grace.

Make no mistake: the crowd is analyzing your every step. Brand yourself and accentuate it with confidence.

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 9/12/12

September 12, 2012 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.

Elevation (Part 2)
As Slope Rises, Leadership Must Rise

Last month, I posted on elevation using a mountain climb metaphor and honed in on the privilege of leadership. The unwritten covenant of leading people:

To be the leader I aspire to be, I must elevate to match the slope before me. Anyone can lead when the terrain is flat or even at a moderate incline. But there comes a time when the journey leads to a peak. It’s on this trail where leadership is tested, validated, and honed.

A few months back, I spoke on elevation. Someone asked, “How do I know I and/or my team need to elevate?” That’s a great question.

How do you know you need to elevate? Self-awareness. Take a good look in the mirror.

  • Comfort. If you feel everything is comfortable, you’ve probably reached a state of stagnation. Comfort is cozy, but retards growth.
  • Perfection. When you believe everything is fine, or you’ve reached the top.
  • Reality. When you are unable to discriminate the top 10% of your staff from the pack because they are all “best in class.”
  • Self-evaluation. When you do your annual review, you think you are a perfect performer.
  • Invincibility. You talk more about past accomplishments than the work ahead.

How do you get your team to realize they need to elevate?

First, admit your own need to elevate, and then make necessary changes. Second, provide clarity around expectations and hold others accountable. Finally, share behavioral examples of what it means to elevate. The gaps should become self-evident. Sharing what it means to elevate helps even the most defensive person begin to see a need for change.

Here are a few behavioral examples to begin with. Feel free to add others in the comments.

Elevation is:

  • Manic attention to detail. Mistakes happen. I make them and we all make them. I get it. That said, when I make mistakes because of lack of attention, it makes me look sloppy and takes away hard-fought wins. When I’m late, turn in inaccurate numbers, neglect spell check, screw up e-mail, storage, etc., it hits my credibility. If I lose credibility, I lose our ability to lead.
  • Loving my people by disciplining them when warranted. Just as I lavish praise and recognition for incredible performances, I must balance with discipline. Discipline should always be private.
  • Leading my customers. Customers are not always right. Steve Jobs recognized this. He knew the concepts customers wanted and designed from there and led. Old IT simply responds to customers – order takers. That worked in the past, but will not work for the future as the slope of competition rises. I must be unafraid to lead my customers, even when the customer does not want to be led.
  • "My team is never my enemy." We are a team. We don’t have cycles and emotions to waste fighting one another. I address team conflicts within the context of organizational values and inside our own house. Don’t go outside of this boundary. Don’t go complain to the customer. They have their own issues and don’t want to hear about ours.
  • Not allowing variation from good practice. Or, better said, mavericks will kill you. We’ve all experienced the negative impact of mavericks. Leaders must root out mavericks for the higher good. I am not talking about someone who does things differently and brings unique perspective. I am talking about those who willfully do things they know they should not because they think they know better.
  • Assertiveness. I tire of hearing lame excuses about why things are delayed, i.e. waiting on so-and-so to call or e-mail me, or “The reason we have poor performers is because of HR.” No, I don’t buy that. I pick up the phone or go to their office. Make it happen. The ball is in my court.
  • I can be counted on to do the job expertly and without complaint and without silliness. Reminds me of Garcia. This is required reading.
  • Messaging commander’s intent throughout your organization. If the captain says take the north hill, we take the north hill. If I allow the message to be reinterpreted, I’ll find staff taking the south hill. If there’s a major disconnect between what’s commanded and what people do, it’s a leadership issue.
  • Evaluating employees honestly. If the majority were top performers, we’d have a perfect organization, which we don’t. If I’m friendly to a fault with some of my subordinates, this might blind me, so I must constantly acquire external opinions. If a staff member loses their position, am I concerned more about their impact on our mission or the impact on their lifestyle? My primary concern should be the organization.
  • Knowing I need to elevate. Most do not perceive a need for elevation. Leaders elevate constantly. Period.
  • Being a non-conformist. (Not to be confused with maverick.) Don’t “get” just to get along. Don’t comply simply to fit into the culture. Push against grain where warranted. Change culture if necessary. Never for self; always for the organization.
  • Knowing the mind gives out before the body. Train myself to be strong in mind and my body will follow. Healthy mind, healthy body.
  • Ownership. Own problems. Don’t play ticket tennis. Never give up. Don’t point fingers. Take responsibility and practice accountability.
  • Busting silos. If someone is bleeding, should I wait for a medic since I’m not the medic? No. I go stop the bleeding. Don’t let artificial walls keep you from action.
  • Continuous self-improvement. Don’t wait for a required book study or a class to come along. Ask: How am I better than last year? How have I transformed?
  • Line of sight. Knowing how my efforts lead to the fulfillment of organizational objectives. I must know my individual staff’s mission and staff should know mine. Collectively, they should inspire all of us.
  • Faithfully lifting up and living out the values of the organization.
  • Raising my hand to say, “I found a risk, and we need to address it.”
  • Competency. Doing my job, and doing it well. No shortcuts or cheating the system.
  • Cross-organizational teamwork.
  • Spending more time with users than with my office mates.
  • Embracing correction.
  • Getting eye to eye with those I’ve been entrusted to serve (lead). Never, ever deliver difficult messages via any other means except eye to eye. Never.
  • Pouring myself into those I’m entrusted to serve.

Leadership is tough, especially when the slope rises. You may reach a point along the journey where you hit your limit. That’s okay. Recognize it, and deal with it.

Not everyone reaches the summit. Most mountain expeditions have less than a 50% success rate. Smart climbers know their limits, and they stop and turn around to avoid disaster. Sometimes you need to head back down and regroup before you start back up. Other times, it’s best to let someone else lead.

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 8/22/12

August 22, 2012 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.

Elevation (Part 1 of 2)

Leaders elevate to reach summits. As slope rises, so must leadership.

I soaked in the view from six peaks in 14 months. Some were well-marked, long trails that were more hike than climb (Pikes Peak, 26 miles). Some stood tall, surpassing 19,000 feet (Kilimanjaro). And others involved steep alpine terrain that required technical equipment (Rainier). Each one spawns cherished memories and a bit of bravado.

But here is the truth. In every climb, there came a point I wanted to quit.

8-22-2012 7-00-37 PM

At the start of each ascent, I have a good attitude, ready to lead teams to the top. Easy street. Gear is not an issue and my body is fueled and rested. The terrain is normally flat and the weather agreeable.

But invariably, the pitch steepens and the pace slows. Breathing becomes intentional, and team chatter dissipates. Enthusiasm wanes as fatigue sets in. Uncontrollable variables heighten the challenge. Snow, rain, wind, and freezing temperatures bore through my clothes. Covered crevasses, possible avalanches, and wildlife prey on my senses. Equipment failures attack when I least expect it. And when I need strength the most, I don’t feel like eating or drinking. Negative self-talk creeps in. If no one could find me out, I‘d stop and turn back.

8-22-2012 7-03-16 PM

On August 7, we left Muir base camp just after midnight. We awoke to howling winds blowing ice and sand into our faces. We immediately threw on ski masks and added insulating layers. Despite fresh batteries, my head lamp failed. This was going to be one tough climb to the top of Rainier. And so we began.

After crossing the Muir snowfield, we had our first break at 2 a.m. I was already thinking, “What the heck did I get myself into?” Guides checked on their teams and warned that the most difficult sections were still to come.

Some turned back to Muir. If I turned, would my team give up as well? If I continued without inspiration, would I put my team in danger?

The unwritten covenant of leading people: To be the leader I aspire to be, I must elevate to match the slope before me.

8-22-2012 7-02-08 PM

Settle the mental gymnastics before you even get in the situation. That’s what saved me on Disappointment Cleaver. When I became discouraged, I fell back on the truth. It is imperative that leaders have bedrock beneath them for times such as these. Climbing mountains figuratively or otherwise requires self-assurance. Here are some techniques to ensure truth and sure footing when your toe nails turn black and your feet get sore and blistered.

  • You will rise to your level of training. Conquer smaller mountains in preparation. Listen intently to your instructors and learn how to self- and team- arrest in the event of a fall. Be ready for anything.
  • Extreme endurance. You’ve trained hours per day for years. Despite your screaming hamstrings, know that you have the physical endurance to succeed. Be fit to lead.
  • Mind over matter. Climbing is 75% mental. Win the battle of the mind first and know you can handle the stress of difficult situations.
  • Zero defects. Invest in the tools and clothes required to handle variation in weather and terrain. Cut no corners, and pursue only perfection.
  • Fanatical self-discipline. From proper planning to mimicking our climbing guides’ every move, radical discipline separates the boys from the men.
  • Care of self. Even if you lose your appetite or feel the pressure to meet a deadline, eat, drink, and rest at breaks. I can only take care of others after taking care of myself.
  • What can stop you from elevation? Nothing except yourself.
  • Dig deep for the strength within, and continued your march across the glaciers of MU and up steep snowfields of CPOE. Resist the wind and cold of opposition, and crest the summit with elation. And don’t forget to celebrate.

8-22-2012 7-04-14 PM

With all these summits you face, you’ll learn more about yourself and your leadership abilities. Learn to elevate as the slope rises. Make it an unspoken covenant with those you lead.

Climb on!

Elevation Part 2 will contain 20+ key actions to help you move from base camp to summit.

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 8/1/12

August 1, 2012 Ed Marx 10 Comments

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

Burn the Resume

8-1-2012 5-56-16 PM

Unlike Hillary Clinton’s infamous visit circa 1996, I landed in Kosovo under relative calm. We flew in an unmarked military aircraft that was appointed more as a corporate jet than government transport. Despite the sight of armed soldiers, we had no fear of danger.

Coming off the plane, we were greeted by a chiseled young Army sergeant named Jeff Masters. “Welcome to Kosovo, ma’am/sir,” which he punctuated with a crisp salute.

A month prior, I had received a call from the Army. I feared the worst. My deputy CIO Mike had voluntarily been activated to Kosovo as part of an aviation mission. To my great relief, he was fine.

So why the call? Christmas was approaching, and the Army asked me to join generals, politicians, and business leaders on a trip to encourage the troops stationed in Kosovo. I had resigned my officer commission five years earlier, and the opportunity to spend time with troops again was a special honor.

Our roles had reversed. My deputy was now in charge. He took me out in a “don’t ask for permission” lights-out, fly-by-terrain excursion in his Blackhawk. What a rush. Mike pushed the flight envelopes trying to make me sick. Surprisingly, I did not pay a deposit to my barf bag. If I had, I would’ve never lived that one down.

Sgt. Masters, the soldier who initially greeted us, was assigned as our escort to make sure we got from point A to point B without getting lost or killed. He went out of his way to make sure our party was comfortable, answered all questions, and pointed us to the mess hall and latrine. He was polished and confident, and his passion for service was evident. In fact, that first evening, we observed an award ceremony where Sgt. Masters was decorated for superior performance. Generals sang his praises. I knew instantly I wanted this man to work with me when he left the service.

8-1-2012 5-55-02 PM

Sgt. Masters, a combat medic, had no technical experience. Before active duty, he was a carpenter’s apprentice. I didn’t care, because this man possessed what couldn’t be taught: a passion for service and superior leadership. Like anyone else, he could learn IT.

My convictions grew stronger as the week progressed. Once discharged from active duty, Jeff Masters brought his talent to my IT division.

I’m not big on resumes or the typical prerequisites. In the struggle to land my first “professional” job, I kept hearing recruiters cite my lack of experience or targeted education. Although I knew I could do the job, I could never break through. I was equipped with a Master’s degree and modest experience, but moreover, a passion to move mountains. A huge chore list growing up and having to pay my own way through college had built in me a hearty work ethic.

I had the goods for success, yet I could not get my foot in the door. I was frustrated.

When I did enter the workforce, I found little correlation between experience and education and actual performance. Ideally, you seek a high performer with requisite degrees and experience. But by no means is a robust resume a guarantor of success. I owe my career acceleration to leaders who embraced the talent philosophy. Each took what traditional managers would perceive as great risk and offered me opportunities for which I did not “qualify.” I’m forever grateful to my connectors, Mary, Mike, and Kevin.

My journey brought clarity and success to my own recruiting and hiring decisions. Time taught me that the key to good hiring is spotting talent — the natural reoccurring behaviors and thought patterns of a champion. I’ll take talent over years of service or education any day.

Nine months after Kosovo, we assigned Jeff Masters to manage a challenging project that was disorganized and poorly led. A year later, the project successfully wrapped and yielded promised benefits. Working closely with our technical division, Jeff learned field engineering skills and took a leadership role. Next, he joined the application team and learned CPOE. He brought enthusiasm and organization to the team. He was then selected as the IT manager for coordinating the technology of a new hospital construction effort. The hospital opened on time and on budget and is serving its community today.

What a joy it is so see Jeff flourish, leveraging all his talents and continuously learning new skills. I have every expectation that this apprentice carpenter / combat medic will continue to hone his skills and achieve great things for those whom he serves. He has since begun work on his Master’s. But that’s just window dressing for someone who’s already a talented and highly competent professional.

Burn the resume. Hire talent.

Footnote: on our way home from Kosovo, we stopped in Ireland to refuel. We waited in the gate area when another plane pulled in. The soldiers who disembarked were the first rotation of troops returning from Iraq. Realizing the situation, all of the generals, politicians, and leaders formed a “troop line” to welcome the soldiers for a job well done. This marked one of my proudest moments as an American. There was not a dry eye.

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 7/18/12

July 18, 2012 Ed Marx 4 Comments

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

Presence, not Presents

It was the Southern Colorado District Tennis Championships. Playing Pueblo West in the finals, my Mitchell High School doubles partner and I were in for a tough match. For the first time, we would face line judges, a referee, and a crowd (gulp). The stands were full and the tiny stadium was lined with people. We hit a few warm-up balls, and then came the call for player introductions. The crowd and cheerleaders went wild for Pueblo West. “Cool,” I thought. The announcer then called out our school and names next.

The silence deafened me.

Finally, a small but authoritative voice called from outside the fences. “Go, Ed’vard! Go, Ed’vard! Go, Ed’vard!” Yep, my mom, in her thick German accent, cheered us on—one lone fan among the hundreds watching. Out of respect to us, and to honor my mom, the entire crowd broke into applause. We felt the love.

Moms teach us something unique about leadership. But that object lesson often gets lost between high school graduation and our first day in the corporate world. We somehow compartmentalize traits and end up leaving this vital asset outside the doors of our organization. Yet this talent that makes a family tight is also what makes the team tight and the platoon fight.

What is it, you ask? Relationship. I’ll unpack it for us to chew on.

1) The Burden of Visibility. Like it or not, it comes with leadership. Once you leave line staff and enter a position of authority, your orientation must change. Your primary purpose is to serve the team or platoon that actually does the work. Your time is no longer your time. Your calendar becomes your staff’s calendar. A great leader learns to be unselfish—just like Mom taught.

2) The Tactic of Availability. How available are you? Your staff could tell you because it’s not something you can easily mask. Do you solely demand your agenda be met, or do you occasionally meet with them on their agenda? When is the last time someone popped into your office unannounced just to talk? How often do you spend time outside of work with staff? Do you know all your staff names and what team they are a part of? (That can be tough!)

3) The Participation Act. (This requires prioritizing, rearranging your schedule, and good time management.) Take part in life events. Even ten minutes of your life can make a decade of a difference to staff. Join in the celebration of a new baby, a marriage, or a graduation. When tragedy strikes, mourn with the family. Visit sick staff at home or in the hospital. Think about what really matters in light of eternity and make the sacrifice today. If Mom was an example of caring for her fellow man, then practice what she preached through her actions.

4) Engagement. The more a leader engages, the more impact the department has. Be real. Be transparent. Who wants to serve a stodgy, close-minded, secretive leader? Nobody. Think back to whose house you played at as a kid. Probably the home where Mom baked the cookies, offered wise counsel, and didn’t mind messes. If you’ve ever dreamed of making your organization the best place to work, then engage.

A true story: Norman’s soldiers feared death in the brutal killing fields of the notorious Batangan Peninsula. He vowed none would ever be left behind. One day, he received word that his men had encountered a minefield. He rushed to the scene in his helicopter and found several soldiers still trapped. Norman urged them to retrace their steps slowly. Still, one soldier tripped a mine. Severely wounded, the man flailed in agony, and the soldiers around him feared he might set off another mine. Norman, also injured by the explosion, crawled across the minefield to the wounded man and held him so another could splint his shattered leg. One soldier stepped away to break a branch from a nearby tree to make the splint. In doing so, he triggered a mine, killing himself and two other soldiers. That explosion also blew an arm and a leg off the artillery liaison officer. With much effort, Norman led all the survivors to safety. Although he had every right to stay safe, he returned the minefield to retrieve the injured. He could have lectured his staff on the dangers of war and the need to look out for one another. Instead, he showed the way. He served. Nobody ever questioned his commitment to his staff. As a result, they fought harder.

We recently had a tragedy with one of our staff. I mourned the loss of this great person and cried with the family who just lost their daddy. But I also cried because of the outpouring of love and support I witnessed from staff and leaders. We had leaders attend the ceremony who were not in this person’s chain of command, but came out in support for this man and his family. They could have just written a check for a special scholarship fund, but they also chose to be there. Presence, not presents.

Time holds top value to the heart. We can’t let that value slide simply because we’re on the corporate ladder. Don’t let the rat race run over your humanity.

Reap the benefits. They are numerous. When staff know you care, their level of engagement rises. You can rah-rah all you want at staff meetings or in your blogs, but they will respond to the tangible evidence. Words can ring hollow.

General Schwarzkopf, who saved the young soldiers, went on to become General of the Army. He led the Gulf War effort via Operation Desert Shield and Operation Desert Storm. In his autobiography, It Doesn’t Take a Hero, the General speculates that the way he was present with his soldiers in the minefield firmly cemented his reputation as an officer who would risk his life for those under his command.

My partner and I lost that tennis championship match 6-2, 6-1. Mom could have just given me a gift that evening or taken me out to dinner. But what spoke volumes was the fact she took the time out of her busy day to stand in the heat and watch her son play tennis. I preferred losing and having my mom there more than winning without her. That is how much time together means to me. It means the same to your staff.

Presence, not presents expands a good leader into a great leader.

P.S. While you are attending staff’s life events, watch who shows up that did not have to be there. Write down their names, because you’ve probably just identified an emerging leader of a unique breed.

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 6/27/12

June 27, 2012 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.

Excellence, the Road Less Travelled

Another summer working for meager wages was no longer an option for John and me. Both married with kids, we searched for a breakaway strategy where we could make decent cash to hold us over until our first big break. Under-experienced and over-educated in the utopic college town of Fort Collins, this proved a herculean task.

Nevertheless, armed with respective degrees in psychology and Spanish (teaching certificate), we came up with a vision that would forever change our lives. We started our own company. Men… who do Windows!

We visited our local janitorial supply store. With 10 minutes of in-store advice and a $100 investment in buckets, soap, and squeegees, we were bound for glory.

After analyzing our competition in the Yellow Pages, we realized we’d need a bold approach. Competing with dozens of vendors and with no time or money for static advertisement, we took an unconventional approach. We created fluorescent-colored flyers and paid teens to deliver them to targeted neighborhoods. Our phone began to ring.


We bid each job in person and dressed in nice clothes. We parked our company car (a urine-colored Honda CVCC) down the road a few houses so as not to tarnish the high-end brand we strived for. Who would notice the 24-foot extension ladder strapped on top of an 8-foot car? We wore “uniforms.”

We priced our services higher than our competitors — a bold move. But we hoped to differentiate ourselves by stressing customer service and excellence.

Included in our bid was our happiness guarantee: “We not only clean your windows, but your screens and window sills as well. When we enter your home, we take off our shoes. We have towels under all of our tools so you never need worry about us leaving your home a mess. We will move all drapes and curtains and furniture as needed. Prior to us leaving your home, we will inspect each window with you. If you are dissatisfied with any, we will redo them until you are happy with our work.”

We closed 90% of our bids. Our window redo rate = 0.01%.

After a few weeks, we could not keep up with demand and had to stop all advertising. It became vogue in some neighborhoods to have the Men… who do Windows sign in their yard. A few customers insisted on serving us lunch on their decks overlooking a lake. Excellence creates demand.

With graduate school awaiting me and another summer break for John, we resurrected the business the following year with the same results. We grossed an average of $400 per day, with the cost of doing business a low 5%. Excellence is profitable.

John and I believe our success was attributable to the high quality we put into our craft. We encouraged one another to be our best as we honed our squeegee skills to ensure a streak-free finish. Why would people willingly pay a 50% premium for our window-washing services? Because they knew it would be done to perfection. Our customers knew we would meet expectations and not leave without their approval. Excellence elevates the performance of those around you.

We both replicated this value in our personal and professional relationships — John as a teacher and later a pastor and I in healthcare. This pursuit of excellence has blessed our families and careers. Moreover, the people and organizations we serve have benefitted. Excellence creates differentiation that separates good from great.

Ten years after Men…. who do Windows, I was invited back to Colorado State University to serve on the advisory board of the college from which I received my Master’s. During lunch, I was approached by a fellow board member who asked if I had ever cleaned windows. I revealed myself as the founder of Men. He looked me straight in the eye and earnestly exclaimed, “My windows have never been so clean!”

Imagine — 10 years later and he still recalled the service he received from our company for washing windows. Excellence is not forgotten.

Twenty years after Men, both John and I visited Ft. Collins with our families. The owners of Trios AVEDA Spa and Salon knew we were in town. They had a big social after-hours shindig taking place one evening, and yes, they asked if we could reprise Men and clean their windows so they would dazzle. We obliged. It was a great reunion, and we still had our skills. Excellence sets a pattern for future performance.

The Men experience was priceless. Alas, the time came for us to move into our chosen professions.

Rather than sell the business, we gave it away to others in similar circumstances as we had been in two years’ prior. We taught them everything we had learned, from window washing basics to customer relationship management. Even the happiness guarantee.

By the end of the first season, the business lost half its value. We mourned when Men folded midway through the following year. Excellence requires passion to attain and sustain.

A long time ago, a writer in Greece observed the games that would eventually become the Olympics. He said, “Do you not know that in a race all the runners run, but only one gets the prize? Run in such a way as to get the prize. Everyone who competes in the games goes into strict training. They do it to get a crown that will not last, but we do it to get a crown that will last forever.”

Excellence is doing everything you do with the very best you have.

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 6/13/12

June 13, 2012 Ed Marx 10 Comments

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

When the Worst is Best

Years ago, I played on a church softball team. We lost every game we played in the city league for multiple seasons.

Some team members were proud of the fact we were well known for our “good attitudes and behaviors,” but I wanted no part of a losing team, bad or good attitudes aside. I figured if we won a few games along the way, our good sportsmanship reputation would be better respected.

I stayed engaged. As the best player on the team, I was eventually asked to manage the team. I essentially took over the Bad News Bears.

Early the next spring, I held tryouts. I also secured a sponsor who provided us with all the equipment and uniforms necessary to field a team. My criteria for players? In addition to good attitudes, they had to be better players than me. I could hold my own fielding and batting, so I figured if I were the threshold, we would be competitive.

We practiced. We scouted our opposition. We started winning. In making lineup adjustments, I eventually scratched myself out of the starting lineup.

We took first place in our league and won tournaments. We were now known for good sportsmanship and as the team to beat. Fun and satisfying! I still have all the trophies boxed up in the attic, unable to completely let go.

What I learned about leadership and teamwork during my softball era helped shape who I am today.

My objectives at work are similar. As I build teams, my goal is to be the least-talented and gifted leader. If I am the threshold, I think we will serve our organization well.

You’ve heard the adage that C leaders hire D players and B leaders hire C players, but A players hire A+ players. My ultimate objective is to eventually work myself out of a position. When a leader leaves an organization, it should be positioned to accelerate.

Hiring and cultivating leaders who are—or who can become—better than you takes confidence. It’s an intimidating step that will expose insecurities you didn’t know existed. Fight through the weaknesses and self-doubt. Learn from your team.

But be careful! Don’t let your insecurities interfere. Don’t sabotage your leaders out of fear. Put on your big boy pants and die to yourself.

Die. To. Your. Self.

Here’s the deal. Being the best on your team limits your organization’s potential. Being the best in a position where you’ve reached the top means you can’t learn from those around you. Where is the genuine satisfaction in that?

If I insisted on being the best player on my softball team, I would’ve made great plays and batted in some runs. Would we have won? Probably not. Sure, I would’ve received plenty of ego strokes, but at what price?

Ironically, not only did our softball team win, but I improved as a player. At work, I continually grow. Why? My team. Funny how that works.


Thank you for your responses on “When the Worst is Best.” In addition to those on HIStalk, I received many via Facebook, LinkedIn, Twitter and e-mail. They are overwhelmingly positive, albeit some missed the primary point and  took offense to forming a competitive team from a church.

Let me put it this way. As a carpenter, Jesus himself would not only have made himself one heck of a bat, He would have aimed to win. Since we had 100+ turn out for the tryouts, we also fielded some recreational teams for those who just wanted to “play” and did not care about winning.

There is room for that in softball, but in our profession where we impact people’s lives, I only want the best and I am not ashamed to say it.

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 5/30/12

May 30, 2012 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.

Memorial Day: What is Your Legacy?

5-30-2012 6-59-02 PM

April 2007. While in Washington DC on business, I spent some time sightseeing with fellow/former Army officers. One gentleman was the recently retired commanding officer of the 3D US Infantry Regiment (Old Guard) charged with guarding Arlington Cemetery, including the Tomb of the Unknown Soldier.

He gave us the most unexpected honor. He prearranged for a couple of us to lay the flowered wreath at the Tomb during the evening changing of the guard.

I still get the chills as I reminisce that moment: escorted between sober, armed soldiers; laying a measly garland of flowers before a solemn tomb; silently saying “thank you” for the millionth time to men of sacrifice with no identity, lost but never forgotten. The sight of our flag coupled with the singing of our national anthem generally brings tears to my eyes, so this honor was as good as it gets.

A sacrifice… never forgotten. Despite language, religious, and geographical differences, humanity shares a universal desire: to make life meaningful. Whether it means having an impact on a family, a village, or a nation, we all want our lives to count for something.

The Memorial Day Service my wife and I attended this weekend reminded me of the brevity and sanctity of life. Every song sung, every speech read, and each poem recited proved life was meant to be lived with relevance and significance. Am I living in such a way that beneficiaries will take time to reflect on my contributions?

For some, contribution means laying down life in battle to defend freedoms. For another, service and sacrifice will have a different flavor. Whatever we are called to do, let us impact people positively and serve the forthcoming generations.

I began to personalize these thoughts in terms of my career. “There’s no limit to the amount of good you can do if you don’t care who gets the credit.” I don’t know who said that, but it’s a truism that helps me keep a healthy perspective. The world isn’t about me, but it does either gain or suffer based on my involvement, how much I give and take.

My new philosophy goes like this:

Let my employer be a better place for teaching, healing, and discovering as a result of my leadership. Let the decisions I preside over have lasting beneficial effect. May I treat others in such a way that their children and their children’s children will benefit. May I always keep the long term in mind to avoid compromise and complacency. Let me leave my employer a better place than when I arrived. May those who I serve have accomplished more than otherwise possible, furthering their careers and thus their impact. May clinical and business outcomes have been positively impacted and lives improved.

Though no one else might see it, my epitaph will read, “My service in healthcare mattered.” In the end, even if no one remembers our names, maybe they’ll still place a metaphoric wreath at a tomb in honor of all of us who served to make healthcare better.

What about you? What legacy will you leave behind?

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 5/16/12

May 16, 2012 Ed Marx 10 Comments

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

The Good Boss

One of my assignments as a young captain was serving as the convoy commander for our combat engineer battalion. We were moving over 250 vehicles across the state of Colorado. Given the size and type of vehicles (Hummers, dump trucks, semi-tractors carrying bulldozers), we covered a good 15 miles of highway end to end.

I missed a turn and inadvertently split my convoy in two. Applying a few off-road techniques, I’d put the pieces back together within a couple of hours. But not before catching the attention of the battalion commander.

At our next stop, I steeled myself for one of the famous ass-chewings our commander was known for. We both stepped out of our Hummers. He looked at me and said, “Carry on, Marx!” He spun back around and climbed into his vehicle.

That was it. And you know what? For me, that’s all it took and he knew it. He purposefully chose a different form of discipline for that situation. Later, he told me that he could tell by the look on my face that I had learned the lesson and understood the gravity. He did not have to say anything more. And he didn’t.

Earlier this year, I posted the Bad Boss. It is always easier to point out the negative over the positive. So what is the Good Boss?

I don’t believe there is a magical checklist of Good Boss attributes. There are too many variables and permutations. Put simply, the Good Boss first and foremost does not follow a checklist. She understands every person is unique and should be treated as such. Just like my commander following my convoy fiasco.

I crowdsourced for input. Here is a compilation of attributes of a Good Boss. This is not research or academia or consultant or stats based on one person’s experience. It is not a checklist. These are ideas, and I imagine they reflect the thinking of your staff as well. Ponder the following and adopt as your situation dictates.

Ensures Appreciation and Value

  • Thanks subordinates regularly
  • Demonstrates gratitude in words and action
  • Rewards success
  • Personalizes awards and recognition
  • Listens often
  • Gives the subordinate glory for success


  • Takes active interest in the subordinate’s career and guides growth in the job
  • Teaches the subordinate how to best interact with customers
  • Encourages professional development and provides educational opportunities
  • Willing to learn from the subordinate
  • Hopes one day the subordinate will step into his position
  • Guides the subordinate to their ultimate goal, even if it means losing them


  • Never steals ideas from subordinates
  • Always honest and ethical to the core
  • Does not undermine anyone
  • Possesses a strong work ethic
  • Treats everyone without bias (race, religion, ethnicity, gender, age)


  • Sets high but reasonable standards and removes non-performers
  • Gets more out of subordinates than they can get from themselves
  • Sustains the continuity of the organization by hiring only “A” players
  • Provides insightful and regular feedback
  • Elevates performance without the subordinate even noticing
  • Provides appropriate tools and training for the job


  • Holds individuals accountable to performance standards so the team does not suffer
  • Represents team and department with passion and confidence
  • Makes the subordinate feel proud to be on the team
  • Takes public responsibility for the action of the team when failures occur


  • Makes themselves transparent and vulnerable
  • Admits errors and apologizes without excuse
  • Gets to know subordinate as a person (family, hobbies)
  • Is in tune with their emotions and not afraid to show it (smile, laugh, cry)
  • Shares their wisdom in decision making and is open to other possibilities


  • Encourages vision
  • Articulates and lives the mission and values of the organization
  • Tells the subordinate when to be practical and when to dream


  • Remains positive when things don’t go as planned
  • Always finds the good in bad situations


  • Does not micromanage and allows for creativity and self-expression
  • Welcomes and supports innovation and creativity
  • Recognizes individuals strengths and positions people accordingly
  • Knows when to be the boss, friend, or mentor
  • Knows when to lighten difficult moments


  • Leads by influence and not by position
  • Jumps In the trenches as needed
  • Walks the talk and shows flexibility
  • Trusts, respects, and gives benefit of the doubt
  • Possesses high emotional and social intelligence


  • Promotes work-life balance
  • Allows for downtime
  • Able to charm Joint Commission surveyors!

Is this how your employees describe you? Which of these attributes will strengthen your leadership? Remember, one size does not fit all. Treat everyone in the style that works best for that individual and circumstance.

Be the boss! The good boss.

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 5/2/12

May 2, 2012 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.

Get Off of My Cloud!

1960s entertainment nailed the future. Star Trek tricorders are here. Lapel communicators are ubiquitous. And who can forget the Rolling Stones singing about the Cloud?

Most agree that mobility and agility are the future. The cloud is the infrastructure which enables them. The cloud is the delivery of computing as a service, not a product — akin to a utility. The cloud enables technology to propel the speed of business.

Friends recently returned from a trip abroad. The advanced wireless infrastructures found in third-world countries both astounded and pleased them. By unintentionally leapfrogging the technological revolution, these regions had bypassed the incremental advancements of the last 30 years and gone straight from laggard to leader. Societies that have not had a telephony infrastructure, for example, are suddenly delivering the highest per capita cellular subscribers.

Leapfrog advancement. Can we do it in healthcare IT? Maybe a better question to ask is: do we need to?

YES! Mobility, enabled by the cloud, is the path to the future.

Healthcare organizations viewed as laggards now have the potential to leapfrog peers. The cloud will empower them to bypass heavy capital investment and kludgy hardware and render single-organization data centers obsolete. You can shrink implementation timelines from months to weeks. Focus your institution on implementation and optimization rather than worry over floor space or cooling requirements.

If we don’t transform our organizations by routing capital away from brick and mortar to cloud-based mobile applications and services, the third world will pass us up.

As legacy hardware and software contracts expire, look for cloud alternatives. Basic requirements for any new application should include cloud capabilities. If the vendor has no cloud offering, be concerned. Ask deep questions. You don’t want the clock turn to 2015 and you still have data centers bursting at the seams with legacy applications residing on heavy iron.

The cloud has been around for several years in one form or another. Non-healthcare industries have embraced the cloud successfully. Some worry about security, yet the number of incidents are no different in the cloud versus in-house. Breaches occur in both. Security is not the barrier.

As a leader, show courage. Move your organization forward. Become relevant by leveraging mobility. Embrace the cloud!

Hey you, get onto my cloud!

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 4/11/12

April 11, 2012 Ed Marx 10 Comments

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

Satisfaction—I Can’t Get No….

“You have a Masters in Computer Science?”

The hiring manager’s initial question took me aback. Human Resources had obviously misread my degree qualifications, yet my resume still passed the screeners.

Eager to land my first salaried position, I cleared my throat and hoped my answer wouldn’t displease. “Although I do know something about computers, my Masters is in Consumer Sciences, the philosophy and practice of customer service.”

Despite her realization that I had the “wrong” degree, the hiring manager looked past this and focused on talent. And thus began my journey into the convergence of healthcare, technology, and service.

This initial position was not IT, but rather an adjunct to the corporate strategy office. Specifically, physician relations. They wanted a person with a technical background who could market the IT applications, thus endearing physicians (and their referrals) to the hospital.

IT had only achieved 5% physician adoption. They lacked the service orientation and communication skills necessary for success. By adopting service-oriented practices and strategies, we increased utilization to 85%. It was during this time that I experienced my defining moment, launching my healthcare IT career.

Customer satisfaction is a passion of mine. A service orientation mindset changes an organization. I’ve seen the positive correlation. Not only are more customers satisfied, but the benefits extend outward. Employee morale increases. Productivity increases. The organization becomes more effective and efficient.

Here are a sampling of results achieved by customer-centric teams.

  • In a mid-size hospital, we deployed several applications to physicians in our region with hopes of gaining market share. We poured service all over our offerings and reached a 91% customer satisfaction rating. In one year, we went from 45% to 55% market share in four strategic indicators.
  • In an academic health system, we quadrupled “top box” customer satisfaction scores in four years. Financial and quality scores increased exponentially on the same slope. Employees who were once embarrassed to be part of IT now delighted in the honor of being part of the team.
  • In an integrated health system, we increased “top box” satisfaction 30% in three years. While we maintained revenue targets, we exceeded many quality targets.

How do you achieve superior customer satisfaction and sustain the gains? My team identified nine keys:


Right people in the right positions. Everything rises and falls on leadership (Maxwell). The first thing you must do is ensure the right people are operating in the right roles. Although painful, you must remove some from the “bus” and have others change seats. The quickest way to change the direction and service orientation of your organization is to put people into positions that best utilize their natural talent.

Effective communication. Personally and sympathetically counter negative perceptions and battle anecdotal commentary with facts. Establish monthly reports with dashboards on service levels, project status, key deliverables, and achievements. Share the good, the bad, and especially the ugly. Deliver presentations whenever and wherever you can, evangelizing IT. Become a valued member of every management team.

Relationship building. Strong relationships cover a multitude of sins. Assign IT leaders directly to operational leaders and make routine calls and visits to address concerns. This allows operational leaders to have a single “go-to” person for all their IT interactions and reduces associated complexities. Involve IT leaders in organizational events such as blood drives, sporting events, service opportunities, volunteering, and charity work. Establish a program for connecting with clinicians.

Strategic planning. “Where there is no vision, people wander.” This proverb characterizes IT: a bunch of well-intentioned professionals without direction. Consequently, there is stifled progress, pent-up demand, and frustration. Solicit input from your enterprise and fashion a strategic plan. Review annually and ensure organizational alignment and convergence.

Comprehensive governance. Implement a formal but agile governance process comprised of and led by customers. This ensures IT alignment with organizational vision and gives you a level of rigor, accountability, and transparency not previously possible. Include rank-and-file customers, senior executives, and especially nurses and physicians.

Continuous quality improvement. Your survey vendor will provide in-depth analytics and recommendations based on the results. For instance, after learning that nurses represented our most dissatisfied customer group, we swept through nursing floors and made sure IT became a clinical care enabler. We added hundreds of mobile computers to patient floors to satisfy their greatest complaint — lack of devices.

Aligned incentives. Create a single key performance indicator on which incentives and raises are based … the annual customer satisfaction score. Everyone will become focused on service.

Execution excellence. Without excellent execution, all other strategies are moot.

The secret weapon. The secret weapon is heart. Heart is the wellspring from which motivation emanates. Empathy, compassion, and humility combine to mold a heart that seeks to serve. I’ll hire those with high talent and high heart but mediocre skills any day over someone who has low talent and no heart. Skills can be taught, heart is caught.

Superior customer satisfaction and information technology need not be mutually exclusive. It is less a matter of programs and more about a sustainable leadership imperative that transcends culture. It is a journey, not a destination, and requires a steadfastness of focus, discipline, and courage.

Unlike The Stones, you can get Satisfaction. Hey, hey, hey, that’s what I say …

How do you create a service oriented culture? Share your ideas below and I will send you a presentation I did on developing a customer service culture plus the accompanying Gartner case study.

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 3/28/12

March 28, 2012 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.

Caught, Not Taught

As a parent, the most frightening rite of passage for me to tackle was not the sex talk, it was the car talk. As in watching my kids head down the street solo in a two-thousand pound, steel and fiberglass projectile. They had attended classes, studied a manual, and passed a test. But were they really prepared?

Not fully. They lacked one critical element.

In the workplace, I advocate professional development and have witnessed the benefits of classroom teaching. When I began to analyze this process, however, I realized traditional training suffered a maximum effectiveness. Think about this. After reading a book on teamwork, were you able to convert all the learned lessons into action? Why do some managers respond to training while their classmates do not? Why do leaders take life-changing courses, yet nothing changes?

Critical skills can only be caught, not taught. My children, for example, had the head knowledge for driving, but that information didn’t come to life until they took it on the road. Experiencing the streets helped them to catch—or ingrain—the skills for successful driving.

How do you help your team catch? Ability to drive is a necessity that comes with an inherent motivator—drive or be stuck living under my roof with my rules!

How can you create this driving-like context that motivates your staff to live out what they learned in the books? The following methods have worked for me.


Never fly solo. Do your best to always have a sidekick with you. If I have a team member in the hospital or a funeral to attend, I take an emerging leader with me to provide comfort. When I walk around to visit the team, I have a manager with me. They learn from the experience through observation and active participation.

Be vulnerable. When I have tough decisions to make or challenges to contend with, I open the kimono. I don’t shelter my team or pretend to know the answers. I include them. The young leader learns there is no voodoo or secret sauce. Some day they will face a similar issue and it will be familiar.

Share the stage. When I’m invited to speak, write, or interview, I often have one of my leaders with me. Sometimes observing, and other times co-presenting. One of our young directors had not presented before, so I had him observe me at a local university. The next time, we co-presented. Now he speaks routinely on the national stage.

Be transparent. Leverage social and business media. I Facebook friend any of my team who has interest. I connect with any on Twitter or LinkedIn. In the work environment, I mircoblog daily about what I am doing and why. This allows multiple avenues for insight. For instance, I may share my thought process on how I deal with setbacks.

Engage a mentor. Ongoing, planned partnerships focused on helping a person reach specific goals over a pre-determined period. Unfortunately, the art of mentoring has rarely caught on in the business world, healthcare included. Mentoring can be a difference maker.

Connect to others. As a leader, how do I impact the heart of my team? How do I create an environment where we can cultivate compassion? How do I help them view their job as more than a paycheck, but as a contribution to a patient’s life?

Ask questions. Whenever I’m around people I admire, I fire off a number of questions, then just listen and learn. I soak up wisdom.

Create hang time. It’s easier to talk when we’re not disguised in stuffy work attire. A non-business setting encourages conversation, but you must create these situations. I have surprised my team with an ice cream fest and invited individual members to attend employer-sponsored professional sports with me. I attend their symphony performances or listen to their garage bands at a local bar. I invite them to join my family for Broadway shows (we always buy extra tickets.) Make it happen!

Offer social opportunities. Do you learn etiquette from a manual? Emerging leaders who seek to become vice presidents should know how to handle themselves in a cocktail party situation and know the difference between red and white wines. My wife and I purposely host parties in our home to create a safe place in which to practice so they can learn to be comfortable mingling among executives. It’s also another occasion to get acquainted with and show appreciation to their significant others.


I’ve had the joy of watching my directs blossom in their careers. Although I invested greatly in their formal training, their development accelerated during active observation. In the last couple of years, several became CIOs. Others took senior leadership positions in professional organizations.

My kids turned out to be pretty good drivers. But if you ask them how they learned, they’ll tell you they caught it by doing it – by making wrong turns, slamming on the brakes at stoplights, and bumping over curbs while parallel parking. The manual finally made sense.

It was caught, not taught.

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 2/29/12

February 29, 2012 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.

Are You an Insider?

My siblings and I took a beating from our peers because of the Bavarian clothes our parents insisted we wear long after our arrival in USA. We were, however, embraced on the futbol pitch. The seven of us kids had the benefit of growing up on the soccer field in Germany. When we arrived here in the mid ‘70s, American soccer was in its infancy. Coaches welcomed our soccer finesse, experience, and smarts. It took time for our teammates to accept us foreigners who played with a different style, but our impact proved undeniable.

What was good for those teammates is equally good for IT.

One of my first healthcare jobs held a single yet challenging objective: “make docs happy.” In that competitive environment, physician loyalty was paramount. My role was one-third ombudsman, one-third consultant, and one-third party planner.

I loved it. I met with physicians daily to make sure their concerns and ideas were appropriately vetted with hospital administration. I dived deep into practice management and provided consulting services ranging from business development to system selection to establishing regional CME events. The most enjoyable aspect was organizing some serious parties to celebrate accomplishments and recognize the medical staff and their contributions to our healthcare system.

Despite my established healthcare background, I transitioned into the position of IT director as an outsider. I brought with me a different skill set. I viewed things differently from my tradition- oriented IT peers.

It was not easy for me or my new cohorts at first, but we helped each other. Mixing outsider perspective and experience with solid IT operations made for a dynamic environment resulting in vastly improved performance and outcomes.

As a believer in the diversity approach, I’ve purposefully sought to develop teams comprised of traditional and non-traditional workers. In a former post, “Got Clinicians?” I share the absolute necessity for ensuring appropriate clinical insights. Now I aim to encourage you to build a healthy mix of non-healthcare experienced talent into your fold.

Most would agree that healthcare, conservative by culture, is three to five years behind the technology curve. Bringing in outsiders who have worked in progressive industries such as finance or international business will help push the organization forward and help ensure currency. Not just currency, but also what is on the horizon. A couple of the chief technical officers I’ve hired have had zero healthcare experience. On both occasions, my organizations experienced a massive technological bounce.

Promoting only from within will continue to retard the growth curve as compared to other industries. It’s all about striking that healthy balance.

So, what about you and me? Even outsiders eventually become insiders. How do we stay fresh and think with the objectivity of an outsider? Spend at least 50% of your learning outside of healthcare.

Some methods to avoid becoming a healthcare IT junkie:

  • Conferences. Choose wisely. Skip HIMSS every other year and go to the consumer electronics show instead. You will see things that will eventually be shown at HIMSS three years later.
  • Blogs. Read posts that are on the bleeding edge.
  • Magazines. Check your subscriptions. At least half should be outside of healthcare and, of course, a high percentage should be business and non-technical.
  • Peers. Spend time with non-healthcare peers. I previously posted on how we compare notes regularly with companies in different verticals. Next up, Kimberly-Clark.
  • Organizations. Actively participate in professional groups such as SIM where you are exposed to peers from across industries.
  • Hiring. Keep yourself on your toes by hiring outsiders who are smarter than you.
  • Diversity. Don’t hire your twin
  • Advisory boards. Participate in those that are vertical agnostic.

Fitting in to please everyone is a worthless pursuit. Avoid that temptation. Hiring outsiders is healthy for your team. This will create more opportunity as new technologies are transferred to the team. Hiring outsiders is beneficial to your organization as you begin to deploy new tools that will enable mission fulfillment. Hiring outsiders advances healthcare. You’ll leverage technology and help reduce the cost of healthcare, elevate patient and clinician satisfaction, and ultimately improve the quality of care.

Most of us German-transplant kids had successful soccer careers in high school and beyond. We helped our coaches take our teams to the next level. Goal! And for at least a few hours each week, we were free from our lederhosen.

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 2/1/12

February 1, 2012 Ed Marx 17 Comments

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

The Bad Boss

New town. New job. I was stoked over what was essentially a startup within an enterprise. As a visual learner and teacher, I asked the office manager for a whiteboard.

No go. The president wanted to keep corporate operating costs low. No worries. I went to Staples, and for the cost of a Starbucks Grande Red Eye, I bought myself a whiteboard.

Before I had a chance to hang my would-be art piece, my boss stopped in and frowned. “What’s this?” After I explained my reasoning, he said, “Take it out.” He wanted all the offices to have the same minimalist look and feel.

Well, my kids loved it. That whiteboard became central to their homeschool activities. I’ve used it over the years for meetings at home.

Little did I know, the rejected whiteboard was only an omen of the legalistic reign under which I was now employed. I was tempted to pack up and head back south. After all, I had a 90-day “get-out-of-jail-free” card from my former employer who would graciously welcome me back. Our old home had not yet sold.

Tempted as I was to escape, I knew running away was wrong. If I quit now, I would never learn perseverance. I had made a commitment and I would keep it, no matter how aggravating. I knew I would use this challenging experience to prepare for the future. Angry and disillusioned, I stuck it out.

Most of us have had a manager who’s aggravated the heck out of us. National employee engagement scores from Gallup suggest that many are presently in such situations. Web sites such as Really Bad Boss are extremely popular. Numerous best-sellers have been written on the subject. And did you ever ask yourself why The Office and Dilbert are such big hits? Because we can all relate on some level to bad bosses. I suspect all of us will have the opportunity to encounter one along the way. This was mine.

I make an effort to understand these concerns because I don’t want to be a bad boss. And I’m very aware of my potential to become what I hate. We’re all susceptible.

That said, I’ve been blessed to work with predominantly good bosses. So here is what I learned to make the best out of bad-boss situations:

  • Honor leadership. Part of my career plan is based on the premise of honoring those in authority over me. This can be tough. Clearly, you should never turn a blind eye to unethical behaviors or abuse. I am solely referencing a difficult and disagreeable boss. Actively give honor to them. It may not change them, but it will change you.
  • Make your boss famous. Another toughie. Why would you make a bad boss famous? Because if you can make them better, there’s a chance your situation will improve. Don’t talk up how wonderful your division outcomes are, but give the glory for good things to your boss and take your lumps when things are not so good. Leadership demands humility. “There’s no limit to the amount of good one can do as long has he doesn’t care who gets the credit.” Author unknown
  • Take the good. Most bosses are bosses because they have done something good and have the capacity for more. Seek out the good and apply it to your career. My anti-whiteboard boss taught me the importance of having a “kitchen cabinet,” developing key informal relationships that serve as a sounding board and advisory committee. Life is too short to not learn from all circumstances.
  • Check the mirror. Take inventory of the bad and look for signs of these traits in yourself. If you find one, pull it out. Guard against bad-boss behaviors creeping into your own style. If your boss is inclined to knee-jerk reactions, don’t start flailing your arms every time you are faced with a challenge. Recognize bad-boss behavior and never replicate.
  • Leading up. This might seem impossible, but keep faith that you can influence a change in your boss. Lead by example. Although your voice may not be heard, your actions will be noticed, subconsciously or otherwise.
  • Think long term. Look ahead and remind yourself that today’s actions dictate tomorrow’s decisions. If you quit when things are tough, you will become a quitter. Stick things out. Don’t tap out too quickly.
  • Speak no ill will. Avoid the trap of complaining about bad boss to other people. This will only exasperate the situation and make it worse than it is. Speak blessing instead.
  • Seek first to understand. Figure out the drivers for bad boss behavior. They are likely stress induced. Most bad bosses are well-intentioned leaders who’ve lost their way because of personal and/or professional pressures. Identify the sources of stress and you might help reduce or eliminate it. At the very least, you will sympathize and realize the behavior is not a vendetta against you, albeit it feels like it.
  • Avoid a bad boss. Forbes shares five tips to spot a bad boss in an interview. Gather your own references. Call the person who most recently held the position. Call on the other direct reports. If you are well networked, get the internal buzz on your potential boss. Many a bad-boss situation could be avoided if you research diligently and listen to what you hear. Don’t believe things will change because you believe you are better than your references. They won’t.
  • Joy in suffering. This is the toughest one for me, but the most important. “Suffering produces perseverance; perseverance builds character; and character produces hope.” It’s an upward, spiraling cycle throughout life.

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So if you have a bad boss, you have a choice. Life is too short to be in a bad boss situation, but you owe it to yourself, your people, your boss, and your organization to make it work.

I persevered with the anti-whiteboard boss. I established a “kitchen cabinet” as I’d learned from him. I was promoted out of that division and into corporate, where I became CIO. Hope never disappointed me.

And then I purchased the biggest damned whiteboard ever made.

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 1/25/12

January 25, 2012 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.

The Annual Review

They say people fear giving a speech more than death. I say people fear performance reviews more than speech and death combined.

Despite having had some excellent managers over the years, I can’t say that I ever had a review I enjoyed or gained much from. And frankly, I am not sure how many helpful reviews I deal out. Reviews are not a strength for most. They should be.

Admit it. You appreciate the person who lets you know the tag is sticking out on the back of your shirt. Or that you have oatmeal stuck in your braces. If I’m going on a date with my wife, I often ask my teenage daughter, “Do I look hip in this outfit?” Her enthusiastic nod—or more often, her grimace of embarrassment—tells me the truth. She helps me improve.

We want to know these details about ourselves, trivial as they may be. So why does our attitude change in the work setting? Nothing trivial there. In fact, our efforts—and non-effort—can have a serious affect on the department, if not the entire organization. My performance is never self-contained. My conduct, attitude, and effectiveness cascade through the ranks. My subordinates frequently do what I do … and what I do NOT do. Not surprisingly, their people follow their example.

Does your annual review reflect the real you? Do your assessments accurately reveal your staff?

How easy it is to cave in to temptation and give overly optimistic reviews to avoid discomfort. I’ve done it; you’ve done it. We’re all guilty. At the end of the day, I kick myself because I’ve shortchanged everyone. In fact, I’ve undermined my employee and my organization. Worse yet, if I’m not modeling appropriate and accountable reviews, my subordinates will follow my poor example. (Ouch. I feel the pain as I write.)

This post is as much of a kick-in-the-rear encouragement to me as it is to you. Since it’s that time of year again, we the leaders are going to invest the time and energy to make the review honest and meaningful. You with me?

Here are four tips:

  1. Spandex. Brutally, honest friend. If you want to know where you stand with weight management, pull on a pair. Someone can tell me I’m fit, but when I see the rolls of fat hanging over the spandex … as Clapton might sing: ♫ “It don’t lie, it don’t lie, it don’t lie … Spandex!” ♫. This sort of accountability keeps me on the right path. We need Spandex feedback in our careers to ensure that our performance remains in check. Give honest feedback even when it’s uncomfortable. Your employee deserves to know the truth no matter how brutal. Nobody likes flab.
  2. Satiate the hunger. Deep down, most of us long to improve. If I can give my subordinates one tangible thing to work on, most will clutch it like a pit bull clenching a bone. Imagine if your boss gave you one strength to focus on every year to help you move to the next level and you really did something with it. You might become CEO. That annual performance review might become something to look forward to.
  3. Break it down. Several years ago, I switched to doing performance reviews quarterly with several of my directs. This helped make the annual review less dreadful with those who chose this format. When you’re tracking progress, evaluating, and encouraging throughout the year, there are no surprises to contend with. The annual review almost becomes a formality.
  4. Abundance of counselors. If I don’t get a bone to chew or my Spandex feels loose, I move on to other senior leaders that I trust. Some of the best feedback for improvement I ever received did not come out of my manager’s review, but rather from the next office over. I encourage my directs to seek the same. The combination of both leads to spectacular outcomes.

For Christmas, I received the latest in athletic gear, compression shorts. Compression shorts are medical grade – Spandex on steroids. While I track my pulse, pressure, Vo2, weight, blood chemistry, and speed, few things let me know where I stand health-wise better than my new shorts. They offer a whole new level of accountability and transparency.

Honest feedback to stimulate improvement is what our people and organizations need the most. That and Spandex.

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 12/28/11

December 28, 2011 Ed Marx 18 Comments

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

The Connecters

For six-year-old Herbert, a train ride was nothing new. But this train was different. Cold. Smelly. No seats. Conductors wore helmets, carried guns, and yelled. Shrouded in darkness and smushed between people’s legs, Herbert clung to his mother and aunt. Passengers wept and prayed. Days later, they disembarked at Gurs.

Horrid scarcely described the inhumane conditions in the “relocation” camp. Herb dug through the trash each day, foraging for crumbs. Six months into the torment, a soldier grabbed him and carried him outside the camp gates. The French Resistance, hiding in the night, whisked Herb into the woods.

Dodging armed patrols, they traversed the countryside and came to a convent near Lyon—Herb’s new home. During routine inspections, the nuns would hide him, the only Jew amongst gentiles. A year later, the Swiss underground led him on foot over the Alps into Switzerland, where he found solace in a group home for Jewish boys.

Herb never saw his family again. While he scaled mountains to freedom, they boarded trains for Auschwitz.

After the war, Red Cross officials connected Herb with relatives that had immigrated to the United States years prior. A young adolescent, fluent in French and German, Herb sailed across the Atlantic. Lady Liberty greeted him in the New York harbor. He learned English. Five years later, Herb returned to Germany as an American soldier.

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He fell in love with a young fräulein. They had seven children. I am the youngest

At the end of each year, I reflect and give thanks for many things in my personal and professional life. I’m grateful for what I call The Connecters: the beautiful people who held my dad’s hand. From the German guard at Gurs who led him through freedom’s gate, to the hands of the men and women of the underground. For the nuns who loved a boy of a different faith. For the schoolmasters who hid my father in defiance of the law and for the hands of my immigrant uncle who welcomed him into his New Jersey home. They connected my father to his future. In my heart, I kiss those hands.

This year, my gratitude focuses on my personal Connecters — those who helped enabled my then-future career. While hiring me didn’t affect life or death, I am thankful to those who took a gamble on me. Here are my Connecters and what they taught me:

Pastor Rick Olmstead. In a small but growing church, Pastor Rick invited everyone from the congregation who had an interest in leadership to visit his home for a barbeque. He had hoped for gray heads of wisdom, but ended up with four young-in-their-faith sophomore college students. Trusting in a higher power, Rick pushed forward and invested in us. We eventually became part of the team that enabled multi-year, double-digit growth. His exceptional mentoring and leadership formed the foundation of who I am today.

Major Loomis. The Executive Officer of the 244th Army Reserve Engineer Battalion. This officer’s additional duties involved overseeing the Cadet program. As a nervous nineteen-year-old combat medic, I interviewed with him for one of the few coveted Cadet slots. I knew others had interviewed better than I did, but he took a chance and showed me unmerited favor. I went on to become a combat engineer officer. Upon earning the rank of Captain, I served as the battalion motor officer and battalion movement officer. I learned much about organization, leadership, and process.

Mary Hein. She agreed to interview me because she had misread one of my degrees. She thought I had a Masters in Computer Science when in fact it was a Masters in Consumer Science. When I brought this to her attention, she let it pass and continued the interview. I had very little experience to speak of, yet she offered me my first salaried professional position. I cried (not in front of her, of course.) Mary taught me poise, communication, and brand. She helped hone my leadership.

Mike Gogola. I was interviewing for a director of physician relations position when I realized it was actually an IT position. “You have the wrong person,” I told Mike. While I was good at physician relations and marketing, IT was not my forte. To this day, I’m not sure if he was desperate or sincere, but Mike assured me I had the right stuff for the position. He surrounded me with good technical people and I learned on the go. Mike took me with him to networking opportunities and conferences. He taught me project management and IT.

Kevin Roberts. Kevin believed in me before anyone else saw my executive potential. He took a major risk in supporting my bid to become a CIO at a young age and without requisite experience. He shielded me from naysayers as I learned to walk and then run. He pushed me to become increasingly independent, which grew my confidence. He believed in me.

I’m thankful for those men and women who saved my dad and made my life possible. And I’m thankful for the men and women who connected me, took a risk, and enabled my career.

Who are you thankful for? Take time this holiday to let them know your appreciation. But don’t stop there. Ask yourself who you can help connect. When is the last time you took a risk to help an eager wannabe advance?

Leaders are called to Connect.

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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