Government // Leadership
01:22 PM
Anthony Guerra
Anthony Guerra
Building a Culture of Analytics
Jun 21, 2016
This session will provide you with best practices for introducing analytics concepts to the busine ...Read More>>

Guerra On Healthcare: Implementing EMRs Despite Reluctant Leadership

Hospitals must become meaningful users of electronic medical records, but not every hospital CEO is willing to step up and lead the charge. Here's how healthcare CIOs can get leadership on board and get the job done.

Slideshow: Who's Who In Healthcare IT
(click for larger image and for full photo gallery)
It's been said in countless presentations, manuals, and interviews: transformative clinical IT implementations cannot be led by the CIO. The IT department must support the change, but it cannot force clinicians to do anything -- that impetus must come from both the clinical leadership and the hospital administration (think CEO, COO, CFO).

I have absolutely no doubts this is an accurate recipe for success, but what happens when you're missing a key ingredient, such as a willing leader in the aforementioned positions? What happens when CEOs won't lead the electronic medical record (EMR) implementation, when they are either too busy or (more likely) too risk-averse to put their stamp on a project which has tons of potential to make very powerful people angry (think high-revenue-generating independent physicians).

At that point, the tried-and-true axioms of success break down, because no one goes beyond the premise, "IT can't lead this." When the people who must lead refuse, what's a CIO to do?

First off, we must assume that, in this scenario, the CIO has no intention of throwing in the towel, no intention of conceding, "the person who had to lead would not, so that's why the project was unsuccessful." In the scenario I'm crafting, failure is not an option.

This means the only course for the CIO is not to lead, but to make the leader lead, to make the CEO, COO, and/or chief medical information officer understand what role they must play in the process. This means e-mails, phone calls, stopping by the office, grabbing coffee, talking to people who have influence over them, cajoling, communicating, educating, scaring ("This is how much failure will cost"), and, if necessary, going over their heads (to the board) to get the message across.

Make no mistake about it, as CIO, you will be blamed for a large-scale clinical IT implementation failure, despite the fact you cannot lead it. Let's start with this premise (reality) and move on. If you cannot overtly lead it, but you will be held responsible for it, then you must, somehow, lead indirectly. If the public-facing leader is reluctant, weak, or cowardly, that's not a "Get out of jail free card." You must play the cards you've been dealt, and make that leader lead. You must do whatever it takes.

Ironically, some people reach the pinnacle of corporate success by being consummate responsibility-evasion artists. You know them, they are the ones who never really commit to anything, always kicking the can down the road with phrases like, "That's an interesting solution. I think we need to consider the downside involved before we move forward. Let's revisit it at the next meeting." When it comes to EMR and computerized physician order entry (CPOE) implementations, these people are kicking your career down the road. Don't let them get away with it.

Anthony Guerra is the founder and editor of, a site dedicated to serving the strategic information needs of healthcare CIOs. He can be reached at

Comment  | 
Print  | 
More Insights
Newest First  |  Oldest First  |  Threaded View
2014 US Salary Survey: 10 Stats
2014 US Salary Survey: 10 Stats
InformationWeek surveyed 11,662 IT pros across 30 industries about their pay, benefits, job satisfaction, outsourcing, and more. Some of the results will surprise you.
Register for InformationWeek Newsletters
White Papers
Current Issue
Top IT Trends to Watch in Financial Services
IT pros at banks, investment houses, insurance companies, and other financial services organizations are focused on a range of issues, from peer-to-peer lending to cybersecurity to performance, agility, and compliance. It all matters.
Twitter Feed
InformationWeek Radio
Archived InformationWeek Radio
Join us for a roundup of the top stories on for the week of June 19, 2016. We'll be talking with the editors and correspondents who brought you the top stories of the week to get the "story behind the story."
Sponsored Live Streaming Video
Everything You've Been Told About Mobility Is Wrong
Attend this video symposium with Sean Wisdom, Global Director of Mobility Solutions, and learn about how you can harness powerful new products to mobilize your business potential.