Healthcare IT brings new roles, challenges to hospital org chart (as published by Billian's HealthDATA)

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As health organizations settle into vendor partnerships and continue with the arduous task of digitizing health, a wellspring of healthcare executive search activity has sprung forth as providers seek out IT-savvy candidates who can help deliver on the promise of healthcare IT (HIT).

Billian’s HealthDATA recently spoke with Stefan M. Werdegar, Vice President of the Healthcare Information Technology Practice at executive search firm Tyler & Company, to learn more about in-demand HIT roles and market consolidation’s impact on the hospital C-suite.

Population health has cropped up in hospital placement news recently. Is this a position you see many hospitals establishing? Are other roles taking center stage as a result of HIT initiatives?

We’ve heard from clients that population health is a big focus, but specific carve outs in this space are not yet widespread. While some organizations have created positions in this field, others have concentrated a team under the CIO or patient experience leader. This makes sense due to the analytics involved in understanding a group’s makeup and needs, and identifying how the organization can best serve them.

When the bottom line is affected, leaders take notice. Due to the correlation between Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores and reimbursements/incentives, organizations are dedicating resources to patient experience efforts with the goals of improving HCAHPS scores and increasing the likelihood that patients will refer the hospital to others, to name a couple.Traditionally, this specialization fell under quality, but as ties to profitability tighten, the trend we’ll see is more (and/or new) positions under a “patient experience” umbrella.

As we conduct more searches in this space, we find different schools of thought in terms of the best background for candidates. Some believe candidates should possess a clinical background while others prefer the hunt start outside of the healthcare industry. Candidates with clinical history have “been there and done that” – a  classic characteristic that genuinely is embraced in such a knowledge- and experience-prized industry like healthcare. These executives are interpreted as “one of us” among physicians, nurses and other clinical staff.

In the other camp, we have organizations interested in exploring process- and customer-relationship management strategies from other industry leaders. They find fascinating how to apply the fresh perspectives gained from leaders in customer-relationship and satisfaction heavyweights like Ritz-Carlton and Disney.

The position is often a hybrid that includes quality and organizational development roles. It even includes some functions normally reserved for the COO as this patient experience leader is responsible for process improvement changes within clinical operations that drive outcomes and satisfaction. Because demand greatly outweighs supply at this time, executives with backgrounds in nursing, IT, HR and even customer service (outside of the healthcare industry) are seen as ideal candidates for working with quality teams, strategizing with the C-suite and being ambassadors to physicians. The time is right for patient experience directors.

Another position that deserves mention is Chief Security Information Officer. Hospitals have employed Directors of Network Security, but safeguarding the organization’s technical and information assets and compliance have become intense front-and-center issues, especially when considering the Health Insurance Portability and Accountability Act (HIPAA) rules. We’re starting to see the advent of a C-suite position to address this critical and strategic area.

IT has become highly complex.Thus, spreading the workload between specialists managing applications and those responsible for the technical infrastructure is gaining momentum. Due to the many moving parts within these divisions, we’ve seen titles escalate to Chief Technology Officer (CTO) and Vice President of Technology, as well as increased demand in these areas.

Another role that is in high demand is the Chief Medical Information Officer (CMIO). We interviewed Michael J. McCoy, M.D., former CMIO of Catholic Health East, who provided a high-level perspective on CMIO role and how it differed from a CIO. Dr. McCoy offered insightful knowledge on what the role is today, why hospitals need and benefit from an IT specialist who is a physician, and the role’s challenges.

Additionally, we’ve seen roles sprout for specialists responsible for maneuvering through health information exchanges (HIE). We should expect to see this become a nice growth area for IT since these specialists sometimes are tied to hospitals’ initiatives surrounding accountable care organizations (ACO) and population health.

Have things like ACO alignment and mergers/acquisitions impacted executive placement activity?

In general, there is much more turnover due to consolidation – whether it’s due to duplicate positions or organizations’ downsizing  to reduce cost.

The American College of Healthcare Executives published a report showing that U.S. hospital CEO turnover had increased to 20 percent in 2013. This is especially true in smaller, rural, community hospitals that are not tied to a larger system and are pinched financially.

Because of  the uncertainty and perceived issues that executives experience with merger/acquisition activity, they begin to look for their next opportunity.When we interview executives and ask about their motivation for changing jobs, many have a premonition of danger ahead or “see the writing on the wall” in terms of a lingering merger or buyout.  We also have seen cases of Baby Boomers deciding to retire, which create vacancies.

Although we hear the buzz word “succession planning” for the CEO role, more organizations are implementing this for critical positions. Planning ahead to find the next leader of the organization, operations, finance, IT – you name it – may involve developing internal talent, mentoring and promoting; soliciting the help of an executive search firm partner; or a combination.

What challenges do you see as you work with healthcare organizations on executive searches?

Managing placement timeline and candidate expectations is a challenge. Clients have specific and complex needs that they desire be met with an A+ person who at times doesn’t exist for that job description and salary. Through communication and information discovery, we reach a happy medium.

Across the board, there are salary issues. Because many of these positions are relatively new, requirements for titles like Vice President of Patient Experience, Vice President of Case Management and CMIO are moving targets. Many salary compensation firms don’t even have the information to benchmark new roles, and compensation can be vary drastically.

Compensation may also create parity issues. For example, an organization may employ a Vice President of Quality, who can be higher in the organizational chart than the Vice President of Patient Experience. It can be challenging and possibly a disruption to the pay scale to compensate the Vice President of Patient Experience at market rate if it equals or surpasses the compensation of the next tier.

What advice would you give candidates looking to make a move up or into healthcare IT?

While we are navigating in somewhat uncharted waters, some clear competencies and skills for candidates have surfaced. The below are regarded as differentiators.

  1. Implementation experience: In IT, “roll-up-your-sleeves” executives who have “been there and done that” and have been involved in go-live(s) surpass those who lack this experience.
  2. Business acumen and business sense: While it’s applauded if one rises up the technical ranks, an IT executive also needs to think like a successful business person. That is, one who understands the strategic direction of the hospital and the real business impact of HIT.
  3. Physician relations: This is critical. More and more of our clients seek specialists who have worked with large medical group organizations on IT issues and are highly regarded by physicians.
  4. Playing well with others: In years past, IT was tucked under the CIO and interaction with clinicians, the C-suite and  ancillary departments was minimal. In today’s integrated world, no matter what level you work on within IT, having polished relationship skills and experience working with other groups are essential.
  5. Non-healthcare outlook: While clients tend to prefer executives with healthcare experience, there’s an uptick in considering candidates who offer non-healthcare perspectives. Thus, those who have worked in industries such as banking or hospitality – even for a short stint – are seen as prized commodities.
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