Five Questions for Your CIO

Chief information officers need to understand far more than just technology. With nearly two decades of experience managing IT systems, Randy McCleese offers five key questions that all healthcare technology leaders need to ask and answer about their role.

Randy McCleese, CIO, St. Claire Regional Medical Center
Randy McCleese, CIO, St. Claire Regional Medical Center

1. Does your organization want to be a technology leader?

Many healthcare institutions prefer to implement innovations after they’ve been vetted and proven reliable elsewhere. However, for chief information officer Randy McCleese, it’s important to keep pushing the envelope.

Shortly after his arrival at St. Claire Regional Medical Center, he was responsible for replacing the existing network, which had become very unreliable. Although it was more expensive and much less commonplace than it is today, he was successful in having fiber optic cable installed.

“In 1997, I knew we needed something that in the near future could accommodate images and other kinds of media, and I wanted it to last at least 15 years; it’s been 18 years, and the backbone of that system is still in place,” McCleese says. “Ultimately, our total cost of ownership has been less than if we’d made a more traditional choice.”

He also views technology as a competitive differentiator—something vital for St. Claire, located in Morehead, Kentucky. “Quite honestly, being a leader in innovation draws more patients,” he says. “We’re 60 miles from two major cities where new technologies are being used, and 100 miles from another system that offers round-the-clock clinical consultations via video. We need to do more to maintain a level of technological leadership in order to keep patients here.”

2. Who drives the organization’s corporate technology strategies?

Like many community hospitals, St. Claire Regional Medical Center’s board is made up of individuals with varying levels of technical knowledge and expertise. As a result, technology considerations are often added as afterthoughts to initiatives for new services. McCleese believes it’s important to educate decision-makers on how technology can enhance projects and therefore needs to be part of the process from the beginning.

“We need to be certain that executives are clear on how technology helps produce more streamlined, efficient, and cost-effective results for all sorts of projects,” he says. “To make that happen, technology has to be part of the discussion from the beginning—not tacked on after the fact.”

“Technology has to be part of the discussion from the beginning—not tacked on after the fact.”

3. Are decisions made by consensus or unilaterally by those in charge?

Top-down decisions always face challenges when it comes to implementation, especially in healthcare.

McCleese feels strongly that decision-by-consensus is important for two reasons. First, it’s based on a full range of information and input as to how decisions will affect stakeholders who have to work cooperatively and collaboratively. It draws on the “wisdom of the group” to balance the overall impact on all parties involved.

Second, adoption and implementation are much easier to accomplish. To illustrate, McCleese points to an EMR purchase decision at St. Claire. “Our CEO asked the selection committee to ‘sell’ the recommendation to the rest of the organization,” he says. “Because it was based on so many opinions from so many different disciplines, it was more readily accepted by the organization than a unilateral, ‘less-informed’ decision would have been.”

4. Am I doing enough to keep the organization’s culture open to change?

To avoid resistance to innovative approaches at St. Claire (and throughout healthcare), McCleese is very active in technology advocacy. He served as the 2014 board chair of the College of Healthcare Information Management Executives (CHIME), is a former Advocacy Midwest vice chair of the Healthcare Information and Management Systems Society (HIMSS), and the 2015 CHIME foundation board chair.

“Regardless of the culture, CIOs have to continually raise awareness and educate peers and the public,” he says. “The better their understanding and openness to new policies and technologies, the higher-quality healthcare we can deliver.”

5. Is there an adequate talent pool to support the desired initiatives?

In a small market like Morehead, McCleese has developed innovative ways to help supplement his technical staff. These include the creation of an informatics group that engages St. Claire’s clinical staff. Although they’re not technology experts, they provide valuable feedback to technologists about how well new solutions perform on a day-to-day basis. This approach helps eliminate departmental silos and supports acceptance of new processes and procedures.

“Our guidepost is making sure we’re enabling clinicians to do the best-possible job and offer the best-possible care,” McCleese says. “If the technology can reduce a critical function from five steps down to two in an intuitive way, then we know we’re doing our jobs.”