Controlling vs. collaborative IT leadership and what it means to your healthcare organization

Forgive me, but I simply need to vent. Think for a moment about your hospital or health system's IT leader. Would you describe this person as controlling or collaborative? Do you even really know? And what difference does it make?

In my role at Microsoft, I meet with many business and clinical leaders in health and healthcare. I also work closely with our account executives and solutions experts who call on IT leaders of hospitals, health systems, and clinics around the world. Over the years, I've concluded that IT leadership often falls into one of two categories; controlling or collaborative. Within a few minutes of visiting most healthcare organizations, I can usually tell if the IT leadership is controlling or collaborative. There's often a very direct correlation to the organization's ability to innovate and transform.

Although the IT leader in a healthcare organization may hold a variety of titles including IT Director, Chief Technology Officer, or Chief Information Officer, for purposes of this post I am going to refer to the IT leader as the CIO.

The controlling CIO runs a very tight ship. There's no question about that. He insists that all information about new technologies, products or solutions go exclusively though him or someone in his department. Vendors are not permitted to meet with anyone else in the healthcare organization without the implicit permission of the CIO or his delegate. Meeting with a clinical leader or business leader outside of IT, and especially without the blessing and presence of IT, is strictly forbidden. Breach this rule and there will be hell to pay. The downside of this kind of controlling behavior is that information about new technologies, products and solutions may never reach those who need it most. It's ironic that in this case the Chief Information Officer seems to be the person withholding or at least filtering the very information his organization needs most. The motivation behind this behavior may be driven by a need to "protect" IT staff from taking on more work. It may also be motivated by fear that a new technology or solution will reduce IT staff and is therefore threatening to the IT department and the CIO's power in the organization. While withholding or filtering information may be good for the CIO and his staff, it is very damaging to the organization. Clinical and business leaders don't know that they don't know. This stifles innovation and holds back the organization in adopting new technologies that will help drive clinical and business transformation.

The collaborative CIO also runs a tight ship, but she is driven to make sure that clinical and business leaders in her organization are up to date on the latest technologies, products and solutions. She is a collaborative mentor who helps other leaders and end users improve organizational performance. She encourages other leaders in her organization to meet with relevant vendors and IT experts to make them aware of the latest advances. She often organizes meetings with vendors and proactively invites other leaders in her organization to attend. She selflessly does what is best for the entire organization rather than what is best for her department. She understands that her organization's business is patient care and every IT decision and project should be aimed at improving business and clinical processes for better care access, quality and cost. She views IT as a facilitator of business and clinical transformation. She also knows that besides the technology it is more often the people, processes, behaviors and cultures that determine the success or failure of IT projects. Knowing this, she includes stakeholders in the earliest discussions about new technologies and solutions and encourages their continued support, education and involvement every step of the way. She makes sure that every person in her organization has access to the information they need to make the best decisions about what technologies and solutions they will use to drive personal and organizational performance.

So is your IT leader controlling or collaborative? Is he or she driving your organization forward or holding you back? Do you even know? If you are a business or clinical leader in your organization, I would urge you to find out. Like I said, you may not know what you don't know. Trust me, your fiercest competitors will be those organizations whose technology leaders are far more collaborative than they are controlling.

Bill Crounse, MD        Senior Director, Worldwide Health          Microsoft  



Comments (2)

  1. Martin Soles says:

    At my previous employer, the CIO was a mix of both. We liked to be kept informed of all these decisions that people would try to make without any thought to how it could be implemented or integrated into what was already in place. It wasn't so much being controlling as guiding. Otherwise, we'd probably have had a state wide system being run from some college dorm (yes, that's a true scenario that we stopped).

    There were many cases where we would be asked to do something that was impossible because there's no method to filter, sort, or group patient data by eye color when that information isn't stored anywhere other than the clinicians' mind.

  2. hlthblog says:


    I agree that it is seldom totally to one side or the other. However, in my experience the more controlling the IT leadership, the less likely an organization will be innovative and forward-thinking. Like I said, the business and clinical leaders in that environment don't even know what they don't know. One controlling CIO told me he didn't want others in his organization to learn about the latest new technologies and solutions, because he was tired of saying "no" to them. If they knew about it, they might want it.  He didn't want to be known as the guy always saying "no".  But is that the role of the CIO? I don't think so. Better to say, let's work together to determine if this is really a good idea for the organization and if so, then let's figure out how we can make it happen.

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