When I first became a CIO, my role involved writing applications and managing architecture at a detailed level. Over the past 17 years, my role has become much more strategic, ensuring the right investments in the right overall architecture are made with appropriate resources to support them. I've had to master the political, communication, and interpersonal skills of leading rather than the technical skills of being a strong individual IT contributor. Along the way, I've learned the difference between commanding and leading.
In an academic health center, formal authority is rarely exercised. The ability to get things done (or not done) depends upon reputation, trust, and personal influence. The greatest leadership I challenge I face in 2013-2014 is that the plate is overfilled with ICD10, MU2, HIPAA Omnibus Rule, and the Affordable Care Act. The majority of my leadership efforts involve getting the entire organization to focus on the regulatory must-dos, while deferring nice-to-haves. I do this because it is the right thing to do for the institution, but equally important is to triage work away from my staff, which are at the breaking point because of too many demands.
Budgets over the next year at most hospitals are not likely to enable the hiring of new resources beyond those needed for ICD10, HIPAA related security updates, and ACA related analytics. My leadership task is to limit work to the right work, attempting to buffer my staff from the mayhem of competition for scarce IT resources.
With all the tensions and anxieties involved in running governance committees, planning efforts, and communication outreach, what drives me to do it?
I recall reading a quote from General Shinseki about his views on leadership from his retirement message in 2003:
"You must love those you lead before you can be an effective leader. You can certainly command without that sense of commitment, but you cannot lead without it."
I have maintained my role at BIDMC for 17 years because of loyalty, admiration, and affection for my staff. I've encountered many leaders who do not understand loyalty and are driven by fame, fortune, or the next new thing. I'm hopeful that my devotion to staff helps with creating a positive culture, reduces turnover, and builds informal authority -- a sense that we're all in this together, fighting important battles every day.
Top down command and control works in some organizations and some industries. Some employees in organizations which thrive on command and control have told me that they work with constant fear of failure/criticism. My hope is that leadership built on the the strength of employee relationships creates a joy of success motivation without fear. Whenever bad things happen, and they do, we should ask how our work processes enabled the mistake, celebrating the learning and not blaming the individual.
When I was young, I thought that management meant authority, power, and self-reliance. Over time, I've learned that management is about relationships, collaboration, and creating a community of people who support each other. Leading a team of people you admire is much more satisfying than commanding and that's why I'm still a CIO.