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Health IT leadership must drive big-picture strategies

Publish date: SEP 01, 2010

FOR TECHNOLOGY professionals leading IT efforts among health plans, the biggest changes in recent years haven't come from hardware and software, but rather, from their roles in implementing and understanding new strategy and business concepts.

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While technical mastery remains a given for any chief technology officer (CTO), their success today relies more on being a leader, innovator and strategic thinker.

"For CTOs, technical skills are necessary, but no longer sufficient," says Brian LeClaire, vice president and CTO for Louisville, Ky.-based Humana. "Their ability to succeed, both now and in the future, will depend on their ability to understand the business side of healthcare, as well as their ability to think and act like a businessman. That change has been happening gradually over time, but its pace has been greatly accelerated by the emphasis that health reform puts on IT."

Given the impact that technology has on budget, expense and revenue generation, CTOs need to be planners and doers—which means they should have a seat at the strategic planning table. Without it, they won't understand the context of the IT value proposition and won't be able to properly align the technology strategy with the business plan.

"In the past, CTOs could succeed by being expert technologists who simply executed the strategies developed by their C-suite counterparts in finance and operations," says Michael Tucker, general manager of PBM products and technology for global healthcare IT consultancy, IMS Health. "However, in today's environment, the CTO needs to be well versed in the business strategy and key performance measures that drive overall business success. In other words, a successful CTO needs to convert technology innovation and project execution into concrete business value."

CTOs who want to play a greater role not only need to brush up on their business knowledge, they also need to become adept at marketing themselves to both co-workers and external business partners, LeClaire says.

He says the CTO should focus on using technology to accomplish at least one of three things:

  • Increasing top-line revenue;
  • Lowering costs; and
  • Improving services and quality.

LeClaire says they need to be proactive by identifying a solution that meets one of those criteria and then they must be able to present it to the organization's business leaders and others who are responsible for execution.

State health directors breathed a loud sigh of relief last month when Congress finally managed to approve added funding for Medicaid just before leaving Washington for its summer recess.

Exchanges could bring in millions of potential customers. Insurers need to begin formulating marketing plans now.

Because members are becoming more cognizant of their out-of-pocket expenses, many are turning to complementary and alternative medicine therapies as a less-expensive alternative

Controversy continues to swirl around Medicare's two-year-old policy of not paying for what it considers preventable hospital-acquired condtions. CMS has decided for now not to expand its list of 12 serious adverse events for which it does not reimburse hospitals.

Many organizations have started filing patent applications directed to such business improvements, such as online insurance claims formatting and filing, for example.


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