James W. Brady, PhD, CHCIO, and Chief Information Officer, Los Angeles County Department of Health Services

Digital transformation has had an impact on all industry verticals, making companies much more collaborative. This has enabled siloed business units to better communicate with each other, leading to seamless operations internally as well as with other external business entities. As a CIO, I believe the secret sauce for delivering best-in-class enterprise capability and business value is pillared on majorly two aspects—the enterprise team and the IT team. Within organizations, bringing siloed units together, whether they are small or large enterprises, can be a complicated and cumbersome process.

In health care, we have seen our industry dramatically reformed with the advent of digital and advanced technologies. This has proven to be effective in some organizations, and even within parts of larger organizations. But often, we have not been able to universally take advantage of it. As a result, the cost of healthcare services in the U.S. continues to be too high. In addition, we remain challenged with the inaccessibility of healthcare services to all. This has brought about a need for us to re-evaluate and redesign the way we operate healthcare facilities, with the goal now to make our services more efficient and cost-effective. Furthermore, we also need to look for ways to make our software systems more standardized across our hospitals and clinics so that patients received the best care at the lowest cost, highest quality, and in the most convenient manner.

  It is important for CIOs to understand the culture of their organization, where their IT organization has been and is moving to, and to closely partner with their executive peers in order effectively drive enterprise transformation within the organization 

As a part of the Los Angeles County Department of Health Services, which has been in existence for more than a century now, we have witnessed a steady growth as we have expanded our health care services to meet the increasing needs of our patients. What has been a huge step forward for us is the recent implementation of an electronic health record (EHR) system that has enabled the integration of every individual facility’s records into one unified system. The implementation of an EHR system is a strategic initiative that is designed to transform an organization into a modern enterprise. In doing so, challenges can arise because much of the organization often continues to operate individually. Alongside this, with technologies applicable only to a handful of systems within the organizations, it further becomes complex to bring about an entire culture change, to make all the employees work in unison. The other factor that plays a vital role in creating robust enterprise capabilities is to have the right board of directors and leaders who are also enthusiastic in bringing their business units together. We also need to look into measures to improve the business model into operating more like an enterprise, while focusing on the stakeholders as well as team management, at the IT level.

In my opinion, several factors determine the shaping of a successful enterprise. One of the most influential factors is the size of the organization, along with the current structure that is in place. A simple place to get started is by creating virtual or matrixed teams, where IT employees would retain their current position and yet be a part of the large enterprise organization. For example, a matrixed enterprise model can include project managers located within the central office as well as within various siloes in the organization. This allows for more versatile teams who can respond to enterprise needs with increased flexibility and agility. In some cases, matrixed teams that include both IT and business individuals can form a Center of Excellence (CoE), as we now see often within the DevOps model.

Another important factor that has to be considered while bringing the workforce together is understanding the difference between shadow IT and business IT. Shadow IT refers to those people within the organization who are technologists but are engaged in various IT activities with the involvement of the formal IT department. This shows how the business is proactive in their enthusiasm for the use of technology, but it can lead to a number of drawbacks. It becomes the responsibility of the IT leaders to pay attention to where they have shadow IT groups in their organization, and why this exists. Perhaps the IT department isn’t providing the services their business partners truly need. As a result, business units feel the need to venture out on their own to meet their technology needs. CIOs and their organization heads should realize that bringing together shadow IT into mainstream IT cannot only improve their services and products and incur lower expenses, but it will also let the business units focus on their domain expertise instead of trying to manage technology on their own.

On the other hand, business-led IT occurs when business leaders take an active role in technology to drive the business goals of an organization. Obstacles can arise initially if the business is left all to themselves and IT leadership is not engaged. The secret of a successful enterprise is when IT leadership works in close partnership with the business leaders of the organization to prioritize and implement high value initiatives.

In summary, CIOs must take on an organizational and IT leadership role in order to be effective in today’s enterprise. Understanding the culture of the organization and driving change in a way that gives people a chance to catch the vision and make the transition to a more collaborative and integrated team-based model are powerful methods to help transform the organization. Enterprise teams will ultimately assist in lowering costs as the organization moves to a more centralized and standardized approach. The expansion of the IT staff into new operational areas increases the scope and productivity of the organization, along with moving the organizations to a more advanced approach. CIOs and IT leaders need to develop their emotional intelligence by understanding the importance of partnering with the business, and understanding that learning and education are lifetime pursuits.