If you are drinking from a fire hose, you need to focus or you will drown. When so much new info is coming your way every day, you need a framework.  When I started my present interim CIO engagement, I knew I needed to understand some key areas right away. They included strength of the leadership team, staffing, system performance, user satisfaction, budget, vendor relations, security, and IT governance.

Issues with system performance and dissatisfied users will find you even if you don’t go looking. Without solid system performance for your production environment, it’s hard to discuss anything else with your executives. If the issue affects your clinicians and their ability to see patients and manage their workload, you need to pay close attention. And you need to work with your team to figure out what’s going on and resolve it. System performance affects user satisfaction.  Whether users love or hate a system they depend on, it has to be fast and reliable.

To quickly assess the IT leadership team, you need to understand their background and experience, their current scope of responsibility and their primary concerns. What are they struggling with?  What help is needed? Are staff aligned with the highest priority initiatives and is there adequate staff dealing with production support? Does the team have the right skills to be successful?

It doesn’t take long to learn the major vendors and whether they are serving the organization well. This is when you want to know your account executives and the escalation path for issues – not just the lead salesperson.

The operating and capital budget for the current fiscal year and IT financial performance needs to be an early discussion with the right people on your team and finance. In health care organizations everywhere, there is pressure to reduce costs. IT is part of that. Managing to budget is one thing. Finding opportunities where there may be duplication, inefficiencies or waste means going a level deeper.

Every new CIO wants to know the security profile of the organization they just joined. Is there executive level support for a strong security program? Is there a competent leader in the Information Security Officer role? Is there adequate budget and staffing to support the security program? And is the workforce security aware?

Many organizations struggle with IT governance. One of my former bosses and a Chief Operating Officer once said, “we’ve never met a good idea we don’t like”. But governance is about making choices and setting the relative priority of the work that is going to move forward. Some requests shouldn’t be approved – when you are working with objective criteria to evaluate, it’s easier to make these calls. And once approved everything can’t be number one. Establishing the appropriate governance bodies and setting clear decision making rights are critical.

The job of the Chief Information Officer is not an easy one. I can’t count the number of times that people have said to me, “I wouldn’t want your job”.  Yet it is a critical one in any organization, and it can be very rewarding when you and your team have a positive impact. But first, you need to get the basics right. Once you do, there is great opportunity to leverage new technology and innovate. What organization doesn’t want that?