Becoming Better Business-Technology Leaders

Every study shows that organizations as a whole, especially chief information officers, continue to struggle with business-technology alignment. It remains one of the top management issues. No other group in any organization talks about alignment as much as information technology groups. 

I have been long been arguing that aligning technology with business is a fundamentally flawed and limiting concept. Instead, companies should achieve a true melding of technology and business minds?what we call "convergence."

To better understand the myriad ways in which organizations are converging, the BTM Institute, the non-profit research think tank established by BTM Corporation, routinely interviews executives at a variety of companies and institutions.

Our years of research, including the creation of the Business Technology Convergence Index, shows converged companies far outshine their non-converged competitors in shareholder returns, revenue growth and profitability. Business and technology decision-making and activities are fully integrated.

The New Leadership

Check into New York-Presbyterian Hospital, the largest hospital in New York City, and, according to their CIO, you will be given responsibility for your own care.  

"Our leadership feels very strongly that our patients own their data," says Aurelia Boyer, the hospital?s CIO. "Many hospitals say they own the medical record and require patients to sign an agreement to view their medical record. We really want to be an advocate of empowering patients to take control of their healthcare."

This has been the goal of those seeking to reform the chaos?a very expensive chaos?that is our health care system?s management of the information that overwhelms the delivery of care. In fact, this ?system? was never designed as a holistic system and certainly doesn?t operate that way.

New York-Presbyterian is on the leading edge of change, however, and every day it demonstrates the benefits of technology:

? Reduced patient errors through electronic physician order entry
? Eliminated transcription errors
? Reduced pharmacy errors because all scripts are sent electronically
? Reduced dosing errors in pediatrics, where dosing is calculated using weight and age

Fewer patient errors mean lower costs and better outcomes. Administratively, the same data is used to measure and manage the hospital?s delivery of services.

?We have the management portal, which comes up on everyone’s desktop,? Boyer says. ?At the weekly leadership meeting we review the results by rotating through the different indicators we collect on the dashboard. Some of them are throughput related, such as are how much are we behind budget, and where did the patients in the emergency department come and go from. We have an entire series of quality indicators for all of the things we’re required to measure. These things include central line infection data, the length of stay data, even hand washing.?

These things are possible because the hospital has invested in technology, following a seven-year plan. More importantly, its management of technology is converged with its management of healthcare.

One sign of a converged company is that the people making decisions on business and technology are the same people ? they are conversant in both. They have an understanding of the business mission and an appreciation for the technologies that enable it.

At New York-Presbyterian, CEO Herbert Pardes, also a physician, is intensely involved in technology decisions. ?The CEO, as well as the COO, agree that a really robust information technology infrastructure provides the required underpinning for getting healthcare to where it needs to go on these quality measures and efficiencies,? Boyer says. ?To this end, our executives have the widely held view that technology is one of our critical initiatives.?

Boyer herself is a trained nurse.

?My background in nursing gives me certain advantages. In addition to being a nurse, I’ve held many different administrative roles in a hospital. Together this experience has helped me to understand how the workflow goes, and how the patients move, and, thereby why the management dashboard needs to look like it does. I can better discern what constitutes helpful data and what doesn’t. My staff comprises many nurses and a few practicing physicians who work for us part time. These physicians provide us with the best of both worlds by helping us to make good decisions about what systems we should be using. In the next decade, most healthcare CIOs will be MDs.?

Questions For Reflection

? If you are on the ?business side? of your company, are you able to talk intelligently with the technologists and understand what they are trying to tell you? Are you engaged in technology decisions?

? If you are on the ?technology side,? are you able to recognize your jargon, drop it, and explain technology in terms the business people will understand? Do you have input on business strategy?

? More to the point: do you or your organization still think in terms of ?sides??

? Would you be able to function as CEO Pardes and CIO Boyer do?make decisions about both the business and the technology knowledgeably? If not, what are you missing?

Stories such as these provide real-world guidance for leaders facing these extraordinary times. The patterns of organizational structure and behavior that got us to this point won?t take us into the future. Neither will our old attitudes and skills.

The situation at New York-Presbyterian is still somewhat rare but not unknown. The line between business and technology has blurred and even disappeared at many leading companies. The split between business and technology minds may have been normal in the early days, but it is unnecessary and even harmful today.

Convergence has many faces. It begins with a comprehensive self-examination by an enterprise that leads to a unique, customized roadmap for maturity advancement of their business-technology management practices.

It is also true that leaders who practice business-technology management (by whatever name they call it) bring to it different skills, perspectives and practices. Their particular priorities are an important component, because the road to convergence is different for each company, depending on where it currently finds itself.

These matters are no longer someone else?s problem. The changes required to get a company in fighting shape will be the responsibility of every leader, no matter his or her function or level.

Faisal Hoque is an internationally known entrepreneur and author, and the founder and CEO of BTM Corporation ( His next book, The Convergence Scorecard, is expected later this year. BTM innovates business models and enhances financial performance by converging business and technology with its products and intellectual property. ? 2009 Faisal Hoque | [email protected]