Incoming tech chiefs often face a litany of challenges, from deciding how to modernize legacy IT platforms to figuring out which vendors to work with.
Those problems can be exacerbated if the company has been slow to upgrade technology over the years or hasn't historically viewed the IT division as a key aspect of the overall growth strategy. Nowhere is that perhaps more true than in the healthcare industry.
The sector is governed by stringent regulations — like patient privacy laws — and for many years IT was often not a focus for the enterprise, making some tech overhauls more difficult. Hospitals and other healthcare providers also tend to operate with smaller profit margins than peers in the other industries, meaning there is less money available for IT investments.
Those were all problems Paola Arbour had to deal with when she took the job in 2018 as chief information officer of Tenet Healthcare, an $18 billion hospital chain with locations across the US.
The hire was a recognition that Tenet needed someone who could "bring technology to bear into a company that has spent probably too much of its time not appreciating technology the way it needed to," she told Business Insider.
Before joining, Arbour spent much of her career in the technology industry. She was a top executive at consulting firm ProV International and cloud computing firm ServiceNow. Arbour also spent over five years at Dell, ultimately serving as vice president of strategic pursuits for the tech giant.
Tenet wanted "somebody who actually served CIOs and had knowledge of what it's like on that side," she said. "To actually sit in the chair and drive a culture change around how you treat the internal business organization like a customer."
Like other CIOs, Arbour had the difficult task of changing the perception internally of the tech team. She shared the four steps she took to help make sure the IT department became a more central focus within Tenet.
Treat the company as a customer
Organizations are used to focusing much of their attention on ensuring the best customer interactions possible. That's why it remains a key guiding principle for many digital overhauls.
But less attention is paid to the need for the IT department to view the enterprise itself as a customer. Many CIOs are eager to "deliver technology inside their company [but] not really knowing how and not necessarily having a seat at the table" to make it happen, said Arbour.
To push the cultural shift internally, Arbour went on a listening tour of the organization to learn the successes and failures of the IT department to date. She then created "client delivery leaders," a position that sits within the various departments in Tenet that helps coordinate needs between the business and the tech teams.
"They own the service level, they own the customer experience measurement, the scoring, they also own the financial metrics," said Arbour.
As always, however, available funding was a limitation to pushing the major changes Arbour was seeking. She pressed the IT team to employ more automation, streamline organizational structures, and use more software-enabled services to free up capital for various projects — an approach other tech leaders at healthcare providers have also employed.
Manage the vendors
With the rise of artificial intelligence and other advanced tech, the number of vendors offering services ranging from data management to plug-and-play AI platforms has exploded.
That means the CIO has to be even more educated on the needs of the business to ensure they are making proper investments and partnering with the right organizations, something Arbour excelled at given her background in the tech industry.
"There's not a company on the planet [where] IT does everything on their own," she said.
Know the talent you need
Tech talent is in short supply, so knowing the exact positions the IT department needs can help make the hiring challenge less arduous.
Arbour knew that a strong cybersecurity team was important, so she elevated the department to sit within the IT sector and poured additional funding into it. "We created a whole different approach in cybersecurity that is very preventative, very predictive," she said.
Tenet also previously outsourced a portion of its engineering teams. Arbour took that all in-house and had to hire people to fill those roles. "You've got to shake up the talent, shake up the environment," she said.
For those positions and others, Arbour and her team personally wrote the job descriptions to ensure they were attracting the right talent.
Making such sweeping changes to any team can elicit backlash and brush up against internal resistance. That's one reason why Arbour says it's so important for CIOs to be humble. One way that is easier is if there's buy-in from the top.
The executive team told her "have the courage to make the changes that you believe are the right thing to do and we'll support you," Arbour said.
"I'm pretty clear on what my seat at the table is and I'm pretty clear on the.guardrails," she added. The key, Arbour said, is "humbling yourself enough to be a servant of the business."