When asked what IT-related event scares them most, several of the CIOs whose teams won our Best Hospital IT Departments rattled off a list of somewhat common dangers. Other executives, meanwhile, were more concerned with under-delivering on innovation.

"I don’t want to get a phone call one day telling me our datacenter is on fire," said Jesse Diaz, CIO of Phoebe Putney Health System (#2 Large hospital) in Albany, Georgia.

Henry County Medical Center (#3 Small hospital) IT director Pam Ridley added that a disaster – weather-related or otherwise – that knocked its data center out would be an IT nightmare for her.

"Downtime. Mine is downtime," said Inspira Health Network (#4 Large hospital) CIO Tom Pacek. "Everything is electronic so we can’t have downtime. Clinicians don’t know what to do when the systems are not up."

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Neck and neck with downtime as a frontrunner among IT nightmares was, of course, health data breaches.

Silver Cross Hospital (#2 Medium Hospital) CIO Kevin Lane pointed to security incidents from outside the system as a particularly thorny risk. Sonney Sapra, CIO of Tuality Healthcare (#1 Medium hospital) said "security breaches are the one thing that keeps me up at night."

But two CIOs interviewed for the Best Hospital IT Departments 2016 awards ranked disasters, downtime and data breaches lower than technology and innovation challenges.

"The nightmare for me is when we don’t understand what our customers' needs are as we shift toward a better consumer experience," said Jon Brown, CIO, Mission Health System (#5 Super hospital) in Asheville, N.C. "We’ve created a system for the user, but now we’re creating a consumer-based system. The nightmare is getting systems out there that aren’t good for our clinicians and patients."

Methodist LeBonheur (#1 Super Hospital) CIO Mark McMath, meanwhile, answered at first with one word: disruption. 

"I wake up every morning worrying about not being disruptive enough to ourselves by ourselves," McMath explained. "There’s so much VC money going into healthcare, so many great minds, that I don’t want to turn into the next Circuit City, Kodak, you name it."

McMath added that no hospital should just rest on having a great staff or great technologies in place right now.

"We have to stay relevant," said McMath. "That means we have to be willing to step out and be much more transformational and even more aligned with the expectations of those we serve. IT is a big part of that. We really have to do a lot more a lot faster — that’s always top of my mind."

What's your worst IT nightmare? 

Bernie Monegain, Jessica Davis and Diana Manos contributed to this report.  

Healthcare IT News Best Hospital IT Departments 2016: 
⇒ Meet the winners
⇒ CIOs talk emerging tech's with biggest potential
⇒ Post-EHR era: Bunk buzzword or almost here?
⇒  CIOs share secrets of managing a happy health IT team
⇒Interactive map: Best Hospital IT Departments 
⇒ Gallery: The people behind winning IT shops