PHOENIX — Tony Scott is perhaps the biggest bigwig in information technology. He is the CIO of the United States, with an office on the White House campus. He is the third CIO of the United States, appointed by President Barack Obama on February 5, 2015. When it comes to IT in the government: What he says, goes.

Scott gave a special address to attendees at the CHIME 2016 CIO Fall Forum, where he emphasized two key points about the realm of IT today: the process of digitization and the threat inherent in maximum interoperability.

Scott discussed a key matter in health IT today, which, according to him, is the threat posed by the technical paradigm of the last 40 years: maximum interoperability.

"It's a design principle that has served us really well — until now," he said. "The specs have gotten so good, manufacturing has gotten so good, it's just assumed everything is going to work. We have focused on interoperability as the prime design point, but we have failed to go the next step: I can interoperate with you, but should I? Is that thing I am hooking up to reliable, is it what it represents itself to be, or is it masquerading as something, or is it truly operating the way it should? There is a whole set of questions that now one really wants to ask with a cybersecurity lens in mind."

Scott said it is fortunate that there is a lot of investment today going into answering these questions, to support a more secure IT environment and allow these questions to be asked, answered, configured and operated.

"We have to move there," he said. "There is no really easy way to bubble wrap around old technology to do that work. CIOs have to be the visionaries that say there is a different way to do this."

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Scott also discussed what he called "true digitization" taking place in healthcare and elsewhere. 

"Digitization of the enterprise is a big issue; the transformations taking place in nearly every part of the U.S. economy, and in nearly every country around the world, are tremendous," Scott said. "Much of the money we've spent on technology over the last 35 to 40 years has been on automating manual processes. The workflow or activity didn't change much. Now we are in this new era of mobile devices and great networks and sensors, meaning we don't have to do and probably should not do work the way it was done before." 

This transformation of how things work is digitization, and it's been seen most notably in media, entertainment and banking, Scott explained.

"One important thing about digitization that is the missing link that many people don't appreciate is that the organization chart really is the challenge, it gets in the way of us realizing our full potential," he said. "If you look at the technology architecture, the applications, the infrastructure, how work gets done, and where the seams are, if that is a one-to-one match for your organization chart, you are probably in trouble. You probably are not thinking digital and not seizing the opportunity there through the use of modern technology."

A better sign for true digitization is when every IT design an organization creates starts from a customer viewpoint, thinking about what the customers needs are and how he or she wants to get information and use it, Scott said.

"That is real digitization," he explained. "You should not have to understand what the organization chart of the institution is in order to get the information you need. But in most institutions the way we fund things and have governance over them is too often tightly bound with the organization chart in the industry we serve. Lessons learned in other industries show that digitization will blow up that paradigm. Economics and customer demand drive you to a completely different place."

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