In her view, some organizations recognize the value of CIOs, while others take potshots – "and they’re having to protect their staff from potshots," she said.
It's hard for CIOs to respond to all the demands.

"You have somebody out there who says, 'It's only going to take 10 minutes. I want it done now,' but it's not on the governance list; it's not on the prioritization. And, you've got somebody that's called, how do you deal with them? It's not going to take 10 minutes, and, if you don't get it done that person's unhappy. It's a very difficult position – everybody wanting everything and wanting it now."

The pressure and stress mounts.

"It is a lot of money at stake," Kirby observed, "and it's up to these individuals to lead large teams, lead complex projects at the executive level. These projects aren't IT projects. They're organizational projects that they want to be successful."

Pay rises, but does not keep pace
According to the SSi-Search survey and white paper, "the typical healthcare CIO today is a highly educated male, who has served in the role for 10 years and earns $286,000 a year."

Branzell believes CIOs are being paid fairly, but the compensation probably has not kept pace with other C-suite jobs.

"Part of it is that the role of being a true C-suite transformational leader is relatively new," he said, "so, it may take a little time to catch up with the other C-suite leaders from a comp perspective as well as seeing those benefits in there. You know, with great benefit comes reward."

He said most CIOs he knows from the top 50 to 100 organizations are "all being well taken of."

Maybe so, but Dixon pointed out that the compensation has not kept pace with the increasing workload. CIOs surveyed reported receiving raises of 10 percent or less over the past five years.

"According to our white paper, the majority report that their responsibilities have increased both in complexity and skill about 25 to 50 percent," Dixon said. "It's dramatic."

"It's hard to compare healthcare CIOs to CIOs in other industries because our world is so unbelievably complex to begin with, and then we're going through a tumultuous period right now, and I don't think any other industry can claim that to the same degree that healthcare can in that regard," Dixon added.

"Executives hiring CIOs are probably going to have to think seriously about increasing compensation. We're seeing that."

Because there are several CIOs retiring and no one on the bench to hire – Branzell has noticed efforts by organizations to keep their CIOs happy.

"We're starting to see now the concept of golden handcuffs and packages and contracts that are kind of back-loaded to keep people around," he said.

[See also: CIO salaries lag as work multiplies.]

Turnover, churn, half-life
At one time there was a high turnover in healthcare CIOs, a high turnover throughout the C-suite, said Branzell.

"I think at one time, the term was three to five years was kind of the life of the CIO in an organization," he said.

Some called it the "half-life," a term borrowed from science, referring to how long it would take for half of the unstable, radioactive atoms in a sample to decay.

"I think at one time, the term was three to five years was kind of the life of the CIO in an organization, which really I think was true of most of the 'C-suite' jobs," Branzell said.

Recruiters have told Branzell recently there is no one on the bench, no one sitting on the sideline looking for jobs. "There are just no CIOs in need of work, so you can kind of consider that kind of a zero unemployment rate," Branzell said. "Then on top of that if you're really looking for the top 10 percent to 15 percent CIOs. The only way to get them is to steal them."

Some have retired. Others, like John Glaser, former CIO at Partners HealthCare in Boston, have gone to work at vendor organizations. Glaser serves as CEO of health services at Siemens Healthcare. William Bria, MD, formerly CMIO at Shriners Hospital for Children's, joined consulting firm HCI Group.

However, Branzell envisions a better situation ahead. He sees many up-and-comers in the industry. We've put now over a thousand students into our boot camp, of which probably 70 to 75 percent of those are next generation leaders that are not in CIO jobs yet."

"That's one of the things I'm very optimistic about," he said.

"In every class you see three, five, maybe as many as 10 that you go: 'OK, that's someone I see in a CIO job – in one year, five years, maybe 10 years,' and it almost always comes to fruition. You can just look at them and go 'that's a great leader who just needs a chance.'"

Branzell advocates for the training of the next generation of other IS executives. It's something under discussion at CHIME.

There are many possibilities: chief security officers, chief technology officers, chief application officers, chief innovation officers, chief data officers, and the list goes on.

"We refer to that as the C-suite of CIO," Branzell said. "Those are new and emerging executive roles that really complement the whole IS concept, and we're seeing those really as great executive grooming opportunities."