The healthcare C-suite is getting crowded.

Chief Innovation Officers and Chief Transformation Officers have been joining the fray for a few years now. We can't forget about Chief Medical Informatics Officers, Chief Technology Officers, Chief Nursing Officers, Chief Data Officers.

And the Chief Digital Officer is perhaps the newest kid in town.

So what does it all mean for the careers of chief information officers and other IT pros aspiring to the CIO post, which used to be the undisputed top tech guru?

"We are experiencing an exciting shift where the next generation of industry executives are well educated and trained in technologies through all of their respective disciplines, whether clinical, financial, operations, marketing, etc., and every manager is also an information manager in the digitalized organization," said Doug Brown, managing partner of Black Book Research.

Money talks: Here's what it says

Those new additions to the C-suite mean smaller slices of the budgetary pie to go around, and many CIOs are now operating with tighter margins and wielding less purchasing power than in the past, according to Black Book data.

Let's just look at the financials. Black Book’s survey of 1,500 executives found that as recently as 2015, CIOs controlled 71 percent of technology purchasing decisions, By 2018, rather startlingly, that had plummeted all the way down to a measly 8 percent.

It's no secret that the CIO role is changing. Prominent tech leaders such as Cleveland Clinic CIO Ed Marx, Beth Israel Deaconess Medical Center CIO John Halamka, Phoenix Children's CIO David Higginson and Children's Mercy Kansas City's David Chou (who has the title Chief Information and Digital Officer), all told Healthcare IT News earlier this year that modern CIOs are brandishing skills more aligned with sociology and business school training than technology.

Just 29 percent of CEOs told Black Book they consider the CIO tactical rather than strategic. A whopping 88 percent of participating colleagues said they view CIOs as tech developers and deployers instead of drivers of innovation and transformation. It's worth noting, however, that 81 percent of CIOs self-identify as playing a transformational role.

Cloud + digital transformation = disappearing data centers?

One could argue that some of the very technologies these IT gurus have championed, notably cloud computing and the overarching IT trend known as digital transformation, are now changing the nature of their own job.

Stalwart IT analyst house IDC predicted, for instance, that as hospitals move more and more apps and services into the cloud, the model will change the nature of IT shops into lines of business responsible for acquiring new services rather than building and managing them in-house.

That migration to the cloud is happening faster than many might think. Symantec's Internet Security Threat Report uncovered a big chasm between the number of cloud apps CIOs believed their hospital had, at 30-40, and the actual total of 928 on average already in place.

And here's a bold prediction about just how prevalent cloud will be in the near future: "Five years from now none of us will have data centers," Halamka said. "We're going to go out to the cloud to find EHRs, clinical decision support, analytics."  

Halamka said that almost two years ago, back at HIMSS17 so there are still at least three years to go. In the meantime, smart CIOs are considering which skills to either fine-tune or develop in order to stay relevant.

Next-gen CIO skillsets

Most CIOs recognize that change is coming. Ninety-one percent, in fact, said digital transformation is reshaping their roles in fundamental ways. Hospital CEOs and board members told Black Book, meanwhile, that they are looking to hire more consultative-type tech executives.

Those hires would be focused on orchestrating integration, meeting business goals, evaluating innovations and consulting with the line of business managers who are more involved in IT purchasing decisions than ever before.

Black Book ranked some of the most sought-after skills of CIOs for 2019: the ability to drive innovation as a critical element of success, bring connectivity as a leader over the flow of information throughout the broader organization, and have the expertise to communicate in the era of medical and financial data.  

IDC, in its CIO predictions for 2019 just last week, said that CIOs will need to reinvent their roles and become more predictive about the most effective ways to harness emerging technologies to drive strategic enterprise goals. The firm also said that IT chiefs will be compensated according to business key performance indicators aligned with those broader organizational goals.

Read more Innovation Pulse columns from Healthcare IT News.

"Old school CIOs versed in infrastructure and applications management will still be needed in a technical support sense," Brown said. "CDO is a role for visionaries and executives trained in organization development and strategic planning first, tech second."

Brown was careful to point out that noting the reality of CIOs ever-evolving role is not to say that IT executives will fade away anytime soon. Indeed, the running joke CIO stands for Career is Over that has been making the rounds for some time now has not proven true.

"If a current CIO has vision and strategy in her or his or DNA, then they will transition well into the CDO role," Brown said. "Others just won't cut it. I foresee CDOs orchestrating tech through operations, marketing, quality, finance, clinicals."

Orchestrating tech? Perhaps "Chief Orchestration Officer" will be the next big C-suite splash nipping at the heels of CDOs and CIOs — there are at least a few of them out there, if you look in the right places.

Twitter: SullyHIT
Email the writer: tom.sullivan@himssmedia.com