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Health IT

Chief Information Officer Job Getting Tougher, But Pay Lags Behind

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money CIO

Sharp CIO Bill Spooner comments on the trend.

As more and more health IT deadlines for adoption, regulation, security and go-live crop up this fall, health system Chief Information Officers (CIOs) bear much of the responsibility for making those transitions go smoothly. But, according to recent reports, their compensation hasn’t been increasing in step with their expanding workloads.

“All CIOs report that workload has increased both in terms of scope of responsibilities and in terms of complexity,” according to a survey of 178 CIOs at community based hospitals, academic medical centers and integrated delivery systems published in August. “The majority, 44 percent, claimed that demand on their performance has increased between 25 and 50 percent over the last four years, while 23 percent report responsibilities have increased 50 to 75 percent.”

Much of this increase in workload can be attributed to the HITECH Act of 2009 and the Affordable Care Act, passed in 2010.

44 percent of CIOs received less than a 3 percent raise from 2011 to 2012.

But this and other surveys indicate that CIO pay has not increased accordingly, with the majority reporting their compensation has increased by 10 percent or less over the last four years.

In February of 2013, a College of Healthcare Information Management Executives survey of 263 member CIOs found that 44 percent received less than a 3 percent raise from 2011 to 2012, with 18 percent of respondents reporting no increase in base salary. Three quarters of the CIOs received less than a 5 percent pay increase.

18 percent reported no increase in base salary. 

Despite a lack of raises, CIOs usually aren’t going hungry, making an average of $200,000 to $300,000 per year, according to both surveys.

spooner“I don’t like to gripe about my compensation, because I’m well paid, but at the same time I think that it does need an examination, no question about that,” said Bill Spooner, who has been chief information officer for more than 15 of his 30 years at Sharp HealthCare in San Diego.

Due to their aggressive IT efforts, Sharp has been on the Hospitals and Health Networks 100 Most Wired list for 12 of the last 14 years.

“In my organization, we have probably 2,500 physicians in the network, and many of them need your attention or support at once.” – Bill Spooner, CIO, Sharp HealthCare

A big job, and getting bigger

“The importance of the CIO has just grown immensely over the past five years,” said Spooner, citing Meaningful Use requirements and the ICD-10 transition, which is “life or death for the revenue stream.”

He doesn’t know of any CIOs who have been compensated for those increases in responsibility.

“Today we are trying to shift entirely away from paper to a fully electronic system, which brings huge responsibilities in terms of usability of those systems, in smoothing out the patient care workflow and ensuring those patient care systems are there,” he said.

“In my organization, we have probably 2,500 physicians in the network, and many of them need your attention or support at once,” he said.

Even for health organizations that stick to one EHR vendor, though they may look simple from the outside, their CIOs are still juggling to manage many different systems, he said.

Not-for-profit health systems have to figure out how to woo up-and-coming IT professionals.

“If you peel back the covers of even those organizations, you’ll find that even those kinds of models have several hundred other applications supporting them, whether that’s third party laboratory systems or connections to medical equipment and  devices, you have an extremely complex environment,” Spooner said. “It’s our responsibility as IT leadership to connect those products to one another with interoperability to ensure that data flows efficiently and accurately from one system to another.

“Technology is a lot more complex than it was 20 years ago or even 10 years ago,” he said.

Like many industries, healthcare is in an era of rapid technology evolution, with migration toward cloud-based services and stricter security requirements, but healthcare faces unique challenges on top of those.

For instance, not-for-profit health systems have to figure out how to woo up-and-coming IT professionals, competing with other industries that may offer more or better stock options and bonuses, Spooner said.

“Recruitment and retention is a major concern,” and that falls under the purview of the CIO as well, he said.

Raising Awareness

Spooner reiterated that he’s not complaining about how much he is paid (and anyway he’s on his way out of Sharp, helping recruit a replacement to take over in March of 2014), but that health reform is pushing everyone to tighten budgets.

“It’s actually a really good time to be a health IT leader… you’re on the leading edge of healthcare reform.”

“Many organizations are being asked to downsize, find ways to operate more effectively,” he said. “We can’t stop doing things, we just need to do them smarter.”

It’s actually a really good time to be a health IT leader, he said. “It’s a pretty exciting time, and challenging. You’re on the leading edge of healthcare reform.”

He’s not asking for higher pay, but hopes that other members of the healthcare workforce will see these numbers and recognize how important the CIO has become to the organization.

“I’m not saying I demand more money, but I can see that it’s an issue,” he said. “As a collective body we need to continue to raise awareness and make sure our leaders respect how our jobs have changed.”