This installment in our “C-suite conversations” series features Sarah Hatchett, who was appointed SVP, Chief Information Officer of Cleveland Clinic last May.

Cleveland Clinic is one of the world’s largest and best healthcare systems, with 80,642 caregivers, 23 hospitals and 276 outpatient facilities around the globe.

In this Q&A, Sarah shares the story of her healthcare technology leadership career, a journey which began somewhat by chance. She discusses her strategic vision for the future of healthcare and the CIO role, including the integration of AI and fostering a culture of collaboration. Her story highlights the challenges and rewards of guiding one of the world’s most highly regarded healthcare institutions into the future.

Key Takeaways

• The interim CIO role is like being on a job interview every day. Following a friend’s advice to “own it from the beginning” helped Sarah make big decisions with confidence and demonstrate that she was ready for the challenge.
• Some may think that once you are the CIO, you’ve arrived. But in many ways, it is just a new beginning.
• Cleveland Clinic’s approach to integrating GenAI into its operations includes piloting AI solutions, moving all data to the cloud, and developing in-house teams with the skills and the processes to execute on their AI ambitions.
• Sarah’s keys to retaining talent and driving team engagement are open communication, celebrating achievements, and fostering a sense of belonging.

Q & A with Sarah

Judy Kirby: How did you get into healthcare technology?

In those early years, I came to have a deep appreciation for healthcare IT. What I loved about it was the intersection of the two – the way that technology enabled and improved healthcare workflows. I really enjoyed the go-lives because you are actually in the clinical spaces with clinicians. It was fascinating to see the tools that you helped build in practice.

Over time, I gained experience and advanced into project and program leadership, but what always resonated was the human connection between the technology and the healthcare that we deliver.

JK: Congratulations on your new role as CIO for Cleveland Clinic! Can you walk us through how you became interim CIO and how that developed into the full-time role?

SH: I am going on seven years here at the clinic. I actually moved to the Cleveland area to have the opportunity to work for Cleveland Clinic. It’s just one of those once-in-a-lifetime opportunities to work for such an amazing brand, such an amazing organization. I first came here to work on EHR-related transformation projects. The Cleveland Clinic’s first Epic agreement dates back to 1999, so we had this amalgamation of lots of different technologies and custom code. With the transition to an Epic enterprise agreement, we needed to rapidly implement new modules and core functionalities throughout the organization.

We developed a playbook that helped us design the way that we were going to use Epic software into the future, which we called that Global Design. And Cleveland Clinic was becoming global. We had a number of acquisitions and construction projects in the UK and elsewhere, and we needed to create a program around that.

Then we created IT’s business office – forming the practical aspects of running IT like a business, procure-to-pay, HR, finance, communications, etc.

More recently, I led enterprise applications before taking on the interim CIO role just over a year ago. I was interim for 10 months and then secured the permanent role in May of 2024.

JK: What were some of the unique challenges that came with being an interim CIO, and trying to earn the full-time position?

SH: Well, there’s the practical aspect of it, which is that you’re on a job interview every single day. You are constantly being evaluated based on your performance, which is extremely tolling mentally and physically.

I got some coaching from my predecessor that I thought was very valuable, which was to “Own it from the beginning.” This advice helped me avoid anxiety about, “Should I be making this decision, or should I wait for the official CIO?” The advice I received gave me a lot of clarity and confidence in the decision-making process, knowing that I’ve been entrusted with this responsibility of leading the team. I wanted people to know that I was ready for the challenge.

JK: Sometimes, getting your team engaged is the hard part. How did you rally them to support you?

SH: One key advantage I had was my deep experience here at Cleveland Clinic, having come up through the ranks for seven years. I know so many of our team members from our shared work. There was trust built and credibility that I could draw from.

One hallmark of my leadership style is having an open door and connecting with people on a personal level. One of the very first things I did as interim was change the tone of our monthly CIO address and made it more of a fireside chat. I spend a lot of time celebrating achievements, recognizing new caregivers, and sharing fun things that are going on around the division.

I receive a lot of positive feedback indicating to me that those things really resonate with the team. They loved feeling connected, not just to me, but to each other. You want people to feel that their voices are heard, and you show that through results, through actions, and through change.

JK: Did you have to do any politicking, so to speak, within the clinic to sort of help your cause?

SH: I believe that if you show up in an authentic and genuine way trying to understand how you can help solve people’s problems, that tends to cut through.

The first order of business during my interim CIO phase was to meet with every single market leader and institute chair to introduce myself and say, “Here’s my cell phone number. We’re here to help you.”

Another thing is that we try to focus on metrics. How are we actually delivering? Let’s look at the data. Let’s look at the facts and figure out where we need to be and what we can do to improve things.

JK: You had a lot of support from the previous CIO, Matt Kull. How did that affect your succession?

SH: It was a real pleasure working for Matt as a leader, personally and professionally. I think the succession planning that we did together in a very intentional way had a lot to do with how the situation panned out, and I’ll be forever grateful for him and the amount of time that he invested in me and growing me as a leader.

JK: Tell me more about the intentionality.

SH: Matt and I entered an implicit agreement that I had intention and that he had intention and that we were going to build on this in a real kind of structured way.

Having that kind of open dialogue really helped clarify where we stood, and it provided line of sight into the specific things that we were going to do to support that type of relationship. That is something I would encourage every leader to do – have a leadership plan. It doesn’t have to be called succession explicitly. Maybe it’s just mentoring, or maybe it’s coaching, or maybe it’s guidance, but entering into it with intentionality is going to make that work together all that more valuable and measurable.

JK: Recruiting and retaining talent has long been a challenge in IT, even before the pandemic. It’s changed a lot since then. What’s one of your most effective recruiting and/or retention strategies?

SH: Career recognition and compensation are certainly and should absolutely factor into your retention strategy, but first and foremost, you have to focus on culture, and make sure your leaders are making people feel inspired and valued.

We do quite a bit of employee engagement surveying and action planning. The metrics that we consistently score high on are “I feel a sense of belonging” and “I feel like I’m part of the team.” That’s retention right there.

JK: Cleveland Clinic is on the cutting edge of so much. How is AI affecting your organization and your strategy? And as CIO, what type of work are you leading to plan, evaluate, and implement with GenAI and ChatGPT?

SH: Late last year we launched our digital strategy, which is largely focused on the use of AI to transform the healthcare delivery process, and there are three key components to the strategy. The first one is Pilots. It’s very early, and this is nascent technology. I don’t think we understand the full value proposition on what these tools can do for healthcare, so, we want to be trialing what those look like. We have a number of pilots in flight right now working with point solutions from different key vendors in the industry.

The next piece is around Platform. We have to move our data into the cloud. We were working off an on-prem data analytics warehouse. Moving the data into the cloud and coming up with a cloud data strategy is going to be absolutely essential to unlocking AI and GenAI capabilities into the future.

And the last piece is what we call our AI Foundation. It’s great that we have pilots and this new toolset, but we have to have a team that can build some of this in-house. This not only reduces our dependencies on vendors but helps us be a truly creative, innovative force for good in the industry. So, the foundation piece is building the skillsets, the team, and the processes to be able to execute on our AI ambitions.

JK: One of the things I hear a lot about from CIOs and CEOs is security. How are you addressing all the security concerns and other interruptions like we saw with CrowdStrike?

SH: This has been very relevant during my time as both interim and now, new CIO, after the CrowdStrike incident, Change Healthcare and a number of other industry-shaking events. The executive team and the board are freshly interested in technology and security. It’s an exciting and, in some ways, frightening time to be in healthcare IT leadership.

For the last decade, we have been committed to growing a cyber program that has truly become world-class. Today, we have an amazing team led by a CISO doing a fantastic job in all of the key areas around cyber.

So now, the question is “What’s the next level?” Even if we’re secure in our perimeter, if we do excellent incident response and have amazing IT and cyber hygiene, that’s not enough. The cybersecurity organization of the future needs to extend out into the business. We need to focus on business resiliency and become an enterprise function proactively managing risk in our organization.

JK: In what is your first CIO role, what have you found to be the biggest challenge, and the biggest reward?

SH: Prior to becoming CIO, I was responsible for segments of IT, such as EHR, business operations, or M&As. One of the biggest challenges when you’re in the CIO role is you have to have an integrated understanding of all domains of the organization.

I have an amazing team that I lean on heavily for a lot of the technical and cybersecurity expertise. That’s where building the team becomes of utmost importance. You need a strong team who understands how to work together and can work with you as their leader to make sure that you don’t have any blind spots. I think we do a really great job at that.

The size and complexity of everything that we’re doing at Cleveland Clinic never ceases to amaze me. I’m always learning new things. That would be the other key to success: being a learner, knowing that you’re always going to have to continue to develop and adapt, whether that’s about new technologies or new lines of business.

Some people may think that once you are the CIO, “you’ve arrived.” But in many ways, it is just a new beginning.

JK: For someone who is offered an opportunity to serve as interim CIO, or interview for the role, what advice would you offer?

SH: One thing that has really helped me is building a support network of peers and seasoned leaders. They can be internal to your organization or external. For example, I was very fortunate to have several other female leaders going through an interim phase here at t Cleveland Clinic at the exact same time as me. These peers have been a valuable source of support.

JK: How do you see the CIO role changing? What will this job look like in five or ten years?

SH: The CIO is never going to be the foremost technical expert who knows everything, and you don’t want to be the only person in the spotlight, because this is truly a team effort. The technology is coming so fast and furious, and it’s so diverse, so complex, so embedded. The effective CIO views herself or himself as an activator and not as a dictator. How do we activate technology so that it delivers the most value to the business?

JK: One of the things that we keep hearing about is sustainability. What is your level of involvement in those initiatives?

SH: Here at Cleveland Clinic, sustainability is owned by our facilities group, who is a close partner to us, whether that’s through power consumption in the data center or all the way down to the individual workstation. Lately, healthcare organizations are feeling cost pressures, and this could be another area where it’s a win-win for IT to get involved. If you can contribute to overall cost savings because you’re reducing power utilization, either in your team or the technology that we use, that’s a huge win for organizations who may be facing really tight margins and trying to save money.

JK: Sarah, had you not joined Epic all those years ago, leading you into a career in technology, do you think you would have stayed in publishing as originally planned?

SH: Yes. I am still interested in publishing, writing, or teaching because, in addition to loving books, I’m a very by-the-book person. I am not suggesting that there is always a right or wrong answer to things, but rather there is wisdom to be captured through learning and experience that eventually becomes best practice. I am passionate about the ability to absorb information and then share it back to others.

JK: Outside of work, books, and spending time with friends and family, what’s something you love to do?