Heather Nelson brings a unique blend of operational skills, strategic vision, and deep dedication to healthcare to her job as SVP and CIO of Boston Children’s Hospital. In this edition of “C-suite Conversations” Heather shares with Judy how she launched her IT leadership career, the mentors who shaped her path, and how she’s building empowered, forward-thinking teams.

Boston Children’s Hospital is one of the largest pediatric medical centers in the United States, offering a complete range of healthcare services for children from birth through 21 years of age. Boston Children’s is home to the world’s largest pediatric research enterprise and is the primary pediatric teaching hospital for Harvard Medical School.

Key Takeaways

• IT teams must be empowered to move beyond reactive service delivery. Heather is building a culture where technologists proactively contribute to enterprise strategy and problem-solving.
• CIOs need a seat at the table from day one. Delaying IT engagement can hinder project success but early collaboration leads to smarter, more scalable solutions.
• Flexible, hybrid models help attract and retain top-tier talent across the United States. IT executives should see remote work as a strategic asset, not a compromise.
• Whether it’s AI governance or sustainability efforts, successful innovation comes from clear governance frameworks, cross-functional collaboration, and a shared sense of mission.

Q & A with Heather Nelson

Judy Kirby: Heather, your entire career has been in healthcare technology. How did you choose technology and healthcare, and why have you stayed?

After a year, I got a job as a system administrator in case management. The job was implementing a case management system for our case managers in the hospital and our health plan, Priority Health. I taught myself what I needed to know because I was not a computer programmer by any stretch. Later this led to a job as senior analyst in IT when Butterworth and Blodgett were merging to become Spectrum Health in the late ’90s. We had selected Cerner as our EHR and my job was to focus on the legacy systems. That’s how I got into healthcare IT.

I stayed in healthcare IT because I had a tremendous manager who saw something in me that I didn’t see in myself right away: that I was a people leader, a strategic thinker, and that I knew how to bring people to the table to have a conversation. She promoted me from an analyst to a team lead while we were implementing Cerner, rolling off legacy systems. This allowed me the opportunity to understand hospital operations from a perspective larger than just the project I was focused on. I’m just so fortunate, Judy, because I’ve had such tremendous mentors and folks who looked out for me as I grew up in my career. As I always say, “In IT, we’re the people who take care of the people who take care of patients.” That’s why I stay.

Judy: You’ve continually been promoted and grown into increasingly responsible positions during your career. What skills and abilities have helped you do that successfully?

Heather: I love operations and understanding the problems we’re trying to solve. I love the relationship aspect of what I do. I think what’s helped me succeed is building and fostering those relationships, especially coming into a new organization. So I credit my listening skills, my ability to build relationships, and the fact that I’m a straight shooter. I’m an executor, which means I like to get things done. Sometimes that’s a weakness that I have to balance, because I’m not a very patient person.

I look for opportunities to stretch my abilities. The CIO role is so different today than it has ever been, and it’ll continue to evolve. You have to be seen as a strategic partner and have a seat at the table, not be seen as an order taker. I don’t want anyone on my team to be an order taker. I want them all to feel empowered as strategic partners, to have the conversations, and to bring options forward.

Judy: How do you position your team not to be order takers? How do you train them and help them show up as strategic partners?

Heather: A lot of my team members were used to someone calling them or sending them an email, and using a first in, first out approach. We had to restructure how we take in work and how we prioritize work. I told them, “As we move to new enterprise systems, we have to be very thoughtful, and we have to think through an enterprise lens. We have to understand the risk and the impacts of making a change or a request.”

We talk a lot about this in our monthly departmental town halls, and at quarterly leadership meetings. We talk about how important it is that they all feel empowered to ask questions, to ask for a seat at the table, and to bring options. I’ve been here three and a half years, and we don’t have it nailed down perfectly yet. We’re still learning, both as a leadership team and as a department, but I practice what I preach. My job is to advocate for my teams and their job is to let me know when they need help, when they need a different voice at the table. That’s really how I enable and empower my teams.

Judy: How did you decide who to seek out as mentors, and how have they bolstered your career? And as a corollary, how are you helping your team pick mentors?

Heather: For me, it was observing senior leaders in the organization, watching how they interacted and communicated. Then, I would ask my manager, “Can I go meet with so and so? Would you mind if I reached out to them?” I was fortunate that I never had an upline who felt threatened by that. I sought out female executive leaders because IT was a very male-dominated environment when I was getting started.

When I’m asked to be a mentor, one of the first things we talk about is, “How are you building your network? Do you understand what that means? Do you have someone besides me who you trust and who you look to for guidance?”

I still have a lot of mentors I can reach out to and throw something at them that I’m struggling with. You’re one of them, Judy.

I encourage folks to look for leadership mentors and peer mentors. I think having peers you can lean on and trust is just as important as having someone who can move you up in your career. You need to strike that balance.

Judy: I hear from a lot of CIOs who are concerned about the division of technology within the organization. Some are responsible for data while others aren’t. Some have AI, some have cyber, some have analytics. What areas fall under your leadership?

Heather: I see digital as part of what healthcare IT is responsible for. Every organization is structured differently, but here at Boston Children’s Hospital, there is a separate digital health team. Obviously, we work very closely together. And there are times when the lines are blurred a little, but we just work through that. Everyone brings value to the table. Everyone has a job to do.

I have data and analytics, I have cybersecurity, research informatics, medical informatics, and all of the systems and over 22,000 devices across the enterprise, so it is a very big scope. I’m partnering with our chief innovation officer on AI. The two of us have stood up AI governance in partnership with our senior executive leaders, who have provided tremendous support for this. I don’t want his job and he doesn’t want mine, so we have found a way to partner, because there’s so much potential for AI in healthcare.

We’ve been using AI for a long time at Boston Children’s, especially in the research space. Now, how do we take innovation happening in one small group and make it work for everyone? A lot of good things are happening and AI is crossing multiple teams, which is okay because we’ve created those guardrails and some structure.

Judy: How do you see the CIO/CDIO role evolving over the next three to five years? What are some of the new responsibilities and new job qualifications?

Heather: Having strong financial acumen is so critical for a CIO or a CDIO. We manage multi-million dollar operating budgets and capital budgets. You have to make sure that you help the organization build ROI from the investments it makes. Healthcare organizations are doing a lot of building, a lot of facility work. More and more we’re moving out into the communities. Then we also have connected care, hospitals at home, virtual visits and virtual care. What technologies do we need to bring to bear there? How are we pivoting from only bricks and mortars to supporting these new workflows?

And it is different for our care teams, who are accustomed to having the patients and the patients’ families physically in front of them. But it’s hard to get to Boston Children’s because driving in Boston is not easy. If we can care for our patients at home with wearables, or with a virtual visit, and they don’t have to worry about the stress of driving or finding parking, how awesome is that? So as CIOs and CDIOs, we have to make sure that we’re at the table early, that we understand what problems we’re trying to solve, and bring some recommendations, whether that’s from a business lens or financial lens, and support the processes.

We’re change leaders and change management is hard. No one wants to change but I need to ensure that utilization and adoption is where it needs to be. Therefore, we need to wear business hats, strategy hats, operational hats, and financial hats as much as we have to wear technology hats.

Judy: A lot of CIOs aren’t at the table early, or they’re late to the party, so to speak. How do you make sure you’re present early in the conversation?

Heather: One way is using situations where we were late to the table as examples. So often we’re given dates – “We have to open the facility to our first patients in January.” “Well, I appreciate that you’ve set this date but we need lead time to be able to deploy and to test it, so realistically, it’s going to be February. We have to help them understand the complexities of the technologies, and that we can’t just flip a switch and make everything work. Next time, please bring me and my team to the table earlier.”

Governance is a big part of this. We have an IT executive steering committee that is chaired by some of my operational partners.

Judy: Another big concern I hear about on a regular basis is the lack of up-and-coming IT leadership talent to fill future healthcare CIO positions. Are you seeing this?

Heather: I don’t see it, and maybe it’s because of the market that I’m in. I’m in the Boston market and previously the Chicago market. Every market is so very different when it comes to talent, whether it’s recruiting or retaining. I’ve spent the last three and a half years building a team. The leadership team I have today is completely different from the one I had when I started.

Whenever I’m hiring leaders, I’m thinking about who can potentially sit in this seat if I leave for a new opportunity or if I win the lottery. We spend time as a leadership team talking about succession planning at Boston Children’s. Not every organization does it but I think you have to be intentional about it for it to be successful.

Judy: So you’ve been recruiting and retaining the best senior level talent. What are some of the keys to your success there?

Heather: I think it’s the name, Boston Children’s. People want to work here, and many of them have worked here for a very long time. I mean, I have tenure on my team of 20, 30, 40, even 50 years. I think a hybrid work environment is a big draw as well. We have team members from Florida, from Idaho, from almost all the states that we can hire from, which has enabled us to get some really great talent.

Having big projects like an Epic implementation, and our next big, a new ERP implementation draws talent as well. Sometimes they start as a consultant, and then they want to stay and work at Boston Children’s full time because they are so excited about the mission, and seeing the fruits of their labor.

Judy: Some organizations are calling their people back. Some are struggling with the remote versus the hybrid and how to grow those who haven’t built the relationships. What have you learned along the way? What’s made you successful doing that?

Heather: We are not calling people back. Boston Children’s senior leaders, in partnership with our Chief Human Resource Officer, have created the policies and the environments where some people will be 100% remote. Their roles are conducive to that, but for the most part, I have a hybrid environment in IT. I’m in the office most days. There are 20 to 30 people who are in the office every day. During the EHR implementation we had folks who needed to be on site four days a month. Not four days a week, four days a month. Some people didn’t even want to come in four days a month, so they chose to leave and I was okay with that.

Judy: What unique things have you done to engage your team in activities remotely?

Heather: This past fall, we did a costume contest, and we had it online. We even did a pet costume contest. We had different virtual conference rooms set up so people could walk through and see each other. Sometimes at our town halls, we’ll do a water cooler session, give people a topic, and send people off into groups to engage. I do a “coffee with the CIO” for all my new hires every month, just to get to know one another, because many of them will remain remote and will never come into the office.

Judy: I read an article recently saying that people who work in the office, at least part-time, if not all full-time, are more likely to be promoted than those who are totally remote.

Heather: I haven’t seen that in this organization. I think that the work that you do, whether it’s remote or in person, speaks for itself. And I think those who are remote are very intentional, and want to grow and want to take on new things. I think they actively seek it out and make themselves known to their leaders. I don’t have metrics on that, but anecdotally I have a nice blend of that in my department.

Judy: As CIO, are you involved in any strategic initiatives around sustainability?

Heather: Yes. One of the pillars in our enterprise objectives and strategic plan is around sustainability. In the Boston market and being in Massachusetts, sustainability, being green, the environment are top of mind. We’ve done a lot of building over the last few years, and there are many requirements and regulations around sustainability that our senior VP of facilities understands. She is amazing. I try to help as much as I can by limiting the size of our technology footprint and keeping things in the cloud. Maybe we don’t need a printer in every room, just one printer at the nurses station, for example.

There is a realization that how we’ve operated in the past is just not sustainable. It’s not good use of our finances and it’s not good for the environment. So we are very, very conscientious about how we deploy any new facility and what goes into that facility. Because it is an enterprise priority for the organization, all of us are aligned with that and my teams think about it a lot, especially in our data centers.

Judy: If you hadn’t become an IT leader, or a doctor or PA, what other career do you think you were cut out for?

Heather: I would love to be a COO, or a CAO, or even a CEO of a health system. I’m just so drawn to operations. I love learning the ins and outs of the hospital and I think being a CIO has afforded me that because IT crosses every single vertical of the organization. Maybe there’s still a COO or a CAO or some type of operational role in my career path. I wouldn’t shy away from it.

Judy: What’s something you love to do in your free time?

Heather: I am a workout fiend. I love the Peloton and the Peloton app. I have a 667-day streak going of doing something Peloton. Whether it’s running, biking, whatever, lifting weights, it is a stress reliever for me. It’s something that I make time for every day. It’s a non-negotiable for me.