Renown Health is Northern Nevada’s largest not-for-profit healthcare network, serving over one million patients each year. Renown operates hospitals, clinics, and specialty centers, offering advanced care in trauma, cancer, cardiology, and more. Based in Reno, Nevada, Renown employs 7,300 people.

Q & A with Chuck

Judy Kirby: Chuck, you and I have known each other for more years than we care to admit, and we’ve witnessed a lot of change in healthcare technology. What got you into healthcare technology in the first place?

Eventually, I landed a data entry job at UMass Medical Center, where I met the guy who was running the computer center all by himself. He needed help, so he hired me and trained me in computer operations—doing backups in the middle of the night, working with old equipment. I moved up from there, becoming a supervisor as we hired more people, got more equipment and started automating more things. What I liked about it was I got to do a lot of different things. We ran wiring through ceilings, set up printers and did a lot of hands-on work, but it was great training. That was my start in tech back in 1981.

Judy: So I have to ask, what was your first salary? Do you remember?

CP: I think it was somewhere around $10,000. So, it wasn’t great, but I got overtime. I wore a beeper, and back in the day, a beeper was a status symbol because only doctors carried beepers.

Judy: In what ways has the CIO role changed the most in recent years?

CP: Most of my decision-making is not dictatorial as it was at the beginning of my career. Now it’s more of a collaboration. At Renown we take an SBAR approach: Situation, Background, Assessment, Recommendation. Everything comes through our president’s council, which is made up of all the CEO’s direct reports. We meet every Wednesday.

There really aren’t IT SBARs anymore other than data center and network stuff. But if we’re going to move to Workday, the Chief People Officer would bring that, or operations. IT has a role, but they’re organizational implementations now, not IT implementations. I know a lot of CIOs who struggle with this because they want to own it. That’s a dying breed of CIO right now. The CIO who is out there collaborating with the organization, giving up some of the ownership is the future.

Judy: In what other ways do you see the CIO or CDIO role evolving over the next three to five years?

CP: I think we need to be more of a people connector across the organization. We really need to open up the IT world and share. There are things like citizen coding coming along. If you’re not open to that in IT, again, you’re going to have to move on.

I think my job is going to be more about understanding the problems that we’re trying to solve. What kind of team do I need to put together, and connecting all those people so they can now collaborate without me being in the room all the time. They’re coming up with the solutions and that’s where the power is. Maybe it’s like being the conductor of an orchestra.

If I were a new CIO coming into an organization, I would spend all my time the first 60 or 90 days building relationships, first across my peer group, then down through the organization, at VP level, director level, and certainly my team.

Judy: In your opinion, should there be or can there be one leader over all technology and where should that leader report?

CP: I think in big organizations like Cleveland Clinic, Mayo, and Stanford, they’re huge and you have to have gatekeepers. You have to have that chief analytics officer, chief AI officer, chief digital officer. But most health care organizations are more like Renown in size and complexity than Cleveland Clinic. I don’t think many one to two billion dollar organizations are big enough to be creating the role of chief data officer, chief analytics officer. They need more of a collaboration model and a strong governance model.

This raises a related question: Do you need a CMIO anymore? CMIOs were brought in when electronic health records took off because of Obamacare. We needed CMIOs to do the translation between IT and the doctors and get them to buy into EHR. Well, everybody has it now. At Renown, we have a lot of people who really understand the EHR. Many doctors are like CMIOs within their own area.

It really comes down to education. For example, I’m going to my president’s council in a couple of weeks to talk about our AI policy. But I’m really using it as an opportunity to educate them on AI. That way, when these things start to come forward, they can help me choose which ones are going to work for our organization, as opposed to the shiny bright object. We don’t need a chief AI officer at Renown. If I’m doing my job educating them, working with the right vendors and bringing the right tools in, then we don’t need that type of person and I would say other organizations the size of Renown don’t need one either.

Judy: The average tenure for healthcare CIOs is still about four years. You have had eight jobs in 30 years, roughly about four years per job. Can you talk about the short tenure in this profession?

CP: Well, some of it is due to moving up in your career. When you get your first CIO job at a small hospital and you’re 35 years old, you’re going to move to that next one and the next one, because you’re building your career. There’s more money and bigger organizations.

A lot of CIOs struggle when there is a new boss. There are some new bosses who come in, and they have a CIO that they worked with previously who they want to bring on board. There’s nothing you can do about that. Other CIOs don’t last very long because they could not adapt to the new CEO’s style.

It comes down to relationship building. If I’m a CIO, and I’ve been in an organization for two years, and I have not built relationships across the organization, I’m doing things in silos, and a new CEO comes in, I’m in big trouble. But if I have built those relationships across the organization, where I’m a valued partner, when a new CEO comes in, and he or she asks the CFO about IT and our relationship, then you have someone else advocating for you. That’s powerful.

I have given CIOs this advice when a new boss is coming into the organization. For your inevitable one-on-one with the new CEO, put together a presentation about how you lead your organization and how your organization benefits the rest of the business. What you want to do is leave the new CEO with the impression that he or she doesn’t have to worry about your org right now. Because you can imagine that there are a lot of issues the new CEO needs to worry about. You don’t want to be one of them.

But you still have to be transparent. If you have problems, you’re going have to tell him or her, “I’ve got this one area in IT that I’m still focused on. You’re going to hear noise about it but here are the things we’re doing to resolve it.” That’s okay, because when that CEO goes out there and hears from others about this problem in IT, she or he won’t be surprised by it.

Judy: That is great advice. One of the big concerns I hear about over and over is the lack of up-and-coming talent in IT leadership to fill CIO positions. What are your thoughts about this void?

CP: There aren’t enough mentors out there right now. Unfortunately, a lot of CIOs I know that have been at it for 20 or 25 years are looking to retire. I get it. I think about it a lot myself these days because it’s not an easy job. I ask them, “Can you hang in there a little bit longer and do some mentoring? Because you have wisdom that you can pass down to this younger group so that they don’t make the same mistakes that we made.” I try to get out there and mentor as many people as I can.

When you go to CHIME and HIMMS events—and I have great respect for those organizations because they do add value—but a lot of their presentations are around what’s coming, like GenAI. And vendors are saying, “Pilot this, pilot that, it’s going to move your career forward.” Some young CIOs decide, “Let’s do this. I’m going to put it on my resume, and it will lead to my next big job.” But unfortunately, they’re chasing the shiny bright object.

When I got to Renown, we were spending seven percent of total Opex of the organization, which by any benchmark is way too high. And we were known as the department of “No.” We had morale issues, customer service issues, and we were in the bottom five in employee engagement. Fast forward 18 months, and we moved to the top in engagement and customer service, and brought our spend down from seven to four percent, saving millions of dollars for the organization. So, I ask rising IT leaders, “If you and I were going head to head competing for a new CIO position, and I tell my seven percent to four percent story, and you tell your shiny bright object story, who do you think is getting the job?”

And people say healthcare IT doesn’t have enough money compared to banks and other industries. But there’s plenty of money in healthcare IT. Plenty. We’re just spending it on the wrong things and wasting a lot of money. I like to call it, stick to the knitting.

Judy: Where exactly do you see the waste and how can CIOs add value to their organization by cutting costs?

CP: If you have no governance, the organization is going to go around you and figure out a way to buy that application or buy that product without you. And, so you end up with $30 million in software maintenance. Another example is moving things to the cloud. What people don’t realize is that the cloud doesn’t save you money. It may allow you to fire things up faster but there’s a cost to that in the cloud.

When I go into a new organization, the first thing I do, besides developing the relationships I talked about, is to find out what the governance looks like. How does that work? Is there an SBAR type of approach? How does somebody go from an idea stage to approval to the implementation stage? Is there a process that you can put your finger on? I can tell you that in most organizations it’s all disjointed and a big mess.

At first, strong governance sounds like you’re just slowing things down, but you’re actually speeding things up. Here at Renown, if it’s an SBAR that comes to the President’s Council, we meet almost every Wednesday, so it’s not going to be a big delay. If it’s approved it goes into an enterprise PMO process, and we have a gate process that we go through that everyone understands. It’s hard work though to implement it, but you’ve got to do it to be successful.

I’m worried about the IT leaders coming forward as others retire and move on. And with this AI craze, we really need to focus on platform enabled AI. What does that mean? Epic is working on 100 AI projects right now, and I’m going to look at 10 of those. It’s integrating with DAX Copilot, for example, or Ambience. They’re integrated with AI and Epic supports it—that’s platform enabled AI. It has gone through a process already. Epic is doing all the work for you. They’re doing the Cleveland Clinic work. They do the Stanford work with the startups. They’re making all the mistakes, but they’re planned mistakes. You don’t need to be first to be innovative. You just can’t be last.

Judy: Looking back at your own journey, what career advice do you have for technology professionals interested in becoming a CIO, besides stay away from bright shiny objects?

CP: First, find a good mentor. One thing that people need to understand is that when you are at the director or VP level, you are 80 percent operational, keeping the trains running on time, and 20 percent strategic. When you become CIO, you flip that overnight. You become 80 percent strategic and 20 percent operational because the people below you are doing the operational stuff. What do you need to do to make that switch? And I’m telling you, a lot of people can’t make the switch because they like the day-to-day operational stuff. They feel good going home at night because they accomplished 10 things. You don’t get that instant gratification at strategy level. It takes a year, sometimes years for things to happen. So, if you’re an instant gratification type person, you’re not going to fare well. That is why when I’m mentoring rising IT professionals, I encourage them to get introspective as to what their abilities are today. It’s okay if you don’t want to make the leap. I’ve had unbelievable operational people report to me. They make a good living and they’re happy doing that, and that’s okay.

I have known others who have gone into the CIO role and weren’t happy, and it affected their personal lives. Some got divorced, they couldn’t sleep at night, they were miserable, they got the Sunday scaries. On Sunday afternoon, are you really nervous about Monday? If you are not sleeping well on Sunday nights, that’s a problem. You should be energized! That’s a little test you can give yourself to know whether you’re in the right job.

Judy: What is some advice you have for CEOs when they’re hiring their technology leaders?

CP: Candidates all come with references, and of course, those are all going to be good. So, you have to find people to talk to from the organization that they’re coming from, or where they worked previously. Leverage your network and try to have a confidential conversation about the CIO candidate, about their relationship building. Because what CEOs are looking for is a good fit. Yes, the candidate has to be competent, but will they be a good fit with the rest of the team?

The good CEOs I know will have the C-suite candidates interview with the entire C-suite to find out, “Can our CFO work with this individual? Can the chief people officer work him or her?” I think that’s the most important part.

Judy: What do you love to do in your spare time?

CP: I’ve learned as I get older that life begins at the edge of your comfort zone. So, in 2013, at age 55, I started running marathons. I had no idea I could actually run one, never mind train for one. It was the hardest thing I’ve ever done, and it changed my life. I actually became happier and I have picked up other challenges. Pick something that you would normally say no to and just go and do it and it’ll change your life.

The poet George Eliot—actually a woman named Mary Anne Evans who took a man’s name because you couldn’t get published as a woman in the 1840s in England—wrote something that has stuck with me to this day: “It is never too late to be what  you might have been.” I’m kind of like a cowboy now. I remember growing up watching Westerns with my father. We both loved them, but we were in New England which wasn’t a place where you dressed up as a cowboy or rode horses. I easily could have said no to the photo shoot, no to riding horses. 

I’m trying to impart to people that it is never too late. Just because you turn 50 or 55 or 60 doesn’t mean you stop doing things. You only get one life. Find something you love to do and give back. Mentoring is my give back and I’m doing a lot more charity work as well. But I’m also doing new things, saying “Yes” more than “No”. And, you know, I wish I had learned this when I was 30. That George Eliot saying means a lot at any age.