HEALTHCARE IT LEADERSHIP | INTERIM CIO ADVISORY
Most health systems treat interim CIO engagements as a holding pattern. The organizations that get the most value use them as a strategic window. Here’s how to approach the search.
Patty Lavely | Founder, CIO Consulting LLC | Boardroom Qualified Technology Expert (QTE) | CHCIO
When a health system’s CIO departs, whether through retirement, resignation, or a transition following an acquisition, the instinct is often to move quickly. Post the permanent role, find a temporary solution, and keep things running until the real hire is in place.
That instinct isn’t wrong, but “keep things running” is a low bar, and it tends to produce a low outcome.
The health systems that get the most value from interim CIO engagements are the ones that approach the role strategically. They don’t just ask, “Who can step in and hold this seat?” They ask, “What do we want to be different by the time this engagement ends?”
CIO tenure has declined sharply in recent years. The 2024 Nash Squared Digital Leadership Report found that over 70% of CIOs have been in their positions for fewer than five years, with nearly 40% serving for two years or less.[1] In healthcare specifically, the average CIO tenure has hovered below four years for much of the past decade.[2] That means transitions are frequent…and how an organization navigates them matters enormously.
Here’s what to look for, and what to ask, when evaluating interim CIO candidates.
1. They’ve actually held the CIO role.
This sounds obvious, but the interim market includes a wide range of backgrounds. Look for someone who has previously served as a permanent CIO at a health system of comparable scale and complexity. Consulting experience is valuable, but it’s different from being embedded in an organization. An interim CIO needs to make consequential decisions quickly, manage a team under uncertainty, and hold credibility with clinical and operational leadership from day one. That comes from having done the job, not just advised on it.
Follow-up prompts for the interim search:
- At how many health systems have you served as CIO, and what was the scale of each in terms of beds, annual revenue, and IT staff?
- Can you describe a time when you had to make a significant technology decision under time pressure, without full information? What was the outcome?
- How do you establish credibility with clinical and operational leadership in the first 30 days of an interim engagement?
2. They ask about your team before they ask about your systems.
In an early conversation with an interim candidate, pay attention to where their curiosity goes. Are they asking about your EHR platform and your infrastructure? Or are they asking about your IT leadership structure, your team’s morale, and how decisions get made?
Technology problems in health systems are almost never purely technical. They’re organizational. An interim CIO who understands this will spend their first weeks building trust with the team and diagnosing the culture, not just reviewing the tech stack and integrations.
Follow-up prompts for the interim search:
- In your first week in a new interim role, what questions do you ask the IT team, and what are you listening for in their answers?
- Tell me about a time you inherited a demoralized or disorganized IT team. What did you do first, and what changed as a result?
- How do you distinguish between a technology problem and an organizational problem when you first arrive?
3. They can communicate across the organization, not just within IT.
The interim CIO will need to interface with your CEO, CFO, CNO, and board often, usually within the first 30 days. Look for someone who can make IT concepts understandable to non-technical executives, who can frame technology risk in financial and operational terms, and who won’t get lost in the room when the conversation turns strategic.
Ask for a specific example of how they’ve presented a technology recommendation to a board or C-suite. Listen for clarity, not jargon.
Follow-up prompts for the interim search:
- Walk me through how you would present a significant technology risk to a board that has no IT background. What language do you use, and what do you avoid?
- Describe a time when you had to deliver difficult technology news to a CFO or CEO. How did you frame it, and how was it received?
- How do you build relationships with the CNO and CMO in the first few weeks of an interim engagement, particularly if there has been tension between IT and clinical operations?
4. They have a plan for the handoff.
The best interim engagements end with the incoming permanent CIO stepping into an organization that is more stable, better documented, and more strategically aligned than it was when the interim arrived. Ask candidates directly: what does a successful handoff look like, and how do you plan for it?
An interim who is thinking about the handoff from the beginning is working in your organization’s interest, instead of their own.
Follow-up prompts for the interim search:
- What does a successful handoff to a permanent CIO look like from your perspective? What documentation or artifacts do you ensure are in place before you leave?
- Have you ever been asked to extend an interim engagement beyond the original timeline? What drove that decision, and how did you handle it?
- How do you prioritize what to work on during an interim engagement knowing your time is finite and the permanent CIO will need to own the outcomes?
5. They’re honest about what they don’t know.
No interim CIO arrives on day one with full knowledge of your systems, your culture, or your history. The best ones know this and say so. They ask a lot of questions. They don’t make big claims early on. And, most importantly, they build credibility through consistency, not confidence.
Be cautious of candidates who arrive with solutions before they’ve fully understood the problem.
Follow-up prompts for the interim search:
- What is something you got wrong early in a previous CIO or interim engagement, and what did you learn from it?
- How do you handle a situation where you’re asked to weigh in on a decision before you have enough context to do so confidently?
- What are the limits of your expertise, and how do you handle areas where you need to bring in outside support or defer to others?
The interim CIO role, done well, is one of the highest-leverage investments a health system can make during a leadership transition. Instead of viewing it as a placeholder, you can view it as a strategic asset, if you hire accordingly.
Navigating a CIO leadership transition?
Patty Lavely works with health systems across the country on CIO transitions, interim leadership, and technology strategy. Book a call with her here.
About the Author
Patty Lavely is the founder and principal consultant of CIO Consulting, LLC. She is a Boardroom Qualified Technology Expert as certified by the Digital Directors Network, a Certified Healthcare Chief Information Officer and Digital Executive of CHIME, and a Fellow of the American College of Healthcare Executives. She holds an MBA from Florida State University.
Sources
[1] Nash Squared. “Digital Leadership Report 2024.” Nash Squared, 2024. https://www.nashsquared.com/digital-leadership-report
[2] Becker’s Hospital Review. “The Average Healthcare CIO Tenure Is Less Than 4 Years, Survey Finds.” Becker’s Hospital Review, 2020. https://www.beckershospitalreview.com/healthcare-information-technology/the-average-healthcare-cio-tenure-is-less-than-4-years-survey-finds-4-notes/