Leadership

Succession Planning for the Healthcare Information Professional

Background

The recent COVID-19 pandemic has caused tremendous strife within organizations worldwide. Although public health professionals warned of such an event, the definitive perspective of a pandemic was not taken seriously until it occurred. Despite the immediate attention paid towards eradicating COVID-19, this impactful vector remains prominent in societies around the globe and commands constant attention. As a former United States Army Medical Service Corps officer specializing in the management of healthcare information systems and processes, I often engaged my personnel in preparation for succession. This included cross-training for all personnel so any mission could be accomplished by everyone, because in the military, everyone is subject to mortality through job performance. But when it comes to most healthcare organizational Chief Executive Officers (CEOs), mortality is often an afterthought. 

As specified by Santora (2020), “many CEOs do not plan for succession and possess the false belief that they are immortal” (p.4).  Contrary to this, some CEOs have died from complications of contracting COVID-19 with no succession plan in place to address the business of the organizations they led. In similar fashion to organizational CEOs, health information management professionals often lack succession preparation for their organization’s information technology infrastructure. As research is conducted, more than 50% of companies do not have a succession plan and cannot name a successor to manage health organizational information technology (Larcker & Miles, 2010). The lack of a successor contradicts the purpose of organizational leadership, and it is essential that healthcare information technology professionals prepare for any contingency.

Considering societal changes, succession planning is an important topic directly linked to organizational leadership and to a management history where French pioneers first recognized and documented its success (Rothwell, 2001). Succession planning demonstrates that organizational information technology leadership is “investing in the next generation of leaders” (Blackaby & Blackaby, 2001).” To ensure effective and efficient management of healthcare information technology, professionals must comprehensively understand the importance of succession planning and then develop and implement a plan tailored to the organization and its resources.

Why We Need Succession Planning

As healthcare information technology professionals adjust to a myriad of challenges, an essential question gets asked repeatedly: Why do we need succession planning? This is often answered inversely by healthcare organizations as they attempt to address this vital aspect of effective organizational continuity (Blouin, McDonagh, Neistadt & Helfand, 2006). Historically speaking, organizations have researched succession planning within their ranks and applied the results in a manner that ensured  reparation for potential contingencies. Now, organizations have been forced to take succession planning seriously due to COVID-19 impact, employee turnover, and increased attacks on healthcare information technology infrastructure. 

COVID-19 Impact

For all organizations, especially healthcare information technology organizations and departments, COVID-19 has exposed important areas that were often neglected. Organizational leadership, particularly Chief Information Officers (CIO) for healthcare organizations, often lacked support regarding succession training, primarily because many CEOs didn’t think succession was important for generating organizational revenue. Succession planning challenged the limits of organizations, which exposed leadership to circumstances where immediate adjustments were needed. Furthermore, COVID-19 forced leadership to review their succession planning to address current situations or crises. With COVID-19 occurring in such short order, organizational CIOs should ensure their succession plan is adjustable to applicable situations.

Employee Turnover

For any industry, there are factors that contribute to its employee turnover which fluctuate in their own way. The first is the current state of the economy, which is continues to be strong for healthcare information technology professionals. This benefit stems from a lack of qualified information technology professionals and an over-dependence on those with experience (Kim, 2005). Additionally, “salary increases, bonuses, enhanced benefits, employee development, alternative schedules and flextime, telecommuting, and enhanced IT training” (Kim, 2005, p. 138) from within their organization, and from competitor organizations significantly contributes to turnover rates. Another factor is organizational performance. If an organization is not performing well or is in financial peril, employees tend to believe they will be on the receiving end of layoffs or terminations. The next is organizational culture. If investments are made in rewards, leadership, and professional development, then organization culture may reduce employee turnover (Deepa & Stella, 2012, p. 161). Another factor is unrealistic expectations which leaders may place on information technology professionals, thinking their personnel are miracle workers instead of people who deserve understanding and reassurance to perform their jobs. Lastly, organizational demographics can impact employee turnover. In similar fashion to organizational culture, demographics force some to look for other organizations that have a diverse workforce inclusive of individuals they can relate to. 

IT Infrastructure Attacks

In society’s every-changing environment, the presence of a cyberattack is commonplace and continually increases as technology advances. According to Cremer, et. al (2022), cyberattack associated costs continue to increase, and as of 2020, cyber defense costs reached over 1 trillion USD. Even with this amount, associated cybercrime costs are anticipated to exceed 105 trillion annually by 2025 (cybercrime, 2020). For the healthcare information technology professional, this information translates into increased management costs including personnel retention. Therefore, a comprehensive understanding of succession planning and affiliated parameters can ensure full preparation.

Best Practices in Succession Planning

To reduce associated anxiety, “good succession planning should be designed to meet the needs of the organization, particularly to support its strategic direction” (Barnett & Davis, 2008; Rothwell, 2005). Since healthcare information technology demands expertise, all succession planning should be systematic, adaptable, and intelligently inclusive of the organization’s business processes (Dowell, 2002). In similar fashion, all activities utilized to manage organization or department information technology infrastructure need to be included. To develop best practices, there must be an emphasis on identifying successor candidates who should be a part of the overall organizational succession plan. If the organization does not have a plan, then individual departments should develop a process, and leadership should consolidate these plans to establish an overall organizational succession plan.

An organization’s succession plan should anticipate employee advancements or departures as best as possible. Creating a succession plan involves developing a system that is simple, flexible, and amendable for continuous improvement (Conger & Fulmer, 2003). For individuals who are gaining leadership knowledge, skills, and abilities, they often possess talents to move up within the organization and should be evaluated and included within the succession plan. Through talent identification and review, skillsets can be matched for individuals and functions. 

Conversely, not all individuals considered for advancement will possess the technical skills for succession but may have the aptitude to achieve those skills. If or when a succession occurs, an organization should ensure there is a process for individuals to obtain the skillset so the process continues without degradation.
An example of succession preparation is provided within the military and serves the greater good of the organization. Redundancy is an essential element of military business processes that trains leaders at all levels to accomplish the mission in any event. Military professionals often train their leaders to ensure they can perform the duties of the individual directly below and above them on the organization chart.  Through applying this concept, all individuals are aware of the tasks associated with the position within their section and create a de facto succession plan (Blanken & Lepore, 2012). Although military redundancy appears to advance governmental bureaucracy, it furthers policy development which is essential in creating succession planning. 

Facing the Future

Succession planning means facing an uncertain future within the healthcare information technology sector, and technological transformation, industrial knowledge and fluctuating business environments equal doubt. With succession planning, change must be accepted as a constant within the global healthcare ecosystem to introduce new knowledge and strategic innovative frameworks (2022). 

The adaptative nature of good succession planning continues to evolve, thus healthcare information technology professionals must grow alongside it (Barnett & Davis, 2008).  Succession planning provides opportunities for healthcare information technology professionals to sustain strategic planning initiatives, which advance a body of knowledge that ensures industry and professional longevity. As long as opportunities are present to advance succession planning, then healthcare information technology will continue to bear fruit for the industry. 

References

Barnett, R. & Davis, S. (2008). Creating greater success in succession planning. Advances in Developing Human Resources, 10(5), 721-739. DOI: 10.1177/1523422308322277.

Blackaby, H., & Blackaby, R. (2001). Spiritual leadership. TN: Broadman and Holman.

Blanken, L. J. & Lepore, J. J. (2012). Unpacking the various meaning of redundancy: from refining the concept to military planning. Defense & Security Analysis, 28(4), 326-342. 

Blouin, Ann Scott PhD, RN; McDonagh, Kathryn J. PhD, RN, FAAN; Neistadt, Allyson M. MPH; Helfand, Bradley MA, MPH. Leading Tomorrow's Healthcare Organizations: Strategies        and Tactics for Effective Succession Planning. JONA: The Journal of Nursing   Administration 36(6):p 325-330, June 2006.

Cohen, B., Amoros, ´ J.E., Lundy, L., 2017. The generative potential of emerging technology to  support startups and new ecosystems. Bus. Horiz. 60 (6), 741–745.
Conger, J., & Fulmer, R. (2003). Developing your leadership pipeline. Harvard Business Review,   81(12), 76-84.

Cremer, F.; Sheehan, B.; Fortmann, M.; Kia, A.N.; Mullins, M.; Murphy, F.; Materne, S. Cyber risk and cybersecurity: A systematic review of data availability. Geneva Pap. Risk Insur.      Issues Pract. 2022, 47, 698–736.

Cybercrime Magazine. Cybercrime to Cost the World $10.5 Trillion Annually by 2025. 13 November 2020. Available online: https://cybersecurityventures.com/hackerpocalypse-       cybercrime-report-2016/ (accessed on 15 October 2022).

Dowell, B. E. (2002). Succession planning. In J. W. Hedge & E. D. Palukos (Eds.), Implementing organizational interventions (pp. 78-109). San Francisco: Jossey-Bass.
Garcia-Perez, A., Cegarra-Navarro, J.G., Sallos, M.P., Martinez-Caro, E. & Chinnaswamy, A. (2022). Resilience in healthcare systems: Cyber security and digital transformation,          Technovation, 121, https://doi.org/10.1016/j.technovation.2022.102583.

Kim, S. (2005). Factors affecting state government information technology employee turnover intentions. The American Review of Public Administration35(2), 137-156.

Larcker, D.F. , & Miles, S.A. (2010, June). 2010 CEO succession planning survey. Retrieved             from https://www.gsb.stanford.edu/faculty‐research/publications/2010‐ceo‐        succession‐planning‐survey (accessed 15 May 2020).

Rothwell, W. (2001). Effective succession planning. New York: American Management  Association

Santora J. C. (2020). COVID‐19: An Urgent Imperative for CEO Succession Planning. Board Leadership2020(170), 4–5. https://doi.org/10.1002/bl.30164

Secundo, G., Toma, A., Schiuma, G., Passiante, G., 2019. Knowledge transfer in open innovation: a classification framework for healthcare ecosystems. Bus. Process Manag. J. 25 (1),           144–163. Shaygan, A., Daim, T., 2021. Tech