For John Hummel, managing the way all 41,000 employees across the Sutter Health network perceive his IT department is one of the most important aspects of his job. Hummel, senior vice president and CIO at Sutter, a 28-hospital health-care system in Northern California, believes he can't accomplish anything without paying careful heed to the way his IT department is seen, heard and understood. And there's quite a lot that Hummel hopes to accomplish—including an electronic medical records system, an electronic medical orders system for administering prescriptions (known as computerized physician order entry, or CPOE), a virtual ICU initiative, an ERP implementation and a network upgrade.

To make sure that the administrative, clinical and executive staff think about IT in the way Hummel wants them to, he engages in what he calls political theater. And it's a leadership skill he's mastered. On a Monday morning in February, for example, Hummel sits in a regularly scheduled meeting with his executive IT staff to ensure that they're all delivering a consistent message about the status of several key projects, including the ERP implementation and the electronic medical records system. Later that day, Hummel and two members of his staff will be going into a meeting of the Executive Information Technology Committee (EITC), Sutter's IT governance body, and he wants everyone to be prepared. One thing that he wants to happen in the meeting is to get the EITC (which consists of the CEO, COO, chief medical officers and executive vice presidents) to agree on the group of individuals who will make decisions about the electronic medical records project. So Hummel rehearses his staff as if he were directing a play, cuing them on when and how to ask various questions.

"When we get to the agenda item on the charter, governance and budget for EHR [electronic health records], say, 'We would like to have EITC approve the EHR committee structure. We are here to gain approval for the current structure,'" he instructs his staff.

John Hummel, CIO at Sutter Health, believes the best way to advance his IT agenda is to understand his stakeholders, customize his messages and maintain a sense of humor. Such staged communications are necessary at Sutter and, indeed, at every organization—especially for CIOs. That's because IT is so complicated, involves so much change and creates such anxiety in employees. Therefore, CIOs have to carefully craft their message. "The idea is to make everything seem so well-planned and well-done that people get this overwhelming sense of confidence in you and don't mind being led down the primrose path," says Hummel. And because CIOs have a limited amount of time with an audience—whether that audience is the board, the executive team or the CEO—they have to spend time up-front to research and rehearse their message so that when they do get that minute in the elevator with the CEO, their delivery is flawless and convincing, says Hummel.