What a difference a year makes. Last July, Darren Dworkin was CTO at Boston Medical Center (BMC) and a freshly minted Ones to Watch winner. Today, he\u2019s CIO at Cedars-Sinai Hospital in Los Angeles.Those who knew him then were not surprised by his meteoric rise. Dworkin\u2019s intelligence and willingness to learn quickly won the attention of his superiors at BMC, where he worked for five years. \u201cDarren was incredibly energetic and confident,\u201d says his former manager, BMC CIO Meg Aranow. \u201cThe things he needed to add [to round out his leadership abilities] were political and people skills.\u201dAnd during his tenure at BMC he acquired those skills, in part by consistently setting stretch goals for his team and inspiring his staff to achieve them. Dworkin\u2019s nomination for the 2005 Ones to Watch award was in large part a formal \u00bfrecognition that he was ready to take the next step.The 35-year-old Dworkin caught CIO\u2019s eye for his ability to use IT to solve problems unique to hospitals, including a bed monitoring system and a remote-access portal that lets clinicians treat patients regardless of location. Evidently, Dworkin also caught the eye of recruiters. In January, he accepted the CIO position at Cedars-Sinai, one of the largest nonprofit hospitals in the Western United States. One of his primary responsibilities there is to install an electronic medical records system. It\u2019s the sort of project that the energetic and confident Dworkin would like to just charge ahead with. But one of the lessons he learned in his rise to CIO is this: He needs to be patient, involve users in the selection process and cultivate user support. Patience doesn\u2019t come naturally for Dworkin\u2014it was the leadership quality he had to work on the most at BMC. \u201cIt is not a hard skill to learn,\u201d he says. \u201cI just need to keep reminding myself to do it.\u201dAs for his first impression of life as a CIO? \u201cYou always think that the position above you has more power than it actually does,\u201d he says. That said, he acknowledges that the stakes are a lot higher for a CIO. \u201cIt is easier to take a risk when you are the number two,\u201d he says. \u201cOn your way up it is equally important to gain lessons from successes and failures.\u201d Now, as CIO, he doesn\u2019t have the same luxury to fail.The CIO role is more strategic than the number-two role. This wasn\u2019t a huge surprise\u2014Dworkin has noted throughout his career that the lower you are the more tactical your role is\u2014but, again, it magnifies the consequences of success or failure. And he has to count on the tactical people to execute his strategy in a way he never has before.\u201cI try to be inspirational, but ultimately I\u2019ll succeed or fail based on the people I have working for me,\u201d he says.