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Executive Voices 2025
Understanding the Healthcare IT Needs of C-Suite Leaders
Author
Emily Paxman
For healthcare organizations, every decision regarding technology carries weight. Yet many software vendors struggle to understand the broader goals and constraints of the healthcare executives making purchase decisions. Even when offering focused solutions, vendors cannot truly support healthcare organizations’ success unless they grasp what the leaders are trying to accomplish. At KLAS, our mission is to amplify the voice of the provider to drive meaningful change. As such, this report shares insights from healthcare’s C-level leaders in enterprise leadership, operational/technological, and clinical roles—detailing what they are working toward, what stands in their way, and how vendors can better support them. We hope these perspectives lead to more thoughtful engagement and stronger partnerships that center on healthcare organizations’ success.
Beyond Technology Challenges, C-Suite Leaders Are Navigating Internal Alignment Challenges
Technological success is becoming more dependent on internal alignment among IT, clinical, operational, and financial leaders. Interviewed C-suite leaders say that even well-designed solutions often fail when only one department’s needs are considered. CMIOs and CNIOs report that many system decisions are made without adequate clinical input, resulting in inefficiencies and frustration. CFOs and CEOs express concern when investments lack shared definitions of value or when an implementation suffers from fragmented ownership. CIOs and COOs highlight the importance of tools that enable cross-functional coordination and shared performance metrics. Interviewed leaders across all roles share the most praise for vendors that demonstrate fluency in each stakeholder’s priorities and offer collaboration frameworks that bring decision-makers together. Internal alignment is no longer a nice-to-have goal at an organization; it is the difference between successful technology adoption and organizational resistance. Vendors that help unify perspectives and drive consensus position themselves for faster sales cycles and longer-term renewal.
Cost Sensitivity Is a Primary Factor in Gaining Executive Trust
Among executives in enterprise leadership and operational/technological roles, cost concerns are a dominant theme, and price is only part of the equation. CFOs are consistently deterred by vendors whose pricing models are unclear or misaligned with usage patterns, preferring vendors that offer a transparent total cost of ownership and multiyear planning tools. CEOs share similar concerns, often citing unexpected charges or creeping fees as justification for switching vendors. COOs and CIOs report frustration when inflexible cost structures delay critical upgrades or prevent system expansion. Even CMIOs cite cost as a factor when technology lacks visible impact on clinical workflows. Across roles, cost transparency is increasingly seen as a test of vendor integrity. Vendors that present clear pricing, flexible packages, and a credible financial-value story tailored to executives’ needs are significantly more likely to build lasting trust with customers.
LEADERSHIP INSIGHTS
The following sections share feedback from executives in enterprise leadership roles (i.e., CEO/president, CFO, CDO), operational/technological roles (i.e., CIO, CISO, COO, CTO), and clinical roles (i.e., CMO/CMIO, CNO/CNIO). Each role’s section covers what matters most, top-of-mind outcomes, critical unmet needs, internal barriers to success, and suggestions on how technology vendors can help.
Enterprise Leadership Roles
CEO/President
Summary:
CEOs and presidents focus on the following outcomes: financial performance, system growth, and clinician retention. Their decision-making is guided by a vendor’s strategic fit and clarity of execution. They favor vendors who deliver on promises, connect IT investments to big-picture goals, and improve system reputation and competitiveness. Broken trust and overcomplicated solutions lead to replacements.
What Matters Most:
- Strategic alignment and simplicity: CEOs want vendors who can clearly articulate value in terms of growth, efficiency, and transformation. Overselling or overcomplicating quickly leads to skepticism.
- Clinician experience: CEOs are acutely aware that physician and nurse burnout affects enterprise risk. Technology that helps retain staff and improves morale is seen as directly tied to success.
Top-of-Mind Outcomes:
- Improved market position, access, and clinical quality metrics
- Better ROI visibility across financial and clinical domains
- Value from simplifying portfolios and strengthening a few key vendor relationships
Critical Unmet Needs:
- Clear, longitudinal performance metrics that link spending to enterprise impact
- More strategic support for system-wide transformation, not just departmental optimization
Internal Barriers to Success:
- Fragmented decision-making that often derails promising initiatives
- Frustration when technology conversations are overly tactical or mired in jargon
How Technology Vendors Can Help:
- Tell a cohesive executive story—how the platform supports system-wide performance, retention, and expansion.
- Back up claims with real-world impact metrics from similar peers; CEOs value credibility over flash.
- Support board-level communication, including slide decks or summaries tailored to high-stakes presentations.
CFO
Summary:
CFOs are focused on financial predictability and long-term sustainability. Their approach to technology is consistently pragmatic; they value vendors that simplify cost modeling and are deterred by vendors that introduce surprise fees or overcomplicate ROI tracking. CFOs’ buying decisions hinge on perceived value-for-spend and confidence in the vendor’s ability to execute at cost.
What Matters Most:
- Transparent and flexible pricing: CFOs often initiate replacements when vendors use opaque pricing models, hidden fees, or rigid bundles. CFOs are deeply wary of solutions with high switching costs or poor forecasting tools.
- Cost-to-value alignment: CFOs prioritize vendors who can demonstrate specific financial outcomes, not just efficiency claims. CFOs lean toward platforms that reduce FTE burden or directly impact revenue cycle KPIs.
Top-of-Mind Outcomes:
- Sustainable operating margins through cost savings, improved reimbursement, or labor optimization
- Multiyear financial modeling support; CFOs prefer vendors that help build total cost of ownership and/or ROI projections over several fiscal cycles
- Standardized reporting that bridges financial, clinical, and operational departments
Critical Unmet Needs:
- Contract language that reflects actual utilization, not just license volumes
- Tools that are modular, allowing incremental spending rather than full-suite commitment
- Vendors who can clearly show impact on cash flow; CFOs strongly support such vendors
Internal Barriers to Success:
- Reduced trust when CFOs are brought in after a decision is made on a technology short list
- Misalignment with clinical peers around what drives value
How Technology Vendors Can Help:
- Provide contracting transparency and flexible negotiation terms.
- Show line-item level cost implications, including support, integrations, and upgrades.
- Partner on financial impact reviews post-implementation.
CDO
Summary:
CDOs are the enterprise unifiers of healthcare data. Their job is to make information usable across clinical, financial, and operational domains, yet they are too often sidelined by others during technology purchase decisions. CDOs prioritize long-term architectural flexibility, robust integration, and the reduction of data silos. In buying decisions, they consistently choose platforms that streamline data pipelines, facilitate enterprise-wide analytics, and reduce the friction of cross-departmental collaboration.
What Matters Most:
- System-wide data liquidity: CDOs are highly critical of platforms that trap data in silos. Instead, they strongly prefer tools that natively support enterprise data access and reduce reliance on manual exports or workarounds.
- Architectural alignment: CDOs expect solutions to integrate seamlessly with broader infrastructure strategies, especially in organizations consolidating tech stacks. Technologies chosen must be interoperable, API friendly, and modular.
Top-of-Mind Outcomes:
- Unified analytics ecosystems that connect operations, clinical strategy, and business intelligence
- Platform consolidation to reduce technical debt and duplicative systems; CDOs are vital to migration decisions that occur after a legacy platform is determined to be unable to scale or support analytic velocity
Critical Unmet Needs:
- Tools that automate data normalization in addition to offering access
- Reusable data models and self-service insights without IT dependency; tools that lack these models and insights often get replaced, even when their core functionality is sound
Internal Barriers to Success:
- Securing cross-functional participation in data governance efforts
- CDOs being looped in to vendor evaluations too late to shape the architecture conversation
How Technology Vendors Can Help:
- Provide integration playbooks and architectural transparency; vendors who offer concrete pathways to harmonize data across the EHR, ERP, and niche platforms are preferred.
- Equip CDOs with change management tool kits to gain buy-in from skeptical peers.
- Partner in developing data governance frameworks, not just selling reporting dashboards.
Operational/Technological Roles
CIO
Summary:
CIOs sit at the crossroads of innovation, operations, and risk. They are tasked with aligning technology strategy to enterprise goals, managing vendor ecosystems, and ensuring performance across infrastructure and applications. Their feedback reveals a dual focus: visionary leadership around digital transformation and pragmatic control over implementation complexity and cost. CIOs are highly sensitive to disruption risk, stakeholder alignment, and vendor accountability.
What Matters Most:
- Strategic alignment and stability: CIOs favor platforms that support organizational transformation while remaining operationally reliable. Potentially disruptive technologies are only welcome if they scale predictably and provide clear, measurable benefits.
- Governance and control: CIOs want tools that simplify portfolio management, enforce standardization, and enable clear oversight of contracts, data, and performance.
Top-of-Mind Outcomes:
- Enterprise IT harmony resulting from systems that integrate with each other, reduce duplication, and scale with the organization
- More-agile response to evolving business and care needs through modular, configurable platforms
Critical Unmet Needs:
- More flexible vendor relationships that support co-innovation without requiring custom development
- Unified management across cloud/on-premises hybrids, third-party apps, and core platforms
Internal Barriers to Success:
- Competing executive priorities that stall or splinter technology decisions
- Limited bandwidth to simultaneously support governance, road maps, and change management
How Technology Vendors Can Help:
- Show how your solution fits into an organization’s broader IT strategy, not just a single department.
- Provide proactive life-cycle support ranging from implementation through optimization.
- Partner on rationalizing legacy technology, managing vendor sprawl, and scaling enterprise standards.
CISO
Summary:
CISOs play a vital but often unseen role, managing cybersecurity risks while maintaining public confidence and patient trust. They are gatekeepers of digital risk, and their influence on buying decisions is growing rapidly. They prioritize proactive security, embedded compliance, and usability that doesn’t compromise protection. They often advocate for replacement when a vendor fails to meet modern security expectations.
What Matters Most:
- Zero-trust principles, role-based access, and end-to-end encryption: CISOs push back hardest against platforms with outdated or loosely managed permissions.
- Secure interoperability: Chosen platforms must connect to other systems without exposing vulnerabilities. CISOs favor vendors that support secure APIs and detailed audit capabilities.
Top-of-Mind Outcomes:
- Minimizing risk exposure and improving breach readiness posture
- Achieving HIPAA, HITRUST, and SOC 2 compliance efficiently
- Integrating cybersecurity across the stack—i.e., identity, infrastructure, and application layers
Critical Unmet Needs:
- Fast vendor response to vulnerabilities and incidents; many CISOs are concerned about lagging patches or poor handling of breaches
- Strong vendor-side support for user education, training, and simulations
- Proactive architecture transparency rather than reactive reassurance
Internal Barriers to Success:
- Resistance from clinical teams who see security as disruptive to workflows
- Struggles getting budget allocated for preventative measures
- Being brought into technology decisions too late in the game
How Technology Vendors Can Help:
- Include risk documentation and real-world threat models in proposals.
- Provide easy-to-deploy security tooling that doesn’t require custom scripting.
- Build security advisory services into the engagement model—not as optional extras.
COO
Summary:
COOs oversee system performance. They are focused on throughput, handoff integrity, and making sure the entire operation runs as a cohesive unit. COOs are highly engaged in evaluating solutions tied to logistics, capacity management, and efficiency. These executives often replace vendors who cause bottlenecks or create blind spots in performance monitoring.
What Matters Most:
- Operational efficiency and transparency: COOs want tools that allow them to measure, monitor, and optimize every aspect of service delivery. They prefer platforms with real-time dashboards, configurable alerts, and service-line visibility.
- Workflow standardization across departments: COOs often advocate for systems that reduce variation and drive alignment across care settings and roles.
Top-of-Mind Outcomes:
- Improved patient throughput, shorter wait times, and reduced handoff errors
- Predictive resource allocation, such as staffing or bed capacity, to avoid bottlenecks
- Vendor support for frameworks like Lean/Six Sigma initiatives and demonstrated performance improvements through clearly tracked KPIs over time
Critical Unmet Needs:
- Better integration between clinical tools and administrative/operational platforms (e.g., scheduling, capacity, revenue flow)
- Ability to generate cross-functional reports without requiring data exports or manual stitching
Internal Barriers to Success:
- Lack of unified data across departments that prevents visibility
- Change fatigue among middle managers that slows adoption, even when ROI is clear
How Technology Vendors Can Help:
- Offer turnkey dashboards that connect the dots between operations, finance, and quality.
- Provide industry benchmarks and advisory services to show how peer organizations succeed.
- Build momentum through quick-win use cases and tactical automation.
CTO
Summary:
CTOs are the strategic guardians of healthcare infrastructure. Their focus is on building agile, scalable environments that accommodate growth, innovation, and interoperability. In buying decisions, they advocate strongly for architecture simplicity and open systems. They are deeply skeptical of locked-down platforms, instead preferring transparent, modular, and future-proof designs.
What Matters Most:
- Modern architecture and open APIs: CTOs consistently replace vendors who obscure architecture or require too many workarounds. Platforms that enable plug-and-play integration, CI/CD pipelines, and standards-based interoperability are favored.
- Scalability and cloud readiness: Vendors that lack clear cloud road maps—or offer only partial migrations—are often cut. CTOs strongly prefer vendors that offer flexible hybrid models or that can support multiorganization scaling.
Top-of-Mind Outcomes:
- Reduction of technical debt and infrastructure complexity
- Smoother cloud transitions, with minimal downtime and predictable security layers
- Accelerated DevOps workflows and internal API reuse
Critical Unmet Needs:
- Architectural clarity at the pre-sales stage; CTOs often cite frustration with sales teams who lack technical fluency
- Version control, rollback capabilities, and sandbox environments for testing and staging
Internal Barriers to Success:
- Competing priorities from nontechnical executives
- Budgets often steered by ROI use cases, not long-term architectural risk
How Technology Vendors Can Help:
- Offer white-labeled architecture diagrams, threat models, and deployment recipes.
- Include technical stakeholders in road-map previews, especially when dependencies or API changes are coming.
- Share reference implementations and sandbox accounts to prove extensibility claims.
Clinical Roles
CMO/CMIO
Summary:
CMOs and CMIOs serve as the crucial link between clinical care and digital infrastructure. They champion the physician experience, and their decisions are grounded in how well technology elevates patient care while reducing friction for providers. These leaders often lead or heavily influence evaluations, especially when vendors fail to keep pace with clinical workflows, specialties, or usability expectations. Additionally, these leaders demand substance over sizzle, and they have little patience for feature sets that ignore real-world practice.
What Matters Most:
- Clinician workflow alignment: CMIOs choose tools that feel intuitive to physicians, reduce charting burden, and integrate into natural workflows. CMIOs frequently advocate for replacements when systems generate frustration, delay, or physician burnout.
- Support for specialty care: These leaders prioritize vendors that offer deep configurability or prebuilt support for multiple specialties, especially in large health systems or ambulatory networks.
Top-of-Mind Outcomes:
- Reduced documentation time and provider burnout; solutions must ease—not expand—cognitive workload
- Care coordination and communication improvements across care teams and settings
- Interoperability, real-time messaging, and embedded clinical pathways
Critical Unmet Needs:
- More rapid and responsive vendor iteration based on clinical feedback; several interviewed CMOs/CMIOs are frustrated with long wait times for workflow fixes or clinical content updates
- Personalization capabilities that support role-based views, especially for high-variation environments
Internal Barriers to Success:
- Difficulty translating clinical needs into technical requirements that vendors and IT teams can understand
- CMOs/CMIOs not being final decision-makers and thus having to influence CIOs/COOs with clinical rationale
How Technology Vendors Can Help:
- Involve CMOs/CMIOs in road-map development, not just testing cycles.
- Showcase measured clinical outcomes and provider satisfaction benchmarks.
- Provide tools to help build consensus with clinical leaders during change.
CNO/CNIO
Summary:
CNOs and CNIOs are stewards of the largest clinical workforce. Their mission is to create environments where nurses can deliver safe, efficient, and compassionate care without being burdened by documentation or rigid workflows. In buying decisions, CNOs and CNIOs are often concerned about usability and alert fatigue. They represent those who are working at the point of care, and as such, they want partner vendors that (1) seek to understand the needs at the point of care and (2) design solutions to meet those unique needs.
What Matters Most:
- Ease of use at the bedside: CNOs pursue replacements when platforms require extra clicks, duplicative documentation, or time-wasting workarounds. Mobile-first and context-aware designs are especially favored.
- Care continuity tools: Transitions of care are frequent pain points. Nurses want seamless handoffs, clear shift summaries, and visual indicators that prevent things from falling through the cracks.
Top-of-Mind Outcomes:
- Minimized charting burden and fatigue, especially in inpatient and high-acuity settings
- Enhanced patient safety through meaningful alerts and real-time task visibility
- Better staff morale and retention thanks to reduced friction with systems
Critical Unmet Needs:
- Tailored training models that work for shift-based learning, not generic webinars
- More nursing-specific input in product design; interviewed CNOs/CNIOs are often dissatisfied when features are clearly physician-centric
- Better support for shared devices, team-based care models, and quick login/lockout functions
Internal Barriers to Success:
- Limited seat at the strategic table compared to CMIOs or CIOs
- Cultural challenges with change adoption, as nursing units often bear the brunt of go-live fallout
How Technology Vendors Can Help:
- Conduct shadowing with nursing staff to map real workflows.
- During go-lives and shift changes, provide real-time support, not just nine-to-five help desks.
- Elevate nurses’ influence on product road maps via design councils or pilot programs.
About This Report
Insights for this report come from two sources: (1) KLAS Decision Insights data and (2) KLAS performance data.
KLAS Decision Insights Data
Since 2017, KLAS has been gathering information as to which vendors are being replaced, considered, and purchased and what factors drive these decisions. KLAS Decision Insights data does not represent a comprehensive census or win/loss market share study. Rather, it is intended to help organizations understand which vendors have market energy and why. The data set in this report comes from organizations that are making or have recently made a purchase decision validated by KLAS from May 2024 to May 2025.
KLAS Performance Data
Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. For this report, interviews were conducted from May 2024 to May 2025 using KLAS’ standard quantitative evaluation for healthcare software, which is composed of 16 numeric ratings questions and 4 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.
Writer
Sarah Brown
Designer
Jess Wallace-Simpson
Project Manager
Joel Sanchez
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2025 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.