The C-Suite Rewrites the Org Chart: How Health Systems Are Elevating Technology Leadership

When Sanford Health created a new tech-focused C-suite role earlier this year, the move was notable not only for its scope but also for its location.

Sanford, a Sioux Falls, South Dakota–based, 56-hospital system serving largely rural communities across the Upper Midwest, established the inaugural position of executive vice president and chief transformation officer in early January. The role is designed to oversee enterprise technology and digital strategy, artificial intelligence and data analytics, as well as Sanford’s innovation and research teams — functions that, until now, were more distributed across the organization.

The system tapped Tommy Ibrahim, M.D., to fill the new role. In discussing the position, Ibrahim has emphasized the need to leverage AI and other emerging technologies to advance value-based care in an especially challenging rural health care environment — one marked by workforce shortages, thin margins and long travel distances for patients.

By elevating digital strategy, AI and transformation under a single executive leader, Sanford is signaling a broader shift underway across health care: Technology leadership is no longer just about systems and infrastructure. Increasingly, it is about enterprise value creation, care model redesign and long-term sustainability — particularly for systems operating in resource-constrained settings.

A New Model for Executive Technology Leadership

Sanford Health’s decision reflects a growing recognition among health system leaders that traditional IT leadership models are being stretched by the pace and scale of change. Artificial intelligence, automation and advanced analytics are moving beyond pilot projects into core clinical and operational workflows, demanding clearer ownership and tighter alignment with organizational strategy.

Rather than positioning technology solely as a support function, Sanford’s inaugural chief transformation officer role is designed to connect digital capabilities directly to enterprise priorities — such as improving access to care, supporting clinicians and strengthening value-based care performance across rural markets. The move also gives the CEO and board a single point of accountability for how emerging technologies are evaluated, governed and scaled.

Evolving the Executive Suite for Digital and AI

Sanford’s approach is increasingly echoed across the field, as hospitals and health systems experiment with new or expanded executive roles that complement or extend beyond the traditional chief information officer. While titles vary, the underlying intent is similar: ensure that digital transformation, AI governance and data strategy receive sustained executive focus and authority.

Many of these tech-focused executive roles share common responsibilities. They are typically charged with setting enterprise-wide digital strategy; overseeing AI and data governance; coordinating across clinical, operational and financial leaders; and translating technology investments into measurable outcomes.

These roles often serve as the point person for all tech initiatives, helping organizations avoid fragmented decision-making as digital tools proliferate. In many cases, direct reporting lines to the CEO underscore the strategic importance of the position and help accelerate alignment across departments.

Some organizations are creating entirely new C-suite positions. Others are broadening existing roles to encompass innovation, analytics or enterprise transformation. In both cases, the shift reflects a common conclusion among leaders: Technology strategy now rises to the same level of importance as clinical, financial and operational strategy.

Examples Across the Field

Cleveland Clinic

Leadership established a chief artificial intelligence officer role to oversee enterprise AI strategy, governance and safety, focusing on opportunities where AI can help transform patient care, caregiver experience and organizational efficiencies. The position is designed to ensure that AI tools are clinically appropriate, ethically deployed and aligned with organizational goals, addressing both opportunity and risk as adoption accelerates.

MUSC Health

Charleston, South Carolina

Digital leadership has increasingly been positioned as an enterprise transformation function rather than a traditional IT capability. The system’s enterprise chief digital transformation officer oversees digital strategy with a mandate that spans workflow redesign, clinician experience and operational performance. By framing digital initiatives as change management efforts focused on how care is delivered rather than which tools are deployed, MUSC Health is aligning technology investments more closely with frontline realities.

NYC Health + Hospitals

Large public systems are also formalizing new executive leadership models to manage the growing complexity of data and AI. NYC Health + Hospitals, the nation’s largest municipal health system, has established executive roles dedicated to enterprise data and artificial intelligence oversight, including a vice president and chief data and artificial intelligence officer. The structure reflects a deliberate effort to elevate data, analytics and real-time intelligence to the executive level — supporting systemwide decision-making across a vast safety-net environment where operational coordination is critical.

Governance and Guardrails

As technology leadership rises in prominence, health systems are also grappling with governance questions. Clear role definitions are essential to avoid overlap with CIOs, CMIOs and operational leaders. Many organizations are formalizing AI oversight committees, data governance structures and escalation pathways to ensure safety, compliance and transparency.

Boards, too, are paying closer attention — seeking assurance that digital investments support organizational strategy and that emerging technologies are deployed responsibly.

The emergence of tech-focused C-suite roles signals a broader evolution in health care leadership. Rather than asking whether technology should have a seat at the table, many systems are now debating what kind of seat and how much authority it requires.

As Sanford Health and its peers demonstrate, there is no single blueprint. But the trend is clear: As digital capabilities become inseparable from care delivery and operations, executive leadership structures are evolving to match that reality.