Why today’s CNIO must plan for digital crisis

When clinical systems fail, nurses do not stop delivering care — they work around the technology. But those workarounds can yield medication delays, incomplete information and legal exposure that can follow a health system long after the screens come back on.

That shift is reshaping the chief nursing informatics officer role. Once centered on documentation and system adoption, CNIOs are increasingly accountable for how digital breakdowns, algorithmic tools and data gaps affect patient safety across the enterprise.

At Akron, Ohio-based Summa Health, CNIO Marc Benoy, BSN, RN, said the role has moved beyond serving as a connector between nursing and IT. Today, he views it as an executive function focused on clinical digital safety, resilience and risk — particularly when technology disruptions spill directly into care delivery.

“Digital workflows do not respect professional or departmental silos,” Mr. Benoy said. “That naturally expands the scope of accountability.”

That expanded scope reaches well past nursing workflows. CNIOs are often responsible for the reliability of clinical processes used by physicians, advanced practice providers and interdisciplinary teams, reflecting a reality in which digital workflows no longer align neatly with professional boundaries. As a result, CNIOs and CMIOs increasingly share governance over order entry, documentation integrity, decision support and AI-enabled tools.

That shared ownership has become unavoidable as digital risk shows up in places health systems once treated as purely technical. Cybersecurity incidents, for example, no longer stop at data loss. When systems are unavailable or degraded, clinicians still have to place orders, administer medications and communicate across teams — often without the digital scaffolding on which those workflows depend.

“When technology fails, it isn’t just an IT disruption,” Mr. Benoy said. “It becomes a patient safety event, an operational crisis and a legal vulnerability.”

That reality has pushed CNIOs into planning not just for downtime, but for clinical continuity under digital stress. Traditional workarounds — such as reverting to paper — no longer hold up against the complexity of modern care delivery. 

Instead, CNIOs say their role increasingly involves identifying where digital fragility could compromise safety and redesigning workflows before a disruption forces clinicians to improvise in real time.

At, CNIO 

Jared Houck, BSN, RN, said the role’s center of gravity has shifted upstream. 

“The CNIO operates less as an implementer and more as a front-line leader,” he said, particularly as regulatory and safety expectations are embedded directly into system design.

At Cleveland-based MetroHealth System, CNIO Jill Evans, MSN, RN, echoed those sentiments, noting the role has moved decisively away from system rollout toward stewardship.

“CNIOs are no longer just implementers of systems,” she said. “We are the stewards of safe, compliant and ethically sound digital nursing practices.”

Artificial intelligence has accelerated that shift. As AI-enabled tools move from limited pilots into daily clinical use, CNIOs are increasingly involved in deciding where automation fits — and where it does not. Legal teams may negotiate contracts, but CNIOs say accountability for clinical reliance often rests with the leaders who authorize workflow integration.

“If a nurse or physician uses an AI-driven tool that fails due to bias or drift, accountability will focus on the executives who authorized its use,” Mr. Benoy said.

Interoperability has followed a similar trajectory. What was once framed as a compliance obligation is now widely treated as a patient safety issue when critical data fails to follow patients across care settings. CNIOs are increasingly accountable for ensuring digital pathways are reliable, traceable and defensible — especially as information blocking regulations frame access to data as a patient right.

Those pressures are reshaping how CNIOs define success. Adoption metrics still matter, but they no longer capture the full scope of the job. Increasingly, CNIOs are judged by whether technology-enabled care holds up under strain — during outages, cyber events, data gaps or algorithmic failure — and whether patients remain protected when it does not.

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