Black Book™ 2019 Chief Financial Officer Survey Reveals Growing Collaboration With Chief Information Officers

Pressures to the alliance remains a problem in health systems including a continuing lack in understanding on both parties to converge on strategies, investment mindsets, healthcare customer experience, business models, and agendas.

​​Black Book™ surveyed nearly 1,600 hospital and health system Chief Financial Officers, Vice Presidents of Finance and RCM, Controllers, Business Office Managers, Staff, Consultants and Directors to spot trends, collect insights and assess the gaps and urgencies of financial technology administration. Additionally, 124 CEOs were polled to compare and contrast organizational viewpoints to the same situations and circumstances.

The 2019 Black Book survey indicates the relationship between senior information systems and financial operations officers is becoming more collaborative and stronger. The set of polls spanning the last six months identified the growing trend that CFOs are shifting their priorities from cost-cutting to rapidly investing in financial technologies. 52% of financial executives report the implementation of advanced analytics is the most pressing followed by (44%) broader distributed ledger technologies.

The year-to-year comparison of Black Book’s financial leadership technology surveys reveals dramatic changes in the adoption of financial services IT after nearly 7 years of recorded declines or reductions in the budgets allocated for financial software and upgrades.

91% of CFOs surveyed agreed that their past organizational CIO and senior IT management did not support a culture where financial technology upgrades and acquisitions were prioritized as initiatives that impacted enterprise health system strategy.

90% of financial leaders and management strongly agreed that the CIOs and IT management undervalued the needs of financial digital transformation and financial tools, instead prioritizing and convincing their boards that their electronic health record vendor related offerings were the best spending plan.

This has resulted in 94% of marginally performing hospital CFOs nationally claiming they are not prepared to handle new healthcare delivery and payment models with the tools they currently have. Comparatively, 89% of the top financially performing hospitals in the country report having the organizational technology tools to address modified payment strategies.

While senior financial officers struggled with the pressures of smaller operating incomes, rising labor and supply costs, shrinking volumes, reduced reimbursements, declining patient volumes and changing healthcare delivery models, 83% report that in the past fiscal year  they received add-on responsibilities of organizational productivity, strategic technology and innovation growth initiatives, and exceptional performance.

"In a noticeable shift since the acquisition of enterprise-wide EHR systems led by CIOs, CFOs have become the executive charged with digital transformations to improve competitive advantages, strategic growth and innovation across all customer touch points, while measuring the technologies’ ROI," adds Brown.

Although CIO-CFO collaboration in health systems is critical, 93% of CFOs in financially struggling facilities report barriers to agreeable cooperation, but so did 84% of CFOs in successfully performing health systems.

88% of CFOs report having increased involvement in their health system IT agenda since the implementation of their enterprise EHR as compared to 14% in 2015.

Main barriers to health system CIO-CFO Collaboration according to 2019 survey participants

85% of all respondents state that their current organizational structure prevents enhanced CIO-CFO collaboration. 89% of CEOs interviewed disagree with this statement.

82% of CFOs state they have insufficient understanding of IT issues as the barrier to them not being included in technology selections and approvals prior to 2014.

84% of CIOs surveyed in Q4 2018 claimed the processes and tools in finance are incomparable to IT functions and remain a significant barrier to mutual understanding.

90% of all respondents agree that the absence of key performance indicators that link IT agendas to financial performance greatly limits their success.

98% of respondents strongly agree that it’s the healthcare CFO’s job to ensure their organization fully realize the benefits of technology investments, not the CIO’s job in 2019.

About Black Book

Black Book™, its founder, management and staff do not own or hold any financial interest in any of the vendors covered and encompassed in the vendor satisfaction surveys it conducts. Black Book reports the results of the collected satisfaction and client experience rankings in publication and to media prior to vendor notification of rating results and does not solicit vendor participation fees, review fees, inclusion or briefing charges, consultation requirements and/or vendor collaboration as Black Book polls vendors' clients. 

Black Book™ has polls for vendor satisfaction and industry trends across the healthcare software/technology and outsourcing sectors around the globe. Since 2009, Black Book began polling the client experience of now over 840,000 healthcare software and services users. Black Book expanded its survey prowess and reputation of independent, unbiased crowd-sourced surveying to IT, clinical, operations and financial professionals, physician practice administrators, nurses, consultants, executives and hospital information technology managers.

For methodology, auditing, resources, comprehensive research and  vendor ranking data, see or contact us at

Results of the 2019 Revenue Cycle Management software and managed services user surveys will be announced in August. The annual Black Book CFO & Senior Finance Leadership Report can be viewed at

Source: Black Book Research