SAN ANTONIO, TEXAS — "The train is moving at a high speed, do you want to play a game of chicken or take the wheel?" That was Albert Oriol's rhetorical question to CIOs who work at hospitals that have been slow to pay attention to the transition to ICD-10.

Oriol, CIO at Rady Children's Hospital in San Diego, speaking on a panel at the CHIME Fall Forum, said that CIOs may have to fill the leadership void if no other executive takes ownership of the issue. At Rady, Oriol is fortunate to serve with the CFO and assistant CMO on an ICD-10 steering committee. "It is shared ownership," he said. In fact, Rady began work on its transition to ICD-10 a little more than two years ago, yet Oriol said the organization still has a long way to go before crossing the finish line.

Rady isn't necessarily alone. A KLAS report issued last week suggests that only 9 percent of health care providers "are over halfway there in terms of being fully prepared for ICD-10." Oriol and his fellow panelist Carole McEwan, project manager at SSM Healthcare, urged the more than 700 attendees gathered in San Antonio to view ICD-10 as an organizationwide event. It's not just about coding or IT. It should also be viewed as a way to vastly improve clinical documentation, which is something we discussed in our September cover story.

ICD-10 isn't the only topic of conversation at this meeting. Today's sessions will focus on using IT to bring costs under control, meeting meaningful use requirements and improving clinical efficiency. We'll have ample coverage of these topics in Friday's report.

One thing that isn't necessarily on the agenda, but is on people's minds is CIO burnout. Health care is going through some major changes and a lot is riding on new technologies and major implementations. I spoke with a handful of people during the coffee breaks and at the opening reception and almost all talked about the tremendous pressure on hospital IT departments. How they — and the rest of the executive team — manage the workload in the months and years ahead will be critical to an organization's ability to thrive in the future.

Matthew Weinstock is senior editor of Hospitals & Health Networks. Follow his tweets at