Jackie Njoroge is VP, Digital Transformation and Operational Excellence at US Oncology.
Walk into any executive meeting , and you’ll likely hear goals about growth, operations, outcomes and customer experience—universal themes, regardless of industry. What’s harder to see, at least on the surface, is how much of that conversation is now inseparable from technology.
For a long time, the relationship between IT and other parts of the business was transactional. You needed hardware, you submitted a ticket. You wanted to demo new software, IT installed it. There was a clear handoff and for a while that model served its purpose.
But today, as technology becomes more deeply woven into how organizations operate, that model has given way to something more integrated. IT can no longer sit adjacent to the business and respond to predefined needs. Instead, technology leaders must be embedded in how those needs are defined, prioritized, and executed.
This means a fundamental shift from service provider to strategic partner.
What A ‘Seat At The Table’ Actually Requires
There’s a tendency to think a seat at the table is something IT is given. In my experience, it’s something that must be built and actively maintained on both sides.
On the IT side, it starts with how you show up. You have to be able to speak the language of the table at which you’re sitting, translating technical capabilities into business value and being precise on the “so what.” Why should a CFO care? What does this mean operationally? How does it impact patient or customer outcomes?
That translation needs to exist across the team, not just at a leadership level. Everyone has a role in connecting what they’re building to what the business is trying to achieve.
On the business side, there must be appreciation that IT brings more than execution. At many organizations, IT is still brought in after the problem and solution have already been defined. At that point, partnership has already been lost and IT is effectively back in a service‑provider role.
In healthcare, IT leaders clearly need to understand clinical workflows and operations. But they are often left out of conversations where they also need visibility, for example in aspects like construction. Knowing how a space is designed or built helps an IT team determine what they’re able to do from a networking or technology standpoint. Decisions made early about physical space or infrastructure can constrain or enable what’s possible. Proactive IT considerations belong at the beginning of a project, not as remediation at the end.
How The Work Has Changed
Point solutions don’t go very far when everything is connected. Interoperability, scalability and sustainability all come into play, which pushes both IT and business teams to think more at an enterprise level.
But when technology is embedded from the start, we shift from a transaction of services to a transaction of expertise—technical, operational and increasingly, domain-specific.
For IT leaders, this model requires a fundamentally different mindset. You have to stay grounded in business outcomes, communicate across functions and carry enough context to connect decisions across clinical, operational and technical environments. Teams must build shared understanding, such as keeping stakeholders informed, aligning on the “why” and ensuring decisions don’t get lost in handoffs.
In addition, as teams become more capable of self-service, IT’s role shifts from gatekeeper to guide—knowing when to step in and when to create the right pathways so others can move forward without creating risk or fragmentation.
Where Alignment Breaks Down, And How To Fix It
Most of the friction between business and IT comes down to how work is perceived.
From the business side, it can feel like IT is moving too slowly. I liken this to a duck paddling. Above the surface, it looks like the duck is moving slowly, but below the surface its little webbed feet are paddling furiously. In IT, a lot of the effort is happening below the surface, where we build foundations, strengthen security and establish guardrails. The work isn’t always visible, so progress can feel slow without context.
At the same time, IT teams can feel like the business is moving too slowly. Decision-making on the business side can take longer, especially when new tools or approaches are involved. Concepts like rapid testing and iteration require a level of shared understanding that doesn’t always exist yet.
Layer in evolving risks and the gap can widen. As technology advances, so do the threats around it, meaning additional constraints that can feel limiting if the reasoning isn’t clear.
When that alignment breaks down, you start to see workarounds, shadow systems and slower outcomes overall.
What helps is straightforward, even if it’s not always easy: Consistent communication, transparency around trade-offs and a shared view of what success looks like. Over time, that builds the trust needed to move faster together.
Building A True Partnership
We’re operating in a period of rapid change. Systems are more connected, expectations are higher and the pace isn’t slowing down.
In that environment, the partnership must be real, built on shared ownership, aligned priorities and, increasingly, aligned incentives.
It also requires investing in people who can connect the dots: Product managers, analysts and others who can move between business needs and technical execution.
And it takes discipline: The willingness to have candid conversations, navigate trade-offs and stay aligned even when the path forward isn’t obvious.
Leaders who continue to treat interactions between business and IT as service requests will move slower than organizations that don’t.
The organizations that move forward most effectively are the ones that recognize that IT expertise must be integrated from the start into the identification and development of organizational solutions, not just the implementation.
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