Weider says the changes that have taken place inside healthcare IT departments over the past 16 years have helped groom ambitious IT professionals for CIO roles. He notes that when he first became a healthcare CIO, IT's mission was running billing and registration systems. Today, IT's on the front lines, providing effective, high-touch healthcare to patients.

"The skills [IT] people had before are no longer sufficient," says Weider. "You can't just support a system anymore. You have to lead a project, and if you're leading a project, you're essentially a manager of a team."

Some members of Weider's IT staff are also getting plenty of experience working with Ministry Health Care executives. "The people in my division sit down with executives every day and explain things to them, offer them options, report on how we're doing in support of them. We have people two levels deep who have no problem sitting down with executives and working with them," says Weider. "That's an absolute requirement in IT now. &they understand the business we're running and our strategic direction. They know how to communicate effectively, and they can explain our direction to their peers and the folks who report to them."

While a career in IT remains a stepping-stone to the CIO role, the specific path people take within IT is changing. Marlin Hawk's Cowan says that in the past, CIOs largely came up through the IT infrastructure ranks. That's happening less now because so many companies are outsourcing infrastructure.

Today, he says, the CIOs who rise through the ranks in IT are increasingly coming from business-facing IT functions, such as enterprise shared services, enterprise architecture, business relationship management, advanced product development, and sales and marketing IT. Part of the reason individuals in business-facing functions are increasingly moving into CIO positions is because they have the relationships with the executives who select the next CIOs. They're also getting the exposure to the business that's critical to be successful in the role.