# 7 projects top of mind for IT leaders today > Source: > Published: 2026-09-21 10:01:00+00:00 As CIO of DaVita, [Madhu Narasimhan](https://www.linkedin.com/in/mnaras/) drives IT priorities that align with the business mission. For the healthcare company, that means providing kidney dialysis and other services for patients with chronic kidney failure and renal disease. “We’re being super intentional on how we bring in technology. We want to make sure we’re solving the problems of the organization and focusing on the needs of the patients,” she explains. That has Narasimhan focusing on several critical projects: bringing more AI capabilities to the company’s custom-built electronic medical records (EMR) system to enable caregivers and staff to work more effectively and efficiently; establishing a strong governance program for those AI capabilities; improving the interoperability of the EMR and other systems to ensure the continuity and orchestration of patient care; and ensuring adequate cybersecurity protections are in place. To achieve those objectives, Narasimhan’s team implemented Glean, an enterprise work AI and search platform, to make searching, retrieving, and summarizing the vast trove of medical, insurance, and administrative data easier and faster for employees. IT team members are also working with clinicians to deploy and scale ambient listening capabilities. They’re also launching AI models to identify patients at risk of missing treatments schedules so caregivers can proactively intercede. And they’re using AI coding capabilities to speed their development work. Narasimhan’s list of top projects — and the reasons behind them — will sound familiar to most CIOs. Research consistently shows that AI adoption remains the No. 1 priority for IT leaders. Studies also find data initiatives, business process improvements, organizational transformation, and cybersecurity improvements atop CIOs’ agendas — and their budget investments. [CIO.com’s 2026 State of the CIO Study](https://foundryco.com/research/state-of-the-cio/) found that accelerating AI-driven innovation is the top business initiatives driving IT investments this year, cited by 39% of respondents. Increasing operational efficiency (32%), increasing cybersecurity protections (32%), and improving profitability (31%) rounded out the top four areas where IT investments are going. CIO.com / Foundry All this work aligns with what CIOs say is their No. 1 objective today: to transform IT into a [business value–driven organization](https://www.cio.com/article/3498544/how-leading-cios-cultivate-business-centric-it.html). “Boards and CEOs are looking for return on their technology investments,” says David Ulicine, who as executive director of executive education at Carnegie Mellon University’s Heinz College of Information Systems and Public Policy oversees the CIO Certificate program. Here is a look at several IT projects top of mind for IT leaders today. That demand for ROI is playing out [when it comes to AI initiatives](https://www.cio.com/article/4114010/2026-the-year-ai-roi-gets-real.html), says [Thomas Phelps](https://www.linkedin.com/in/thomas-phelps/), CIO at Esri and Innovate@UCLA chief strategist. He lists as a top task implementing AI in a governed and responsible way so that users adopt it and it deliver returns. To ensure that, Phelps pursues AI initiatives that analyses show will drive top-line revenue growth, optimize costs, improve margins, deliver exceptional customer or employee experience, enable world-class operations, and/or enhance security. He points to the deployment of AI in Esri’s contract lifecycle management process as a case in point. Esri now uses AI to review contracts to determine which are standard and which “need that heavy human touch.” Phelps also cites as an example the use of AI in the sales process, where intelligence is being deployed “not just for looking at optimizing our sales approach and process but also for our ongoing care and feeding of an account and for customer experience.” He says AI helps stitch together the various components of customer sales and support, “so we have a holistic view on how the organization is supporting a customer.” As has long been the case, technologies won’t deliver returns if people won’t use them. That’s true with AI, too, which faces a [unique change management challenge](https://www.cio.com/article/4215423/now-more-than-ever-cios-need-to-be-change-agents.html). “If employees aren’t incentivized to use AI, if they’re afraid of AI, then they won’t adopt it,” Phelps says. That’s why numerous CIOs say boosting AI adoption is among their top projects today. Phelps works with business leaders to identify what manual tasks they’d like to shed using AI, which helps get both adoption and create champions of AI use. Similarly, [Steve Januario](https://www.linkedin.com/in/stevejanuario/), CIO of BILL, maker of a financial operations platform, is also prioritizing AI adoption and responsible AI use as part of the company’s roadmap toward becoming an AI-native entity. “Almost everything we’re doing right now is hyperfocused on AI, getting the most from it, and making sure we keep it under control,” he says. “So we’re teaching people the right way to use it and encouraging people to have an AI-first mentality. We’re telling them that if there’s [a task] you’ve done twice, you should think about automating it the third time.” Januario admits that AI adoption was slow at first. But he says consistently promoting AI, offering targeted training, and creating champion groups have spurred more workers to use AI and workers to use it more often. (The company has dashboards to show employee use of deployed AI tools.) Januario now focuses on ensuring workers “use the right AI tools for the right job” and become more skillful users of AI overall. “[Earlier this year] we measured just if they were using the [AI] products, now it’s more about how they’re using the AI products,” he adds. Like many other CIOs, [Brian Conneen](https://www.linkedin.com/in/bconneen/), CIO of Finance of America, a reverse mortgage provider, is deploying agents that can perform the tedious work that humans have been doing. He says this improves employee and customer experience as well as the company’s operational efficiency and profitability. To accelerate his company’s use of AI, Conneen created an AI strategy and built an IT platform for actual AI deployments. He says this two-pronged approach ensures AI initiatives align to business strategy, that the company has a strong data foundation to fuel AI use, and that the company doesn’t end up with numerous separate AI services. He notes the approach creates “cohesiveness” as it advances its AI agenda. However, Conneen says building a company that’s ready for a future where agents work alongside humans takes more than a strategy and a platform to become a reality. Humans must learn to lean into using agents, too, he says. To ensure that happens, Conneen works on changing human mindsets so that workers are comfortable delegating their tasks to agents and trust that AI can successfully perform the tasks. “I’m working to get them to embrace this and shed the [belief] that ‘Only I can do this work’ by showing that agents can make a valuable difference to the business, and showing how when people lean into this, it allows them to do so much more and to have more time for the work that really needs their attention,” he explains. CIOs also remain committed to process improvements, seeing it as essential to gain value from their AI initiatives as well as critical to boosting workplace efficiency and productivity. Research firm Gartner found that [63% of CIOs list improving processes as a goal](https://www.evanta.com/resources/cio/survey-report/top-3-priorities-for-cios-in-2026) when operationalizing AI, making it the second-most cited objective after improving business outcomes (cited by 74%). Phelps lists process improvements as one of his top projects at Esri. “You don’t solve business problems with just technology,” he says. He considers the current state and the to-be state and then works with his business counterparts to determine what is needed to get to the desired future state. He also tasks the process-improvement consultants in his IT department’s enterprise architecture team to work through the analysis and identify whether new technology is required and/or whether changes in workflows are necessary. Most times they can improve the process without implementing new technology but instead by adjusting workflows and how the existing technology is used to “deliver the [desired] net increase in business capabilities,” Phelps says. [Modernization](https://www.cio.com/article/4135451/6-strategies-for-accelerating-it-modernization.html) likewise remains a top IT initiative for CIOs, as a means for improving efficiency, productivity, and user experience as well as enabling AI innovation and cybersecurity improvements. [CIO Deanna Towne](https://www.linkedin.com/in/deanna-towne-3322072/) has been undertaking such work at nonprofit Contexture, due in part to mergers and acquisitions that brought three health information exchanges (HIEs) into one. “What were three different platforms are now a single net new one: the Contexture platform,” Town explains. The work started three years ago with a migration off a legacy HIE to a new one that could carry the organization into the future. It also involved implementing data standards and ensuring all data adheres to those standards, so that patient information is accurate and readily usable by clinicians. Towne is now improving the platform. “We continue to grow and expand it, bringing in more and new data types and building out new solutions, new report types, and new data products to ensure that we’re evolving to meet new needs in the market,” she says. “Continuous service improvement is embedded into how we operate, so we’re always looking for opportunities to improve. It’s built into how we function. That’s very intentional. That takes a lot of focus, because it’s so easy to be done and move to the next thing and never take a look back. But that then quickly piles up and becomes tech debt,” Towne says. That continuous improvement approach applies to Contexture’s cybersecurity posture, too, Towne adds. “We always have a focus on cybersecurity and making sure we have all the controls we need in place and are doing all we can.” [Bobby Cain](https://www.se.com/us/en/about-us/newsroom/experts/details/robert-cain-63eb8a49d5dc77ed07072675/), SVP and CIO for Schneider Electric North America, lists business transformation as one of his top IT projects, stressing that everything IT does should be “about driving business outcomes, not managing technology.” He also lists initiatives that ready the company for the future, a category of work dubbed J2R, for Journey to Readiness. “The top IT projects are going to be in either of those two buckets, readiness or actual transformation,” Cain adds. J2R projects include data transformation initiatives aimed at improving data quality, cleanliness, accuracy, and availability. Cain is also rethinking IT roles by creating new career paths for individual contributors, something he believes helps Schneider attract, retain, and develop the talent it needs now and in the years to come. Recent projects that fall into the second bucket include Schneider’s Titan Program, which is centered on a global SAP S/4HANA implementation accompanied by a transformation of the company’s pricing and contract management processes. [Devan Dewey](https://www.linkedin.com/in/devan-dewey-85885/), a Boston-area CIO, believes IT itself must be remade, an assertion he detailed in his post “[A Mismatch of Scale](https://www.linkedin.com/pulse/mismatch-scale-devan-dewey-egtgc/).” Speaking with CIO.com, Dewey explains that IT once had dominion over big enterprise systems but is now in charge of a multitude of “small agents and apps.” “And everything we learned over the past 40 years, the processes and the mindset, are antithetical to this world of small things,” he says. “If you look at the portfolio of a typical company four or five years ago, it was a portfolio of large, expensive slow-moving things. Now it’s small, cheap fast-moving things. That will take a complete reinvention of how IT works; it requires a reimagining of the pipeline.” Dewey is remaking his IT department for the modern business environment of “small agents and apps.” He created a team that in a 45-day sprint stood up new infrastructure designed specifically to deliver small new things and tested it out by successfully getting two items — prototypes built with Claude — through the newly created pipeline. “Call it a proof of capabilities,” Dewey says. His goal now? To continue building this new infrastructure by adding needed components, such as connections to outside data sources, and becoming faster at moving agents and apps through the pipeline. “It’s really about building an architecture suitable for hundreds of small things, which should set us up for future success.”