Note: This is the second part of our interview series with Marc Besson. Read Part 1 to explore IMAD’s AI deployment, data sovereignty strategies, and predictive care models.
Designing IT infrastructure for decentralized care environments demands high availability, offline capability, and specialized skills. Confare Swiss CIOAWARD Nominee Marc Besson explains how IMAD renamed its IT department to Digital Services, introduced healthcare personnel to technology teams, and laid the groundwork for a Health Operating Center.
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Michael Ghezzo:
Providing healthcare in 18,000 homes creates very different requirements for IT than running systems at one central location. What does this mean for your architecture?
Marc Besson:
It means that we need to design our architecture differently. We need to have solutions that are mobile and can also work offline, because we cannot guarantee that there is connectivity everywhere. At the same time, we need to make sure that the information is synchronised as soon as connectivity is available again.
Reliability is also essential. When I worked in retail or banking, people often told me that an application was vital. Today, the applications and infrastructure we are running at IMAD are really vital. If we have a failure, there can be an impact on somebody’s life. That completely changes the way you look at IT operations. We need to make sure that the solutions we design are fully resilient and redundant.
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Michael Ghezzo:
By building these applications and services for healthcare professionals, you have also changed the role IT plays within the organisation. Many CIOs in our community are working on the same transition from service provider to business partner. How did you approach it?
Marc Besson:
When I joined IMAD, IT was basically a back-office support function. That is no longer what the business needs. Being part of the executive committee enabled me to have discussions at the top level and demonstrate that IT is a core capability of the organisation.
You achieve this by co-building with the care teams, speaking their language, understanding their needs and providing solutions that simplify the way they work or improve the quality of the services they deliver.
Michael Ghezzo:
Does that also change the people and skills you need within IT?
Marc Besson:
Yes. One thing we did was bring people with a healthcare background into the IT organisation. We have nurses and other healthcare professionals working with us, for example. They understand the reality of care and at the same time work with the technology teams.
That helps us bridge the gap between IT and healthcare. We need people who understand technology, but we also need people who understand how our caregivers work, what they need and what happens in the patient’s home. This combination is very important for us.
Michael Ghezzo:
At the same time, digitalisation requires new skills throughout the organisation. How do you prepare employees for that?
Marc Besson:
Digital literacy is a major topic for us. We have developed more than 200 e-learning modules for our employees. The objective is to make sure that people understand the digital tools they are using and are comfortable with them.
We cannot simply introduce technology and expect people to know how to use it. We need to invest in people and give them the skills they need. This is part of digitalisation as well.
Michael Ghezzo:
So the transformation of IT also becomes a transformation of the organisation itself.
Marc Besson:
Yes. IT is now embedded in the services we provide. We are delivering digital services to our employees, but also ultimately to our patients. That is how the role has changed over the past few years.
Michael Ghezzo:
You have been a CIO for quite some time and have worked in very different industries. How do you see the role of the CIO evolving?
Marc Besson:
The role has changed significantly. In the past, the CIO was mainly responsible for infrastructure, applications and keeping everything running. Today, digital is part of the business itself. As CIO, you need to understand the business, understand where it is going and contribute directly to that development.
At IMAD, we have taken this one step further. At the beginning of 2026, we renamed the IT Department to Digital Services. For me, that reflects where we are today. Digital transformation is no longer a discrete programme. Digital is now part of our everyday reality. We are no longer moving towards a digital future. Digital is embedded in the way we work and in the services we provide.
Michael Ghezzo:
What does this mean for the next stage of your work at IMAD?
Marc Besson:
We are now thinking about what I call a Health Operating Center. In a traditional IT operating center, you monitor servers, networks, firewalls and applications. In healthcare, we can begin to think differently. What if we use technology to monitor and support people in their homes?
With connected devices and the information available to us, we can identify situations in which someone may need support and react accordingly. That creates completely new possibilities for home healthcare.
It may also create new professions. Today we have nurses providing care in people’s homes. In the future, we could have what I call digital nurses: healthcare professionals who use digital information to support patients remotely and identify when someone may need an intervention.
That is an example of how digitalisation changes more than IT. It changes the way healthcare itself can be organised.
Michael Ghezzo:
So when you look ahead, technology becomes an integral part of the care model itself.
Marc Besson:
Exactly. And that is why I believe the CIO needs to be part of these discussions. If digital is part of the service, the CIO cannot be responsible only for the enabling technology. We need to understand how the service will evolve and how technology can contribute to it.
That is also why I think the distinction between IT and business will become less relevant. At IMAD, digital is part of healthcare.
Michael Ghezzo:
You have known the Swiss CIOAWARD for many years and have accompanied the community for quite some time. This year we celebrate 15 years of the Swiss CIOAWARD. What does the award mean to you?
Marc Besson:
For me, the CIOAWARD is important because it brings visibility to the work CIOs and their teams do. A lot of the work happens behind the scenes. People see the services, but they do not necessarily see everything that is required to make them possible.
It is also about sharing experiences. We all face similar challenges, even if we work in different industries. Being able to exchange ideas and learn from each other is extremely valuable.
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