Surveys and focus groups helped debunk other mistaken assumptions on IT's part. It turned out, for instance, that patients were more interested in going online to refill prescriptions and schedule doctor visits than to pay bills. After all, patients are not responsible for most of their medical bills; insurance companies are. So Hummel concentrated first on enabling online prescription refills and appointment scheduling through a patient portal. Online payment moved lower on the priority list.

Hummel has been going on rounds with doctors ever since he became a CIO in 1990. "You can find an awful lot by being out there on the floor," he explains. "It's a pretty good way for me to go out there and really connect [with physicians and patients]. If you sit in the old ivory tower at corporate headquarters, you're just not going to understand what their pain is."

Once you know what's really going on in the customer's world, you can spot opportunities to improve customer service. While visiting Sutter hospitals, Hummel saw nurses struggling to incorporate a new medication barcoding system into their routines. (The system lets nurses scan barcodes on the medication bottles, the patient's armband and their own ID badge to make sure the right patients are receiving the appropriate dosage.) He noticed that it was awkward for them to have to push a cart with a computer and barcode reader from room to room; if a nurse needed to respond quickly to a patient, the cart got abandoned. He decided it was worth putting a wireless PC at 5800 bedsides, an investment he calls "a healthy chunk of capital". As soon as Sutter began rolling out the bedside PCs, nurse acceptance of the bar-coding system increased dramatically, and those who hadn't yet gotten bedside access to the system started clamouring for it. Hummel even observed a patient insisting on being placed in a bed next to a PC because he said barcoding made him feel safer. "I don't know why or how," the patient told Hummel. "But by God, I know it's safer."

Another Plus: Making or Saving Money

Sometimes interacting with customers generates ideas that save the company money or time. Dare's work on the front lines at Tussauds' parks made him realize that the phone was an inefficient medium for requesting the transfer of stock from the warehouse to the retail outlets. He implemented a system to allow team leaders to reorder stock electronically on a POS terminal. Dare says that a month into the 2004 season, the new system seemed to be making it easier for employees to keep gift shop shelves fully stocked - and thus to avoid disappointing customers.

Carol Mosely, a vice president of IS at Wal-Mart, says she's in a Wal-Mart store an average of four days a week, observing or talking to customers, or shopping herself. Being in a store so often allowed her to verify feedback that the customers were becoming more familiar with the self-service checkout system and that it could be streamlined. After the machines had been in use for several years, Mosely observed that the self-checkout instructions built into the original system were slowing customers down. So Wal-Mart simplified the instructions and rejiggered the equipment so that the receipt prints out directly beneath where customers sign the credit card authorization. Mosely reports that customers are now getting through faster and that usage of self-checkout has expanded, enabling Wal-Mart to keep its labour costs down.

It's not always IT things that CIOs should be on the lookout for. When Les Duncan was CIO of clothing retailer Express in the early to mid-1990s, he regularly came up with ideas to improve sales during the two days he spent each month working at the San Antonio store. One January, a customer asked Duncan, who is now CIO of Atmos Energy, what the original price on a sale item was. Meanwhile, the executives at headquarters were scratching their heads trying to figure out why the post-holiday sale items weren't selling. Duncan realized that the sticker gun used to mark down prices was obscuring the original price. "The customer didn't know that she was buying a $75 jumper for $20," he recalls. Once shoppers could see they were getting a bargain, merchandise started flying off the racks. When he reported his discovery to the management team back at headquarters, the CEO chided Duncan's colleagues, "I don't know why the IT guy has to find this stuff." The fact that he often did boosted Duncan's credibility in the executive suite.