Joseph S. Smith, chief executive officer of HITvision, has announced a new governance handbook, “Board Governance Guidance: A Practical Framework for Corporate Directors,” designed to help directors and executive leaders address complex oversight responsibilities. The book distills more than 40 years of leadership in health care technology into a concise reference for active governance decision-making.
Mr. Smith developed the handbook after serving both as a senior executive presenting to boards and as a director serving on health care boards.
Governance Insights From Both Sides
Mr. Smith spent 36 years participating in board meetings while working within the Blue Cross and Blue Shield system. During that period, he presented strategy proposals, answered questions from directors and worked with oversight committees for finance and audit.
He later served on the boards of three health care organizations. Moving from executive presenter to director allowed him to observe governance dynamics from both sides of the board table.
“This experience provided the credentials to create the book’s framework, content and structure,” Mr. Smith says. The 103-page handbook helps directors think through governance challenges rather than providing predetermined answers. The book presents eight governance scenarios covering issues such as chief executive officer performance concerns, financial irregularities, strategic disputes and risk oversight.
Additionally, the publication serves as a desktop quick reference for leaders, supporting board discussions and complementing training from governance firms, universities and director associations. “It offers a quick, structured guide to help address issues and make informed decisions,” Mr. Smith says.
New Guidance for Corporate Boards
Corporate boards today face a broader range of oversight responsibilities, including artificial intelligence, cybersecurity risk management and enterprise risk governance. Although directors often receive extensive training, they lack a clear framework to organize decisions during active board discussions.
Mr. Smith’s handbook offers a structured, easily accessible tool for directors to apply when addressing governance decisions. His core goal is to pass on actionable governance knowledge to new generations of directors and executives.
Specifically, Mr. Smith aims to equip them to lead organizations amid increasing operational and technological complexity. It is a mission fueled by his mindset of “earning credibility through sustained excellence.”
A Career Built on Digital Transformation
Mr. Smith's career began in the early 1970s, when the health care industry accounted for roughly 7% of the U.S. economy and relied heavily on paper-based processes. While working with Blue Cross and Blue Shield organizations, he questioned the prevailing approach to administrative claims management, asking why paper needed to move through the system at all.
“Previously, paper exchanges were cumbersome, often resulting in lost documents and claims,” Mr. Smith says. In response, he contributed to the development of large-scale health care digitization efforts, helping build the Blue Cross and Blue Shield InterPlan claims communication system. This platform connected dozens of regional plans and supported growth in membership across the United States.
In the 1990s, Mr. Smith helped lead the development of one of the nation's earliest operational health information exchange (HIE) systems in Arkansas. Working with Arkansas Providers, his team designed, built and implemented its HIE in 2000. This technology enabled hospitals, physicians, insurance providers and other health care organizations to exchange administrative, clinical and financial data electronically.
In 2014, Mr. Smith founded HITvision after his retirement as senior vice president and chief information officer of Arkansas Blue Cross and Blue Shield. Through the firm, he advises organizations and governments on health care information technology strategy.
Mr. Smith earned a bachelor of science in industrial management from Illinois Institute of Technology and a master of business administration in finance from Loyola University Chicago. His work in health care technology earned numerous industry recognitions, including recognition by Marquis Who’s Who. Most notably, his chief information officer peers across North America selected him as one of the Elite 8 CIO Award recipients in 2011.
About Joseph Smith
Joseph Smith is the chief executive officer of HITvision in Philadelphia, specializing in health care IT consulting. He previously spent two decades at Arkansas Blue Cross Blue Shield as chief information officer and senior vice president. His work and impact have also been featured by Apple News and the Associated Press.
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