There are probably very few Chief Information Officers who are trained as nurses. While Toi Wilde’s route to the role at Missouri’s Department of Social Services (DSS) seems unconventional, she is applying her experience to great effect.

With a bachelor's degree in science and nursing from the University of Missouri – “Go Mizzou!” – Toi then earned an MBA in healthcare administration. It was then that her career continued to be drawn to the digital world. 

“When I was working as a baby nurse – they call you baby nurses when you first come out of college – our hospital was transitioning from paper to electronic health records (EHR). And since I was one of the new ones on the floor and most of the other nurses were more experienced, they basically said, ‘Okay, we're going to pull you part-time to be a subject matter expert and make sure that we're ready and our floor is ready to implement this EHR’.

Toi’s next role was still clinical but again involved switching from paper to electronic processes. 

“We were again moving from paper to electronic and I got pulled in for project management and informatics on several large-scale implementations for that health system,” Toi explains.  

“And then I went to Missouri Hospital Association after that, and I was all about clinical data and looking at how we improve health outcomes and it kept dragging me back into the workflows of how people were using their technology.

“Then, last but not least, I went to the Department of Mental Health at the state and led their journey to getting from paper to electronic and then modernising how they did interoperability for long-term supports and services. Now I'm here. So I feel like it just kept naturally gravitating towards it.” 

Toi joined the Missouri DSS in April 2025 and set to work building foundations for a digital overhaul of the state’s welfare services. 

“I think the biggest challenge is balancing all the priorities,” she says. “Tech can be very exciting, but it takes time. It’s about ensuring we stay consistent through the process of modernising. 

“Technology is always evolving every single day. When our policy or our field sees the next new thing, everybody wants to just jump to it. But it's really keeping folks focused on the journey and making sure that they understand the not sexy stuff, like the data, critically matters when you're going through this process.” 

Toi, born and raised in Missouri, is excited by the potential digital and AI services could have on the state’s citizens. 

“The thing that I'm most proud of in the last 12 months, honestly, is taking a step back and recreating a roadmap for the Department of Social Services where we are looking at how we use technology as a tool to push how we're going to serve our social services programmes for the next 10 to 15 years. 

“That takes a lot of commitment. It's a very busy role. So, to take the time to step back, set forth a plan and commit to a journey of transformation in how you deliver services and how your technology will deliver those services is a really big undertaking. 

“But we're very excited about where it's going. It's been a labour of love. I think it will serve our citizens in Missouri very well. And I can't wait to get it fully executed.”