The Journey from CMIO to CIO

May 5, 2014
Louisville, Kentucky-based Baptist Health recently promoted David Bensema, M.D., from chief medical information officer to chief information officer. In a recent Q&A, Healthcare Informatics asked Dr. Bensema how his stint as CMIO will help in his new role.

Louisville, Kentucky-based Baptist Health recently promoted David Bensema, M.D., from chief medical information officer to chief information officer.  Dr. Bensema, who joined the health system in 2006, is now responsible for leading and developing information technology structures across Baptist Health, which owns seven acute-care hospitals with more than 2,100 licensed beds around Kentucky. Healthcare Informatics Contributing Editor David Raths recently spoke with Dr. Bensema about the transition from CMIO to CIO.

HCI: I was interested in talking to you because although Healthcare Informatics interviews CIOs and CMIOs all the time, we don't see many examples of someone moving from the CMIO to the CIO position. So I was hoping we could talk about some of the things you have worked on as CMIO and how you will apply them as CIO. How long were you CMIO and what were some of the things you worked on in that position?

Bensema: I have been CMIO only since July 2013. We are finishing the process of selecting an integrated EHR for the health system. The process began in October 2013 after we did an analysis of our IT system and informatics resources. I led a task force that spent five months evaluating several products and narrowed it to two finalists. That task force had 36 individuals, and only two of us were in the IT department. The rest were clinical users or people involved in revenue management. We had 17 physicians on the task force.  It allowed us to gain insight into usability, and allowed us to look at it from a less technical perspective. In March we reached a consensus recommendation to be presented to the board. We have to wait for the board decision in late June before announcing anything about the system we have recommended. That was a fun process to go through as a newly minted CMIO.

HCI: So were you replacing a system already in use?

Bensema: We had been with McKesson Horizon products on the inpatient side. Obviously the 2011 announcement of the sunsetting of those products had a huge impact. We had been implementing Allscripts in the ambulatory practices owned by the system and affiliated practices.  That was going pretty well, but when we started looking for a product that was fully integrated across the care continuum, Allscripts did not become one of the finalists. But they are still being incredibly cooperative in supporting our practices in achieving meaningful use.

HCI: Once the system is selected, rolling out the implementation will be a challenge. Have you thought through how you are going to approach it?

Bensema: It will be a sequential rollout over a 30-month period, because we know we have a hard-stop deadline of Dec. 31, 2016, when our contract with McKesson ends. We’re working on that timeline now.  We plan to start with ambulatory practices. We plan a four-month lead time on the primary care practices because they are the ones that populate a large portion of the integrated EHR, so that will give us a leg up when we go live with the hospitals and the specialists. We will also come back with 90-day and 180-day optimizations to assess where we are, re-evaluate work flows and make sure that the EHR is providing what the markets and end-users really needed. No matter how much how you try to think ahead and do validation processes, nothing is the same as really doing the work at the bedside.

HCI: What are some things that are different or more complex about the CIO position than the CMIO one? Are there some lessons you learned as CMIO that you could apply as CIO?

Bensema: As CMIO I was tasked with moving us toward meaningful use attestation and CPOE and adoption rates for physicians, which all involved change management. One thing I learned was that there were many other folks who felt just as strongly and were impacted just as much as our physicians by the changes. I think that helped me to get a broader perspective that will be helpful as CIO. Also, I think the fact that I am not a lifelong IT person will be beneficial, because I will keep looking for how we simplify the user experience as much as possible. I remember one physician telling me, “I am not a troglodyte. I will use any technology that helps me take better care of my patients and that works. Give me something that works.” That is going to stay with me.

HCI: How will you be spending your time differently? More focus on budgeting and contracts? And on IT security?

Bensema: The biggest change is that I will have oversight over IT security compliance, over the applications contracting and contract management — to make sure our teams are delivering on their end and to make sure we are getting full value from the vendors and managing our contracts well. So that is a big difference from being a CMIO. The other part involves personnel issues. As a CMIO, I interacted with the entire IT team, but I didn’t manage any of them. I didn’t have any direct reports in that role, and now I have a full team of close to 400 people. That is a big difference. Since I am going to retain the CMIO responsibilities, I have to look at how I extend myself and make use of the executive directors we have. We have executive directors for three major roles: integrated EHR development; operations and applications; and security, compliance and contract management. I will work closely with those three executive directors and of course be available to other IT developers and managers.  We also plan to give physician champions in the markets a more defined role than we previously had. One of the real advantages of having a physician CIO is that I understand the importance of physician champions — people who are still in practice, who have credibility with their colleagues and understand the interactions and interoperability requirements of the system.

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