CMIOs Can Be Heroes

Nov. 29, 2016
I recently had the pleasure of spending a couple of days with a group of about 30 very accomplished chief medical information officers from leading U.S. healthcare systems.

A murder of crows. A pride of lions. A crash of rhinos.  What do you call a gathering of CMIOs?

I don’t know but I recently had the pleasure of spending a couple of days with a group of about 30 very accomplished chief medical information officers (CMIOs) from leading U.S. healthcare systems. It was fascinating to hear them discuss opportunities and challenges in healthcare information technology and how the role of the CMIO is evolving.

I am a former (recovering?) CMIO myself. Many of the issues raised were familiar—perennial favorites as it were: successfully implementing and optimizing health IT (HIT), especially electronic medical records (EMRs). Leveraging data, analytics and clinical decision support to provide actionable information to the right person in the right way at the right time. Smoothing workflows and improving the user experience. Developing governance structures to guide prioritization and alignment of IT initiatives with clinical and operational objectives. Data governance. Cybersecurity. Patient engagement. And population health, to name a few. Truly a Rogues Gallery of usual suspects!

There was a single overarching theme: doing more with less… and with greater speed and agility.

There were also wide-ranging discussions about the changing role of the physician leader in HIT. Many organizations are wrestling with how to make the most of these individuals with their unique mix of clinical knowledge and IT geek-dom. Some CMIOs also have expertise in areas like business strategy, operations or clinical effectiveness.

Here is how I see their journey. In the beginning, CMIOs were part of the IT team with a focus on engaging fellow clinicians and ensuring successful EMR implementation and adoption. Optimization efforts followed those initial implementations. Now their organizations are finally at the starting line of the race to harvest what Jim Jerjis, the CHIO at HCA, calls the “digital dividend”. At this stage the CMIO finds herself in a unique position within her organization: she is one of a few individuals who straddles and can potentially influence operational, clinical and IT activities. That’s a very different role from helping implement an EMR.

Health Systems and CMIOs face a choice: should these physician leaders be down in the engine room or up on the bridge? Both are honorable and necessary roles but they are very different. From my vantage point I am seeing a divergence. In some cases, they are becoming even more specialized. The “Engineer Scotty” is geeking out on analytics or clinical decision support. Others are migrating into more strategic roles. The “Captain Kirk” (or perhaps “Mr. Spock”) is assuming a key role on the bridge with greater responsibilities and a larger team. In some cases, they are becoming CIOs or defining and occupying new roles such as Chief Health Information Officers or Chief Transformation Officers.

Of course I am biased—this is my tribe after all—but I think these are healthy developments. I also believe organizations that recognize and seek to capitalize on the many talents of CMIOs will be far more successful than those who see them simply as the “guy who deals with MDs who are angry at IT.” The best CMIOs matched with the best-fit roles are likely to be regarded as heroes within their organizations as they work to support and enable the efforts of others to deliver high quality and efficient care.

Dr. Dave Levin has been a physician executive and entrepreneur for more than 30 years. He is a former Chief Medical Information Officer for the Cleveland Clinic and serves in a variety of leadership and advisory roles for healthcare IT companies, health systems and investors.