CMIOs at the Hot Center: Planets Seen Aligning at AMDIS

June 25, 2013
What a difference a year makes. Last year (indeed, a year to the day of this writing), the annual Physician-Computer Connection Symposium, held (as it has been for years now) at the Ojai Valley Inn and Spa in Ojai, Calif., opened literally on the day that the top HHS, CMS, and ONC officials unveiled the final rule for stage 1 of meaningful use under the HITECH Act.

What a difference a year makes. Last year (indeed, a year to the day of this writing), the annual Physician-Computer Connection Symposium, held (as it has been for years now) at the Ojai Valley Inn and Spa in Ojai, Calif., opened literally on the day that the top HHS, CMS, and ONC officials unveiled the final rule for stage 1 of meaningful use under the HITECH Act. Indeed, most of the attendees at the annual gathering of members of the Association of Medical Directors of Information Systems (AMDIS) were flying and driving to Ojai at the time that Kathleen Sibelius, Donald Berwick, M.D., David Blumenthal, M.D., and Regina Benjamin, M.D., were revealing the details of stage 1 of MU. Not surprisingly, the conversations at the opening night reception were particularly lively last year.

What’s more, Farzad Mostashari, M.D., who last year headed up policy issues for ONC, flew out to Ojai, and spoke live to the CMIOs present, following a phone call from his then-boss, Dr. Blumenthal. Not only is Dr. Mostashari the number-one official now at ONC (and this year, he connected with the assembled AMDIS group via phone hookup); what’s become eminently clear over the past year is how incredibly central CMIOs have become to helping their organizations achieve meaningful use—and a host of other critical strategic objectives in healthcare. Need to figure out how to embed evidence-based physician ordering into your CPOE? Better get a CMIO. Need to begin the complex set of processes around leveraging clinical information systems to reduce unnecessary readmissions, eliminate healthcare-acquired infections, end so-called “never events,” and prepare the way for ACOs, all under federal healthcare reform? Better get a CMIO. What about sorting through the welter of issues around pulling together key clinical and financial data in order to improve core patient care delivery performance and prepare for ACO development? Once again—better get a CMIO—and fast.

Here’s the thing: as absolutely important as CIOs are these days to doing everything hospitals, large medical groups, and integrated health systems absolutely must do to move their organizations forward to produce the improved clinical and operational performance that the purchasers, payers, and consumers of healthcare are demanding, CMIOs are emerging as equally important to all those efforts.

All the presentations being made at this year’s AMDIS gathering, including those offering new survey results, are underscoring a simple fact (yet one with huge implications below the surface): and that is that CMIOs, as well as other physician and clinician informaticists, are in a more central position than ever before in terms of our need for them to help lead clinical transformation of healthcare. Indeed, it’s unimaginable how we as a society might achieve the “new healthcare—one with improved patient safety, care quality, patient and family satisfaction, clinician effectiveness, cost-effectiveness, accountability, and transparency—without CMIOs and their fellow physician and clinician informaticists. In short, the levels of responsibility set to land in CMIOs' laps are potentially staggering.

So just as the bright spotlight of anticipation, expectations, potential, and pressure began to fall seriously on CIOs as a group about ten years ago, so that same spotlight is now landing squarely on CMIOs as a cadre. And it’s clear that the CMIOs gathered this week in Ojai understand that, though it’s also clear that the dramatic acceleration in focus on their role is also causing CMIOs to feel the kind of pressure that the last-at-bat hitter feels in the classic bases-loaded, bottom-of-the-ninth baseball game.

Clearly, our organizations need a heck of a lot more CMIOs—particularly CMIOs, and more and more, CMIOs with whole teams of medical informaticists working for them. And they need them pretty fast. Fortunately, there is no group in healthcare today that is collectively more thoughtful, analytical, dedicated, clever, and humane. And the national leaders among their profession are already producing results that are establishing the framework for huge advances in healthcare in the next few years.

In sum, no group of healthcare professionals faces a bigger overall set of challenges when it comes to transforming our healthcare system from the inside. Luckily for all of us, no group is better prepared to help bring their colleagues to the table to together work on the enormous issues facing our system and our society.

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