Chief Health Information Officer: What’s in a Title?

Dec. 23, 2014
The role of some chief medical information officers is becoming increasingly strategic. One of the symbols of that transition is a new title popping up for system-wide CMIOs: chief health information officer.

In the past few weeks I have had the chance to interview several chief medical information officers about how their positions are becoming increasingly strategic as their organizations move from EHR implementation to population health initiatives and analytics. And one of the symbols of that transition is a new title popping up for system-wide CMIOs: chief health information officer.

Pamela Dixon, managing partner for healthcare executive search firm SSi-SEARCH, said the CHIO role, although still fairly new, is evolving in interesting ways. The roles of CMIO and CNIO are both becoming increasingly strategic in nature, she said. “They are paving the way for a more unified approach under the title CHIO. It’s difficult to generalize about what that title means. It is going to vary from organization to organization, for example, in terms of reporting structure. The CHIO may report to the CIO or may also have a dotted line to the chief clinical officer, CMO and/ or COO, she added. As an example, Dixon’s firm recently helped Duke Medicine with a search for a system-wide CHIO. She noted that the title was important as it signaled greater strategic involvement for the CHIO,” she said. Duke's CHIO reports to the CIO, Dr. Jeff Ferranti, who is also a physician. 

Besides Duke Medicine, organizations such as Texas Health Resources, OHSU, and Geisinger all have CHIOs. "They are all doing really valuable work with a strong system focus. I think these organizations and these leaders are helping evolve the role, but we are at the beginning of the curve,” Dixon said.

Over the past five years, most health systems have rightfully been focused on implementing EHRs, she explained. But leading organizations in the field are interested in looking ahead at what technology can do across the care continuum, inside and outside the clinic’s walls, as they focus on the transition from volume to value. She said, "When health systems are at that point in their evolution, it makes sense to start thinking of the CMIO role as much more than implementing an EHR. The attention then turns to optimization and soon thereafter you want to look for leaders who have carried expanded responsibilities focused on population health. They are looking well beyond the EHR."

In a recent talk with Luke Webster, M.D., CMIO of 30-hospital Christus Health, he mentioned that he is suggesting that Christus change his title to CHIO to reflect the broader scope of responsibilities. Webster, who is the first system-wide CMIO for Christus, has a health informatics team of 100 people and is creating a regional CMIO structure. The centralized informatics team in the Dallas office focuses on standardization of content, telehealth and remote monitoring, as well as clinical and business intelligence and predictive analytics, Webster said. Part of his role is helping the organization embrace an enhanced role for informatics. “The challenge is making the pivot happen within an organization that may have its own preconceived ideas about informatics is or what a CMIO’s role is,” he said.

Webster reports to the chief clinical officer, who is a peer with finance and operational leaders. “A lot of the evangelizing about the value of informatics is with his peers on the executive council as well as out in the regions with clinical and administrative leaders,” he said. “It is beginning to happen. But there is a lot of seed planting before it takes root.”

Whether they have the CHIO title or not, system-level CMIOs have quite different roles, Webster said, and not every CMIO is a good fit for these positions.

“I think many current CMIOs evolved into the role and may not be well equipped to make the transition to a much more strategic, executive-level role,” he said. CMIOs must ask themselves whether they are interested in that transition, he said. “My role is quite different from the average CMIO, with its own set of challenges, frustrations and stresses,” he said. “Not everybody is well suited to that. Second, you have to ask yourself whether you have the skill sets required. Webster said that for his role, he could see the value of adding an MBA if he could find time to go back to school.

For those interested in this topic, Webster is going to give a presentation at HIMSS called “From CMIO to CHIO: Information, Integration and Innovation” on April 15 at 8:30 a.m. in Room S100A. (Session ID 130).

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