CMIO 2.0 — meet the chief health information officer

When hospitals began adopting EHRs, CMIOs became the liaison between the IT department and clinical staff during implementation projects. But now that the majority of hospitals have their EHRs in place, the role of the CMIO is shifting, and hospitals and healthcare organizations are finding ways to incorporate this evolution of positions in their strategic leadership structures.

Historically, CMIOs helped select and then implement the systems, providing the clinical point of view for the projects. Now, the next-generation CMIO is focused on transformation and innovation, and using IT in a way that produces value for an organization, says Hillary Ross, a principal in the IT practice at executive search firm Witt/Kieffer and leads the IT and informatics physician recruitment.

Ms. Ross says there are several names used to refer to this next-generation CMIO, a common one being chief health information officer (which is what this article will use to refer to the next-generation role). While these job titles do fluctuate, as do the details of the positions, there are common elements sought in individuals taking on the next iteration of the CMIO.

"It's hard to come up with a fast and hard definition of the second-generation CMIO," Ms. Ross says, though some common responsibilities include data analytics, population health efforts, innovation, developing new tools and even serving as a liaison between hospitals and for-profit commercialization arms.

To illustrate these differences, one can look at job descriptions of open CMIO and CHIO positions. A January 2014 position description of an open CMIO role at The University of Texas Health Science Center in Houston outlines principal duties and responsibilities mostly related to hands-on interactions and improvements with the clinical system. Ms. Ross was one of the authors of the description, which mentions responsibilities such as building relationships with physicians to gain support of IT initiatives, reviewing medical informatics trends to develop implementation strategies, leading clinical leadership groups in creating protocols and workflows and working to deploy evidence-based best practices.

Comparatively, a job description from Sacramento, Calif.-based Sutter Health for a CHIO is much more focused on larger strategies and developing action plans. Sutter Health's CHIO job description does mention selecting, designing and implementing clinical IT systems, but parallel to those requirements are the ability to convert large data into meaningful information and possess managerial skills to create plans and strategies.

IT leaders regularly discuss optimization of systems and maximizing the use and ability of already-implemented IT systems to achieve the greatest value. Though optimization is a growing focal point, it still doesn't quite capture the renewed focused of the CHIO, Ms. Ross says.

"[Optimization] means getting the value and use out of the systems that are implemented, and making sure the clinicians are using the systems to the best of their ability. To me, that's still falling in the CMIO's role," Ms. Ross says. "But taking the data from those systems and analyzing it and using it to make changes and transform — that's where you get into the second-generation CMIO."

All of this isn't to say the need for a traditional CMIO is diminishing; there will always be a need for a CMIO because systems are never fully implemented, Ms. Ross says. Every system enhancement and upgrade requires leadership to guide clinicians through.

"The CMIO is definitely here to stay," Ms. Ross says. "As organizations have made such significant investments in their clinical information systems, they need the expertise of a CMIO to get that ROI."

The skill sets for CMIOs and CHIOs certainly still overlap, but the CHIO requires a broader scope of operation. Ms. Ross says Witt/Kieffer often consults with clients on whether CMIOs can effectively become CHIOs, which she says certainly can be the case if CMIOs have the desire to do so. "The [CHIO] is a visionary, the person that lends strategy to the needs of the organization, leadership and management skills. It's much greater than just technical skills," she says. "[CMIOs] have to ask themselves if they have a passion for that work. Some are just interested staying involved on the technical side."

As more hospitals and healthcare organizations establish a CHIO role, new challenges emerge related to the organizational and structural elements of introducing a new executive to the table.

"It's important once that decision is made [to create a genuine CHIO role] to set that role up for success," Ms. Ross says, adding other elements of a well-crafted CHIO role include a seat at the decision table, a budget and resources. "When I say a seat at the decision table, [I mean] a genuine opportunity to have input in the vision and strategy for where the organization wants to go and to help create that path to achieve those goals."

More articles on IT leadership:

Allegheny Health Network taps Cleveland Clinic exec as CMIO: 4 things to know
5 questions with UC San Diego Health's new CIO Dr. Christopher Longhurst
How CMIOs can ease the pain of IT transitions

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