The 3 top priorities of a CMIO and what keeps them up at night: Hospital for Special Surgery CMIO Dr. Steven Magid

Steven Magid, MD, chief medical information officer at Hospital for Special Surgery in New York City, explains how a CMIO can be most helpful in preventing cyberattacks and his top priorities to maintain clinician engagement.

Responses have been lightly edited for clarity and length.

Question: How has your role as CMIO evolved over the past two to three years? How have your responsibilities changed since you took on the role?

Dr. Steven Magid: My answer to this question is strongly influenced by the fact that [Hospital for Special Surgery] implemented Epic in January 2016. My responsibilities progressed from EHR selection to design to implementation to stabilization to optimization. By all accounts, the implementation was very successful — we received HIMSS stage 7 certification in November 2017 and the HIMSS Nicholas E. Davies Award of Excellence for Information Technology in 2018 — and has allowed me to focus on utilizing the large amount of data and turning it into actionable information. For example, as a musculoskeletal-surgical hospital, applying risk stratification and pathway development will lead to improved surgical outcomes.

Q: What do you consider your No. 1 priority as CMIO? How do you ensure you're successful?

SM: I believe that there are three priorities, not just one. The first and foremost is being an advocate for patients and their caregivers. First, do no harm applies to everything we do, including the safe use of information systems. Secondly, to engage clinical staff to embrace and spearhead information systems. Without clinician engagement, there can be no progress. And lastly, to be an effective translator and communicator between the IT staff and the clinical staff.

Q: What is the biggest challenge you're facing as CMIO? What keeps you up at night?

SM: The biggest challenge I face is continuing to advance those priorities I previously mentioned. We continue to set our sights higher.

What keeps me up at night is very different: cybersecurity and downtime — somewhat interrelated concepts, since one often leads to the other. Although there are many layers of technical protection to prevent a cyberattack, the most vulnerable area is still human behavior.
This is where the CMIO can be most helpful. Similarly, careful attention to down time procedures and policies are needed, but this is not enough. Table tops and drills are the key to preparation.

Q: Which apps and technologies do you find most helpful, and which do you think will be passing fads?

SM: The biggest problem with apps is the plethora, as well as the lack of curation — though this is changing. Telemedicine is here and will be increasingly important. Voice recognition and [natural language processing] using AI will help with EHR documentation and [clinical decision support].

I am also interested to see how blockchains will affect our future. I do not think that it is a passing fad — though similarly it will not be a panacea. If it can be connected to the [Internet of Things], it will be incredibly powerful.

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