Becker's Hospital Review

73 CIO / HEALTH IT Not just an EHR liaison: What has changed most about the CMIO role By Giles Bruce F rom strictly implementing EHRs to now overseeing a variety of digital health initiatives and having growing leadership and strategic positions within health systems, the job of chief medical information officer has evolved quite a bit over time. Becker's recently asked CMIOs from across the country what has changed most about the role in recent years. Note: eir responses have been lightly edited for clarity. Usman Akhtar, MD. Virginia Hospital Center Health System (Arlington): e CMIO role has changed from a luxury "nice to have" to a critical role necessary for a health system to thrive. Phil Bernard, MD. University of Kentucky Healthcare (Lexington): e role of the CMIO has changed from being an implementation champion in the past. We no longer have to convince the clinician of the power of the EHR. In the current role, the CMIO is the key clinician leader tasked with increasing clinician efficiency to improve patient outcomes. We embed workflows to maximize quality metrics. We eliminate non-value-added activities to increase physician wellness. We are the effector arms that allow our physicians and advanced practice providers to function at the top of their licenses. James Blum, MD. University of Iowa Healthcare (Iowa City): I would say the CMIO role has evolved from one of a physician leader of EMR implementation, to then a provider-EMR satisfaction champion, to now a leader of healthcare practice innovation that uses IT as their toolkit. eir focus is now less about EMR configuration than it is on the application of systems, technologies and analytics to drive care. J. Clay Callison, MD. University of Tennessee Medical Center (Knoxville): Early on, the role of the CMIO focused primarily on EMR evaluation, implementation and adoption. Although EMR expansion and conversion are still happening under their leadership, the CMIO now can focus more on innovative and strategic initiatives that improve patient access, patient and physician engagement, timely data exchange, and ultimately better outcomes for the patient. Put another way, now that we have the blocking and tackling down, we are able to work on the deep pass downfield that scores a touchdown. Neal Chawla, MD. WakeMed (Raleigh, N.C.): CMIOs today need to know a little less about deep tech and more broadly about how tech is used and integrated across all parts of the health system. John Chelico, MD. CommonSpirit Health (Chicago): e CMIO of today has moved from concentrating on how individual providers are using technology to how every facet of the healthcare continuum is interacting with the systems we manage. CMIOs today are focused on using technology to improve the care of the communities we serve when they are in and out of our patient care facilities. Scott Cohen, MD. Bassett Healthcare Network (Cooperstown, N.Y.): Looking back 10 to 15 years ago, the CMIO/informaticist served as the traditional EMR champion and architect as well as IT liaison and translator. With health informatics now the "way we do business," we have seen the CMIO position transform into an integral part of the healthcare leadership team. Rarely does a project or initiative go ahead without IT and informatics playing a critical role. With the "great resignation" a huge part of our lexicon, automation, clinician efficiency and patient self-service have become critical pathways to help us weather our staffing crises and are likely the new normal. Jordan Dale, MD. Houston Methodist: I would say the initial CMIOs were focused on implementation, or getting their clinicians across a finish line of major go-lives — which naturally pivoted to optimization of workflows, support and design of EHRs and other clinical applications. Today, many CMIOs now focus more on health system strategy, growth and alignment with other senior leaders to maximize value by using a core set of clinical applications to achieve the health system's goals — reducing workforce burden, improving quality/safety, reducing costs, etc. David Danhauer, MD. Owensboro (Ky.) Health: In my tenure as CMIO over the last 10 years, the greatest change I have seen in the role is the transformation from an EHR implementer to a clinical IT strategist. e CMIO is now integral with the other IT leadership and organizational clinical leadership, guiding the best visionary approach to IT optimization and technology purchases. Chris DeFlitch, MD. Penn State Health (Hershey, Pa.): e role of the CMIO has developed over the years from a physician champion for EMR conversion, to an optimizer for technology and process, to now a trusted senior leader in mature health systems that understand the depth and breadth of technology to better patient, provider and systems outcomes. Anthony Dunnigan, MD. Valleywise Health (Phoenix): In my nearly eight years as our system CMIO, there have been many changes. I initially came aboard largely to help mature and optimize our EMR, which the system had been on for four years. is was a combination of provider support/efficiency; discipline around functions such as documentation and billing/coding; and exploration of other underutilized features such as patient engagement tools (our patient portal), population health functions and advanced data and analytics. I still perform many of those functions, but like other CMIOs, my role has become more strategic in ensuring we are aligning, changing and expanding EMR functions to strategy — particularly where third-party vendors are involved and a regulatory spin is in place. A great example is the recent information blocking regulations, which required new technical build on the documentation side to ensure the right types of notes and results would become available to the patients in their portal, as well as strong engagement with the providers on best practices and awareness of the availability of this information to the patients. I've played a similar role as our clinical decision support tools have evolved. Probably most impactful were the sudden changes in rules and regulations around telehealth that occurred in March of 2020. We were able to get a platform up and running in 38 hours and went from zero to over 500,000 televisits in 24 months. ese examples hopefully highlight the burgeoning role of the CMIO as a key strategist. Farhan Fadoo, MD. San Joaquin General Hospital and San Joaquin County Clinics (French Camp, Calif.): CMIOs have taken on greater levels of strategic leadership in managing health system innovation through evolving digital health portfolios, expanded roles in business intelligence and analytics, and executive responsibility for achieving

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