Becker's Hospital Review

74 CIO / HEALTH IT population-level health outcomes. ese responsibilities have been layered on top of the legacy CMIO duties that relate to EHR implementation, adoption, usability and optimization. David Fleece, MD. Temple University Hospital (Philadelphia): I think the pandemic brought a few issues to the forefront for us in this role: virtual patient care, the need for nimbleness, and the degree of provider frustration and burnout in healthcare. Much has already been said about the rapid increase in telemedicine, so I won't recapitulate that here. In terms of nimbleness, we had to rapidly stand up not just telehealth but also mass immunization programs, large amounts of new data reporting to public health and governmental agencies, a field hospital, and new policies and processes within the [emergency department] and hospital units. Patrick Guffey, MD. Children's Hospital Colorado (Aurora): e CMIO of the past was focused on EHR implementation and securing provider support. Now, the CMIO is an integral member of the leadership team, leveraging the EHR to solve problems and improve patient outcomes. William Harvey, MD. Tus Medicine (Boston): Over the last five to eight years or so, there has been an evolution in the potential roles that CMIOs play. Some CMIOs, usually those more junior, are focused on issues like system implementation, clinician support and training, and serving as a liaison between the clinician community and the IT department. at has evolved into CMIOs whose responsibility includes system design and data analytics. ey may, for example, supervise physician-builder programs and support quality improvement through design and implementation of clinical decision support and analytics. e most recent iteration is sometimes termed chief health information officer. is role typically involves managing larger teams who work on all the domains noted above, but also may include leading multidisciplinary informatics teams including pharmacy, research or nursing. CHIOs may also be distinguished by their role in helping to determine organizational strategy as members of a more senior executive team. Regardless of title, a CMIO's role continues to evolve over time from that of a physician liaison to an executive leader. Diane Hunt, MD. Chief Health Information Officer (and former CMIO) of Deaconess Health System (Evansville, Ind.): Over the last 10 or so years, the role of the CMIO has changed dramatically. Back when I moved into clinical informatics as a specialty, I was seen as the physician liaison who could get doctors engaged and excited about the transformation to an electronic health record. Once we got over that hurdle, the CMIO role grew to include the job of finding ways to optimize the use of various clinical soware solutions and developing new and innovative ways to improve the business of caring for patients. Recently, over the last two to three years, we have evolved once again to be much more strategically focused. I no longer spend my days working in the EHR and analyzing workflows or clinical decision support build. We now have a seat at the table for most health system initiatives, generally from both the clinical informatics and data analytics perspectives. Data has become the key to our organization's success, and as a health system CMIO it is the responsibility of our team to ensure we implement workflows and tools that allow us to accurately collect, visualize and ultimately analyze that data. It has been a fun ride, and I definitely look forward to seeing how we continue to adapt to changes in the healthcare world moving forward. Allen Hsiao, MD. Yale New Haven (Conn.) Health and Yale School of Medicine: ere are arguably few roles that have changed and evolved over the last decade as much as that of the chief medical information officer. For many of us, we started off as the uber physician champion for EHRs, willing to take some time away from clinical care to help usher in a new era where doctors and nurses weren't jockeying for the paper chart, or worse, couldn't even locate it in time for a patient visit, to where healthcare data is now all digitized. Now CMIOs are focused on a few things: how we can better refine and optimize EHRs to be easier to use and minimize clicks and chart bloat; advancing clinical decision support to be increasingly sophisticated and comprehensive (so the system can identify opportunities to improve care, taking into account variables, results, social determinants of health and even genomics); how to transform data into information; and identify ways we can automate tasks to save clinicians time. e transition from paper to EHRs hasn't been easy or smooth — and there is still much to do to improve and refine systems to make them easier for physicians to use, especially to be compliant with compliance and regulatory rules, Cures Act, etc. — but we now have the digital foundation in place to really begin to improve patient care, and the delivery of it, in ways that we couldn't have dreamed before. And I believe CMIOs will be — and need to be — right in the thick of that important work. Maia Hightower, MD. Chief Digital Technology Officer of University of Chicago Medicine (and a former CMIO): What has changed the most about the role of CMIO in recent years is the variability in the scope of responsibilities of the CMIO by organization. Each CMIO has shaped the role to meet organizational needs matched with individual strengths. e core responsibilities of the CMIO remain the same, including optimizing the EHR experience for providers. In addition, many CMIOs have expanded into the broader digital transformation ecosystem, including digital transformation strategy, digital health, data and analytics, AI and population health. Julie Hollberg, MD. Emory Healthcare (Atlanta): As multiple healthcare markets consolidate, many of us are leading EMR transitions from one vendor to another, which involves change management on a much larger scale than smaller implementations within our own institutions. Jeffrey Hoffman, MD. Nationwide Children's Hospital (Columbus, Ohio): For many organizations, the CMIO role was created primarily to help implement EHR systems and assist other physicians in adopting the new technology. In the past several years, however, the CMIO role has undergone significant changes, which were further accelerated in response to the pandemic. At the same time, EHRs themselves began to mature from pen-and-paper replacements for paper charts to full- featured patient and population management systems. Today, CMIOs are oen thought leaders and strategic partners at their organizations, working to leverage advanced analytics and sophisticated AI tools to transform patient care and reshape the care experience, while simultaneously addressing health disparities, balancing innovation with patient safety, and addressing the looming crisis of widespread physician burnout. Steven Magid, MD. Hospital for Special Surgery (New York City): I am not sure if the role is actually changing, or if the environment is shiing and the role must respond. e CMIO's role was, and will continue to be, acting as an agent of change; helping to translate between clinicians and IT (who oen speak different languages); and representing clinicians and their patients at the budget and IT table. But as the world changes, the CMIO's role must respond: e best example is, of course, COVID. As an integral part of the response team, the role changed overnight. "Digital" and its myriad of meanings were barely on the horizon a decade ago. Now CMIOs have to keep up

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