Becker's Hospital Review

76 CIO / HEALTH IT Andy Spooner, MD. Cincinnati Children's Hospital Medical Center: A lot has changed about the CMIO job. Early on — early to mid-2000s — it was all about implementation, since so much had to be built from scratch to get something useful in place. Now we can go live in many clinical areas with 90 percent less design work. Now it's almost all about how to expose information to the right party, and not expose information to the wrong party. Our goal before was to share everything with every legal recipient upon request; the notion of "information blocking" never crossed our minds. e 21st Century Cures Act introduced underdeveloped definitions of what should be held back, which has spawned thousands of varying interpretations of what we can share and what we should not, especially when it comes to the care of adolescent patients. row in the regulations from 42 CFR Part 2 for drug-use treatment, state laws about confidentiality that conflict with federal standards, heightened interoperability capabilities across the industry, and greater expectations from everyone that everything should be doable online, and one can spend most of one's day trying to figure out the paradoxical goal of sharing and protecting information simultaneously. Dusadee Sarangarm, MD. University of New Mexico Health (Albuquerque) as told to Becker's in July: e CMIO role a decade ago centered mainly on moving paper processes to electronic ones (i.e., documentation and order entry). Now CMIOs are leading the rollout of entire EHRs for health systems, as well as new bolt-ons like telehealth platforms, patient apps, secure text messaging and artificial intelligence tools. Our role has become logarithmically more complex as we continue to manage the EHR design at our institutions while at the same time shaping the strategic decisions of some of the largest acquisitions for a health system. As such, we are integrated into the C-suite more than we were previously. In short, 2012 CMIOs were a nice-to-have. In 2022, we are an absolute necessity if a health system wants to keep one of its most expensive assets, the electronic health record, in good condition. Jonathan ierman, MD, PhD. LifeBridge Health (Baltimore): e CMIO role had traditionally focused on implementing and optimizing the electronic medical record system. Here alone, there was ample work needed to help providers transition from a world of paper notes and verbal orders, to electronic records and computerized provider order entry as incentivized by Congress through meaningful use and the HITECH Act of 2009. More recently, as healthcare undergoes a digital revolution, the CMIO role has broadened to include everything digital from apps to interfaces. e CMIO works with SMART on FHIR apps that function within the EMR platform and third-party apps running on bedside tablets. e CMIO also manages the flow of clinical data through interfaces between the EMR and health information exchanges, medical wearable devices, or third-party platforms that unify the patient experience, such as the "digital front door" many health systems have developed. ere is also the field of data analytics to make sense and derive meaningful information from the massive amounts of clinical data now recorded. AI and predictive analytics are gaining traction in the healthcare IT space for predicting patient outcomes and providing clinical decision support for providers to intervene before a medical condition becomes more serious. Finally, many CMIOs are deeply involved with telehealth and work to implement and develop telemedicine programs for their health systems to serve patients remotely for their healthcare needs. Together with my team of medical informaticists, I work in all of these areas in my current role and enjoy working in the fascinating and ever- changing crossroads of technology and clinical medicine. Allison Weathers, MD, and Eric Boose, MD. Enterprise Associate CMIOs of Cleveland Clinic: Although always key, with the pandemic the physician leader roles — CMIO, associate CMIO, medical director of IT — felt like they became even more critical. Physician IT leaders were able to provide the necessary guidance and direction to ensure that the right work was prioritized and that needed solutions were quickly developed and implemented. e role of "translator" between the IT departments and clinicians/ providers — which has always been an important part of these jobs — was even more crucial with all of the fast-paced changes that occurred. Now with the challenges that health systems are facing post-pandemic (staffing shortages, etc.), CMIOs and other IT physician leaders help ensure that the focus is on projects and initiatives that align with the mission and values of their health systems and advance strategic goals. Emily Webber, MD. Indiana University Health and Riley Children's Health (Indianapolis): CMIOs have definitely changed in the last several years. Most have seen their roles expand to include technology supporting health outside of the clinic and hospital walls — whether this is telemedicine and digital health during the urgency of COVID, or supporting the Cures [Act] final rule and promoting interoperability, or establishing remote home-monitoring programs. I think the CMIO role has always been aligned so closely to the electronic health record and the leadership around leading change in that area. It makes sense that informatics skills and experience have grown in innovative ways to support patients and communities. Mark Weisman, MD. TidalHealth (Salisbury, Md.): e CMIO role has taken on more strategic significance in the last few years. Initially, the CMIO was instrumental in the success of an EMR implementation, but that work is mostly behind us now. A CMIO can bring the clinical, business and technology perspective that senior leaders need to position their organizations for future success. We are seeing an increase in the number of physician CIOs for this reason. ose roles are starting to blur. Alan Weiss, MD. BayCare Health System (Tampa, Fla.): I think the work of CMIOs initially was focused on the implementation of EHRs, which meant establishing governance, exploring technical configurations and massive amounts of training across the enterprise. Sure, CMIOs are still optimizing their EHRs, and that work is going to always be there, but our work has now shied to help become change agents within organizations. We now help with the development of population health and value-based care; we lead our health systems in analytics used to refine our approach to patient care; and we are integral in changing transformation efforts to improve quality, increase efficiency and reduce costs. Kirsten Zeitler, MD. Edward-Elmhurst Health (Warrenville, Ill.): Out of all medical leadership roles, the role of the CMIO has evolved more than any other role in the last several years. No longer is the focus on evaluating and implementing an EHR; the CMIO now assists the organization in a multitude of capacities. With the vast breadth of data and innovative solutions in healthcare, the CMIO has become truly a steward of progress. e CMIO helps navigate their health system through rapidly growing amounts of data, regulatory changes, as well as the logarithmic growth of artificial intelligence capabilities. ey do this while supporting their providers, clinical staff and administration with the technology available in their system. I view the role of the CMIO as a bridge between medicine as we currently know it to what medicine will become over the next several years. Having a leader who is able to understand, balance and communicate the evolving progress and innovations in healthcare defines the focus of the CMIO role today. n

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