Becker's Hospital Review

68 Question: From your point of view, how has your job or the role of a CMIO changed over the past few years? How do you ex- pect it to change in the next few years? Mary Dallas, MD. CMIO of St. Charles Health System (Bend, Ore.): The role of the CMIO con- tinues to evolve, but in different ways across dif- ferent organizations. For me, it originally felt like an advisory role in a way, acting as a translator between physicians and IT staff. The goals were to help configure systems to fit into clinical work- flows, drive consensus on content and build across colleagues and work on technical projects as a clinical representative member of a team. Today, the role feels more strategic in nature, such as managing an informatics department with re- sources focused on using technology to achieve adoption and desired outcomes. This includes a deeper functional understanding of the technol- ogy environment and planning alongside clinical and technology leadership to optimize existing systems as well as invest in development of new ones. The need for managing information to both drive better clinical practices and for measure- ment and reporting has put a big focus on analyt- ics as well as clinical decision support. Neil R. Kudler, MD. Vice President and CMIO of Baystate Health (Springfield, Mass.): At Bay- state Health, the role of CMIO was first created in March 2012 after successful execution of mean- ingful use stage 1. While meaningful use had been the key focus of the medical informatics team, so too was the deployment and cultivation of the or- ganization's enterprise EHR. Over the last 2-plus years, the role of CMIO has become defined by participation in and leader- ship of a variety of strategic objectives, many, though not exclusively, IT-related. Design, de- velopment and deployment of various health IT tools is an essential component of the CMIO role. Over the next few years, the role of CMIO is sure to become more strategic as new tools make their way into healthcare delivery. Defining the IT/in- formatics three-year roadmap, in collaboration with my partner CIO, will be critical in order to scout and anticipate the necessary resources for population health, predictive analytics, software as a service to provider end users, leveraging health IT for clinical research and more. Mark Wess, MD, MSc. CMIO of Greenville (S.C.) Health System: The role of CMIO has been in- creasingly recognized as facilitating transforma- tion of healthcare processes and improving data management. In addition, it has been heavily re- lied upon to address needs for incentive programs (e.g., meaningful use), payment reform (e.g., accountable care initiatives) and improved out- comes. The role has changed from a more tactical and project-oriented one to one that is focused on strategy and leading teams. In the next few years, I anticipate that data man- agement and reporting will increase under the direction of the CMIO to serve the multiple con- stituents. They will continue to work closely with the CIO and IT to refine the application portfolio. In systems with good foundation applications, the emphasis will be on optimization and efficiency. Q: What is the most useful skill a CMIO can have? Dr. Dallas: The most useful skill is being able to be an effective change agent. Dr. Kudler: Communication skills are the most critical. The ability to speak to a variety of audi- ences and tell the story of HIT should never be undervalued. Writing skills are also crucial for ongoing communication. And openness to new or divergent ideas — a 'receptive' communication style — is also highly useful. Dr. Wess: The most useful skill is communication. The effective CMIO must listen to the needs of his or her stakeholders and then translate those needs across business units. The successful individual needs to facilitate the discussion to next steps and then translate that into action. For large initia- tives, the CMIO must keep leadership and staff informed of objectives, timelines, milestones, roles and progress. These communications assist in engaging the appropriate resources and facili- tating the transformation. Q: What is the biggest challenge you're facing right now? Dr. Dallas: Leveraging technology and driving adoption of EHRs to achieve a growing list of re- quirements, many of which don't actually make clinical care better. The level of reporting and data needs make documentation complex in the EHR, and drives physicians, nurses and other caregivers to feel like they are treating the computer and not a patient. This is very frustrating, and there are no easy ways around these requirements, regardless of which EHR product(s) you use. As the require- ments increase, the level of satisfaction from clini- cal end users decreases, and it is difficult to keep these balanced. Dr. Kudler: The biggest challenge I am facing is to accomplish a growing list of objectives, large and small, with limited human and financial resourc- es. My team receives EHR enhancement requests on a daily basis and, in spite of a sharp and tal- ented IT shop, we are unable to keep pace with the organization's appetite for new. Currently, there are over 400 requests on the list, and these only pertain to day-to-day functionality of the EHR. Dr. Wess: In our integrated delivery system, we have a multitude of large scale projects, all of which are needed and have significant risk. Exam- ples include transitioning to an enterprise EMR (replacing more than three dozen legacy applica- tions); upgrading and implementing applications to support meaningful use; selection and imple- mentation of clinical integration network/ACO solutions; a data warehousing initiative including master data management; and additional report- ing for multiple enterprise initiatives. Our biggest challenges with existing products are shifting targets and quality of products. Examples of shifting targets include meaningful use, pay- ment reform timeline and ICD-10 timeline. As for "Physicians who go into administration typically relieve themselves of that identity, choosing to stop seeing patients and/or interacting with docs as docs. The CMIO should always use the tools they promote, and make that known to provider colleagues. Docs are not impressed by C-suite or VP titles." — Neil R. Kudler, MD, Vice President and CMIO of Baystate Health

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