Roundtables

e 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 management and re- porting will increase under the direction of the CMIO to serve the multiple constituents. ey will continue to work closely with the CIO and IT to refine the appli- cation 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: e most useful skill is being able to be an effective change agent. Dr. Kudler: Communication skills are the most critical. e ability to speak to a variety of audiences and tell the story of HIT should never be undervalued. Writing skills are also crucial for ongoing commu- nication. And openness to new or divergent ideas — a 'receptive' communication style — is also highly useful. Dr. Wess: e most useful skill is communication. e effective CMIO must listen to the needs of his or her stakeholders and then translate those needs across business units. e successful individual needs to facilitate the discussion to next steps and then translate that into action. For large initiatives, the CMIO must keep leadership and staff informed of objectives, timelines, milestones, roles and progress. ese commu- nications assist in engaging the appropriate resources and facilitat- ing the transformation. Q: What is the biggest challenge you're facing right now? Dr. Dallas: Leveraging tech- nology and driving adoption of EHRs to achieve a growing list of requirements, many of which don't actually make clinical care better. e level of reporting and data needs make documentation complex in the EHR, and drives physicians, nurses and other care- givers to feel like they are treating the computer and not a patient. is is very frustrating, and there are no easy ways around these requirements, regardless of which EHR product(s) you use. As the requirements increase, the level of satisfaction from clinical end users decreases, and it is difficult to keep these balanced. Dr. Kudler: e biggest challenge I am facing is to accomplish a growing list of objectives, large and small, with limited human and financial resources. My team receives EHR enhancement re- quests on a daily basis and, in spite of a sharp and talented 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 deliv- ery system, we have a multitude of large scale projects, all of which are needed and have significant risk. Examples include transition- ing to an enterprise EMR (replac- ing more than three dozen legacy applications); upgrading and implementing applications to sup- port meaningful use; selection and implementation of clinical inte- gration network/ACO solutions; a data warehousing initiative includ- ing master data management; and additional reporting for multiple enterprise initiatives. Our biggest challenges with exist- ing products are shiing targets and quality of products. Examples of shiing targets include mean- ingful use, payment reform time- line and ICD-10 timeline. As for the quality of the vendor products, we experience challenges with usability, lacking functionality and "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 3 Three CMIOs on Their New and Changing Role

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