The CMIO Quick Start Guide is a series of posts on the role that the Chief Medical Information Officer (CMIO) plays within an organization. As the number of healthcare organizations pondering the addition of a CMIO to their staff increases, it’s vital that every organization understand the benefits of hiring a CMIO, what they’ll actually do once they’re hired, and how you can expect them to improve your operation. Over the next few weeks, we’ll cover these topic and how you should bring one on to your team to ensure mutual success. Stay tuned for a new post every Tuesday.
In this post, we’ll cover what a CMIO is, what that extra “M” in between the “C” and “IO” really means, a sample daily routine of a CMIO, their typical responsibilities, and the hard and soft skills needed to succeed in the CMIO role.
What is a CMIO?
A Chief Medical Information Officer (CMIO) is an executive position that manages the strategy and direction of health IT systems in a healthcare organization with a focus on clinical outcomes. A typical CMIO has clinical experience as a physician, a knack for leading and managing change, and an understanding of the many technical disciplines that affect a healthcare organization’s clinical and IT systems. You’ll often find them acting as a liaison between the physicians and providers in the organization and the information technology staff.
CMIO vs. CIO
Despite similar sounding titles, a CMIO is not the same thing as a Chief Information Officer (CIO). They do have many similar responsibilities in terms of overall strategic direction of the organization, although they have significantly different focuses.
In particular, the CIO focuses primarily on the technical aspects of the systems the organization is using (think IT architecture, databases, software update roll-outs, etc.) while the CMIO focuses primarily on the clinical aspects of the systems the organization is using (think clinical adoption, integration into clinical workflows, clinical decision making, how IT systems impact patient safety & quality of care, etc.). Both positions need a base of understanding in the other’s position to work together, which is why the CMIO comes from a clinical background with training in technical disciplines while the CIO comes from technical disciplines and sometimes has nursing or clinical training or has learned about healthcare through “trial by fire”.
What Does a CMIO Do?
A CMIO typically comes into an organization that already has a CIO running the day-to-day and long-term aspects of the organization’s clinical IT systems. From what we’ve seen, the organization that brings on a CMIO usually has a good IT staff in place, but the physicians and clinical staff have a difficult time trying to get their issues heard by IT management. Meanwhile IT management can’t understand why the physicians are complaining, since the systems are installed and working up to spec.
Us technical folk often get wrapped up in things like bandwidth, normalized databases, back-end integration, front-end plugins, and the list goes on and on. Not many computer science major have studied clinical workflows or know how it feels to be paged just after getting to sleep while on-call and then having to be on your game like someone’s life depends on it.
As for the clinical folks, improving patient safety, providing quality care, and the satisfaction that comes with knowing you helped someone are major benefits of the job. Oftentimes the technical folks view the physicians as the lucky ones with high salaries, high prestige, and high levels of education who get to feel like their work actually makes a difference. What they don’t understand is that while the tech people go home at five, the physicians stay in the office, dealing with entering data into the EHRs, managing patients and billing, making calls to insurance companies, and managing the grudge work, all while hoping they’re not slapped with a malpractice suit. Unfortunately this is something that goes unnoticed by most non-providers in an organization.
Can you see where the communication and understanding between the two groups may break down??
Enter the CMIO.
A CMIO oftentimes serves as a bit of a therapist between these two groups. They improve the well-being of the physicians by addressing their complaints about the systems that require large amounts of their time. At the same time they collaborate with IT and develop mutually beneficial solutions to improve the concerns that IT notices but isn’t sure how to address.
Besides A Human Bridge, What Else Does a CMIO Do?
In addition to therapist and connector, the CMIO is a strategic planner, a manager of clinical champions, a clinical workflow engineer, a provider of clarity for governance and decision making, a customer advocate, and a creative and resourceful problem solver. They fill a critical gap in the healthcare organization’s executive offices.
Strategic thinking and long-term planning play a part in most of the day to day actions of a CMIO. Organizational values must be met and vetted in every new hire and continue to be displayed in everyday activities. Should they not, a CMIO may be responsible for letting those who do not fit those values find a position in a different organization that will take them (i.e fire them). The physicians and personnel that do display the values the organization is looking for and have an interest in improving the clinical IT systems often become the clinical champions of the organization and bring forth issues expressed by their colleagues and promote the solutions developed by the CMIO, the clinical champions, and the IT staff.
Items that need decisions may be presented to the CMIO and other executive or decision-making staff. The CMIO may provide inputs and thoughts, and may make any decisions required or assign action items as needed. If the action is significant to the future of the organization, the CMIO may take and present the item to the CEO or to the board for review and a vote.
This is just a broad description of some of the primary responsibilities of the CMIO. Other responsibilities may include analyzing, purchasing, and implementing clinical IT systems, building culture of the department and organization over time, managing customers, establishing governance, and other duties as needed.
An Example of a CMIO’s Daily Schedule
8:00-8:20 AM: Daily executive scrum meeting
8:20 – 9:00 AM: Check and reply to email
9:00 – 9:30 AM: Meeting with a disgruntled member of the pathology department having issues with recent EHR update
9:30 – 10:00 AM: Review change management request for new feature to be added to the point-of-care system
10:00 – 11:00 AM: Reread notes and type minutes from yesterday’s strategic planning meeting
11:00 – 12:00 PM: Reply to emails and check on status of ongoing projects
12:00 – 1:00 PM: Lunch
1:00 – 2:00 PM: Brainstorming session with CIO on possible solutions to lab software workflow issues
2:00 – 3:00 PM: Meeting with anesthesia department chair to see how they’re doing with the recent EHR update
4:00 – 6:00 PM: Develop the change management plan for the migration from ICD-9 to ICD-10
What Credentials are Most Requested?
- An M.D from an accredited medical school
- Board certification in at least one discipline. Board certification in Clinical Informatics a plus.
- Technical knowledge of IT systems such as architecture, databases, programming, security, networks, data exchange, etc.
- Principles of project management
- Quality improvement and workflow re-engineering
- An ability to commiserate with the agony physicians feel about their clinical IT systems and a keen aptness to resolve their problems and put them at ease
- A strategic mindset, an ability to get that strategy down on paper and distributed to the organization, and the follow-through to translate that strategy into actionable tactics to move the organization towards its goals
- Understand how the IT systems customers use affect their workflow, well-being, and their ability to make decisions
- Technical knowledge and understanding of the IT systems used within an organization
- An ability to lead and manage change associated with large projects, new and updated systems, and organizational change
- Take constantly evolving healthcare IT industry concepts and apply them into management of the organization
- Oversee the implementation of new projects and systems with budgets often into the millions of dollars
- Develop governance structures that ensure continuity and uniformity between departments’ systems
- Re-engineer clinical workflows and processes, as well as business and IT processes where needed
- Always keep the customer in mind, whether those customers are patients, providers, board members, or other stakeholders
TL;DR: A CMIO is both a tech nerd and clinical champion that ensures that all parties are working together and represented when the big clinical IT decisions have to be made.
Hopefully this post answers many of your questions regarding what a CMIO is and what they actually do. If you have any questions or comments, feel free to leave them below or sent it our way via social media or email.