The CMIO - A New Leader for Health Systems

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This is a review Jonathan Leviss, Richard Kremsdorf, and Mariam F. Mohaideen's (2006) article, The CMIO - A New Leader for Health Systems [1]


First Review

Summary

Physician leadership of health care information technology projects has been identified as a key requirement for success. [1] The authors did a study to identify and evaluate the skills and experiences needed to be an effective Chief Medical Information Officer (CMIO). Surely, CMIO is very essential in ensuring success of EHRs but there are other members of the team who are equally essential in ensuring success of EHR implementation and usage in an organization. MacDonald A and Riahi S wrote an article describing the success story of a EHR implementation in Ontario Shores hospital in Canada. That article is "EHR implementation: one organization's road to success"

Method

For the study, the authors conducted phone interviews with 5 CMIOs from 5 different health systems using a 15 item questionnaire survey. The 5 CMIOs were selected because of the achievements at their health systems.

Results

These are some of the skills / experiences of the CMIO's:

  • All five CMIOs advocated for Computerized Physician Order Entry (CPOE)
    • Set project expectations
    • Created CPOE implementation plans
    • Led communication efforts between physicians and nurses
    • Led the vendor selection process and directed training and go-live support
  • Involved with various committees
  • Had some kind of authority for change
  • Has influence on system's budget decisions
  • Had support staff (either directly or large groups who worked collaboratively)
  • Communicated clinical information systems initiatives
  • Dealt with failed information systems in the pass


Conclusion

"Through the common lessons learned from the interviews of these five CMIOs, the CMIO position's usefulness in an organization has been clarified and justified as the newest addition to health system Chief Officer positions".[1]

Comments

In order for a successful health system implementation, I agree with the author that strong leadership is crucial especially someone with a clinical background. A good CMIO should also be involved with the health system project and consult with their staff on what is best for everyone. For the most part, I agree with the authors. However, I think it would have been more beneficial if they had interviewed more CMIOs. Also, in regards to training, I do not think that the CMIOs need to direct training. Their support staff can be in charge of training end users.

Second review

Summary

Physician leadership and participation are proven to be critical and crucial contributing factors for successful electronic medical record (EMR)and electronic health record (EHR) implementations within the healthcare industry. One of the roles which has emerged and brought to new light physician collaboration is the role of the Chief Medical Information Officer (CMIO).

Method

For the study, five (5) physicians from five (5) different healthcare systems who at one point of their career held a CMIO position were interviewed. A fifteen (15) question survey was developed to assist the authors in focusing their interview questions to skills, professional experience, authority, and resources that may have influenced the interviewees to be successful as CMIOs.

Results

After the interviews were conducted, a set of skills and experiences were determined for CMIO candidates:

  • All interviewees agreed that CMIOs need to advocated for Computerized Physician Order Entry (CPOE) and to accomplish this, one must do the following:
    • Set project expectations
    • Set the communication plan for the project
    • Led the vendor selection process
    • Create and manage IT department with recruited physician champions
    • Facilitate communication between physicians and nurses
    • Participate in meetings
    • Develop training modules and assist with direct training and go-live support
  • All interviewees also agreed that the CMIOs should function as "consultants" by:
    • Chairing various IT committees
    • Be given direct authority to change policy and budget
    • Appointed support staff
  • Professional backgrounds (Board certified in their field of specialty, prior involvement in a clinical information technology project)
  • Possess executive leadership skills and experience
  • Negotiation and conflict resolution skills
  • Prior management training

Conclusion

Today the role of the CMIO is still evolving and coming together as the organizations implement more healthcare information technology projects. As there is no formal training to become a CMIO it would be beneficial for the industry to invest in programs that would assist physician leadership to continue to grow.

Comments

As healthcare initiatives continue to change with new CMS regulations evolving with Meaningful Use stage 3 requirements, I feel that the roles of the CMIO will not only be a critical factor in successful implementations but also prove to be beneficial post go-live. Their expertise and knowledge will allow the organizations to effectively and efficiently support their EMRs and EHRs and staff.

References

  1. 1.0 1.1 1.2 Leviss, J., Kremsdorf, R., Mohaideen, M.F. (2006). The CMIO - A new leader for health systems. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1561791/