Need for Chief Medical Information Officers Grows

As quality of care gains strategic significance within healthcare organizations, so does the need for a chief medical information officer (CMIO), according to preliminary results of an annual survey of physician informatics specialists.

“We are entering an era of really hard stuff. And to us the really hard stuff is where we are leveraging clinical data, where we are taking the blinders off what is a real and substantial variance in care and a substantial variance from best practice,” said Vi Shaffer, healthcare research vice president and global agenda manager for consulting firm Gartner (Stamford, Conn.).

During such a time, a high-level physician with informatics training and leadership skills becomes increasingly valuable, Shaffer said last week at the Physician-Computer Connection Symposium in Ojai, Calif., the annual meeting of the Association of Medical Directors of Information Systems (AMDIS), as she unveiled preliminary results of Gartner’s fourth-annual survey of CMIOs.

“This is a global era shift,” Shaffer said. “The computer-based patient record train has left the station because of the consolidation of many hospitals into integrated delivery systems.” Implementation is well underway, and is moving into physician practices.

“One of the most important roles that the CMIO plays is helping in managing and mitigating the challenges of IT governance,” Shaffer explained. This is particularly important in understanding and explaining the business value of IT and in aligning corporate structure and governance with IT strategy and governance.

Among the 47 CMIOs surveyed as of last week, 89 percent are in their first CMIO position, though 82 percent have had prior administrative responsibility. “It’s a very well-educated group,” Shaffer said. Almost three in five have master’s degrees — typically MBAs or master’s of medical management — in addition to their medical degrees, and 7 percent have Ph.D.s.

Twenty percent of respondents have been with their current organizations more than 10 years, though Shaffer sees a downward trajectory. “We’re going to keep seeing these trends of a significant percentage of CMIOs in their positions for a fairly short period of time because of the growth in the number of CMIOs out there,” she said.

Meanwhile, roles have changed for those who have been in place for a long time. “The CMIO now is taking responsibility for the life-cycle management of the content that goes into the system,” Shaffer said. This includes building and maintenance of order sets, clinical decision support, and collaboration and coordination of hospital departments in the area of evidence-based medicine.

The evolution includes how CMIOs perceive themselves. “CMIOs now believe that strong leadership skills are as important” as clinical and technical skills, Shaffer indicated. Change management skills are lacking but desirable.

Still, most would not go back to full-time practice of medicine. “CMIOs continue to feel very satisfied in their roles,” Shaffer said. They feel the “delight” of helping in the transformation of an organization, and 77 percent want to be CMIOs for the long term, even though one in six would like to do the job elsewhere. 

The majority of survey respondents report to the chief information officer, while only 20 percent work for the chief medical officer. Even fewer are direct reports to the chief executive or chief operating officer, yet 45 percent of CMIOs believe they should report to the very top of the organization.

“Direct report to the CIO is a wedge of separation from the medical staff,” Shaffer said.

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