What does it mean to be a CMIO/CHIO?
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What does it mean to be a CMIO/CHIO?
Sameer Badlani, MD, FACPChief Health Information Officer
Intermountain Healthcare
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Conflicts of Interests
Consulting Engagements: EXL, IMN, GLG
Honorariums: iHT2, Carnegie Mellon University, Hospital Quality Forum, Weiss Hospital
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Objectives
Origins of the CMIO role
Typical job responsibilities and challenges
Evolution of the Role
Challenges and Opportunities
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Brief Bio
M.B.B.S. Delhi University 1992-1998
Fellow/M.S. University of Utah 2001-2003 (Capstone pending)
Chief Resident/ Resident Internal Medicine, University of Oklahoma - Tulsa 2003-2006
Assistant Professor, Hospital Medicine, Department of Medicine, University of Chicago, 2006-2004
Associate CMIO, University of Chicago Medicine, 2010-2011
CMIO, University of Chicago Medicine, 2001-2014
CHIO, Intermountain Healthcare, 2014 –
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What is Informatics?
Biomedical informatics (BMI) is the interdisciplinary field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving, and decision making, motivated by efforts to improve human health. (www.amia.org)
Health informatics is the science that underlies the academic investigation and practical application of computing and communications technology to healthcare, health education and biomedical research. (http://www.medicine.virginia.edu)
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What is Informatics – to me?
Clinical informatics is the field where we attempt to apply principles of information technology, human interface and usability, psychology, change management to the intersection between providers, IT systems and patients in the process of care delivery…
…with the aim of reducing cost, improving efficiency and most importantly clinical outcomes.
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• Major focus on the subject domain (in this case, biomedicine) and the unique challenges that arise at the intersection of people, information, and technology
People/Communication
Information Technology
Informatics
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Origins of the CMIO role
- Originally a physician champion role given to a likeable physician to bring along the not so likeable physicians in an IT implementation
- Formal CMIO titles started becoming common in 2002 but probably dates back to 1992
- Tremendous growth and evolution post the HITECH act of 2008
- According to Simplyhired.com, positions for clinical informatics jobs increased 91% from March 2008 to September 2009.
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Somewhat Interesting trivia
• 65% still practice medicine (down from 71% in 2005)
• 78% have some previous administrative or management experience
• Medical specialty >> Surgical specialty• 67% want to remain CMIOs and not become CMOs
or CIOs• In 2014 pay increased but satisfaction with job
decreased• In 2005 clinical credibility was paramount now its
leadership skills
Source:- Gartner AMDIS CMIO surveys
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Basic reporting structures
- Initially the CMIO role reported to the CIO- Significant trend to now report to the CMO ( reflects
in the change of mindset that the CMIO is an operational/clinical executive not an IT executive per se)
- In 2014 39% reported to CMO and CIO each, only 4% wanted to report to CIO
- Dual reporting relationships are common- Few report directly to CEO
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Common Current portfolio Items
• Tactical problem solver• EMR implementation and optimization• MU 1 and 2• PQRS• VBP – in collaboration with CQO• Optimizing CDS – read pop up alerts
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Attributes
• Clinical credibility• Communication Skills• Patience• Team player• Leadership• Sense of humor
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Challenges
Resources
Institutional mandate
Federal mandates
Balancing tactical and the strategic
Volume to value based care
The cheerleader paradox
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The evolution begins…
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CMIO 2.0 / CHIO
• Key member of the strategic leadership for the enterprise
• Driver of quality and safety improvement with the CQO
• Work closely with CFO around strategy and tactics for the journey to value based model
• Shift focus from technology to strategic physician leadership
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CMIO 2.0 / CHIO
• Leading change through people, process and how we use information rather than new technology and its implementation
• Reducing fragmentation of informatics resources working in silos
• Career path rather than seasonal job• Data – Knowledge – Intelligence• Practice based evidence
Source:- From the playing field to the press box; maestrostrategies.com
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So much technology so little time…
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Source:- Gartner 2014 Healthcare Hype cycle
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Technology and innovations that excite me
Complex event processing, or CEP, is event processing that combines data from multiple sources to infer events or patterns that suggest more complicated circumstances. The goal of complex event processing is to identify meaningful events and respond to them as quickly as possible.
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Service Oriented Architecture and Complex Event Processor
HL7 Events
RuleAuthoring
Complex Event Processing
Messaging
BPM & SOA
VisualAnalytics
Real-timeDashboards
EDA
PredictiveAnalytics
Real time / low latency Data oriented
TIBCO EMS
TIBCO ActiveSpaces
TIBCO BusinessWorks
TIBCO BusinessEvents
TIBCO BE Decision Manager
TIBCO BE ViewsTIBCO RTVIew
TIBCO Spotfire
TIBCO Spotfire R and S+
EHR
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eCART Proof of Concept
None8%
Proactive rounding
25%
Automatic RRT67%
Median 30 hrs prior to arrest
Median 42 hrs prior to arrest
n=12 arrests
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Other things I do
• Associate Editor for the online journal of applied clinical informatics
• Started a certificate course on clinical informatics at UCM
• Secretary on the board for AMDIS• Advise start ups• Learn/read from other industries• Go home on time
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Notes from my journey
• This is my dream job• Focus on the journey not the destination• Keep the long game in mind• Anger is a wasted emotion• Most physicians were not hugged enough as kids• Keep it personal• The patient is why you do this
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The why for me
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The why for me
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Questions - ??
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Resources
www.AMDIS.org
www.CHIME.org
www.gartner.com