The Role of the CMIO

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The chief medical informatics officer (CMIO) (also chief medical information pfficer) is a person with a both a clinical and an informatics background. The CMIO manages clinicians and makes sure they are fully engaged in the electronic medical record, and issues of quality, safety, and usability.

Job description

The potential scope of the CMIO position can vary extremely depending on the organization and its structure. The following are some of the most common job responsibilities.

Strategic planning

  • Developing strategic plans regarding clinical systems and information management
  • Alignment of clinical system capbilities with organizational needs
  • IT Governance
  • Ensure that developments are in line with global trends in medicine, informatics and information technology

Systems development & implementation

  • Clinical systems portfolio management
  • Systems selection or design
  • Demand management - manage requests and expectations of clinical users
  • Risk management - use informatics to support the reduction of risk in clinical operations whilst minimizing additional risk arising from IT systems
  • Workflow integraton - work closely with users so that the clinical and organizational needs can continue to be met in a manner that closely integrates with clinical workflow and enhances effectiveness and efficiency of clinical staff
  • Architectures and frameworks - work closely with IT on architectures and frameworks to maximize the effectiveness and longevity of development work
  • Policies and standards – develop, maintain and enforce information standards and policies to support the above.

Stakeholder engagement

  • Engage stakeholders (clinical leaders and frontline, executive management, IT, patients) through a clinical systems governance process to ensure strategic and tactical alignment of clinical systems with clinical and organizational needs
  • Change management - develop change management strategies to allow successful implementation of policies or initiatives that require informatics support.

Capacity building

  • Build up internal informatics capabilities in the informatics team, clinicians, management and IT department
  • eHealth advocacy - broader advocacy to build up wider support for informatics at the local, regional or national levels

What an effective CMIO needs

The portfolio of a CMIO is a complex and wide-ranging one, but often they are not given the resources nor authority to execute effectively. This section will attempt to flesh out what an effective CMIO needs (thanks to Larry Ozeran for the initial points from the cis-wg mailing list)

The CMIO must be in charge of

  • ongoing communication with all clinicians regarding the effectiveness of existing computerized processes
  • prospective discussion with all affected clinicians and any affected support staff in the selection and implementation of proposed computerized processes
  • managing needs and specifications for software
  • developing and maintaining information standards
  • identification of need, selection of staff, and responsibility for content of all training related to computerized clinical processes

The CMIO must have

  • adequate numbers of support staff as direct reports to manage all responsibilities
  • decision-making control over a budget adequate to support all responsibilities
  • the ability to ensure the needs and specifications are implemented properly, and in accordance to standards set by the CMIO's office

This page has been put up as a result of a discussion at AMIA's cis-wg mailing list.


Healthcare Informatics Issue Date: February 2008

AS I.T. AND CLINICAL CONTINUE TO BLEND, THE ROLE OF CMIO WILL GROW

Sitting at the nexus of healthcare and I.T., CMIOs are in a unique position to ensure both sides of the aisle are on the same page

by Mark Hagland


INTRODUCTION

Utilizing interviews, annual surveys and reports, this article explores the changing role of the chief medical information officer (CMIO). Several points are addressed, including the increasing need for CMIOs as hospitals and health systems implement information systems (IS), the current role and work of the CMIO and the predicted role of the CMIO over the next several years.

DISCUSSION

The need for physicians with clinical experience combined with informatics understanding is becoming clearer and is essential to organizational success. As patient care organizations go electronic, their information systems become the core operational technologies (OT) that make the business run. Knowledge of the clinical process is a crucial component for the successful function of the information technology (IT) systems.

Previously, those who were good at technology could fill the CMIO role simply by being physician champions and encouraging colleagues to adopt changes. That role is rapidly evolving to include knowledge of the business reasons for technology adoption.

Project management and business skills are necessary to support medical care delivery through technology adoption. CMIOs need to be business people and not just “advocates of the medical staff.” A strong knowledge of informatics is necessary.

A survey of current CMIOs reveals their duties to include the building of order sets, the management of clinical content and IS design. An example provided is “the building of order sets to support CPOE. Not only is that set of tasks essential and doable only by clinicians, it also requires an understanding of workflow, data flow, and information flow that only CMIOs can lead the process of determining.”

The future role of the CMIO is solid, expressed those interviewed. New technologies and initiatives will keep the CMIO in demand even after initial implementations have been completed. The CMIO will also become more a part of the clinical team, reporting to the chief medical officer (CMO), rather than staying with the IT team and connecting with the chief information officer (CIO). Concern was raised that progress will be uneven between large healthcare organizations, such as multi-hospital systems and academic institutions, and smaller community hospitals. Smaller facilities often cannot afford or acquire the time and expertise of a CMIO.

SUMMARY

The role of the CMIO has changed from being a medical staff advocate to being a business person with combined clinical experience and informatics expertise. As core technologies become the a priori means of healthcare delivery, the CMIO is a critical component for successful IT implementation and use in the clinical arena. CMIOs are, and will continue to be, in great demand although there is concern they may not be well represented in community hospital settings. In the future, the role of the CMIO will evolve and grow along with changing healthcare technologies, and will persist long after implementations have been completed.

Submitted by Sheri King