At first glance, today's healthcare IT titles seem like a game of Scrabble gone haywire: CIO, CMO, CMIO. At a panel discussion at HIMSS Summit of the Southeast in Nashville, Oct. 12, professionals representing all three job descriptions discussed the changing landscape.
"There's greater success when the roles are clearly defined," said Kent Petty, system vice president and CIO at Wellmont Health System in Kingsport, Tenn. "A CIO should get to pick the hardware and deal with security and warranty issues. A CMIO should have a say on speed and functionality." That leaves the CMO, who is now chiefly a policymaker dealing with issues like physician employment and how to successfully implement an Accountable Care Organization (ACO).
Most organizations are arranged this way, with the CMIO reporting to the CMO, while the CIO reports directly to the COO (or in some cases, the CFO).
"Regardless of titles, it's important to present a unified front," said Steven Heilman, CMIO at Norton Healthcare in Louisville, Ky. "Sometimes the CIO doesn't want to be the point person for CPOE or physician documentation, so it's important to take a team approach."
Petty added that physicians trust a team that balances clinical expertise and vendor management. "When my CMIO sits in the room with me, there's most trust," he said. "It eliminates the impression that projects are being pushed solely by IT.
" Everyone on the IT team must be masterful at managing expectations and achieving consensus. "People keep telling doctors that computers can do everything," said Randy Davis, vice president and CIO at Northcrest Medical Center in Springfield, Tenn. "Then I have to break the bad news that we can't do what they want because of security issues."
"One of my main jobs is to break down silos," said Dana Zanone, CMIO at High Point Regional Hospital in High Point, N.C. "We're in the middle of a CPOE implementation, so I've made sure that a physician, nurse and pharmacist are on every workflow committee. And I meet each week with our inpatient CMO and outpatient CMO." Davis also works hard to involve his entire care team. "We've made transparency a top priority," he said. "We've discovered that a nurse manager, pharmacist or clinical documentation specialist can take care of an alert without it ever reaching a physician."
Petty added that strong governance can help prevent turf wars between the CIO, CMO and CMIO. "We have a physician technology committee that deals with productivity issues and a meaningful use committee that focuses on security," he said. "If their needs conflict, our quality committee plays the referee role. That's one less headache for our board of trustees."
