CMIO Magazine: How has the CMIO role evolved for you?
Dr. Newman: I do not have any formal IT training, but have always considered myself a Geek when it came to technology. As a chief resident at Boston Medical Center in 2003,I worked on a project developing a educational and administrative website for our residents. As a junior attending in 2004 I began an research project that involved engaging with Information Technology at Boston Medical Center. . As a result of that project, right around 2004, I was named the physician consultant to work on our Ambulatory EHR. I developed and implemented standardized clinical documentation forms across the medical center’s outpatient clinics. I should note that as each year went by, I devoted 10% more of my time to IT and informatics. In 2007, I became a manager within IT focused on our Knowledge Management Services and, finally, I accepted the CMIO role in 2009. After much research, we developed our own job description for the CMIO poisition expanding my focus from being predominately ambulatory to the entire hospital.
CMIO Magazine: How would you categorize your current roles and responsibilities?
Dr. Newman: I view my role as focused on two major areas: Clinical Informatics and Academics. On the clinical informatics side, I am the key liaison between IT and the providers. I assist with educating the clinical staff around EHR’s capabilities and reinforcing that this is a tool where we have an opportunity to deploy best practices for optimal patient experience. I also help with developing strategic goals for IT, providing direction, and prioritizing clinical initiatives. I am heavily involved with our overall governance structure and ensuring adequate provider input for our projects . It is very important that the clinical systems usage be driven by operations and not viewed as simply “IT projects”. As a result, I work closely with our CMO and CQO on patient safety and quality projects and making sure IT is empowered to support operations. On the academic side, I work closely with our residents that have an interest in informatics. I provide them with opportunities and projects to enable them to grow within the organization. I also work on various grants and 20% of my time is still spent providing care to patients. I should mention that the transition can be a challenge and it can take months before one can feel balanced in both the CMIO and practicing physician roles.
CMIO Magazine: Who do you report to?
Dr. Newman: I report directly to the CIO and have working relationships with our CMO and CQO.
CMIO Magazine: What would you describe as key factors for success in your role?
Dr. Newman: There are few factors that have made my role a success at Boston Medical Center and they are not in any particular order: Being a practicing physician is essential to my credibility with other providers, allowing me to have in depth discussions with end users as well as assisting and solving design and workflow issues. I have a very supportive management team including our CIO. My technical background has been an asset to be able to communicate to IT, solve problems, and contribute tremendously toward the design or our clinical systems. Assisting with developing and enhancing our governance structures and making sure clinical projects are not perceived as IT projects have contributed to my success. In addition, I am also currently pursuing my MBA.
CMIO Magazine: If the CIO is clinical, is there a need for a CMIO?
Dr. Newman: Yes – I view these roles as differing in focus, one more clinical and the other more business oriented, and having one individual responsible for both can be overwhelming. I believe these roles need to work side by side and a true partnership needs to be formed.
CMIO Magazine: from a CPOE perspective, do you see a value behind it?
Dr. Newman: We have been using CPOE since 2001, and for the past 9 years, I have seen tremendous value in using this. One of the obvious ones is the ability to have access to patient charts throughout the hospital and even remotely so providers can access essential patient data in a quick and timely manner. We’ve developed our own order-sets and clinical pathways to make it easier for physicians to enter orders, expedite workflows and improve outcomes. It is important to recognize that focused clinical decision support and provider engagement and collaboration among all disciplines are critical to a successful CPOE implementation.
CMIO Magazine: Any closing remarks?
Dr. Newman: The CMIO role is a great position and I have certainly enjoyed the opportunity. I believe anyone in this position needs to develop a thick skin and set realistic expectations with clinicians. As I mentioned earlier, if one is also a practicing provider, the transition from scaling back seeing patients and transforming into the CMIO role can take time. It is important to remember that medicine is changing quite rapidly politically, financially and clinically and IT has the power to contribute to and be the enabler to support these changes. However, because IT clinical systems are a very obvious and tangible part of the changing landscape of medicine, they are often blamed as the cause of and not seen as the product of these changes. Learning to listen to clinicians’ frustrations and weed out the true IT issues from anger and frustration at larger policy issues in medicine is key to being successful in this role.