CMIO Magazine interview with Dr. Powell – Miami Children’s Hospital

CMIO Magazine: How has the CMIO role evolved for you?

Dr. Powell: I have been a CMIO for a short time at my organization and all is going well, with good facility wide support.  While new to my current role, I’ve been preparing for the CMIO role for some time. Informatics has been a priority for me during Medical & Bio-Medical Engineering training, practice, and previous IT roles.  Following training, my career started in anesthesia where I functioned as the department’s CMIO.  I was also the champion behind our electronic applications and implementations.  Finally, in June of 2010, I accepted the CMIO role at Children’s in Miami. 

CMIO Magazine:  How would you categorize your current roles and responsibilities?

Dr. Powell: Given the nature of our hospital with our current state, I am in the midst of pre-implementation of our CPOE system.  My current role includes involvement with the implementation of the upcoming EMR, developing an advocacy role with the physicians, nursing, and ancillary staff end users.  I am assisting with the pre-implementation strategy by translating requirements from the clinical to the IT staff.  I am also modeling the ideal clinical practice, which is our future model to ensure sustainability and scalability.  I am also assessing our IT department, including our infrastructure to provide feedback to our CIO.  We need to make sure the foundation is sound for our future plans.  I am also working closely with our clinical community, especially the physicians, to re-gain their trust in the IT department.  I work closely with some of the vendors, especially those that relate to the clinical practice. Overall, I consider myself a visionary and I typically think of technology as an enabler, although sometimes it’s not the answer.

CMIO Magazine:  Who do you report to?

Dr. Powell: I report to the CIO with a dotted line to the CMO

CMIO Magazine:  What would you describe as key factors for success in your role? 

Dr. Powell: The organization recognizes that this is an important and valuable role which is a great starting point for success.  Having a seat at the executive level enables me to give issues the proper attention as they arise.  I get tremendous support from the leadership team and that’s very rewarding. 

We recognized early on that we needed structure to be effective and successful.  We also knew that our organization wasn’t quite ready for CPOE at the beginning and, thus, the organization decided to hire a CMIO [me] to begin the education process and to prepare the organization ready for the culture change [CPOE] we were about to experience. 

It is very helpful that our CEO is a physician and it provides another layer of reassurance that we have the right leadership to make our initiatives a success.

CMIO Magazine: from a CPOE perspective, do you see a value behind it?

Dr. Powell: CPOE has many clinical benefits. It can minimize inefficient variability of physician practice; it can reduce  the omission of important clinical behavior from the orders, it reduces the errors of transcription, and allows for decision support to be provided to the prescriber.  With proper implementation of CPOE (i.e. with ordersets) we’re empowering the physicians to practice more safely by ordering more accurately and completely.  That being said, I don’t believe we have adequately communicated to end users the full value of CPOE and interdisciplinary care planning. Until we’re able to consistently communicate meaningful measures of CPOE success to our clinicians (such as safety, efficiency, and reduced cost) we will have to fight to justify the process to our providers.  So benchmarking for CPOE is critical.

CMIO Magazine: Any closing remarks?

Dr. Powell:  As I indicated, CPOE systems are not perfect but are far better than what we have had in the past.  In our organization we are just implementing our EMR and can’t comment on the impact of that EMR on disease management and evidence based medicine. We are attempting to design our EMR in advance with those principals and goals in mind.  I am very excited about my role and what I have to offer our organization and patient community.