CMIO Interview with Dr. Schlossberg

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

Dr. Schlossberg:  Like many physicians who became involved with Healthcare IT in the 1990’s, my role has evolved considerably. I started as a practicing Urologist who became involved in medical staff affairs. This evolved to health system activities. By 1998, I became the first “Medical Director, Information Technology” at my organization. At that stage, I got to work on a variety of clinical IT projects including, but not limited to, physician portal, help desk operations/ improvements and, ultimately, bridging the gap between IT and Non-IT teams. Since I was involved early in the evolution of the “CMIO role”, I have been able to learn through experience and built on this with an MBA. In 2005, with the purchase of a new Enterprise EHR at my prior health system, my role expanded and I became the “CMIO” (Vice President, Medical Informatics).  Throughout my career, I have always maintained at least a 20% clinical practice.

About year and half ago in 2010, I joined Yale School of Medicine and Yale New Haven Health System as the joint CMIO for both entities.   As this is a large diverse organization, we have 4 other physicians with greater that 50% time devoted to IT. Even though the other MDs report to me, we, work as a team using a highly collaborative and effective approach to drive the clinical system implementation.

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

Dr. Schlossberg: Given the nature of our hospital and the current state of our clinical system implementation, we are in the midst of implementing a large EHR with all the modules including revenue cycle. In the process, we are sun-setting three different hospital systems and consolidating into one platform. At my current role, being involved with the implementation of the upcoming EMR and developing a partnership with the physicians, nursing, and ancillary staff end users is a major responsibility that I take seriously. As in many large projects, I have a close working relationship with our project team and IT leadership.

I am also assessing our IT department, including infrastructure, to provide feedback to the CIO and leadership alike; we ultimately need to ensure that our end users have the best experience possible.  This includes assisting with the Help Desk operations improvements.  As we all know, providers need to maximize their time on the floor as they provide care for our patients so anything IT can do to support this goal such as ensuring the Help Desk can provide timely and effective support, is key to our success.

As the project has evolved, I have been asked to assume responsibility for the deployment of the “EMR” Ambulatory roll out.  Early on, I was also asked to help develop a strategy to build a reliable and accurate data warehouse. Some other areas that fall under my domain of responsibility are web services and mobile applications for the EHR. More and more as I talk to colleagues, I think this is more common to see as the CMIO role has evolved.

CMIO Magazine:  Who do you report to?

Dr. Schlossberg: I have direct line of reporting to the Corporate CIO and the Deputy Dean of the School of Medicine.

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

Dr. Schlossberg: The organization recognizes that this is an important and valuable role which is a great starting point for success.   I get tremendous support from the leadership team, especially the CIO and the project leadership. We recognized early on that we needed to develop a team of MDs within IT to be successful.   Having the ability to work with multiple Medical Directors of IT enables all of us to be more successful. There is too much work for just one person.Successful planning, effective team building and leadership support allows us to “skate to where the puck is going to be”.

CMIO Magazine: If the CIO is clinical, is there a need for a CMIO?

Dr. Schlossberg: The short answer is Yes.  Even with a “clinical” CIO, an organization needs a CMIO or similar role to be the liaison between the clinical community and IT.  While the CIO does that to some degree, a typical CIO has so many other administrative duties that it would be challenging to focus on clinical IT related matters.

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

Dr. Schlossberg:  The name CPOE is not my favorite; I prefer to call it order management.  CPOE is valuable but does not go far enough by itself. Health systems need to end up with an electronic chart. For physicians, we need to make sure they are doing what they are uniquely qualified to do as we ask them to document in the record. The next steps are to build on the systems to provide valuable real time reporting about patients and decision support at the point of care.