Complex organizations like hospitals have no experience with CMIOs and don’t know where to place them on their organizational charts. They generally dangle somewhere as an isolated drop down box with weak relationships with a variety of vice-presidents.
The C Suite does not have any previous experience working with CMIOs and they do not fully understand their role or what the CMIO can achieve for their organization. They get tagged as “champions” that apparently are felt to be critical for successful implementation of any HealthCare informational technology project that impacts physicians and their adoption to such systems.
They typically chair newly created hospital IT and Operations based committees tasked with developing clinical content within their electronic applications and educating physicians about how informational systems will change their future workflow.
Examples include P&T (pharmacy and therapeutics), patient safety committees, and quality assurance committees. CMIOs have important roles to play in their health care organizations but the organization have not properly defined them with the appropriate power and authority.
There are blog sites for medical informatics officers that document their frustration within health care organizations because of their lack of budgetary authority, and their perception of being an “internal consultant without executive presence.”
In their blogs, they describe themselves as “directors of nothing,” and speculate that health care executives are biased against physicians holding leadership roles. As such, they can feel impotent, frustrated, and ineffective as change agents.
I am of the opinion that CMIOs should be an integral part of senior management and corporate governance and are destined to play a critical role as physician executives. They should be given authority to make decisions along side with the CIO. They are in a unique position to effectuate improved safety and quality of clinical IT initiatives.
The case for CMIO as senior leader
Physician leadership is a critical success factor for health information technology initiatives, but best practices for structuring the role and skills required for such leadership remain undefined.
Hospitals would improve drastically if they would just adopt the discipline that is embedded in electronic order entry packages into their paper world. The CMIO should champion standardization, which will alleviate confusion and promote physician adoption.
Many hospitals historically used legacy electronic order management systems. Unit secretaries have been guessing at what doctors want, and then translating their orders into an electronic order.
More and more hospitals are beginning to adopt the CMIO model. There are more CMIO job posting in 2008 that in previous years. This is a good sign.