Q: How did the CMIO role evolve for you?
Dr. Schneider: My career followed a slightly different path than most. After finishing college in the 70s, I ended up in Business School rather than Medical School as originally planned. I worked for about fifteen years in accounting, finance, and manufacturing. My last position was as a General Manger of a “paperless” manufacturing company. There I had extensive exposure to paperless workflows where engineers exchanged files and shared data electronically. When the company was sold, I decided it was finally time to go to medical school. My first rotation as a student in a hospital was a complete step back. We used paper forms for everything. I became a doctor with an eye for technical innovations in HealthCare IT. I wanted to combine my business experience with my clinical expertise to make a positive impact on patient care while improving the work environment for my colleagues. These endeavors lead me to do some healthcare IT consultancy work with a small personal health record company before I accepted my first official CMIO role at a pediatric hospital in Dallas. After 4 years, I accepted my current CMIO role at Baylor Healthcare System in Dallas.
Q: How would you categorize your roles and responsibilities?
Dr. Schneider: I consider myself as Chief Clinical Information Officer. I like to represent all clinicians whether they be physicians, residents, nurses, pharmacy or other staff. We’re all in it together and IT solutions impact not just the physicians but all the constituents providing care for our patients. Part of my role is being a “thought facilitator”, i.e., allowing clinical teams to work together, design systems and make good decisions. My role is to make sure that our EHR governance is working and that good decisions are being formed in the best interests of our patients. Another role is around timely communication with senior leadership.
Q: Describe an average day for you?
Dr. Schneider: Aside from the day to day issues of EHR decisions, I currently spend a significant amount of my time looking working on tactical and strategic planning around implementing our clinical systems in reference to the new stimulus package. I also am involved with vendor selection for our ambulatory practices. I support our new EHR governance structure to help ensure that good decisions are being made at the right time. I also put out fires when necessary and try to ask the right questions to cultivate good answers from our teams.
Q: Is there an opportunity for a CMIO if the CIO has a clinical background?
Dr. Schneider: It depends. If an organization has a strong CIO with a good clinical background and he/she surrounds themselves with strong physician champions who can own the process and assist on an on-going basis, then maybe a formal CMIO role isn’t needed. Although when an organization has a CMIO, it sends a message that they have identified an individual to be the point person and responsible to be the voice for the physician and clinical community. I see tremendous value in having a CMIO.
Q: Do you see a value behind a CPOE system? What are the obstacles?
Dr. Schneider: In the informatics world, we know that it’s not CPOE that brings quality – it’s the use of good decision support at the point of care and workflow, easy-to-use physician documentation, workflow-friendly order sets, customizable viewers, meaningful actionable alerts, etc. I’m very concerned that by just saying CPOE we won’t get all the other things that are needed. There are tremendous obstacles, but one – physician readiness – is declining steadily. Give them good systems to work with and they will use them.
Q: We would like to get your last closing remarks.
Dr. Schneider: There is tremendous value in getting clinical practitioners involved from the very beginning of any clinical IT solution. The practitioners need to own the solution and IT needs to support them and the solution. Otherwise, there will be lots of re-working after the implementation. Rework is very expensive and is disruptive. We need to be more patient focused in arriving at design decisions. We need to challenge vendors to make sure they share the same vision.