What does it mean to be a CMIO/CHIO?

Sameer Badlani, MD, FACPChief Health Information Officer

Intermountain Healthcare

Conflicts of Interests

Consulting Engagements: EXL, IMN, GLG

Honorariums: iHT2, Carnegie Mellon University, Hospital Quality Forum, Weiss Hospital

Objectives

Origins of the CMIO role

Typical job responsibilities and challenges

Evolution of the Role

Challenges and Opportunities

Brief Bio

M.B.B.S. Delhi University 1992-1998

Fellow/M.S. University of Utah 2001-2003 (Capstone pending)

Chief Resident/ Resident Internal Medicine, University of Oklahoma - Tulsa 2003-2006

Assistant Professor, Hospital Medicine, Department of Medicine, University of Chicago, 2006-2004

Associate CMIO, University of Chicago Medicine, 2010-2011

CMIO, University of Chicago Medicine, 2001-2014

CHIO, Intermountain Healthcare, 2014 –

What is Informatics?

Biomedical informatics (BMI) is the interdisciplinary field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving, and decision making, motivated by efforts to improve human health. (www.amia.org)

Health informatics is the science that underlies the academic investigation and practical application of computing and communications technology to healthcare, health education and biomedical research. (http://www.medicine.virginia.edu)

What is Informatics – to me?

Clinical informatics is the field where we attempt to apply principles of information technology, human interface and usability, psychology, change management to the intersection between providers, IT systems and patients in the process of care delivery…

…with the aim of reducing cost, improving efficiency and most importantly clinical outcomes.

• Major focus on the subject domain (in this case, biomedicine) and the unique challenges that arise at the intersection of people, information, and technology

People/Communication

Information Technology

Informatics

Origins of the CMIO role

- Originally a physician champion role given to a likeable physician to bring along the not so likeable physicians in an IT implementation

- Formal CMIO titles started becoming common in 2002 but probably dates back to 1992

- Tremendous growth and evolution post the HITECH act of 2008

- According to Simplyhired.com, positions for clinical informatics jobs increased 91% from March 2008 to September 2009.

Somewhat Interesting trivia

• 65% still practice medicine (down from 71% in 2005)

• 78% have some previous administrative or management experience

• Medical specialty >> Surgical specialty• 67% want to remain CMIOs and not become CMOs

or CIOs• In 2014 pay increased but satisfaction with job

decreased• In 2005 clinical credibility was paramount now its

leadership skills

Source:- Gartner AMDIS CMIO surveys

Basic reporting structures

- Initially the CMIO role reported to the CIO- Significant trend to now report to the CMO ( reflects

in the change of mindset that the CMIO is an operational/clinical executive not an IT executive per se)

- In 2014 39% reported to CMO and CIO each, only 4% wanted to report to CIO

- Dual reporting relationships are common- Few report directly to CEO

Common Current portfolio Items

• Tactical problem solver• EMR implementation and optimization• MU 1 and 2• PQRS• VBP – in collaboration with CQO• Optimizing CDS – read pop up alerts

Attributes

• Clinical credibility• Communication Skills• Patience• Team player• Leadership• Sense of humor

Challenges

Resources

Institutional mandate

Federal mandates

Balancing tactical and the strategic

Volume to value based care

The cheerleader paradox

The evolution begins…

CMIO 2.0 / CHIO

• Key member of the strategic leadership for the enterprise

• Driver of quality and safety improvement with the CQO

• Work closely with CFO around strategy and tactics for the journey to value based model

• Shift focus from technology to strategic physician leadership

CMIO 2.0 / CHIO

• Leading change through people, process and how we use information rather than new technology and its implementation

• Reducing fragmentation of informatics resources working in silos

• Career path rather than seasonal job• Data – Knowledge – Intelligence• Practice based evidence

Source:- From the playing field to the press box; maestrostrategies.com

So much technology so little time…

Source:- Gartner 2014 Healthcare Hype cycle

Technology and innovations that excite me

Complex event processing, or CEP, is event processing that combines data from multiple sources to infer events or patterns that suggest more complicated circumstances. The goal of complex event processing is to identify meaningful events  and respond to them as quickly as possible.

Service Oriented Architecture and Complex Event Processor

HL7 Events

RuleAuthoring

Complex Event Processing

Messaging

BPM & SOA

VisualAnalytics

Real-timeDashboards

EDA

PredictiveAnalytics

Real time / low latency Data oriented

TIBCO EMS

TIBCO ActiveSpaces

TIBCO BusinessWorks

TIBCO BusinessEvents

TIBCO BE Decision Manager

TIBCO BE ViewsTIBCO RTVIew

TIBCO Spotfire

TIBCO Spotfire R and S+

EHR

eCART Proof of Concept

None8%

Proactive rounding

25%

Automatic RRT67%

Median 30 hrs prior to arrest

Median 42 hrs prior to arrest

n=12 arrests

Other things I do

• Associate Editor for the online journal of applied clinical informatics

• Started a certificate course on clinical informatics at UCM

• Secretary on the board for AMDIS• Advise start ups• Learn/read from other industries• Go home on time

Notes from my journey

• This is my dream job• Focus on the journey not the destination• Keep the long game in mind• Anger is a wasted emotion• Most physicians were not hugged enough as kids• Keep it personal• The patient is why you do this

The why for me

The why for me

Questions - ??

Resources

www.AMDIS.org

www.CHIME.org

www.gartner.com