Andrew Resnick, MD: Clinical informatics programs have the potential to advance strategic goals for higher quality care, population health management, cost containment, physician satisfaction, and more. But many health systems don’t realize the full benefits of these programs as a result of organizational structures or hiring decisions. Chief Medical Officers (CMOs) are in a unique position to elevate these programs to achieve important organizational goals by embracing strategic collaboration.
My colleague Julie Massey, MD, Chartis Clinical IT Practice Leader, discusses how CMOs can partner with Chief Medical Informatics Officers (CMIO) and clinical informatics teams to promote technology innovation that enhances workflows, reduces administrative burden, and supports high-quality patient care.
With more than 25 years of experience as a pediatrician, physician executive, and advisor to health delivery organizations, Julie helps clients align IT and clinical operations to drive quality and performance improvement activities. Having previously served as a CMIO, Julie has extensive experience in physician leadership, clinical informatics and operations, change leadership, population health, and clinical variation management. When she’s not working, you’ll find her practicing mindfulness and enjoying the beach.
Chartis: Why is it important for CMOs to partner on clinical informatics, rather than considering it more the realm of IT?
Massey: Rather than a specific area of IT, clinical informatics is the intersection of technology and clinical care delivery. For instance, a CMO who has a goal to reduce readmissions or hospital-acquired conditions needs to understand how the technology can support that goal—including how it can be leveraged to help users navigate workflows to reduce costs and improve patient and caregiver experiences.
Technology can help or hinder these things. CMOs can turn to the CMIO as a trusted advisor to better understand both what the technology can realistically deliver and what its limitations are.
Chartis: For many CMOs, one of the first things that comes to mind with clinical informatics is the challenges associated with deriving value from electronic health records (EHRs) and other clinical applications. If this is a point of intersection and opportunity, what role should the CMO play in addressing these challenges?
Massey: The complex nature of EHRs and other clinical applications often prompts healthcare organizations to take a myopic approach to value realization. For example, organizations solve unit-specific workflow barriers, promote individual clinician health IT adoption, or provide ad hoc responses to disconnected requests for system enhancements. As a result, improvements to clinical information systems are slow and incremental.
And it becomes difficult to maximize the value of investments. Many organizations remain stuck in a foundational-level clinical informatics program that doesn’t move the needle on what matters most to the organization.
Instead, CMOs have an opportunity to take a more coordinated approach and advocate for the use of technology and data analytics to promote system-wide high reliability care, reduce clinician burnout, ease the cost of care delivery, and boost patient engagement.
This requires a multi-disciplinary enterprise-wide approach centered on 2 critical questions: What next-generation, technology-enabled workflow capabilities are necessary to support and grow enterprise capabilities and strategies? And how can we get there?
Chartis: These questions get back to the need for CMOs to partner more closely with clinical informatics teams. How can CMOs cultivate that partnership?
Massey: Yes, partnership is paramount. Clinical informaticists are a key enabler of rapid clinical and business performance improvement. As that bridge between IT and clinical operations, they can help CMOs identify gaps and pain points, refine decision support systems, enhance end user adoption of and proficiency with technology, reduce variation to drive quality and performance improvement, and so much more.
There are many ways to enable this partnership. In some cases, it may be very direct: the CMO might ask for the CMIO to report directly to them if they are currently reporting to the Chief Information Officer (CIO). But partnership can also take the form of adding physician champions to the clinical informatics team to improve provider engagement, support implementation and optimization activities, and provide ongoing support. The CMO can also regularly communicate with the clinical informatics team to identify clinical priorities; establish quality, safety, and other clinical targets; monitor and report progress; and identify systems for feedback and performance improvement.
Chartis: What should organizations aim for in a strong clinical informatics program, and what role can the CMO play in creating one?
Massey: A strong clinical informatics program is one that intentionally deploys team resources in support of specific organizational strategic and operational priorities. But this isn’t how most programs begin. Organizations typically begin at the foundational level and, with the right leadership, gradually progress to something more transformative.
This transformation requires active CMO participation and support. CMOs must remain laser-focused on value so the clinical informatics program doesn’t diverge from organizational priorities. Consistent demonstration of value requires structure, discipline, collaboration, and transparency. Examples of meaningful value can include financial return, improved physician engagement and satisfaction, increased safety and quality, and improved ability to manage complex care.
It also requires CMOs to insist that CMIOs are part of discussions around innovation and even lead specific initiatives in this area. CMIOs need to hear what’s most important to the organization so they know what data might be necessary to ensure success.
Chartis: How can organizations ensure they have the right person for the role of CMIO? And what input should CMOs provide?
Massey: One of the mistakes we’ve seen organizations make is choosing the candidate who is the most technically savvy. But when we think about what’s most important in a CMIO role, the most important trait is the trusted confidence of their colleagues and peers—the medical staff and administration. The CMIO is a change agent; they must be someone who possesses excellent interpersonal skills, clinical knowledge, and the ability to navigate a complex organizational environment and get things done. An interest in and aptitude for technology is helpful but not the most important skill.
CMIOs must have a positive, can-do attitude, and they must understand the interaction between humans and technology. The actual ability to do programming or build the technology itself is not a requirement. How do they bring folks together and facilitate discussions between physicians, other clinicians, administration, and IT? CMIOs need to be able to work through those end-to-end workflows to ensure the technology will best enable the operational priorities.
The CMO should be involved in the hiring process to ensure the person chosen for the role possesses these critical soft skills and clinical knowledge.
Chartis: Looking ahead, where should CMOs focus their attention to promote high-impact opportunities in clinical informatics?
Massey: The answer will be unique to each organization, of course. But all organizations are currently grappling with artificial intelligence—whether and how it may augment clinical decision support and relieve burdened clinicians and staff through exploring smart automation of repetitive tasks.
Regardless of the exact technologies and use cases, the more organizations embed technology into clinical and administrative workflows, the more closely they must partner with the CMIO and clinical informatics team to ensure success.
