As more hospital-based organizations create the position of chief quality officer, the CIOs in those organizations are finding opportunities to work with these new chief quality officers to leverage clinical IT for exciting new initiatives around improving patient safety, care quality, and clinician effectiveness.
“Joined at the hip.”
That's how Mary Reich Cooper, M.D., J.D., senior vice president and chief quality officer at the four-hospital Lifespan Corp. in Providence, R.I., describes her relationship with senior vice president and CIO Carole Cotter.
“We talk every day. We work very closely on almost every initiative,” Cooper adds. “And the main reason for that is that Carole and her team have done a superlative job of developing an IT infrastructure that is the underpinning of our ability to design for quality initiatives.”
From Cotter's perspective, the creation of a chief quality officer (CQO) position at Lifespan, and Cooper's arrival three years ago, invigorated the organization's quality program. “I now know that I have a strong ally who believes in using technology to achieve our strategic objectives,” she says. “We knew there were financial reasons to be meaningful users, but we also knew that we could focus on meaningful use to improve quality, so we have embraced it as an opportunity to work on standardizing data.”
The position of CQO is relatively new, but is becoming increasingly high-profile, and CQOs' partnerships with IT leaders are leading to impressive efficiency and patient safety improvements.
Health system quality management has changed considerably in the last decade. The scope of quality management activity required to even begin to eliminate harmful medical and clinical errors requires expertise in process improvement, evidence-based care, and informatics, notes Scott Hodson, a principal for Maverick Healthcare Consulting, which has offices in Atlanta and Omaha, Neb. “Hospitals and health systems known for their high quality choose to invest in a full-time CQO to manage the effort,” he adds. “To fulfill their role, it is essential that a close and effective working relationship exist between CQO, CIO, and chief financial officer (CFO).” (Hodson says the CFO should be in the loop because organizations that are unable to quantify the return on their investment in quality management risk having that function being viewed as purely a “cost center,” and they could suffer significant cuts in funding at a time when they are most needed.)
The CQO, CIO, and their staffs must work together on a daily basis to develop, implement, and maintain the technologies that are required to provide caregivers with the information they require, Hodson adds. The information, whether it be in the form of “alerts” such as drug-drug interactions, or out-of-range lab results, or in the form of computerized physician orders or clinical pathways, must be correct and effectively accessible and presented in a manner that is easily used at the point of care.
In addition, now that quality improvement is much more data-driven, chief medical information officers (CMIOs), who often came to an organization to work on the implementation of a clinical information system, are stepping up into these CQO roles, notes Arlene Anschel, senior consultant in the IT practice of Oak Brook, Ill.-based executive search firm Witt/Kiefer. “They see it as a way to continue and realize the value of their initial work to improve patient care outcomes and safety.”
And as Anschel's colleague Linda Hodges, vice president and IT practice leader at Witt/Kieffer, notes, projects involving IT and the CQO “provide a realization to the organization that the investments in automation are worthwhile, and that is a good thing for the CIO.”