As a variety of developments and trends in healthcare intensify the demand for patient care organizations to use clinical and other data to analyze and improve clinical and financial performance and overall effectiveness, the chief medical information officer (CMIO) role is becoming more and more firmly entrenched in patient care organizations of all kinds, a new survey released at the AMDIS Physician-Computer Connection Symposium this summer in Ojai, Calif. confirms.
Presenting findings from an online survey of the membership of the Association of Medical Directors of Information Systems (AMDIS), Vi Shaffer, research vice president at the Stamford, Conn.-based Gartner, and Dick Gibson, M.D., Ph.D., chief healthcare informatics and intelligence officer for the Oregon Region of the Portland, Ore.-based Providence Health Systems, on July 14 provided the assembled CMIOs with a snapshot of where their profession stands at this key juncture in healthcare.
Opening the joint presentation, Shaffer said that the survey, which netted 74 respondents and closed just before the Symposium began, confirmed a significant maturation of the CMIO role within hospitals, large medical groups, and integrated health systems. “This decade brings a second wave of major change for the CMIO,” Shaffer told the assembled audience.
“By and large, the previous decade was about an understanding of the need for this position and the gaps involved in functions leading to it. Wave two is very significant: it is an evolution of responsibilities, both within the EHR and beyond; it is growing needs and specific informatics resources-specifically a growth of the CMIO position to harvesting high value from the EHR and information and communications technology overall. That is significant, and it is a stretch of time and responsibilities from before,” she said.
These are among the key findings:
Among survey respondents, 64 percent are currently in their first CMIO position, down from 81 percent in 2010, meaning that more experienced CMIOs are moving to posts beyond their first CMIO positions.
Among respondents, 56 percent are 50 years old or older, while 44 percent are between 30 and 49 years old.
THERE MUST BE A MATRIX RELATIONSHIP; AND THE CHEMISTRY BETWEEN THE CMIO AND CIO IS VERY IMPORTANT.-VI SHAFFER
In terms of where they're headed, 71 percent want to stay in their CMIO job long-term (though 14 percent want to move to a different institution); 7 percent would like to become CIOs; another 7 percent would like to become CEOs or COOs; and 4 percent would like to become CMOs.
There continues to be a very wide range of compensation levels, ranging all the way from $150,000 to above $500,000, but with most survey respondents clustered within two swaths: $250,000 to $300,000 and $345,000 to $375,000.
Within those compensation levels, 41 percent receive a straight salary, while 49 percent receive a salary plus some kind of bonus.
Meanwhile, compared with physicians in their medical specialty and with a similar level of experience, 67 percent make more than such physicians, while 15 percent make the same and 17 percent make less.
In terms of their organizational type, 81 percent report that they work at integrated health systems with affiliated medical group practices, while 9 percent work in standalone hospitals; most have enterprise-wide responsibilities.
MU, ACO CHALLENGES NOTED
Shaffer reported that the top three concerns of respondents over late-stage meaningful use were: challenges with assembling and reporting the required data (by a wide margin); complexity or confusion about the criteria; and a lack of executive leadership and change management in their organizations.
Meanwhile, with regard to the development of accountable care organizations (ACOs) under federal healthcare reform, survey respondents cited the following as their biggest challenges: inadequate compensation to their organization relative to the risk; gaps in information systems for care management; gaps in business, clinical analytics, or reporting; and confusion over criteria.
Gibson shared data from the survey regarding reporting relationships. At this point in time, he reported, 61 percent of CMIOs surveyed now have staff reporting to them, anywhere from one person to 125 people, with a majority reporting in the two to 25 range.
To whom do CMIOs themselves now report? The survey found that 47 percent of those responding report to the CIO of their organization; 29 percent to the chief medical officer (CMO); 5 percent report dually to the CIO and CMO; while 19 percent report to the CEO or COO. Gibson noted several advantages to reporting to the CMO. Among them:
The CMO is more likely to be able to affect change in the organization;
Reporting to the CMO puts the CMIO in a politically stronger position with the physicians;
CMIOs universally report easy relationships with CMOs, while fewer say that about their relationships with CIOs;
The CMO-CMIO relationship was reported as optimal in terms of supporting the quality department;
Reporting to the CMO was cited as being helpful in terms of achieving practice and workflow changes for doctors;
CMOs were seen as frequently involved with local implementations, and they were seen as better-positioned to spur the use of a clinical information system after implementation.