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Making the Shift from CMIO to CIO: One New-ish CIO’s Perspective on the Transition

February 23, 2016
by Mark Hagland
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Christopher Longhurst, M.D. shares his perspectives on the transition from CMIO to CIO

Pediatrician and informaticist Christopher Longhurst, M.D. has already made several significant transitions in his career. After spending 11 years as CMIO at Stanford Children’s Health (formerly Lucile Packard Children’s Hospital-Stanford) in Palo Alto, Calif., Longhurst, 41, on November 1 became CIO at the University of California-San Diego Health (UC San Diego Health); he is also a clinical professor of pediatrics at UCSD Medical School.

Longhurst is one of a number of CMIOs who have transitioned from being CMIOs to being CIOs. He shared his perspectives on the CMIO-CIO transition recently with HCI Editor-in-Chief Mark Hagland. Below are excerpts from that interview.

What are the top areas you’re most focused on right now at UC San Diego Health?

There are three main areas I’m really focusing on. Number one, we are opening a billion-dollar new facility called the Jacobs Medical Center; it’s an expansion. And I’m putting in all the IT for that. That opens this fall. Number two, if you Google UC San Diego Health, you’ll see that we have a new CEO who was just made permanent last month [click here for an article on the Jan. 21 announcement of the appointment of Patty Maysent as permanent CEO of UC San Diego Health]. She was the chief strategy officer when I was hired. She is very growth-minded. So my second priority is supporting all the incredible growth occurring here, which includes a clinically integrated network, affiliations with several local hospitals, a burgeoning telehealth program, and most recently, one of our sister UC hospitals has asked us to consider hosting our Epic electronic health record for them—that’s UC-Irvine. So, supporting the growth in physician practices and hospital affiliations, and collaborations, will be major areas of focus.

Christopher Longhurst, M.D.

That means that you’ll be working a lot with Chuck Podesta [CIO of UC-Irvine Health], then?

Yes, Chuck and I speak almost every day. We’re doing a lot of work together. And, per the three main areas, the third main area, priority number three, is the optimization of all of our information systems.

Which of those three looks hardest right now to do?

Supporting growth. A new building is a new building, we’re putting some technology in, there’ll be a wow factor. And optimization—that’s right up my alley as a former CMIO. But the growth is really challenging, because you’re building a brand-new business, and in many cases, you’re supporting non-employed affiliates. And you need to do it in a value-added way. On the other hand, it’s the most exciting, because we’re looking at hosting a lot of services, not just Epic, but IT services, and that really enables a more integrated model of care. So we’re swinging for the fences, but it’s a little bit scary as a first-time CIO, because you’re swinging for the fences, and you go big or you go home.

Tell me about your experience of the transition from being a CMIO to being a CIO?

Honestly, it’s been easier than I feared. I credit my former CIO, Ed Kopetsky, for mentorship and for giving me opportunities for growth. And my colleague at UCLA, Mike Pfeffer, has done it, too [Michael Pfeffer, M.D. became CIO at UCLA Health in 2015 after having served as CMIO at that organization from 2013 through 2015]. On the other hand, I think there are a number of CMIOs who don’t yet recognize the unique skills and talents that seasoned CIOs bring to the table. It’s not just about being smart around the clinical information systems or understanding the technology; it’s about strategic leadership and understanding the business at a business level. It’s about people management, which is often not strong among physicians. And these are often things that are not taught in medical school.

Also, there is a really unusual trend of physician CIOs at children’s hospitals. But you also have pediatrician CIOs at adult hospitals, for example UCSD, Duke, and Lifespan.

What should CIOs and CMIOs take from your experience so far?

What I would say is that I have consciously stepped out of the CMIO role here. That’s a critical physician liaison person. But the two roles are so different. And it’s hard for someone to move from a CMIO role to a CIO role in the same organization. Because you’ll still be seen as that liaison person. And I think of the roles as rather different, and although the letter C is in both titles, the roles are different. And in some ways, I think you really need a team of physicians in IT. The idea of the CMIO was the one doc in IT, right? And when I left Stanford I had 20 physicians and 30 staff reporting to me. And that’s because I had evolved into a role as a team leader. But some CMIOs are still individuals. In any case, it’s clearly different from the CIO role.

But everybody agrees that you need excellent alignment. And every year, when Vi Shaffer does that Gartner survey, there’s always some discussion of the tension around where CMIOs should report to, right? But I think that’s a misplaced conversation. If CMIOs were smart, they’d want to report to the CIO, because that’s where the resources are. And I liked reporting to the CIO. And that’s how I accomplished things. You can’t accomplish things without resources. And the reality is, though some would say you should report to the CMO, the reality is that the CMIO will always be accountable to the medical staff."