The countdown has begun. The business year is definately winding down. So how will you spend the next 2 weeks of this year? Is this a good time for candidates to interview for a new gig? I guess it depends how quickly the client wants to pull the trigger and how fast the candidate wants to make a move.
GUERRA: Let’s talk about your physician mix — I would imagine you have plenty of independent community physicians that refer patients to your hospitals?
SNELL: Oh, yes. We have many independent physicians who are on our medical staff and then also many who are not on the medical staff, but they refer patients. We maintain relationships with them.
GUERRA: How long have you been CMIO at St. Vincent?
SNELL: Two and a half years.
GUERRA: Where were you before that?
SNELL: I was a CMIO at Saint Joseph’s Regional Medical Center in South Bend, Ind., which is part of the Trinity Health System. I think I was the first CMIO within Trinity. They have several now, but I think I was the first one.
GUERRA: Are you the first CMIO at St. Vincent or did they have someone before you?
SNELL: They created the position and then recruited me.
GUERRA: Obviously you weren’t there, but what can you tell me about the thought process of creating that position?
SNELL: Well, the impetus for creating that position came from both the chief medical officer and the CIO at the time. The CIO has changed; the chief medical officer is still here. He is who I report to. In the past, when I was at Saint Joseph Regional Medical Center, the last one I reported to was chief medical officer, but I reported to a CIO before that. So the CIO and the CMO, they got together and realized they needed an informatics-trained clinician or physician who could help with all the various projects we’re involved in. That goes for not just the inpatient EMR and CPOE but many of the other things too.
GUERRA: You spoke about the different types of governance and reporting structures, do you find one preferable to the other?
SNELL: Yes. I prefer being on the clinical side. I feel that it has more relevance, I prefer to still be viewed as a clinician and working with clinicians and not as an IT person. I work very closely with the IT people, obviously. I don’t have any IT people reporting to me. They all report through the IT directors, and then on up to the CIO. The people I have reporting to me are, for example, an order set coordinator and other people involved in informatics on the clinical side. I like the reporting relationship the way we have it and, of course, our chief medical officer is a wonderful boss. I think I’ve helped him understand informatics much better, and that was something that he was looking for because it was kind of falling on his shoulders. Being the head physician in the organization, many informatics-related questions were coming back to him, and he just didn’t feel like he had the in-depth knowledge and expertise, and that’s why he needed someone to assist him on it.
GUERRA: I would imagine one of the concerns around reporting structure is that you don’t become too closely identified with IT and lose your status and credibility with the clinicians. Is that something to think about?
SNELL: Yes, I think it is. And then there’s the debate that’s raging nationally as to whether the CMIO should still be practicing. And there are pros and cons. When I took this position (I’m a family physician) the size and depth of this organization — plus its relationship to Ascension Health and all the things that I’m doing for Ascension Health — meant it wouldn’t be fair to try to do any kind of practicing. Especially when you consider I was also moving to a new community. So when I left South Bend and moved to Indianapolis, I had to give that up. I don’t really think it affects my credibility that much. I mean, I was in practice 27 years, so I think the credibility is there. I understand clinical workflows, clinical medicine, so I can relate to the physicians quite well. I don’t have to still be practicing.
GUERRA: You were in practice 27 years. Do you think there’s a minimum number of years, or some other formula?