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What Is a CHIO? Dr. Ferdinand Velasco Has the Answer

June 19, 2012
by Mark Hagland
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Texas Health Resources’ Senior Physician IT Leader Points Toward the Future for CMIOs in Large Health Systems
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The Arlington, Texas-based Texas Health Resources (THR), a 24-hospital, 4,100 bed health system, has long been a pioneer along numerous dimensions, including care quality innovation, IT development, and organizational innovation. And now the executives at THR can add yet one more item to their list of progressive moves, and it has to do with a broad-based recognition of where clinical informatics leadership development is headed in their organization.

It is in that context that Ferdinand Velasco, M.D., who has been chief medical information officer (CMIO) at THR for 10 years, earlier this month began transitioning to a new role, designated as chief health information officer (CHIO). In the newly created position, Velasco will continue to report to the organization’s CIO, Ed Marx, but will also now report to the organization’s chief operations officer and clinic clinical officer, two individuals whose recently established office combines joint responsibility for the clinical and operational  sides of the entire organization (and with both the COO and CCO reporting directly to the health system’s CEO). Meanwhile, the individual who had been the associate CMIO, has been promoted to CMIO, and continues to report to Velasco, while the chief nursing information officer (CNIO) also continues to report to him. All of this reorganization also speaks to the broadest operational performance initiatives taking place at Texas Health resources.

Dr. Velasco spoke recently with Healthcare Informatics Editor-in-Chief Mark Hagland regarding the changes taking place at THR and his perspectives on the implications for the broader healthcare system. His comments can also be seen in the June/July issue of HCI, in the feature titled “The Next Wave: In the New World of Accountable, Transparent Care, CMIOs Will Be Essential to Organizational Success.” Below are excerpts from that interview with Dr. Velasco.

Congratulations on this new position, Dr. Velasco. Do you know yet how many people will be reporting to you in the new position?

I don’t know yet; it’s still a work in progress. But the number will basically double. I currently have about a dozen staff. It’s not a large team; my role in IT is largely as a thought leader rather than a manager. And that works out pretty well, because it spares me from a lot of administrative responsibilities, and provides me with a lot of time to spend time with leaders in the organization. That won’t change; I’ll have directors who will have those direct administrative duties, while the associate CMIO will become the CMIO. I’ll also have some quality improvement people reporting to me.

Ferdinand Velasco, M.D.

What’s new about shifting the title from CMIO to CHIO?

The focus [at THR] has been on engaging physicians and getting them to adopt the electronic health record. The CHIO role will encompass the physician areas, but will also broaden out to all clinician stakeholders, across both the inpatient and ambulatory spheres and into the home.

In other words, this is part of a broader shift towards looking across the entire care continuum, all the way from the inpatient hospital, to patients’ homes, and strategizing around clinical IT across that entire continuum?

Yes, that’s correct.

Will this type of shift happen in other organizations as well, over time?

I think it will; we’re not the first organization to do this. Oregon Health Sciences Center [Portland, Ore.] and Geisinger [the Danville, Pa.-based Geisinger Health System] both already have CHIOs. I do think it’s the next stage in the evolution. And it makes sense, because THR was one of the first organizations to have a system-wide CMIO, so this makes sense.

What would your advice for senior leaders in other patient care organizations, particularly in large, integrated health systems that could move down this path?

My advice would be to conceive of the CMIO and the CHIO roles in the context of the accountable care transition, rather than simply as an implementational leader. Because while the implementation aspects are important, they need to be embedded in the work towards population health, analytics, and quality and care management.