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The Rise of the Second-Generation CMIO

December 1, 2014
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Physician leaders shift to more strategic uses of data

In arranging interviews with health IT leaders this year, I have noticed a profusion of new titles, such as chief health information officer, medical director of informatics, and chief innovation officer. Hillary Ross, a consultant for the executive search firm Witt/Kieffer, who specializes in recruiting chief medical information officers and other senior-level IT executives, believes these new titles are part of a wave she calls “second-generation CMIOs.”

“The first-generation CMIO was a change agent, an implementer,” she said. That person did the operational heavy lifting with creating order sets, engaging physicians in new systems, and overseeing training and education. “This next generation is more strategic and visionary,” she said. They are searching for the type of initiatives to leverage the healthcare system’s investment in EHRs, focused on population health, improving patient safety and care and lowering costs.

Some first-generation CMIOs will make the transition to the second generation, while others may struggle with it, she added. “It requires an enhanced skill set,” Ross said. Some organizations may hire both a first-generation CMIO to keep the focus on the EHR implementation, as well as a second-generation CMIO to work on more sophisticated uses of the data being generated.

Although some of the second-generation CMIOs have the word innovation in their title, she doesn’t think health systems are looking for someone with an MBA. “But there is value added in the informatics board specialty, or a master’s degree in informatics, or the 10x10 courses offered at organizations like OHSU,” Ross said.

And although health systems such as UPMC focus energy on commercializing innovations developed internally, Ross said often the innovation focus in a job title refers to physicians bringing new technologies, such as telemedicine, smartphones, and smart pump technology, to the organization and integrating them with existing technologies.

One change she has noted is in reporting structures. When EHRs were first being implemented, the CMIO typically reported to the CIO, Ross said. “Now that the lion’s share of initial EHR implementation work is done, and the focus in on optimizing their use, we are seeing a definite shift in their reporting to the chief medical officer.”

CMIOs with the skills to focus on data and analytics are very much in demand, she said. “It is critical that you have the skill set but also the personal skills. You can be the most educated person in the world, but if you don’t have a personal style that is a good fit with the organization you won’t be successful.” Personal style was important for first-generation CMIOs, she said, and even more so with the second generation.

I hope to interview a few of these second-generation CMIOs about their project portfolios and how their positions have changed. If you fit the definition and want to share your thoughts, contact me at