Two weeks ago I interviewed Hillary Ross, a consultant for the executive search firm Witt/Kieffer, who specializes in recruiting chief medical information officers. She made the case that some CMIOs are evolving into a second generation that is more strategic and visionary. This week I spoke with a CMIO who fits the definition, Chris Wood, M.D., of Loyola University Health System in Maywood, Ill.
Wood came to Loyola last summer from a position as medical director of information systems at Intermountain Healthcare in Salt Lake City. Besides its main medical center campus, Loyola has more than 30 primary and specialty care facilities.
Wood said he agreed with Ross’ premise about a generational shift going on in the industry. He told me that many health systems and their CMIOs are in a transitional phase. “I think some health systems don’t know what to do with their CMIOs after the EHR implementation is largely done,” he said. And unfortunately, some CMIOs may not know what they should be doing and tend to lose focus and interest, Wood added. “They may not know where their career is going. I have thought for several years that we need to be leaders in where the profession goes.”
Not every first-generation CMIO is going to have an interest or the skills to take on these second-generation tasks, he said. “People need to ask themselves if they have a passion for this new work,” he said. If so, he added, they should do a skills assessment. “Nobody is fully trained in these areas. This is a new functionality that the entire health system is looking at. Instead of doing procedure after procedure, we have to step back and ask what is best for the patient, and how we can get rid of waste, improve quality and lower costs. If you are passionate about it, find ways to go out and get training,” he stressed. “You are better positioned than people who don’t have that informatics background. If you are not interested, maybe it is time to consider getting back into practice.”
Wood said he took the position at Loyola because it looked like a second-generation CMIO position. Loyola was Epic customer No. 6. and has had inpatient and outpatient systems in place for many years. The system is actually doing fairly well with meaningful use Stage 2, he said. Of the thousands of employed eligible providers, only 30 to 60 have yet to reach Stage 2 goals. “This isn’t an implementation job; it is more of a job where the leadership, physicians and nurses are looking to get more out of information systems than they are currently able to.”
As Loyola moves into public and private accountable care contracts, it is adding staff to reach out to community partners to take care of populations of patients. “I think my role as CMIO is to help them understand the systems they will need, both for workflow enhancement and to get the data they need to show them how they are doing,” Wood said.
Wood also is focused on analytics. What usually happens is health systems reach out to sister organizations to see what they are doing and hear they have purchased a particular analytics package. “The IT team is then asked to build an interface to that package, instead of developing what they need which is an enterprise data warehouse and business intelligence governance.” Wood says you need a centrally placed person who can help data analysts in business units understand how to use data. “You need clinical business units that understand how to manage change.”
One thing Witt/Kieffer’s Ross mentioned was that second-generation CMIOs tend to report to chief medical officers rather than CIOs. Wood said he reports to a chief of operations who also oversees the work of the CMO. But he also works closely with the chief quality officer who runs a center for clinical excellence and studies all the metrics reported in all contractual agreements to government, to the state, and to private payers. “He has data needs. Clinical programs trying to drive out waste individually have data needs. Researchers at the med school have data needs. The CMIO who can partner with the most important clinical business goals of the organization are going to succeed.”
Wood said his time at Intermountain inspired him to take its approach about crunching data to help physicians to other settings. Starting in the mid-90s, Intermountain reorganized itself to drive out waste and improve quality. “It was very useful for me to be there the last 11 years, see how it is done there and take it to a new environment. I believe Intermountain will continue to be excellent. They built it into their DNA,” he said. “The real challenge is for every organization to build up these capabilities. In a way it may be cheating to come to Loyola, a place that has such excellent researchers and administrators. But I see my time at Intermountain as a stepping stone. I want to say I learned it there, I am going to do it here. And if we succeed here, then it can be done elsewhere, too.”