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Is Your CMO-CIO-CMIO Triad Functioning Effectively?

February 24, 2014
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Ongoing evolution in reporting structure means relationships must be fine-tuned
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Wow! What a great first day I had at HIMSS in Orlando Monday. It reminds me what a privilege it is to be a writer in this field, because I get to interview so many interesting CIOs and CMIOs. It’s just that at HIMSS, a journalist’s life speeds up, and we get to hear from seven or eight impressive IT leaders in a single day. Mine started with a talk with Todd Rothenhaus, CMO of athenahealth, about how his company is using comparative data from across its customer base to help physician groups with efficiency improvements.

Then I had a great talk with Rebecca Kaul, president of UPMC’s Technology Development Center, about its natural language processing development partnerships with Nuance and Optum, as well as the challenges of running an innovation center with more than 150 employees.

Then I spoke with Joanne Rohde, a former executive of open source company Red Hat and now CEO of Axial Exchange, a company that has created digital health trackers, to offer patients a way to track key health metrics, including weight, glucose, cholesterol, medications, pregnancy, migraines, depression, and more. Mayo Clinic is an investor, and clients include Cedar Sinai, Atlantic Health, and the University of Colorado Health System.

My favorite educational session of the day involved the changing role of the chief medical information officer. Mark Van Kooy, M.D., director of clinical informatics at Aspen Advisors, described some of the ways the role is evolving.

“When I encounter organizations struggling with physician engagement, often there is a challenge around the role of the CMIO,” he said. Either they haven’t recognized the need for one or there are gaps in the way the role is configured. CMIOs are becoming change agents, physician advocates, and increasingly they have to have strong management skills, Van Kooy said.

A recent HIMSS leadership survey found that only 32 percent of respondents have a CMIO in their health system. In many organizations, the CMIO reports to the chief medical officer, but Van Kooy said in some organizations, the CMIO is on an even footing with the CIO and CMO and reports directly to the CEO. “There is an ongoing evolution in terms of reporting structure,” he added, and the CMIO’s span of control is also expanding.

The CMO, CIO and CMIO, each with their unique role and responsibilities, form a triad that is essential to meeting critical clinical organizational priorities, Van Kooy said. In considering the CMIO role, it is important to consider how the organization envisions this team working together. “The demands on the CMO-CIO-CMIO triad will only grow and probably exponentially in the foreseeable future,” Van Kooy said. The first step, he added, is to build job descriptions that reinforce the competencies of each and build a strong team.

Van Kooy was followed by Charlie Roche, M.D., who was promoted to CMIO of Shore Medical Center in southern New Jersey last year to fix the problem of physician engagement as the system moves to CPOE rollout in June 2014. Roche described some of the challenges he faces overseeing the implementation of a CPOE system.

“One of the important things is that the physicians see me as a member of the medical staff, not an administrator who imposes edicts,” Roche said. “I think it’s important that the medical staff is involved in choosing the CMIO and continues to be involved in the ongoing projects. That’s why we focused on developing a governance structure.”