There has never been a time in which the job market for physician informaticists has been more dynamic than now. On the one hand, demand for physician informaticists, particularly in high-end roles—the CMIO role and similar—is at an all-time high. But there is also some volatility right now around the CMIO position and related roles in patient care organizations. Among the emerging trends is an accelerating demand for associate CMIOs of various types. Hillary Ross, a consultant in the healthcare IT practice at the Oakbrook, Ill.-based Witt Kieffer spoke recently with HCI Editor-in-Chief Mark Hagland about current and emerging trends in this key area. Below are excerpts from that interview.

Do you specialize in CMIO and medical informaticist placement?

My particular focus within the IT practice is specializing in searches involving physicians with informatics expertise. I also do Ph.D-related searches; but primarily I spend my time with physicians. About five years at Witt Kieffer; before that, I was at Hersher & Associates about 3 ½ years or so. I was a litigation attorney and worked for the Chicago office of a large New York law firm, and I worked with hospitals, medical companies, and was also in charge of recruiting attorneys for our office, and I really enjoyed that.

Meanwhile, a strong focus of the healthcare IT practice at Witt Kieffer involves placing physician leadership at hospitals, academic medical centers, and healthcare companies. And over the past year, we’ve seen demand for certain types of positions. Among others, we’re seeing a rise in the associate chief medical information officer role, with some of the people being placed into that role managing the ambulatory sector in their organizations. One contributing factor is the acceleration in the purchase of physician practices or the salarying of physicians.

We’re also seeing organizations looking for visionary physician leaders to take them to the next level. That is most true in situations in which an organization has already gone well past the initial EHR (electronic health record) implementation process, and are moving towards leveraging their EHR and other clinical information systems to optimize care processes.

Hillary Ross

Another position on the increase is physicians overseeing data warehousing and data management. That is not a new position, but it is an increasingly important role particularly in academic medical centers that perform clinical trials, as well as in big pharma and biotechnology.

What’s more, academic medical centers are looking for physicians to build biomedical informatics research centers, programs, and curricula for their medical schools.

And finally, start-up IT vendor companies are also utilizing informatics to produce medical devices. In addition, these start-up companies are also attractive to hospitals as development partners.

Let’s drill down a little bit on the emerging associate CMIO position. What are patient care organizations, especially integrated health systems, looking for in ACMIOs, and what does that do to the CMIO position?

It seems that, as the CMIO’s position has evolved, this Associate CMIO position has become very popular and important. This associate CMIO position is very operational, leading enhancements of previously implemented systems, and also in freeing the CMIO for the more strategic, futuristic kinds of planning. Now that these systems have the data, the CMIO is looking at and doing the clinical transformation and the data analytics, and organizing all that, and that’s become a full-time job. Meanwhile, for the associate CMIO, an EMR is never completely done. For example, they’re implementing enhancements. So for example, we had placed the CMIO at an academic medical center, and they’re upgrading their Epic system—they were one of the earliest adopters of Epic years ago—and he said, I need someone to manage the enhancement to the Epic system. And he didn’t want to stop practicing one day a week.

Even with the gaining of an associate CMIO, is there still pressure for the CMIO to practice one day a week?

I wouldn’t say ‘pressure,’ but it depends on the culture of an organization. And more and more, if a CMIO comes in with credibility from practice, more and more organizations are willing to forego having the CMIO still practice. But some CMIOs still want to practice a bit; sometimes, it’s rounding. But I know of a system CMIO who’s an OB/gyn, who’s rounding with residents. But what’s interesting about this associate CMIO is the percentage of time they’re going to put into this position; it’s close to 80 percent, whereas the physician champion in an organization is putting in 50 percent or less. The associate CMIOs aren’t even doing so much the informatics, but the operational implementation. The informatics, in terms of data analytics, is what the CMIO is doing.

Another interesting offshoot about the associate CMIO, and I just finished two searches this month about this—they’re bringing in a physician to manage the ambulatory networks. And this is so interesting, because there’s such a trend for these systems to acquire practices now, and so this has created a huge need in these systems for a doctor to oversee bringing in these practices, making sure their electronic health records are compatible or putting in new ones. So, putting in EHRs compatible with that of the mother ship, and training the doctors, all that is such a huge job. And it’s so attractive to the physicians for their practices to be acquired, and for the systems, too, to acquire these practices, and the system CMIO can’t possibly handle all the work.

Do you know of organizations that have both, where there’s an inpatient associate CMIO and an outpatient one?

Yes. But all the titles differ, depending on the organization.

So much is happening all at once. How do you feel about all the confluence of all of these different trends?

I think that this is a very exciting time to be a physician with IT expertise. While some of the changes taking place in healthcare right now are promoting volatility in the job market, at the same time, we are seeing more opportunities in which physician informaticists can have a significant impact on patient care. Now is the time to be open to change and to be prepared for the future.