The business of healing is not new, but the way it is being organized, measured and managed is on the fast track. We are talking about the IT element of healthcare, which has by now reached every corner of the business. As meaningful use challenges the industry on meeting deployment deadlines, it is becoming clear that Chief Information Officers (CIOs) need help. As Chief Medical Information Officers (CMIOs) have become more and more engaged, we see the interaction between these key IT players expanding and continuing to evolve. This is where the future of Healthcare IT is being built.

In its commitment to understand how industry trends are shaping the interaction between the two roles, SSi-SEARCH, a retained, executive search firm focused exclusively on healthcare IT leadership, recently conducted two surveys: one with CIOs, which was conducted in collaboration with the College of Healthcare Information management Executives (CHIME); and one with CMIOs, which was conducted in collaboration with the Association of Medical Directors of Information Systems (AMDIS). Over 100 CIOs completed the survey with CHIME and over 80 completed the CMIO survey conducted with AMDIS. To understand both sides of the equation, the same set of questions were used for both CIOs and CMIOs; however, the responses from CIOs were very different from those of CMIOs on some questions.

In both surveys about 40 percent currently employ a CMIO in a full-time capacity. This was right in line with CMIO respondents, of whom 42 percent said they are full-time CMIOs. Unsurprisingly, the survey revealed that CMIO hires have increased since the passage of the Health Information Technology for Economic and Clinical Health (HITECH) Act.

On the Value of Their Counterpart

A resounding number of CIO respondents, 95 percent, stated that CMIOs have helped them in achieving their objectives. Perhaps more importantly, 66 percent responded that they could not have accomplished their objectives within the same timeline without a CMIO. Only one CIO out of 107 answered that the CMIOs’ impact was “negative, could have accomplished the objectives better without the CMIO.” On the improvement side of the equation, here are a few noteworthy comments from CIOs:

• “It's still a struggle at times for the CMIO to be on the same page as Information Services”;
• “Depends on the clinical regard/respect of CMIO with peers, and upon CMIOs’ willingness to focus on associated administrative work, not just cool gadgets.”

When CMIOs were asked the same question, 81 percent stated that CIOs have helped them achieve their objectives. However, only 47 percent of the respondents answered that they could not have accomplished their objectives within the same timeline without the CIOs, almost 20 percentage points lower the “approval” number CIOs gave CMIOs. Variance continues in the final option, with 14 percent of the CMIOs stating that the impact was “negative, could have accomplished the objectives better without the CIO.” On the improvement side of the equation, here are a few noteworthy comments from CMIOs:

• “CIO fails to have vision of clinical needs. CIO too mired down in management of IT department and hard core IT matters (hardware, networks, security, etc)”;
• “The CIO should be on par with CMIO. Reporting to CIO makes the CMIO the face of tech team….[In which case] the CMIO becomes the CHIEF APOLOGY OFFICER ...”

On How Their Counterpart Can Make Their Job Easier

CMIOs are clearly looking to CIOs for help to create hybrid teams, whereas CIOs would like the CMIOs to “help establish governance to facilitate consensus on software implementation with clinical leadership.” Here are the responses from both groups to the following question: “Working in partnership, what is the number one thing the CIO/CMIO can do to make your CMIO job easier?”

Comments from both CIOs and CMIOs were fairly prolific. Most of the CIOs’ comments suggest that CMIOs can be tremendous facilitators with physicians and they would like to see the CMIOs spend their time there.  

The CMIOs’ comments reflect a certain level of frustration, especially around greater partnership with CIOs. CMIOs offered comments around improving the structure for the role, such as:

• “Make the CMIO position one which is operational—with a defined team and budget”;
• “Establish administrative support for the process of clinical transformation.”

Should the CMIO Role be Permanent?

In a word, yes. In total, 92 percent of the CIOs’ surveys responded that the role should be permanent, and 96 percent of CMIOs reported the same.

CIOs’ comments about the CMIO being a permanent or temporary role are dominated by references to the future importance of the role, suggesting that the role is important now, but will be more important in the future, often with more than a hint at quality and outcomes.

CMIOs’ comments about their role being a permanent or temporary one suggested a strong belief reflected that this is just the beginning of technology playing an important role in delivering healthcare.

On the Road to Greatness

In summary, these surveys demonstrate that the CIO-CMIO relationship is perceived as critical to the deployment of the electronic health record (EHR) and the meaningful and successful use of data after the EHR. Tension appears around the lack of clarity for the still-evolving CMIO role.  The value of the role is validated by the responses at each question, but there is still work to do in figuring out how these two powerful players can make room for each other and complement each other. Understanding that the role is here to stay facilitates the process of establishing structure around the role, including reporting structure, budget/reports, and a more defined career path.  

Pamela Dixon is Managing Partner of SSi-SEARCH, Atlanta.