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CMIOs and Nurse Executives: Moving Forward Together

November 7, 2011
by Mark Hagland
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A new study looks at how CMIOs and CNOs are interfacing for clinical IT implementation success

A new study produced by HIMSS Analytics, a division of the Chicago-based Healthcare Information and Management Systems Society (HIMSS), and sponsored by the Andover-based Capsule, a provider of medical device connectivity solutions, is confirming trends being observed in hospitals nationwide, as the meaningful use process moves forward and clinical IT implementations advance, and that is the increased need for CMIOs to interface successfully with nursing leaders and managers for successful implementations. The study was made public Nov. 8, and its results were released in advance of that date exclusively to Healthcare Informatics.

Based on two separate focus groups held earlier this year, one with CMIOs, one with chief nursing officers (CNOs) and similarly titled nurse executives, the study confirms that both CMIOs and nurse executives have recognized the gulf to be bridged between clinicians on the front lines of patient care and the strategic planning needs of their organizations, with clinical informaticists and senior clinician executives needing to play a key role as facilitators of process change, leaders of implementations, and translator-interpreters for various stakeholder groups within hospitals.

Among the study’s findings:

  • CMIOs believe that “their most basic job function is to bridge the gap between clinical needs and IT; CNOs and senior nursing executives cited that their roles have evolved to be more inclusive of departments outside nursing”
  • CMIOs recognize the importance of their connection with both senior nursing executives and within physicians, and report that they have frequent contact with other c-level executives within their hospitals
  • Among other elements in the mix, CMIOs and CNOs both agree on the importance of medical device integration with the EMR as one piece in the EMR implementation puzzle
When asked how CMIOs and CNOs are making the discussions work that need to be held among clinicians, clinical informaticists, and IT professionals in hospitals, Jennifer Horowitz, senior director, research, at HIMSS Analytics, says, “More and more, I think it’s becoming important to have these senior clinician executives involved, to make sure that the clinical informaticists facilitate the discussions. And both the clinical executives and clinical informaticists need to bring perspectives forward. Traditionally,” notes the Ann Arbor, Mich.-based Horowitz, “CNOs have had clinical operations background; but as the CNIO role evolves forward, that person may have more experience with the technology. And both types of people need to bring that expertise to the table.”
Jennifer Horowitz

And how are CMIOs and CNOs growing in the leadership skills they need in order to make the needed discussions effective? “The CMIO role is one that’s been around for a while, but it’s also one that’s evolving forward rapidly,” Horowitz notes. “And the CMIOs we talked to said that part of their basic job description is to really help bridge the gap between clinicians and IT; and as these CMIOs have gotten more IT experience, they’re more able to facilitate that type of dialogue. And as higher-level executives, they’re able to have executive-level conversations, but at the same time, they’re learning the IT lingo; they’re able to bridge the different languages, as it were. At the same time, they’re articulate in the executive space as well.”

Susan Niemeier, R.N., the chief nursing officer at Capsule, says of the focus group discussions, “The CNOs shared that they see themselves as a true partner with the CMIO. And they rely on them from a decision-making and strategy standpoint. And the role they had 10 years ago is not what it is today,” she adds. “Ten years ago, they were really looking specifically at operations and management, managing managers and their nursing staff. They see themselves now managing all clinical operations in the hospital, across respiratory therapy and imaging and so on, so they’re really running broad operations and are also working more strategically.”

As a result, Niemeier says, CNOs “have their hands in a lot of the key decision-making in the organization, and they see themselves as quite stretched. So they really have to rely on their management team to give them accurate and reliable information. That’s something that many of us had anticipated, but 100 percent of that group felt that their bandwidth was full.”
Susan Niemeier, R.N.

In addition, Niemeier notes, 87 percent of the CMIOs and CNOs who participated in the focus groups “reported that there is a strong level of integration between the IT strategic plan and their organization, per alignment; but from an execution standpoint, there can be gaps,” she says, “so it’s essential to have multidisciplinary teams put together, making sure you have nursing leaders and the CMIO involved, to determine how the technology will be implemented across the hospital to make sure the benefits are achieved. “

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