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At the HIT Summit-Denver, a Robust Discussion of the CIO-CMIO Relationship

July 19, 2017
by Mark Hagland
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At the Health IT Summit in Denver, healthcare IT leaders looked at the CIO-CMIO relationship in the context of the need for transformational change in healthcare

On Tuesday, July 18, at the Health IT Summit in Denver, being held at the Ritz-Carlton Hotel in downtown Denver, healthcare IT leaders discussed the connection between the CIO-CMIO relationship and forward progress in clinical transformation and operational process optimization in patient care organizations. The panel discussion, entitled “CMIOs and CIOs Working Together to Deliver Quality Care and Clinician Satisfaction,” was led by Drexel (Drex) DeFord, a former long-time CIO and president of the Drexio Digital Health consulting firm. DeFord was joined by Louise Schottstaedt, M.D., CMIO at the 17-hospital Centura Health integrated health system (Denver); Amy Feaster, vice president, information technology, at Centura; and Larry Helms, CIO at Valley-Wide Health Systems, a community/migrant health center (C/MHC) based in Alamosa, Colorado, and encompassing 13 primary care delivery sites in southern Colorado.

DeFord began by asking Schottstaedt to share a bit about her background, in terms of how she migrated eventually into her CMIO position. She described herself as having had the privilege of practicing primary care in what she described as a “Marcus Welby-type environment,” one that had prepared her to connect with physicians across the spectrum of medical specialties and practice environments.

“So how did you become a CMIO?” DeFord asked.

“I am a home-grown CMIO,” Schottstaedt replied. “And many who hold this job are home-grown. I am associated with Centura since it was created, and was associated with Centura hospitals for many years. Computers have always intrigued me; I guess it was a natural aptitude that most of us who are home-grown started with. So some aptitude and an interest in becoming involved in computers, whose use is not natural to physicians,” are a prerequisite, to start with, she said. “And then an opportunity. And I think home-grown will continue for another maybe 15 years. I think having CIO relationships that are supportive, is pretty critical to communicating across that chasm between the computer science approach to problem-solving and the medical approach to problem-solving.”

And, Feaster said, the relationship that she and Schottstaedt have is so important that it involves constant communication. “We have each other on speed-dial,” she noted. “The text-messaging goes on all day.”

“What do you work on and talk about?” DeFord followed up.

“We’ve built together, I think, a really successful health IT program at Centura Health,” Feaster said. “And really, we’ve learned as we’ve gone along, made mistakes together, made course corrections, built a fantastic IT governance process that we’ve tweaked. Our goal is to get as much input from the physicians as possible,” she added. “And Louise has been instrumental in that. Getting the physicians engaged, making sure their voices are heard—we know that if they are involved and bring something to us, that will make the process go faster and better. It’s been a long journey, but has been so worth it.”

Asked about his organization’s situation, Helms noted that “We don’t have a CMIO. We’re a small organization, and sometimes we’re at the level where we’re big enough to need more structure, but we don’t have it yet. As a federally qualified health center, we’re a community based organization that provides comprehensive primary and dental care to all, regardless of their ability to pay. We receive funds from the government—actually less than 25 percent of our funding. But physicians sometimes see us in an adversarial way. But now we’re an integral part of things. And physicians ask, why are they impacting the we give? Why do they have a say? And we’ve come a long way. We don’t have a CMIO, but we do have an assistant CMO. And we’re bringing the physicians along to see what actually takes place.” What’s more, he said, “With our new CMO, who used to be the assistant CMO, the attitude is very different; but there are still some challenges that have to be overcome.”


(l. to r.:) Helms, Feaster, Schottstaedt, DeFord

“So where do good CMIOs come from?” DeFord asked. “Where do you find them, and how do you get them into that position?”

“We shouldn’t get hung up on the title,” Schottstaedt said. “Not every organization needs a person with the title CMIO. Larry, what you’ve done is imaginative, and it’s actually just right, for an organization that’s smaller. You need someone who’s interested, and then you need to give them the time and support. And for large versus small organizations, your level of need will be different. Some smaller organizations just need advocacy [and education]. It’s here to stay. Sometimes, that’s the premier role in a smaller role. But it’s going to grow from there I promise. And yes, the suits don’t need to make all the decisions, they’ll let us make some, and let us take some of the lead. Over the lifetime of Centura’s IT system, we’ve both learned, and the physicians have learned: here are the parts that are more effectively run by physicians, and here are the parts where it makes more sense to let the IT experts run things. And we’ve learned from that. So I’m happy to hear that your next CMO is one who has some familiarity and shows more support.”

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