The role of the evolved CIO is multi-faceted, to say the least. One of the most important aspects of a CIO's job is being able to anticipate problems that may arise down the road, and crafting effective strategies for managing them.
As a growing number of CIOs are finding out, this responsibility isn't confined to issues that occur within the four walls of the hospital; rather, it extends far beyond to the laws impacting every patient in the United States. CIOs are also discovering that part of their responsibility includes keeping a close watch on legislative issues affecting health IT adoption, and doing their part to ensure that appropriate bills are being passed to push health IT forward. And as more proposals involving EMR and e-prescribing adoption progress into laws, CIOs are finding that being politically involved and educated isn't merely beneficial from an altruistic standpoint; it can directly impact how their health systems operate.
Bill Stead, M.D., associate vice chancellor for strategy/transformation and CIO at Vanderbilt University Medical Center (Nashville), is an active member of the Tennessee eHealth Advisory Council. Stead views that part of his life as public service, and feels that in the current health IT climate, it's simply too important not to be involved. And he isn't alone; in fact, this type of thinking is increasingly common among CIOs, many of whom now consider influencing legislation as another of their many duties.
“I think that CIOs need to be at the table, and they need to take the time to work on problems that go beyond their boundaries,” says Stead. “You aren't going to see a quick return on investment, but you will see it, and the CIO community needs to be part of that discussion.”
The way John Glaser sees it, health IT is going to keep surging ahead regardless. Therefore, the onus is on CIOs to steer legislation in the right direction and leverage their own experience to ensure that the bills being passed reflect the needs of the health IT industry, says Glaser, CIO at Partners HealthCare in Boston.
“You have to be mindful, as a CIO, that lawmakers want to do something, and if we don't help them, we run the risk that they don't do the right thing,” he says. “It's really important that people who live it — the experience of being in the trenches and in the reality of inpatient and outpatient care — that we bring that experience to the table and say, ‘Here's what would help, and here's what won't help.’”
Many now believe that the more CIOs make themselves available to provide testimony or lend an opinion, the less likely it is that legislation will go awry. For those still unsure of the potential impact of participation, Rich Correll, president and CEO of the College of Healthcare Information Management Executives (CHIME, Ann Arbor, Mich.) offers this piece of evidence: HIPAA.
When the Health Insurance Portability and Accountability Act was passed, he says, “All of a sudden it was law, and (healthcare professionals) had many, many challenging issues as a result of having to comply with it, some of which they might have felt did not made a lot of sense. This is an opportunity now to get ahead of legislation that's being passed, and to influence it and to hopefully educate those who are creating legislation.”
Being politically active, says Correll, offers CIOs a chance to influence what will happen, “rather than having to react, as in the case of HIPAA, to legislation that is created, sometimes without full knowledge of the impact of what is being passed into law.”
Taking a proactive approach is critical, according to John Halamka, M.D., who stresses that even if CIOs dedicate just a few days out of the year to the cause, it can make a significant difference. Halamka, who holds CIO positions at Boston's Beth Israel Deaconess Medical Center, Harvard Medical School, and Harvard Clinical Research Institute, was present during National Health IT Week, held in Washington, D.C. in June. At the marathon event, he served on the Honorary Steering Committee along with such health IT proponents as Senators John Kerry (D-Mass.) and Sheldon Whitehouse (D-R.I.), and Representatives Patrick Kennedy (D-R.I.), Tim Murphy (R-Pa.), Allyson Schwartz (D-Pa.), Phil Gingrey (R-Ga.) and Dennis Moore (D-Kan.), among others.
The experience, says Halamka, was well worth his time, as he was able to meet with several key players, including Sen. Kerry. He urges his colleagues to pitch in whenever possible, even if it means just giving a statement about a technology that was recently deployed.
“We need CIOs to testify about their own experiences with EMRs and CCRs, and to provide information so that we can establish best practices,” he says. “It's imperative that CIOs are involved in legislative activity. By getting involved, it's going to make your job easier in the long run.”
One of the avenues that many politically active CIOs choose is involvement in state-level initiatives. Just recently, Halamka testified and gave statements for a bill signed into law by Massachusetts Gov. Deval Patrick (D) that will provide $25 million to promote the use of electronic records. The legislation, he says, will require hospitals and community health centers to adopt CPOE systems by 2012 and EHR systems by 2015.
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