Data doctors: scarce supply, high demand

By Bernie Monegain
11:29 AM
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Chief medical information officers started to be in great demand in 2011 – just as the job was getting more demanding.

In April, Healthcare IT News spoke to Eric Hartz, MD, an oncologist and CMIO at Eastern Maine Medical Center in Bangor, Maine, who fielded numerous job offers soon after EMMC received a coveted Davies Award in 2008 from the Healthcare Information and Management Systems Society (HIMSS). The award recognizes excellence in the use of healthcare information technology.

Fast forward three years, and the search for CMIOs was becoming even more urgent as hospitals and health networks seek to qualify for government incentives by proving meaningful use of health IT.
In fact, Hartz’s assistant CMIO flew the coop.

“There are phenomenal job opportunities,” Hartz said. “There are not enough CMIOs. For a CMIO who can demonstrate successful implementation of computerized provider order entry, decision support, recruitment of physicians into projects, they’re very much in-demand.”

That came as no surprise to William Bria, MD, whose first job in the early 1980s was as a CMIO at Baystate Medical Center in Springfield, Mass., where he worked with IT pioneers. Today, Bria, a practicing pulmonologist, is CMIO at the 22-hospital Shriners Hospitals for Children system, based in Tampa, Fla. He is also president of the Association of Medical Directors of Information Systems (AMDIS).
It’s not that data is related to the practice of medicine, Bria said. “It is medicine.”

The role of the CMIO, he said, is similar at most institutions. One has to be a translator, bridge and interlocutor.

The responsibilities include making sure the data is relevant, and that it’s delivered to the right place at the right time to impact the delivery of healthcare.

Those responsibilities are increasing over time.

The practice of medicine is always evolving as the body of knowledge evolves, said Bria, offering as example the number of changes physicians have made in defining the ideal blood pressure or the fact that passive smoking was once considered insignificant.

“It’s not a pure science,” he said. “It’s many different disciplines. We must insist on continuous measurement.”

According to a survey conducted by CHIME in February, 66 percent of 93 responding members said they have a CMIO at their hospital or healthcare system.

Stan Huff, MD, CMIO at Intermountain Healthcare in Salt Lake City for four years, said he considers his role atypical. He’s a primary care physician by training but no longer practices medicine. He spends more time on the scientific and engineering activities related to Intermountain’s IT, he said, than the typical CMIO.

“My interest is in system architecture, and how you represent medical data in a structured and coded form so that you can process it algorithmically,” Huff said. He also oversees an EHR development project under way between Intermountain and GE Healthcare.

Huff reports to the CIO, while most CMIOs typically report to the CEO or CMO. Bria says most report to the CMO.

Though Huff’s role may be weighted toward the technologist rather than the physician side, his clinical background does inform his work, and he continues to talk with physicians about IT. In addition, Chris Wood, MD, serves as Intermountain’s medical director for information services, while continuing to practice family medicine. Wood serves as liaison between the IT department and hundreds of physicians.
It’s an essential role, in Hartz’s view.

At EMMC, he sees himself as the go-between the administration and the IT department.

Critical to his role with the health system’s executives, he said, is to “make sure I can articulate the true benefits of what we’re trying to do with IT to reach their strategic goals – kind of give them the vision. And it’s the same thing with the entire information technology staff. I have to bring the medical and clinical part back to them so that they can understand how to make the product that we have work better in a clinical setting.”

In an institution that hasn’t prioritized the CMIO role, there are risks, he said.

“You’re not going to truly understand how the physician fits into the practice with all of these informatics tools that we have. So you might design a process that clearly is inefficient or totally misses the point of what you’re trying to do, because you create a workflow that no one’s going to do.”