What does it mean to be a cmio chio
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What does it mean to be a CMIO/CHIO?. Sameer Badlani, MD, FACP Chief Health Information Officer Intermountain Healthcare. Conflicts of Interests. Consulting Engagements: EXL, IMN, GLG Honorariums: iHT2, Carnegie Mellon University, Hospital Quality Forum, Weiss Hospital. Objectives.

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What does it mean to be a CMIO/CHIO?

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What does it mean to be a cmio chio

What does it mean to be a CMIO/CHIO?

Sameer Badlani, MD, FACP

Chief Health Information Officer

Intermountain Healthcare


Conflicts of interests

Conflicts of Interests

  • Consulting Engagements: EXL, IMN, GLG

  • Honorariums: iHT2, Carnegie Mellon University, Hospital Quality Forum, Weiss Hospital


Objectives

Objectives

  • Origins of the CMIO role

  • Typical job responsibilities and challenges

  • Evolution of the Role

  • Challenges and Opportunities


Brief bio

Brief Bio

  • M.B.B.S. Delhi University 1992-1998

  • Fellow/M.S. University of Utah 2001-2003 (Capstone pending)

  • Chief Resident/ Resident Internal Medicine, University of Oklahoma - Tulsa 2003-2006

  • Assistant Professor, Hospital Medicine, Department of Medicine, University of Chicago, 2006-2004

  • Associate CMIO, University of Chicago Medicine, 2010-2011

  • CMIO, University of Chicago Medicine, 2001-2014

  • CHIO, Intermountain Healthcare, 2014 –


What is informatics

What is Informatics?

  • Biomedical informatics (BMI) is the interdisciplinary field that studies and pursues the effective uses of biomedical data, information, and knowledge for scientific inquiry, problem solving, and decision making, motivated by efforts to improve human health. (www.amia.org)

  • Health informatics is the science that underlies the academic investigation and practical application of computing and communications technology to healthcare, health education and biomedical research. (http://www.medicine.virginia.edu)


What is informatics to me

What is Informatics – to me?

  • Clinical informatics is the field where we attempt to apply principles of information technology, human interface and usability, psychology, change management to the intersection between providers, IT systems and patients in the process of care delivery…

  • …with the aim of reducing cost, improving efficiency and most importantly clinical outcomes.


What does it mean to be a cmio chio

  • Major focus on the subject domain (in this case, biomedicine) and the unique challenges that arise at the intersection of people, information, and technology

People/Communication

Information

Technology

Informatics


Origins of the cmio role

Origins of the CMIO role

  • Originally a physician champion role given to a likeable physician to bring along the not so likeable physicians in an IT implementation

  • Formal CMIO titles started becoming common in 2002 but probably dates back to 1992

  • Tremendous growth and evolution post the HITECH act of2008

  • According to Simplyhired.com, positions for clinical informatics jobs increased 91% from March 2008 to September 2009.


Somewhat interesting trivia

Somewhat Interesting trivia

  • 65% still practice medicine (down from 71% in 2005)

  • 78% have some previous administrative or management experience

  • Medical specialty >> Surgical specialty

  • 67% want to remain CMIOs and not become CMOs or CIOs

  • In 2014 pay increased but satisfaction with job decreased

  • In 2005 clinical credibility was paramount now its leadership skills

  • Source:- Gartner AMDIS CMIO surveys


Basic reporting structures

Basic reporting structures

  • -Initially the CMIO role reported to the CIO

  • Significant trend to now report to the CMO ( reflects in the change of mindset that the CMIO is an operational/clinical executive not an IT executive per se)

  • In 2014 39% reported to CMO and CIO each, only 4% wanted to report to CIO

  • Dual reporting relationships are common

  • Few report directly to CEO


Common current portfolio items

Common Current portfolio Items

  • Tactical problem solver

  • EMR implementation and optimization

  • MU 1 and 2

  • PQRS

  • VBP – in collaboration with CQO

  • Optimizing CDS – read pop up alerts


Attributes

Attributes

  • Clinical credibility

  • Communication Skills

  • Patience

  • Team player

  • Leadership

  • Sense of humor


Challenges

Challenges

  • Resources

  • Institutional mandate

  • Federal mandates

  • Balancing tactical and the strategic

  • Volume to value based care

  • The cheerleader paradox


The evolution begins

The evolution begins…


Cmio 2 0 chio

CMIO 2.0 / CHIO

  • Key member of the strategic leadership for the enterprise

  • Driver of quality and safety improvement with the CQO

  • Work closely with CFO around strategy and tactics for the journey to value based model

  • Shift focus from technology to strategic physician leadership


Cmio 2 0 chio1

CMIO 2.0 / CHIO

  • Leading change through people, process and how we use information rather than new technology and its implementation

  • Reducing fragmentation of informatics resources working in silos

  • Career path rather than seasonal job

  • Data – Knowledge – Intelligence

  • Practice based evidence

  • Source:- From the playing field to the press box; maestrostrategies.com


So much technology so little time

So much technology so little time…


What does it mean to be a cmio chio

Source:- Gartner 2014 Healthcare Hype cycle


Technology and innovations that excite me

Technology and innovations that excite me

  • Complex event processing, or CEP, is event processing that combines data from multiple sources to infer events or patterns that suggest more complicated circumstances. The goal of complex event processing is to identify meaningful events  and respond to them as quickly as possible.


Service oriented architecture and complex event processor

Service Oriented Architecture and Complex Event Processor

Real time / low latency

Data oriented

TIBCO EMS

TIBCO ActiveSpaces

EHR

HL7 Events

EDA

Messaging

TIBCO BusinessWorks

TIBCO BusinessEvents

RuleAuthoring

Complex Event Processing

BPM & SOA

TIBCO BE Decision Manager

TIBCO Spotfire R and S+

PredictiveAnalytics

Real-timeDashboards

VisualAnalytics

TIBCO Spotfire

TIBCO BE ViewsTIBCO RTVIew


Ecart proof of concept

eCART Proof of Concept

Median 42 hrs prior to arrest

Median 30 hrs prior to arrest

n=12 arrests


Other things i do

Other things I do

  • Associate Editor for the online journal of applied clinical informatics

  • Started a certificate course on clinical informatics at UCM

  • Secretary on the board for AMDIS

  • Advise start ups

  • Learn/read from other industries

  • Go home on time


Notes from my journey

Notes from my journey

  • This is my dream job

  • Focus on the journey not the destination

  • Keep the long game in mind

  • Anger is a wasted emotion

  • Most physicians were not hugged enough as kids

  • Keep it personal

  • The patient is why you do this


The why for me

The why for me


The why for me1

The why for me


Questions

Questions - ??


Resources

Resources

  • www.AMDIS.org

  • www.CHIME.org

  • www.gartner.com


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