Growing Demand for CMIOs

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Over the past 20 years or so, large healthcare organizations realized a need for a permanent position that understood both the clinical and the technological sides of the business. This role is referred to as a Chief Medical Informatics Officer (CMIO).

Historically, the duties of a CMIO were fairly broad, as they were the communications bridge between clinical and IT staff for all kinds of IT projects. And because the CMIO lived in both worlds (CMIOs often continue to practice medicine), it was their job to direct IT in terms of what IT projects are most important to physicians. These are the people who understand medicine, hospital policies, and the technology that can be used to create automated workflows. One of the major problems that healthcare IT staff face is the fact that very few have a crystal clear understanding of healthcare workflows, because they rarely see or fully understand the end game. That's why it is so important to have a CMIO who understands both worlds on an intimate level.

But over the past few years, the role of the CMIO has changed dramatically. Because of the new demands for electronic medical records (EMR) and electronic health records (EHR), the focus of the CMIO has not only narrowed, it has become far more crucial.

John D. Halamka, MD, is CIO at Beth Israel Deaconess Medical Center and Harvard Medical School. He briefly describes the different hats he wears while being CIO, CTO, and CMIO in his blog. He differentiates the three roles as follows:

CIO - Responsible for strategy, structure, staffing, and processes for a 300 person IT organization
CTO - Responsible for the architecture of our applications and infrastructure, ensuring reliability, security, and affordability
CMIO - Responsible for the adoption of the applications by clinicians, optimizing quality, safety, and efficiency in their workflows

Dr Halamka then goes on to say "increasing demands for clinical workflow automation, and healthcare reform necessitate that every hospital larger than 50 beds have a full or part time designated CMIO. Given the daunting array of clinical IT requirements over the next 5 years, CMIOs will be increasingly important."

Suggesting that a CMIO is required for healthcare facilities with a few as 50 beds is a fairly radical statement, as most CMIOs are found in organizations with hundreds or thousands of beds. Most small hospitals today lean on the CIO/CTO in collaboration with a physician or two to direct IT projects. But due to the continued growth in EMR and EHR, a formal CMIO seems to be in order so the organization can properly engineer medical record workflows.

Be forewarned, the CMIO's role will not diminish as electronic record adoption is completed. Instead, I see the continued demand for a combination medical physician/IT-guru. I would even go so far as to say that health informatics training should be further refined to better groom physicians looking to develop the skills necessary to become a CMIO. It's not just about knowing medicine and technology but also the ability to articulate information between people with very different professional backgrounds.

If medical professionals choose to take a well planned path that leads to a CMIO role, hospital administrators won't have to haunt hospital hallways trying to find the computer geek doctor who can be groomed into a liaison between clinicians and IT staff.