Section 1.2 Adopt – Plan
Clinical IT Leadership
Health information technology (HIT) projects demand leadership from all clinicians, as these tools
impact care delivery. While management and administrative/financial staff play key roles, many
health care organizations make the mistake of viewing HIT projects as only “IT projects.” This
perspective may work when implementing administrative and financial systems, but as HIT more
directly impacts clinical users, the systems become clinical tools rather than IT tools. Recognize that
end users, those who will be directly impacted by HIT, must play a lead role in planning. Use this
tool to plan for clinical leadership—an important factor for successful HIT implementation.
Physician Roles in HIT
Many physicians are interested in becoming more directly involved in HIT and especially EHR.
Their role is less project manager, and more champion. In fact, physicians rarely focus on the
detailed management of project steps required of a project manager.
Some physicians interested in HIT become chief medical informatics officers (CMIO) or medical
directors of information systems (MDIS). Sometimes these titles are considered synonymous. In
large organizations, the CMIO position is considered an officer position and part of executive
leadership. Depending on the size and type of organization, physician leadership in HIT may
consume from 20 to 80 percent time of a physician’s time. Some physicians volunteer such services
when they can be performed outside of normal work hours; some are moderately compensated
(sometimes only with token compensation), and others are compensated commensurate with either
their past revenue production or equivalent to physicians who serve in other staff roles.
Not every physician will make a good a CMIO or MDIS. The individual needs skills with a strong
focus on people, policy, and process. Candidates for this position may include physicians who are
already engaged in quality initiatives or who have taken a special interest in EHR systems, though
not becoming information technologists. In this tool, CMIO and MDIS are treated as equivalents.
CMIO/MDIS Job Description
Position: Chief Medical Informatics Officer/Medical Director of Information Systems
Reports to: _____________________
Summary: The CMIO coordinates activities of HIT projects with all members of the organization’s
medical staff and lends advice and counsel to the organization on matters relating to physician
interest in HIT. The CMIO may have responsibility for chairing applicable Domain Teams as
selection and implementation of information systems progress and for maintenance of clinical
efficacy on an ongoing basis.
Key Functions and Responsibilities:
1. Solicits broad-based input from HIT projects which the organization is undertaking
2. Engages physicians and others to help develop and use HIT
3. Reviews medical informatics trends to spur adoption of HIT
4. Works in concert with IT staff
5. Leads design and modification of clinical pathways and decision support domain teams
6. Participates in development of solutions that evaluate clinical outcomes
Section 1.2 Adopt – Plan – Clinical IT Leadership- 1
7. Designs and evaluates data collection for clinical purposes
8. Leads development of clinical documentation user interfaces
9. Participates in patient care, assessment, and research
10. Participates in research relative to clinical information systems
Skills/Experience Required:
• Interpersonal skills, consensus builder, approachable, team player
• Collaborative management style
• Creative, good presentation skills
• Grasp of clinical work flow, systems thinker
• Interest in clinical information systems and outcomes measurement
• Flexible, mature sense of priorities
• Solid practical experience
• Politically savvy
• High tolerance for ambiguity
• Contemporary clinician
Nurse and Other Clinician Roles in HIT
Nurses and other clinicians play key roles in all elements of HIT strategic planning, selection,
implementation, and use. Many nurses and clinicians are not only interested in informatics, but some
may be studying nursing informatics or health informatics. Even if you do not have such trained
clinical staff, or if you sense resistance from clinical staff, nurses and clinicians must become
involved in the planning process. Involvement in the planning process:
• Helps educate clinicians as to what is possible with the HIT
• Aids in understanding how HIT can help their work
• Ensures that proper attention has been given to workflow and process improvement to ensure
patient safety and quality of care
• Begins the change management process, where the clinicians build desire for HIT
• Sets expectations for success—no one wants to be a part of a failed project
While small and rural health care delivery organizations may not have the ability to hire a nurse
informaticist or health informaticist for the sole purpose of supporting HIT, the chief nursing officer
(CNO) frequently assumes this role. The following guidance should be followed to ensure that nurses
and other clinicians play key roles in the HIT projects:
□ Ensure that the HIT steering committee includes representation from at least one physician,
one nurse, and one other clinician (e.g., pharmacist, especially when focusing on medication
management automation; laboratory worker; therapist). The health information management
(HIM) professional in the organization, if not tasked to be the project manager, should be
actively engaged. The HIM professional is the official custodian of the medical record and
the individual most responsible for documentation management—roles which must carry
over into the electronic world.
□ Recognize the importance of clinician involvement in HIT by providing some form of
release time, overtime, or recognition for clinician contributions. These efforts will pay back
immensely in achieving success with the HIT.
□ Provide adequate training for clinicians who will be part of the HIT steering committee.
These individuals may need more in-depth understanding of HIT, workflow and process
Section 1.2 Adopt – Plan – Clinical IT Leadership - 2
improvement techniques, data management, and other elements of HIT implementation. You
may need to send some of these clinicians on site visits or to trade shows where HIT is
demonstrated.
□ Provide adequate training for all clinicians. Many end users will need to learn basic
computer skills. They also need to understand what HIT is all about and how it will impact
them. Webinars can be effective ways to gain understanding of HIT. Webinars can be
effective in early education, the selection process, and after selection for orientation.
Vendors will conduct the Webinars once the organization is actively engaged in the selection
process. Before then, you will need to manage them. The effort is well worth the result.
Other Roles in HIT
Administrative/financial staff plays key roles in elements of HIT strategic planning, selection,
implementation, and use. Their support and direction is invaluable.
Additional Resources
A number of professional membership and other organizations provide excellent resources, such as a
body of knowledge, distance learning programs, Webinars, and listservs, for HIT planning. The
following organizations provide a start for your exploration.
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American Health Information Management Association
American Medical Informatics Association
American Nursing Informatics Association
Association of Medical Directors of Information Systems
Healthcare Information Management and Systems Society (HIMSS)
Copyright © 2009, Margret\A Consulting, LLC. Used with permission of author.
For support using the toolkit
Stratis Health  Health Information Technology Services
952-854-3306  info@stratishealth.org
www.stratishealth.org
Section 1.2 Adopt – Plan – Clinical IT Leadership - 3