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
Origins of the CMIO role
Typical job responsibilities and challenges
Evolution of the Role
Challenges and Opportunities
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?
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?
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.
• 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
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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 of 2008
According to Simplyhired.com, positions for clinical
informatics jobs increased 91% from March 2008 to
September 2009.
Somewhat Interesting trivia
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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
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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
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Tactical problem solver
EMR implementation and optimization
MU 1 and 2
PQRS
VBP – in collaboration with CQO
Optimizing CDS – read pop up alerts
Attributes
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Clinical credibility
Communication Skills
Patience
Team player
Leadership
Sense of humor
Challenges
Resources
Institutional mandate
Federal mandates
Balancing tactical and the strategic
Volume to value based care
The cheerleader paradox
The evolution begins…
CMIO 2.0 / CHIO
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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 / CHIO
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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
So much technology so little time…
Source:- Gartner 2014 Healthcare Hype cycle
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
Real time / low latency
HL7 Events
Data oriented
Messaging
TIBCO EMS
EHR
TIBCO ActiveSpaces
EDA
BPM &
SOA
Rule
Authoring
Complex Event
Processing TIBCO BusinessEvents
TIBCO BusinessWorks
Predictive
Analytics
TIBCO BE
Decision Manager
TIBCO Spotfire R and S+
Real-time
Dashboards
TIBCO BE Views
TIBCO RTVIew
Visual
Analytics
TIBCO Spotfire
eCART Proof of Concept
None
8%
Proactive
rounding
25%
Automatic
RRT
67%
Median 30
hrs prior to
arrest
Median 42
hrs prior to
arrest
n=12 arrests
Other things I do
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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
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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
Questions - ??
Resources
www.AMDIS.org
www.CHIME.org
www.gartner.com