CHIME-ing In: CIOs Will Need New Skills, Strong CMIO Support in the Years Ahead

As investments in IT increase at the nation’s healthcare organizations, CIOs will have their hands full in managing the speed of technological change.

Success will involve more than just reacting to the regulation framework that spells out how providers can qualify for additional reimbursement. The buzz around meaningful use is camouflaging the hard work that lies ahead. There are many issues that CIOs and their organizations will face before they can successfully optimize deployment of their facilities’ clinical systems.

The promise of stimulus funds from the federal government has provided instant credibility that is assisting IT’s growing role within healthcare. The prospect of millions of dollars in additional reimbursement for the meaningful use of electronic health records has pushed the discussion of IT into senior executive meetings and boardrooms.

Beyond that, the timing just feels right. The technology that’s foundational to healthcare IT is maturing, and more form factors are available to entice healthcare professionals to actually want to use healthcare IT. Physicians and nurses are increasingly willing to use clinical applications, and healthcare organizations are better able to support them in making the transition. The evolution of positions such as chief medical information officers, chief nursing informatics officers, and others is helping organizations build stronger linkages between clinical care and IT services.

Also, more healthcare organizations are realizing that the future of healthcare reform will require large doses of IT, especially as reform methodologies place a premium on coordinating care for patients and moving clinical information across the continuum of care. The push to test accountable healthcare organizations and the medical home approach points to greater use of IT in various settings, and ubiquitous and seamless exchange of patients’ healthcare information.

But CIOs’ managerial acumen will be sorely tested over the next few years, as they face new challenges, perhaps in areas that haven’t traditionally been their strengths in the past.

CHIME recently published “The CIO’s Guide to Implementing EHRs in the HITECH Era,” an 80-page book that provides detailed assistance for CIOs embarking on EHR projects. Some 170 CHIME members offered assistance based on their real-world experiences, and some of the key success factors in the book may truly challenge some CIOs. Increasingly, they will be called on to communicate effectively, manage organizational expectations, gain clinician support, improve workflow and processes, and train users, among other essential tasks. Unless they have been successful in these skills in the past, their organizations may now weigh their potential to lead them to the promised land and find them wanting.

A variety of factors will make CIOs’ jobs difficult as they lead the transition to implementing electronic clinical records and other technologies. Here’s just a sample:

• Many organizations face shortages of IT staff, estimated at as much as 50,000 nationwide. Training programs are being developed, but will take time to yield new workers.
• There’s concern that the nation’s healthcare IT vendors won’t have enough capacity to handle the rush of hospitals wanting to fast-track EHR implementations or upgrades.
• While the final meaningful use guidelines for Stage One are less stringent than those in the original proposal, it appears likely that hospitals may have a harder time qualifying for stimulus funds in later stages of the program—even as they grapple with other challenges, such as implementing changes to the ICD-10 coding system.
• The exchange of healthcare information is presumed, but many of the HIEs intended to facilitate these exchanges are in relatively early stages of development.

Other challenges lie ahead. To meet them, CIOs will need strong IT teams around them. CIOs’ fellow senior executives, including CMIOs, must continue to offer support. Peer interaction is crucial at state and local levels. And the government must assist providers in achieving funding. All these forces must align if healthcare IT is to truly take hold and support critical improvements in our nation’s healthcare system.

Timothy Stettheimer, PhD is CHIME Board President.