CHIME: CMIOs, CIOs need to unite to enact change
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A couple years before the role of the CMIO position was created at Glens Falls Hopsital in New York, the hospital went through the implementation of computerized physician order entry (CPOE). However, the implementation didn’t go very well. Matthew Dunn, DO, CMIO and associate director of emergency medicine at Glens Falls, took on the position of CMIO two years ago.
The hospital had no CIO from shortly after the CPOE effort until early 2009 when Joan McFaul, vice president and CIO, came on board. “The physicians felt that the CPOE was shoved down their throats,” she said. McFaul tried to partner with the hospital’s existing vendor on an enterprise system. The physicians held so much resentment that no updates had been conducted for several years.
Dunn has been working to re-engage the physician community. He said that a facility’s CMIO and CIO should agree on who are the key players and the steps necessary to gain their support. Clear, honest communication is important as well. “We had a history of overpromising and under-delivering,” he said. It’s better to admit that no system is perfect and that there will be problems and issues to work through. “[Physicians] need honesty.”
To faciltate the process, Dunn restructured the physician advisory group to focus on strategy and solutions, and to encourage greater ownership. The CMIO became a standing member of the medical executive community and now serves as a conduit for all physician/IT issues requiring executive approval. The hospital also hired physician champions and department informaticists.
Dunn sought to develop strong relationships with clinical analysts and other IT staff as needed.
“Most people viewed the problems as the IT department’s fault,” said McFaul. “Since that’s not always accurate, we wanted to establish ownership.” To that end, each department manages its own standing IT agenda to manage issues and maintain accountability.
The efforts have resulted in a “bottoms up” approach to solutions and improvements, said Dunn. There is now agreement on the long-term strategy, confidence in the new vendor, improved support for senior leaders, strong IT leadership, and an increasing level of support from the physician community. “They’re being challenged now,” he said. “If they think something is not working, we say come to the table and tell us why.”
“We totally changed the way we operate,” said McFaul. “We are a stronger organization as a whole.” Glens Falls also is “much more patient centered,” said Dunn. “When everyone operates in different areas with different agendas, they tend not to think about patients as much.”