CMIO Summit: CMOs and CMIOs share common goals
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“That goal is decided by the drivers for the hospital’s strategic priorities for any given time. We’re trying to deliver good care that is safe, efficient, effective, equitable, patient-centered and timely,” said Agrawal, who served as CMIO at Kings County for five years before transitioning to CMO. “In the hospital administrator’s world, we are expected to provide better care for individual patients, better health for the population and we are expected to provide it at a low cost.”
These are the drivers that CMIOs, CMOs and any other other C-suite-level executives need to live by, she added. "Quality doesn’t exist in isolation; it’s in the national agenda. Whatever we are doing ... in the IT world has to connect to the larger challenges, whether within the hospital or at the national level."
Kings County is part of the Health and Hospitals Corporation of New York City, which receives 18 percent of admissions in the city, as well as 36 percent of behavioral health admissions, but only 9 percent of higher-margin survey services. As a safety net hospital, Kings County has a -1.8 percent operating margin. “This is what drives my new world. And for a CMIO to be successful, this needs to be his or her focus as well,” said Agrawal.
There are natural collaboration points between the CMO and CMIO role, including Joint Commission requirements, HITECH Act and the Patient Protection and Affordable Care Act, as well as local level initiatives. “The natural intersection is the analytics and data, information and knowledge,” she added.
The CMIO role has evolved: Now much more time is involved in converting EHR data to analytics, reporting and dashboard information. Likewise, the requirements of the hospital have gone from raw data to filtered data to information to usable knowledge.
“At our institution, the CMIO is another clinical leader, on par with other chiefs of services. Expertise in informatics and in EHR implementation positions you as natural ally with physicians,” added Agrawal.
“We couldn’t have done many improvements in our core measures if we didn’t have an EHR and an active CMIO advocating for it. [This will be] increasingly important to the bottom line,” she said. “Alignment is mandatory. Most hospitals are feeling financial pressure, so it’s very important that your CMIO’s strategy is aligned with the organization’s," said Agrawal. “We have no resources to waste anymore.”
When it comes to reporting relationships, there are all sorts of variations: “I reported to the CMO, and currently our CMIO reports to me in that role. The CMIO is primarily a clinical leader.”
Therefore, reporting to the CIO is not the best way, according to Agrawal. “It dilutes the clincial champion role for CMIO.”
What does a CMO need from a CMIO in order to be successful? Clinical health IT knowledge and solid administrative and people and skills as well as aligned philosophies, Agrawal concluded.