Leadership & Gardens

When I was younger, I had no concept of gardening, neither did I like it all that much. A number of houseplants paid the price of my lack of knowledge. But with age comes knowledge and experience, and I now actually enjoy gardening and have learned to nurture a healthy annual crop of backyard tomatoes.

Just as I evolved into a gardner, so too are many CMIOs evolving with the increasing expectations and responsibilities that accompany the role. This month's cover story, "The Physician's Voice in IT," examines the many opportunities facing CMIOs today, including increased decision-making and more strategic authority within their organizations.

Many CMIOs are liaisons between clinicians and IT. Also, the reporting structures have shifted: some CMIOs, who had traditionally reported to the CIO are now reporting to the CMO as their hospital's EMR implementation evolves. CMIOs are even more focused on system optimization.

This month's story on order sets reminded me of my parent's vegetable garden. As CMIO Robert D. Stanley at Cooley Dickinson Hospital, says, "Managing order sets is like tending to a garden. You're never done weeding."

I remember walking through the makeshift gate of my parents' vegetable garden on hot summer evenings, the weathered, wooden stakes and rows of luscious tomato plants looming high above my head. There was never a weed in that garden. One of my diligent and dedicated parents had seen the offensive weed and immediately plucked it.

Likewise, maintaining order sets are crucial to achieving a successful computerized provider order entry (CPOE) and making the healthcare enterprise flourish.

One of the common challenges with maintaining order sets is the need to confront the cost of the project. Should there be a budget item for order set maintenance? It's a discussion the CMIO must have with the hospital's other executive leaders.

To stay ahead in the latest medical literature, experts suggest hospital's review their order sets at least every two or three years. Updates to order sets should occur anytime the FDA approves a new drug or pulls one off the market.

As Stanley suggests, managing order sets is like tending a garden. Your work is never done.

Please let me know how your "gardening effort" is going and especially the improvements to your facility's processes.

Around the web

The American College of Cardiology has shared its perspective on new CMS payment policies, highlighting revenue concerns while providing key details for cardiologists and other cardiology professionals. 

As debate simmers over how best to regulate AI, experts continue to offer guidance on where to start, how to proceed and what to emphasize. A new resource models its recommendations on what its authors call the “SETO Loop.”

FDA Commissioner Robert Califf, MD, said the clinical community needs to combat health misinformation at a grassroots level. He warned that patients are immersed in a "sea of misinformation without a compass."

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