1. What does it mean to be a CMIO/CHIO?
Sameer Badlani, MD, FACP
Chief Health Information Officer
Intermountain Healthcare

2. Conflicts of Interests
Consulting Engagements: EXL, IMN, GLG Honorariums: iHT2, Carnegie Mellon University, Hospital Quality Forum, Weiss Hospital

3. Objectives
Origins of the CMIO role Typical job responsibilities and challenges Evolution of the Role Challenges and Opportunities

4. Brief Bio
M.B.B.S. Delhi University Fellow/M.S. University of Utah (Capstone pending) Chief Resident/ Resident Internal Medicine, University of Oklahoma - Tulsa Assistant Professor, Hospital Medicine, Department of Medicine, University of Chicago, Associate CMIO, University of Chicago Medicine, CMIO, University of Chicago Medicine, CHIO, Intermountain Healthcare, 2014 –

5. 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. ( 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. (

7. 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.

8. People/Communication
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

9. Origins of the CMIO role
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.

10. Somewhat Interesting trivia
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

12. Basic reporting structures
- 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 % reported to CMO and CIO each, only 4% wanted to report to CIO
Dual reporting relationships are common
Few report directly to CEO

13. Common Current portfolio Items
Tactical problem solver
EMR implementation and optimization
MU 1 and 2
PQRS
VBP – in collaboration with CQO
Optimizing CDS – read pop up alerts

14. Attributes Clinical credibility Communication Skills Patience
Team player
Leadership
Sense of humor

15. Challenges
Resources Institutional mandate Federal mandates Balancing tactical and the strategic Volume to value based care The cheerleader paradox

16. The evolution begins…

17. CMIO 2.0 / CHIO
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

18. CMIO 2.0 / CHIO
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
Source:- From the playing field to the press box; maestrostrategies.com

19. So much technology so little time…

21. Source:- Gartner 2014 Healthcare Hype cycle

22. 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.

23. Service Oriented Architecture and Complex Event Processor
Real time / low latency
Data oriented
HL7 Events
TIBCO EMS
TIBCO ActiveSpaces
TIBCO BusinessWorks
TIBCO BusinessEvents
TIBCO BE Decision Manager
TIBCO BE Views TIBCO RTVIew
TIBCO Spotfire
TIBCO Spotfire R and S+
Messaging
EHR
EDA
BPM & SOA
Complex Event Processing
Rule Authoring
Predictive Analytics
Real-time Dashboards
Visual Analytics

25. eCART Proof of Concept Median 42 hrs prior to arrest
n=12 arrests

27. Other things I do
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

28. Notes from my journey 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

29. The why for me

30. The why for me

31. Questions - ??

32. Resources