I have been around a long time, too and have seen both types of CIOs. Both have huge knowledge and experience holes. At the minimum, it seems either type of leader must have some basic understanding of informatics, the difficulties of system implementation, the implications of implementing systems with no proven track record (just because everyone else is doing it), and the fact that enthusiasm alone does not a successful implementation make.

And the 10×10 programs sprouting up everywhere – 1 introductory informatics course and suddenly you’re an expert! Yes, please, give me more MD CIOs who like to tinker with computers and have taken a whole course in informatics! This will REALLY solve the non-clinician CIO problem. Be careful what you wish for.

I’ve been around too…been through several failed installs. The reasons are well known by those who frequent HIS Talk. We went through one where the clinicians had their say…over and over again…but adminstration never FORCED the docs to give up their paper charts. (I was a clinician at the time)

Massive failure to the tune of 35M worth.

Successful implementations (and the resulting benefits to the organization) come from effective collaboration, which can and should be fostered by the CIO. And the CIO does not have to be the primary project sponsor or champion to do that. In fact, most projects should be championed by an executive from outside of IT.

Not being a clinically-oriented CIO has not been a problem for me because I have RNs (and other clinicians) in both staff and management positions within IT, and we have terrific clinical resources throughout our enterprise. But neither is a clinical system implementation just about clinicians. Again, it’s in the effective collaboration and gathering of various backgrounds and expertise, aligned to achieve a common goal that separates a successful project from one that’s not.

As long as organizations view IT-related projects as the installing of hardware and software, with new and improved screens and reports, and with go-live being the ultimate “goal”, then the real opportunities will be missed. A new system is just a new system. Our real goal should be the enabling of positive change within our organizations through the effective use of IT.

I have recently created a position based on the College of American Pathologist posted job, Director of Diagnostic Intelligence and Healthcare IT Initiatives. The title is kind of a mouth full so I tinkered with the attributes and wrote a short white paper on the Diagnostic Information Officer (DIO); you’ve got to love the acronyms.

Diagnostic Information Officer should focus on every hospital Point of Diagnostic Service (PODS) to include all the enterprise mashups of POCT, FOBT, HCG, ABG, Neonate, CDS, LIS, RIS, CIS, etc… The responsibility of the DIO would be to function (laterally) with the CIO to ensure provision of interoperability for patient diagnostic data which I have been told constitutes over 70% of the typical EMR. CMIO has not been functioning effectively for years or we would NOT be having so many reported vendor IT disappointments. If this functionality sounds naïve, then maybe we should start considering the simple things to fix in healthcare like accurately identifying a “person” a.k.a. Homo sapiens correctly in Admissions before we enroll them as “patient” and provide them their unique “number.”

HIStalk is so cathartic!

It has been a good decade since we have had CIOs in the mold of CIOs’ described in that editorial. I was surprised to see it was from 2006. Failed projects are never the sole responsibility of the any one person, rather are a combination of factors. Trying to blame failed systems on CIOs is like a lawyer going after the person with the deepest pockets.

Accountability is another matter all together. There has to be accountability. Hospitals are the most politically charged organizations I have ever been envolved with. Everybody has their little silos and talk about turf territory. Who does the CIO report to? Is it CEO, COO, CFO, CMIO, CNO? Were is the accountability for all of senior managers in decisions and failed projects.

The hospital silos worked fine when it was paper and the final medical record is scanned. This all changes with EMR and it exposes everyone secrets and bad processes. A CIO inthe 21 century hospital has to be able to reach across all parts of the organization and help develop a strategy for 5 to 10 years into the future.

With the focus on linking pay for performance and the revenue management with clinical solutions through the EMR, I would argue who better to faciliate that discussion than a experienced CIO with input from across the organization.