ORLANDO—The role of the CMIO is evolving and expanding beyond the support of applications to include responsibility for larger, organization-wide operational and strategic objectives, according to a presentation at the Health Information and Management Systems Society's annual conference.

While organizations with no current CMIO—about 32 percent of health systems—face a steep challenge in filling the role but with the support of the medical staff it can be accomplished successfully, according to Mark Van Kooy, MD, director of clinical informatics for Pittsburgh-based Aspen Advisors.

“When I encounter organizations that are struggling with physician engagement, getting uniform physician opinions about work steps and decision support and CIT oversight, often what we see is there is a challenge around the role of the CMIO,” he said, explaining this could either mean the organization has not yet recognized the role of CMIO or there are gaps in the way the role is configured.

Each organization’s unique structure will determine the relative importance of the various components of the CMIO role, said Van Kooy. Among the CMIO competencies he listed were:

• Physician advocate
• Clinician
• Clinical leader
• Technical expert
• Innovator
• Manager
• Compliance

At a time when numerous health IT initiatives are being called for, Van Kooy added that being a change agent also is an increasingly important element of the CMIO role. “We don’t have a lot of time for false starts anymore, so being a skilled change agent is important.”

The American Board of Preventive Medicine now offers certification in clinical informatics, though Van Kooy noted that board certification is not totally necessary nor is it sufficient on its own. Some may have the skills required without certification, while those who do possess it may not have the managerial experience and may need some additional mentoring.

The structure of the CMIO role used to place it under the chief information officer (CIO) and chief medical officer (CMO), but it has evolved to form a triad with those roles that is essential to meeting organizational priorities. Van Kooy explained that the CMO will identify priorities and then monitor or modify behavior while the CIO is focused on setting IT strategy, acquiring and deploying clinical systems and assuring stability. The CMIO assists in setting IT strategy while also driving workflow, decision support efforts and development of clinical system content and design.

The evolution of the CMIO is not yet complete. As population health management and patient-centered medical homes become more of a focus, the demands on CMIOs, CIOs and CIOs will grow exponentially in the near future, said Van Kooy.