Seize the day: Make way for digital healthcare and the CHIO

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 - Luke Webster, MD
Luke Webster, MD, Vice President, Chief Medical Information Officer at CHRISTUS Health

If hospitals and integrated delivery networks are to leverage the potential of big data to significantly improve the health status of populations across the U.S., they are going to need a new kind of physician leader to light the way.

To the point, they are going to need a chief health informatics officer—one under each of their respective roofs.

That was the main message in a HIMSS session at Chicago’s McCormick Place April 15. The impassioned messengers were Luke Webster, MD, a board-certified psychiatrist who works as vice president and CMIO for 60-plus-hospital Christus Health headquartered in Dallas, and Pam Arlotto, CEO of Georgia-based consultancy Maestro Strategies and a past national president of HIMSS.

Titled “From CMIO to CHIO: Information, Integration and Innovation,” the session intimated that one of two scenarios will come to pass: Either today’s CMIOs will soon morph into CHIOs, in effect if not by title, or the healthcare system will build on its acceptance of the first to make room for the second.

The rise of the CHIO will mark a natural next step in the evolution of big-data healthcare, because “you are truly looking at the convergence of informatics, analytics and quality,” Arlotto said. “This is a very, very different environment because of the risk in managing populations. You need the broad perspective of that individual who sees things at a very strategic level.”

Turning down the volume

Arlotto outlined ways healthcare enterprises’ strategic priorities are changing as they move from volume-based to value-based priorities, referring to insights gleaned from qualitative interviews Maestro conducted with more than 60 CEOs, CMOs, CIOs, CMIOs and CNIOs at leading integrated delivery networks.

Setting the backdrop, she showed a timeline of “enterprise maturity transformation,” illustrating healthcare then, now and soon to come. As recently as 2010, we had “bricks and mortar” healthcare, marked by fee-for-service reimbursement, hospital consolidations and practice acquisitions.

In 2015, we’re in the midst of transition, witnessing the expansion of clinical integration, patient engagement, performance measurement and “cross-venue process redesign and early-stage population stratification,” she said.

By 2020, said Arlotto, “digital healthcare” will be the order of the day. Its hallmarks will be true population health management, retail care, virtual care, risk management and consumer behavior management.

CMIOs will continue play a critical role. Today, however, they’re focused on being “the doctors in IT.” They bridge those two worlds, enabling the dual-citizenship denizens to speak a common language without losing one another along the way. Their work is organized around such discrete goals as designing and integrating IT systems, optimizing and analyzing the use of technologies like EHRs and CPOEs, guiding physicians in the use of software and so on. 

Patient-centered, tech-enabled

Tomorrow’s CHIOs will have broader skill sets and more open-ended marching orders.

To succeed in the emerging role and, in so doing, push one’s provider organization to truly improve the health status of its patient population, “you need to be strategic, systematic and able to drive change,” Arlotto said. “We ultimately believe the CHIO is the individual who should be responsible for value realization. They need to have methodologies for deploying and measuring the value of their [informatics] systems.”

Arlotto said CHIOs will work closely with multidisciplinary teams whose members might include process engineers, change-management experts and even adult education specialists, along with informaticists working not only in the clinical sphere but also nursing and pharmacy.

“We’re truly looking for prevention and wellness across the entire spectrum,” Arlotto said, adding that successful CHIOs will concentrate on identifying emerging trends, encouraging innovation and spearheading transformation. “Eventually they will redesign care around what the patient needs, not around technology.”

Overload avoidance

Webster began his part of the presentation on a personal note. He told how his grandmother suffered for years with poorly managed diabetes. This led to a series of strokes, the effects of which were compounded by medical mismanagement and outright care errors. Long hospitalizations and deteriorating quality of life followed.

“I was deprived of her in what should have been another 10 to 15 or even 20 good years of her life,”