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The IT Docs

Gienna Shaw, for HealthLeaders Media, November 15, 2010
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How does the relationship work?

Among those survey respondents who indicated they have both a CIO and CMIO, most (38%) said the CMIO reports to the CIO. More than 20% report to the chief medical officer or have at least a partial reporting relationship with a clinical leader.

Ron Strachan, senior vice president and CIO at WellStar, says he's worked in organizations where the CMIO did not report to IT. "The physician wasn't even on common footing, if you will, and it turned out to not work very well," he says. His relationship with Morris "is extremely collegial and wouldn't be successful any other way."

At THR, CMIO Velasco reports to CIO Marx, with a dotted line to the organization's chief quality officer. But the organizational flowchart isn't as important, the pair agrees, as their working relationship and chemistry. "It's down to the people that you work with, and no matter what the reporting structure is, if you have the right people in right role, you're going to be very successful," Marx says.
"What makes it successful isn't the structural aspect of the relationship but the nature of the working relationship—the interpersonal dynamics. Both of us happen to be very well-suited for our respective roles in the organization."

Organizations can run into trouble, Marx says, when the CIO and the CMIO have competing visions. "He's one of my closest confidants in terms of IT strategy overall and what we're trying to do with IT on the clinical side," Marx says. "It's not perfect, you know; there's tension, but it's a healthy tension that always aims toward the same vision."

Who should we hire?

A CMIO should have more than a passing interest in technology; Velasco says he has long been passionate about IT and using it to improve healthcare. "Even back in the days when I was a medical student, I was doing research and finding ways to use data and information systems, as rudimentary as they were back then, to automate the research process or the clinical processes. And that's something that continued into my residency and in my fellowship," he says. "It was a natural transition to go from that into a formal role as the physician leader for informatics."

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