The roles and responsibilities of a CIO and a chief medical information officer are each vital to a hospital's operations, says Maulik Purohit, MD, MPH, senior vice president and CMIO of University Health System in San Antonio.
Dr. Purohit began his career as a physician interested in research, specifically brain injury. He helped lead the start of a sports concussion clinic at Boston-based Massachusetts General Hospital before the Department of Defense recruited him to create an extensive brain injury center.
"In general, I have been really interested in not just the individual patient but on the whole — what can we classify or predict with brain injury?" he says. "These types of questions are important for the patient and the physician to provide the best care possible."
After a four-year stint at the DOD, he joined University Health System as CMIO. He approached the role with intent to focus on data and population health, whereas most CMIOs take on the post with a focus on the EMR alone, Dr. Purohit explains.
"What I realized in research is even if you have a good study and publish it, it's really hard to move the needle in healthcare," he says. However, CMIOs are able to apply population health data to healthcare IT and improve both patient outcomes as well as the provider experience. "Instead of a study, if we can show the empirical evidence of the intervention in a hospital setting, then more people will pay attention, especially in today’s world of heavy emphasis on quality, outcomes, and metrics. IT has the potential to make patients' lives better depending on how we use it."
Traditionally, the CIO deals with IT infrastructure — hardware, security and interfaces — and a CMIO typically handles the EMR and its clinical applications. But, the roles are evolving tremendously as IT becomes more advanced and integrated with patient care.
Dr. Purohit recently shared with Becker's Hospital Review five things that should be on a CMIO's radar.
1. IT should complement hospital operations, rather than the other way around. "If we want to treat sepsis effectively, we should think of what our ideal operations should be and then make IT a component of that operation rather than IT leading the project," says Dr. Purohit.
2. CMIOs should take a page from the research playbook. "CMIOs need better training in data analytics and data infrastructure so they can understand population-level health and understand the concepts of regression modeling and predictive analytics and how this analysis can guide clinical operations," he says.
3. Because of their focus on clinical operations, CMIOs should help guide IT infrastructure design. "More and more, it's not that IT is doing the hard coding — a lot of things now come prepackaged — but the CMIO should certainly guide the IT build," Dr. Purohit says. "Having that on the early end rather than the back end would be important so the build fits the hospital and clinical operations, rather than the other way around."
4. CMIOs should engage with state and federal regulators on the future of IT. "From a regulatory standpoint, CMIOs should consider how to better involve CMS to guide the direction of EMRs and IT in the hospital setting. CMS has done a fantastic job on the first step, which is adoption, but now how do you take the next step and say 'How do we improve it to today’s level of IT, not just healthcare IT?' I think CMS is going to have a huge role to play."
5. These leaders should learn to communicate well and continuously educate their teams. "Can a CMIO really communicate well with the rest of a hospital on their own terms and educate from executives to physicians to nurses to patients in a way that is meaningful to the stakeholder?"
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