Through the American Recovery and Reinvestment Act of 2009, hospitals and healthcare organizations have the opportunity to become eligible for incentive payments upon demonstrating meaningful use of electronic medical records. However, a shortage of health IT workers in the healthcare industry has added another challenge to healthcare leaders scrambling to implement health IT solutions in their respective organizations. Because of this, it is becoming now more important than ever for hospitals to hire health IT staff members who can serve as veritable support to hospital leaders, specifically CIOs. Here are seven of some of the top health IT leadership and support roles hospitals should hire into their organizations.
1. Chief medical information officer. A CMIO is typically a physician employed by the hospital who, in this position, serves as the liaison to other physicians during health IT initiatives. This individual, who already has a clinical understanding, should also have a deep technological understanding. This prevents silos from building between administrative and the physician staff on health IT processes. "Health IT initiatives like computerized physician order entry are almost always done better when you have a CMIO acting as a liaison between physicians, IT and administrative staff," says Bob Sarnecki, vice president and CIO of Phoenix (Ariz.) Children's Hospital.
For example, Phoenix Children's CMIO is in the process of checking dose ranges for the hospital's already-installed CPOE. Dose ranges for medication can be a tricky situation because rather than being a straight calculation, ranges are based on height, weight and age, Mr. Sarnecki says. "His job in this instance is primarily to translate these ranges and implement them into the CPOE so that our physicians can be warned when a dose is too low and ineffective or too high and dangerous to the patient," he says.
2. Chief nursing officer. Michael Sauk, vice president and CIO of University of Wisconsin Hospital and Clinics in Madison, Wisc., says hospitals would deeply benefit from appointing a CNO who is committed to and believes in the EMRs. In the same vein as the CMIO, a CNO acts as the motivator to nurse managers and nursing staff members. Working with the CNO could be a nursing informatics function, which aids the CNO in developing workflow procedures and policies and training content for the nursing department staff members.
"If you have a CNO who truly believes the organization needs a paperless EMR, [he or] she ensures the nursing directors are committed to getting their staff trained, that the directors of nursing participates in the design and testing of the system and so on," Mr. Sauk says.
3. Chief medical officer or chief quality officer. Chief medical officers and chief quality officers are also key leaders who must support EMR programs, says Mary Anne Leach, vice president and CIO of The Children's Hospital in Aurora, Colo. These leaders must actively use, understand, govern and lead their physician and clinician communities toward meaningful use of EMRs.
"These roles are critical to healthcare IT initiatives due to the fact that EMR and meaningful use projects must be clinically and medically led by such individuals," she says.
4. Operational leader. At UW Hospital and Clinics, there are two operational leaders —for inpatient and ambulatory services — who are responsible for ensuring all departments in their scope of responsibility understand how to use an EMR by adequately training departmental staff.
"For example, we had an operational leader whose role was to represent the ambulatory staff and leadership at steering committee meetings and governance meetings," Mr. Sauk says. "She was involved in the design of the EMR, development for training material and ensured everyone on the ambulatory staff was engaged throughout the process, present for the go-live and available for post-implementation reviews. A similar operational leader was in place for the inpatient departments."
5. Integration manager. One aspect of meaningful use and EMRs that hospitals will ultimately need to grapple with, whether that be within an accountable care organization or within just the enterprise itself, is how patient information is shared so that care can be delivered on a more global scale. At Phoenix Children's, an integration manager is responsible for ensuring health IT solutions such as EMRs are incorporated into physician practice groups with the goal of becoming more connected, more efficient and paperless. The integration manager is also responsible for integrating applications to help support meaningful use initiatives at physician practice groups, such as voice recognition or having patients' vital signs automatically recorded into their EMRs without the need for a nurse to type in the information.
"There will be an increasing need for devices and applications to be hooked into hospitals' EMRs, so that it takes away the need for clinicians to manually transcribe or type directly into a patient's record," Mr. Sarnecki says. "Especially with the nursing and health IT worker shortages, hospitals need to start looking how to do more with less. Integration frees the clinical user to focus on the clinical aspects of their profession."
6. Project manager. Mr. Sarnecki says that while CIOs are usually the individuals charged with spearheading every health IT initiative, project managers can help alleviate the burden of closely managing each and every health IT project. Project managers ensure the coordination of effort between departments and assist in keeping the team focused on both implementation tasks and return-on-investment metrics that collectively define a successful project, he says.
Ms. Leach adds this position will become more important as the health IT solution market continues to expand and offer very specialized products. "Not all clinical applications come from the same vendors. For example, there are cardiology solutions, radiology solutions and other specialized diagnostics and systems that will always have to be interfaced back to the EMR," she says. "On-going integration of different applications requires long-term governance, project management and oversight."
Mr. Sauk also emphasizes the importance of project management. "Without project management, projects slip and miss their delivery date and exceed their budgets. It's important to have good project managers who are used to holding people accountable to tasks that are assigned to them and set up the road to get to destination," he says.
7. Infrastructure manager. Hospitals and healthcare organizations should avoid the mistake of overlooking infrastructural needs by appointing an individual to manage all infrastructure-related issues and projects. Most health IT solutions, including EMRs and CPOE, require more than just software installation and in many instance require major infrastructure overhauls. Because of this, a seasoned infrastructure manager who is keenly adept at the most up-to-date and state-of-the-art technology can help hospitals configure what infrastructure fit their facilities best while also containing costs.
"Right now, healthcare organizations want to get the biggest bang for the buck for health IT systems they put in place. An infrastructure manager would help make sure the systems and applications actually help the physicians do their jobs more effectively," Mr. Sarnecki says. "For example, our infrastructure manager has been transitioning us to virtual servers, decreasing the cost of installing, powering and cooling physical servers by two-thirds. He is also charged with looking for solutions that complement our clinical users' workflow and existing investment in network and server hardware."
Ms. Leach says hospitals must recognize the need for technology leaders, such as directors of technology services, to help oversee the complex technical operations of health IT initiatives on a day-to-day basis. "Our facility is spending $2 million to $3 million annually to keep our infrastructure evolving and performing optimally," she says. "Take an EMR, for example, if it's not up and running at nearly 100 percent availability and performing very quickly, then no physician is going to use it."
8. Director of data warehouse and business intelligence. Eventually, hospitals and healthcare organizations will have to use the data and information collected through their EMRs in such a way that improves clinical outcomes, reduces costs and meets regulatory quality measures. Hospitals should implement data management solutions, such as an enterprise data warehouse, and hire directors who can lead business intelligence functions and analytics programs, including predictive modeling. These kinds of analytics is what will ultimately improve the quality and lower the cost of healthcare as more healthcare providers learn to meaningfully use data to keep patients healthy proactively.
"Analytics means taking the data out of EMRs and other systems, mining the data for opportunities and improving the performance of the healthcare system," Ms. Leach says. "Data warehouses allow data to be collected across different systems, so a hospital could have 80 different source systems collecting data in one location, either virtually or physicially. The question is how that hospital will use the data after it is captured to help the organization perform better."
Leadership roles
1. Chief medical information officer. A CMIO is typically a physician employed by the hospital who, in this position, serves as the liaison to other physicians during health IT initiatives. This individual, who already has a clinical understanding, should also have a deep technological understanding. This prevents silos from building between administrative and the physician staff on health IT processes. "Health IT initiatives like computerized physician order entry are almost always done better when you have a CMIO acting as a liaison between physicians, IT and administrative staff," says Bob Sarnecki, vice president and CIO of Phoenix (Ariz.) Children's Hospital.
For example, Phoenix Children's CMIO is in the process of checking dose ranges for the hospital's already-installed CPOE. Dose ranges for medication can be a tricky situation because rather than being a straight calculation, ranges are based on height, weight and age, Mr. Sarnecki says. "His job in this instance is primarily to translate these ranges and implement them into the CPOE so that our physicians can be warned when a dose is too low and ineffective or too high and dangerous to the patient," he says.
2. Chief nursing officer. Michael Sauk, vice president and CIO of University of Wisconsin Hospital and Clinics in Madison, Wisc., says hospitals would deeply benefit from appointing a CNO who is committed to and believes in the EMRs. In the same vein as the CMIO, a CNO acts as the motivator to nurse managers and nursing staff members. Working with the CNO could be a nursing informatics function, which aids the CNO in developing workflow procedures and policies and training content for the nursing department staff members.
"If you have a CNO who truly believes the organization needs a paperless EMR, [he or] she ensures the nursing directors are committed to getting their staff trained, that the directors of nursing participates in the design and testing of the system and so on," Mr. Sauk says.
3. Chief medical officer or chief quality officer. Chief medical officers and chief quality officers are also key leaders who must support EMR programs, says Mary Anne Leach, vice president and CIO of The Children's Hospital in Aurora, Colo. These leaders must actively use, understand, govern and lead their physician and clinician communities toward meaningful use of EMRs.
"These roles are critical to healthcare IT initiatives due to the fact that EMR and meaningful use projects must be clinically and medically led by such individuals," she says.
Support roles
4. Operational leader. At UW Hospital and Clinics, there are two operational leaders —for inpatient and ambulatory services — who are responsible for ensuring all departments in their scope of responsibility understand how to use an EMR by adequately training departmental staff.
"For example, we had an operational leader whose role was to represent the ambulatory staff and leadership at steering committee meetings and governance meetings," Mr. Sauk says. "She was involved in the design of the EMR, development for training material and ensured everyone on the ambulatory staff was engaged throughout the process, present for the go-live and available for post-implementation reviews. A similar operational leader was in place for the inpatient departments."
5. Integration manager. One aspect of meaningful use and EMRs that hospitals will ultimately need to grapple with, whether that be within an accountable care organization or within just the enterprise itself, is how patient information is shared so that care can be delivered on a more global scale. At Phoenix Children's, an integration manager is responsible for ensuring health IT solutions such as EMRs are incorporated into physician practice groups with the goal of becoming more connected, more efficient and paperless. The integration manager is also responsible for integrating applications to help support meaningful use initiatives at physician practice groups, such as voice recognition or having patients' vital signs automatically recorded into their EMRs without the need for a nurse to type in the information.
"There will be an increasing need for devices and applications to be hooked into hospitals' EMRs, so that it takes away the need for clinicians to manually transcribe or type directly into a patient's record," Mr. Sarnecki says. "Especially with the nursing and health IT worker shortages, hospitals need to start looking how to do more with less. Integration frees the clinical user to focus on the clinical aspects of their profession."
6. Project manager. Mr. Sarnecki says that while CIOs are usually the individuals charged with spearheading every health IT initiative, project managers can help alleviate the burden of closely managing each and every health IT project. Project managers ensure the coordination of effort between departments and assist in keeping the team focused on both implementation tasks and return-on-investment metrics that collectively define a successful project, he says.
Ms. Leach adds this position will become more important as the health IT solution market continues to expand and offer very specialized products. "Not all clinical applications come from the same vendors. For example, there are cardiology solutions, radiology solutions and other specialized diagnostics and systems that will always have to be interfaced back to the EMR," she says. "On-going integration of different applications requires long-term governance, project management and oversight."
Mr. Sauk also emphasizes the importance of project management. "Without project management, projects slip and miss their delivery date and exceed their budgets. It's important to have good project managers who are used to holding people accountable to tasks that are assigned to them and set up the road to get to destination," he says.
7. Infrastructure manager. Hospitals and healthcare organizations should avoid the mistake of overlooking infrastructural needs by appointing an individual to manage all infrastructure-related issues and projects. Most health IT solutions, including EMRs and CPOE, require more than just software installation and in many instance require major infrastructure overhauls. Because of this, a seasoned infrastructure manager who is keenly adept at the most up-to-date and state-of-the-art technology can help hospitals configure what infrastructure fit their facilities best while also containing costs.
"Right now, healthcare organizations want to get the biggest bang for the buck for health IT systems they put in place. An infrastructure manager would help make sure the systems and applications actually help the physicians do their jobs more effectively," Mr. Sarnecki says. "For example, our infrastructure manager has been transitioning us to virtual servers, decreasing the cost of installing, powering and cooling physical servers by two-thirds. He is also charged with looking for solutions that complement our clinical users' workflow and existing investment in network and server hardware."
Ms. Leach says hospitals must recognize the need for technology leaders, such as directors of technology services, to help oversee the complex technical operations of health IT initiatives on a day-to-day basis. "Our facility is spending $2 million to $3 million annually to keep our infrastructure evolving and performing optimally," she says. "Take an EMR, for example, if it's not up and running at nearly 100 percent availability and performing very quickly, then no physician is going to use it."
8. Director of data warehouse and business intelligence. Eventually, hospitals and healthcare organizations will have to use the data and information collected through their EMRs in such a way that improves clinical outcomes, reduces costs and meets regulatory quality measures. Hospitals should implement data management solutions, such as an enterprise data warehouse, and hire directors who can lead business intelligence functions and analytics programs, including predictive modeling. These kinds of analytics is what will ultimately improve the quality and lower the cost of healthcare as more healthcare providers learn to meaningfully use data to keep patients healthy proactively.
"Analytics means taking the data out of EMRs and other systems, mining the data for opportunities and improving the performance of the healthcare system," Ms. Leach says. "Data warehouses allow data to be collected across different systems, so a hospital could have 80 different source systems collecting data in one location, either virtually or physicially. The question is how that hospital will use the data after it is captured to help the organization perform better."