I love this quote:
Leadership has always been a complex calculus and is specific to the domain/environment/population being led. – William F. Bria, MD, FCCP ‘The CMIO Survival Guide‘
So are we willing to be led? And by whom?
As we all know perhaps all too well, ‘healthcare is local‘, in fact hyper-local as the case often is, and not immune from indigenous geo-political and market structural considerations. Whether from a market dominance or top of mind share perspective, healthcare infrastructure carries a considerable amount of political currency – if not outright ideology driving the organization, governance and equity (business model) considerations of local operators. For instance, the State of Texas and it’s commitment to the preservation of independent physician practice is a stark contrast to the practice of Medicine (risk tolerance) in the State of Florida (no Corporate practice of medicine doctrine) or even California for that matter.
Yet in the still emerging space of ‘applied medical informatics‘ whether informed purely by market or even organic forces, before factoring in the material incentives presented legislatively via ARRA/HITECH and it’s aftermath, the space has been in a constant state of dis-equilibrium if not sector chaos as we look for and settle on some market or industry homeostasis if you will.
This narrative has been developing for some time. In 2006 JAMA published: ‘The CMIO—A New Leader for Health Systems‘ wherein it posited physician:
leadership is a critical success factor for health information technology initiatives, but best practices for structuring the role and skills required for such leadership remain undefined
While a tad dated, this perspective was further informed last year when HiMSS released its Annual Leadership Survey (see: ‘About‘ post for results). What this author found of interest then and perhaps still so today with the degree to which the CMIO role penetrated the C-suite culture particularly given the importance of the role as acknowledged by both references above. In 2015 the CMIO was considered part of the ‘executive team’ in only 39% of the sample.
While this is a static picture and therefore not instructive on the relative growth rate of this participation (and standing) in the health system enterprise, it none-the-less follows on the heels of the rise of the CIO as a full fledged member of the C-suite team. Here the evolution from DP Manager or Director (often seen as staff position with an overhead label) to the CIO of a materially staffed operation tasked (or co-tasked) with revenue, market share and business intelligence objectives may offer some insight.
In 2016 the CIO role is well established. Yet, can the same be said of the CMIO? For an excellent post by one of our founding colleagues Nick van Terheyden, MD (@DrNic1), see: ‘Process matters as much as technology, especially when treading new ground‘.
And ‘treading new ground’ is arguably a constant for our colleagues and the vendors who hope to engineer their enterprise success!