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Foundation Members:
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CHIME Presents:
The CIO’s Guide to Implementing EHRs in the HITECH Era
CHIME Member Comments on
Chapter 6: The Role of the CIO in EHR Implementations
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Question posed to members:
As a CIO or senior IT executive, what are your most
important responsibilities in achieving meaningful use?
What are your CEO and fellow senior executives counting on you to do?
Comments:
“Since the funding comes in the form of reimbursement through our annual cost report timing is of the essence to minimize how long our funds are outstanding. Of nearly the same importance is where the funds will come from since our cash flow will be seriously affected by the expenditures.”
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“To guide and direct this effort, to manage the IT component and to coordinate all non-IT tasks.”
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“Enable us to meet the MU requirements (after we complete our Epic conversion) and then secure our share of the ARRA funds. This is very important to our Board as well.”
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“IT is far from the only “attention” grabber in our organization. IT readiness, as it relates to MU, has been mine to address. I am addressing by trying to influence operations that they need to take the point on this. My systems and applications can get us to the threshold, but operations has to leverage the tools in order to demonstrate use. This is not clean one for one of course. System security and HIE remain mine almost exclusively. But operations and patient safety and quality have to take more prominent roles. We communicate to the CEO directly and we also bring it up to his cabinet level executives.”
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“Given the complexities of healthcare reform, all M.U. achievement/work is my CIO overall accountability - although I've seen many state that the work is really 75% clinical operations and only 25% in IT. Besides making sure that our IT solutions roadmap is well understood, I think the most direct accountability for a CIO is meeting the HITECH/HIPAA Security regulations - which is certainly not a slam dunk.”
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“It’s important I stay abreast of what is being decisioned within the industry, how it will apply to us, and recommend what is best for ORHS when implementing technology to comply with the regulations as they apply to ARRA/HITECH. They want me to somehow be able to articulate what I think we have as options, frame the discussion, and facilitate a plan to achieve the objectives associated with the decision reached.
There must be a good bit of informal one on one networking and relationship building with each of the senior team and department directors in order to stay abreast of what they are thinking and to communicate what I know or think will help the organization achieve its objectives. Some how not hearing it for the first time when it is finally presented for discussion and or decision helps significantly. Even better, is having someone else present an idea or solution I believe in.
I am first and foremost expected to build and maintain a team of individuals that will deliver the HIT required when and where it is needed. They also somewhat expect me to maintain external contacts with whom I regularly communicate. “The more I know, the more I know I don’t know.” Exchanging ideas, listening to others to learn what has worked or hasn’t worked is important. Learning to apply this knowledge to our environment here is equally important. I pretty much have to keep a three year view of what I plan to do while remaining flexible; recognizing individual pieces and parts may change positions on the timeline.”
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“To work with all constituencies to understand what it is we are striving for, to get buy in, and to help secure funding and prioritization from the rest of the senior leadership team.”
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“As CIO we have had a path the past nine years which places us in an excellent position to attain meaningful use. Systems evolve best when they evolve and are planned for. My current senior team expects a game plan and review of where we are today and what do we still need to do to make meaningful use a reality in 2011. The most important role I currently have is to maintain the I/S strategic plan, provide leadership, change as needed, be cost effective and stay focused so the plan is executed in a successful manner.”
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“Basically, do whatever it takes to capture all of the dollars available to us thru HITECH.”
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“Implement the new Clinical Information System to achieve many of the individual meaningful use items. Work with Quality to achieve remaining items.”
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“Follow the regs as they evolve and close all gaps as feasible.”
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“The areas for the Hospital that we are not compliant with. Some of these items such as CPOE will be a responsibility shared by the CIO and other members of the Senior Management Team/Medical Staff leadership. The CIO chairs the Meaningful Use Steering Committee and will facilitate keeping the gap analysis updated as well as facilitate the compliance with any of the areas we are not compliant with.”
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“We have a project team actively working on meeting MU and my responsibility is to ensure IT can support, develop and deliver according to the project plan. This is not just an IT project, it is a clinically driven and lead project plan. The executive team is counting on my team to keep them informed and ensure we meet MU on time and on budget.”
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“Implementing a certified EMR.”
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“ My critical responsibilities are two-fold: keep in constant communication with my vendors to assess their readiness and use that information in preparing/adapting both our short and long term vision. Keep abreast of regulation changes as well as industry direction and ensure our hospital has a well defined and achievable plan.”
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“Most important responsibilities include the formation, execution and communication of the plan.
The executives are counting on the CIO/CMIO team to offer the strategic choices for readiness and execution to achieve funding.”
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“They’re counting on me to understand the rules, and build a plan to “bridge the gap” between what we have installed to day, and functionality we’ll need to meet the final rules.”
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“ They are counting on me to "just do it". I am counting on our vendors to team to make this happen. My responsibilities are to identify "how" and "by when" and to engage the teams required to make it happen.”
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“My role as an enabler has been to lead the evaluation team mentioned in item #1 to a vendor selection. This is what I have been counted on to accomplish.”
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“ The most important aspect right now is creating the strategy to obtain "meaningful use" as well as obtaining the resources that will be required.”
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“The most important responsibility has been to lead the effort in finding a solution that meets meaningful use as we know it today. Other executives are counting on me to make sure meaningful use can be met with the planned changes that are currently underway.”
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“To ensure we hit the targets, receive the potential funds, don’t get any penalties while not taking the focus off the outcomes we want in our IT implementations/plans.”
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“First staying abreast of the changes coming and determining how we can meet the criteria by attending web casts/presentations. Working with the vendor(s) to determine where they are and to evaluate their “road maps”. Evaluating where we are (honestly) and what we need to do to meet the criteria. Simply put, CEO & Senior executives are counting on me to get us where we need to be to meet the stimulus and obtain all of the moneys available to the hospital!”
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“They are counting on me to:
1) Stay informed so that I can interpret the intent of the regulations,
2) Understand our readiness and prioritize projects to ensure maximum benefit to the health system.
3) Escalate road blocks to this process for their attention and action
4) Serve as resource for questions and concerns”
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“Most important for me is to provide the roadmap for our organization to achieve meaningful use, timeframe, and expected costs. The latter is significant as the CFO needs to plan for applicable spending.”
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“The most important responsibility I have at this time is advocating for collaboration with both the HIE and the Office of the State Coordinator for HIT”
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“My most important role is to understand the requirements and complete the gap analysis and to make sure it is well understood by my peers on the senior leadership team. In addition I am responsible for assisting with the formation of the work-teams who will be charged with putting action plans in place to bridge the gaps. My Project Manager will be responsible for the management of this project.”
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“Knowing where we are relative to the requirements and identifying any necessary automation investments, but most importantly a plan that also addresses behavioral/process changes necessary to achieve MU. Also working with stakeholders to identify potential financial impact of incentives and/or penalties.”
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“My most important responsibilities are the following:
• Educate senior management about what is required, and what is likely to be required, in our information systems to maximize reimbursement in future, including any incentives/penalties related to meaningful use. They count on me to be most informed about regulatory requirements for IT.
• Author and update IT Strategic Plan that supports overall organization strategic and operating plans, including necessary components for meaningful use (knowing that for us the immediate future does not require meaningful use compliance).
• Oversee our Project Manager and milestones for implementing new clinical system to make sure we meet our objectives for the new system that will help us meet meaningful use criteria.
• Provide some metrics for benefits of new system, including components of meaningful use.
• Keep entire organization informed about progress of new system (and meaningful use if/when meaningful use becomes more meaningful to us).
• Function as lead liaison and negotiator with vendors for all above; in other words, minimize the time they need to spend with our IT vendors on contract and related issues in order to maximize their creative time with vendors.
• Help Senior executives educate their staff about IT vision, direction, and expectations relative to meaningful use.”
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“Three major responsibilities.
Understanding what criteria have not been met.
Planning for resources, funding, staff, timetables and commitments that are required to meet requirements.
Sponsoring, with senior executives, work towards achieving meaningful use.”
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“After identifying gaps, determining the most effective way to achieve meaningful use.”
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“Develop a clear plan identify elements we already meet and those we do not…develop a plan to meet MU.”
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“My principal responsibilities are: analyzing and understanding the requirements, working with vendors in obtaining and implementing the certified versions of my EHRs,leading and facilitating the changes necessary to record and report MU-related data.
While we have not discussed the MU application itself, I assume that I will partner with Finance to prepare and submit the necessary forms.”
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“My most important responsibility is to educate the Executive Team on MU and to ensure that we have funding for the applications and system changes that need to be made to achieve MU. Then execute on the implementation once the funding source is approved.”
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“We are not bound by US requirements to follow meaningful use, but we are adopting the concepts as a means of progressing our EHR evolution and utilization. My most important responsibility in this context is mapping the intent and requirement of meaningful use, into the EHR application configuration, data collection, and data analysis. We call it Meaningful Use Traceability, from the paper document requirement through measurable output.”
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“My primary responsibility is to deliver reliable, clinically useful tools that will help the clinicians and physicians affiliated with the Hospital meet the meaningful use requirements.”
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“The most important responsibility to be able to secure the funding. Meaningful use simply accelerates what has been our plan for a long time. The funds will help us fund these initiatives more quickly. In the end, strategically, this has always been about quality health care and taking care of our patients. The funding is what they are counting on which is really a proxy for the quality of care.”
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“I would say the first is making sure our technology can qualify. The second is to identify the areas of concern and categorize what issues are related to system functionality and what issues are process related (human behavior). IT will be responsible for identifying the issues at hand and forming relationships with nursing/physician champions to implement the changes.”
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“Continue to supply direction of IT solutions that allow us to achieve this goal. I have partnered with the VP of Medical Affairs, Chief Nursing Officer and VP of Finance to begin with to ensure our objectives (the money we speculate we will get) are aliened with the expense it will cost to purchase and implement. I see my role currently as a facilitator/coach/monitor and so on to ensure everything goes to plan. This is not just another IT project. This one affects the entire hospital including the physicians. Teams with various other C-Team members have been developed with them as owners chairing them as they work through what they need to do.”
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“They are counting on me to deliver the IT Strategic Plan which includes Meaningful Use. However, having said that, the other Senior executes are Executive Sponsors for many of the systems that will drive the Meaningful Use requirements.”
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“Meet all requirements”
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“Spearheading the implementation of projects with the Executive team members to achieve MU.”
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“Achieving meaningful use is entirely my responsibility, to include technical and operational aspects. Currently we are working on reporting mechanisms in an effort to approach clinicians with facts about their usage of the system. My CEO expects me to ‘get it done’, and the CFO works with me to negotiate contracts and keep costs down where possible. We are also working with all the payers to take advantage of increased reimbursements associated with certain technology uses, i.e. BlueCrossBlueShield pays more if we use a specific application. The application serves as an HIE and moves us further down the path of meaningful use.”
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“Deliver on all of the Meaningful Use criteria so that we qualify for the maximum dollars available to us.”
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“To get it done so that our hospital can receive all of the ARRA funds that will be available to us. They also expect me to report any delays to achievement of meaningful use and what impact the delays will have on the funds we can receive (if any).”
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“Responsibilities includes being vigilant in watching the regulation process and being active in the comment process; guiding the organization through the process of identifying the current gaps and helping to craft the plan to fill the gaps. I am also working as a resource for our medical staff and helping them to understand their portion of the new regulations.”
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“As the CIO, my role is to be knowledgeable of pending legislation (including, but not limited to “Meaningful Use”) so we are ready to exploit opportunities as they arise, and to address concerns before they become business risks. My fellow senior executives count on me to know what’s coming, to know “where we stand “as an organization, to develop action plans to remedy gaps, and to requests resources/assistance as needed. We’ve requested a clinical/business sponsor for Meaningful Use – our Chief Quality Officer – and we’re looking forward to his, and other senior executives’ sponsorship of the key initiatives we’ll be undertaking to qualify for Meaningful Use incentives.”
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“They expect me to:
1. Provide Leadership
2. Identify the needs
3. Propose the solutions
4. Execute the identified, approved solutions.
5. Advise them of what contributions are needed.”
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“They expect that I stay abreast of “meaningful use” requirements, of our vendors and their ability to enable us to meet these criteria, and the timetable in becoming compliant. Currently, the problem is not with upfront dollars, resources, or commitment; but rather with our HIS vendor is meeting the same needs for their 2500+ customers. Some of our projected installs, based on signed contracts, takes us out to 2012. As such, we will most likely not be included in FY11 federal dollars.”
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“primarily delivery.... but as important... help set priority of projects and to interpret what is needed to most inefficiently achieve stages 2 and 3 of MU which focus on consumerism, quality and assumes high level of interoperability with error free data... IT leadership needs to communicate the complexities and make sure leadership both admin and clinical decision makers understand that their decision will make a significant different in goal accomplishment..... ie... IT must communicate complexity, adherence to standards, etc as constraint to meeting goals.... not just implement......”
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“I am finding that I am looked to for subject matter understanding, articulation of the need, and interpretation of technical elements. Some amount of program management reporting is necessary for large project interdependency management. The CEO and others are counting on the executive sponsors, including the CIO, to deliver incentive monies.”
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“a. Implement the technologies according to our internal plans and timelines.
b. Facilitate a process by which we will create a methodology and process for measuring, monitoring and modifying our adoption and utilization success
c. Ensuring we have the necessary tools and information exchanges established to fulfill the mandated public reporting and quality reporting criteria.”
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“The most important responsibilities are ensuring we have a good understanding of what is required to achieve meaningful use, a good plan to implement the technology and associated work process changes and continual sponsorship throughout the organization to maintain the high priority… The CEO and Other Executives are counting on me for the above and continual communication regarding status and needs…”
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“My responsibilities are to be aware of the market and our vendor partners abilities to meet the criteria. The Team expects me to execute the plan outlined by the governance committee structure above.”
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“1. Secure our ability to capture all available monies.
2. Facilitate data requirements and capture for all physicians/specialties.
3. Secure accurate reporting.
4. Work with vendor(s) to confirm capabilities.”
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“My most important job is to consult with the users on how they use the tools we have given them. We have what we need to make MU. We need to use them correctly. I am blessed with a Clinical Group and Medical Staff that actually get that, and are willing to drive to use it right even if it means process change. While yes, some docs still complain about CPOE 2 years later (and do not hesitate to let me know that) we are still at nearly 75% compliance overall, all orders. We are proud of that.
Sr. MGt, the CEO and Board are looking at me for three things:
1) Be totally and thoroughly knowledgeable on what needs to be done
2) Bring the solutions to the table
3) Get them running, USED, and protected.
I get great support, albeit at times a bit reluctantly, to make this happen. All the years of trust building are really paying off at crunch time right now.”
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“To keep the process moving, provide solutions to issues, help define process changes”
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“On the inpatient side we are very close to being fully qualified to meet the Meaningful Use standards. On the physician practice side, we have 100 docs already on our clinical EMR…their qualification should be a slam-dunk. On the specialty clinic side we have 1000 docs to migrate to a clinic EMR. We have completed about 20 of them…equal to two clinics. We have 85 clinics to go. We are developing our strategy and trying to strike the balance between a quick roll out, and implementing change at a rate faster than the organization can absorb. Stay tuned…”
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“Insure that there is a valid action plan, assigned responsibilities, and due dates”
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“I think all pieces, in particular the decision support and quality initiatives and the sharing of data.”
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“- understand what is required
- provide direction to the team who ill be doing the heavy lifting to get ready
- debrief senior management
- working with CMIO and Clinical Informatics in developing action plans.”
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“Senior Management is counting on meeting MU in the first year. It is my responsibility to make that happen.”
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