The CHIME/AMDIS CMIO Boot Camp was held in Ojai, Calif. last month. It’s the third time the course has been offered, but the first time I had a chance to participate. I absolutely loved it: a great faculty and 30 engaged and energized CMIOs. It was over way too fast.
While the course has a very packed curriculum, the Q&A sessions were some of the most fun. How do you deal with a CMO who isn’t supportive? How do you get a project funded when you don’t have a budget of your own? And inevitably, who should the CMIO report to?
Vi Shaffer and Dick Gibson at Gartner have been surveying CMIOs for the past ten years or so, and this question generates a lot of discussion and interest every year. Vi shared this year’s preliminary results at the annual AMDIS meeting that followed the Boot Camp: a third of the CMIOs in the survey reported to the CIO, another third reported to the CMO, and 10 percent had a dual reporting relationship to the CIO and CMIO. When asked who they wanted to report to, only about 6 percent said the CIO. About 30 percent said the CMO, 40 percent favored a dual CMO/CIO setup, and about 20 percent said CEO, COO, or some other CxO.
And so the Boot Camp attendees were a little taken aback when I offered my opinion: “It doesn’t matter who you report to.”
Let me explain. The CMIO has to build and maintain relationships with a wide range of key stakeholders. First, the CMIO is the voice of the medical staff for informatics topics — she serves the physicians. In many if not most organizations, that’s not the same as serving the CMO. But the CMO is definitely a stakeholder the CMIO needs to think about. Obviously, the CMIO is also the voice of IT for many clinicians, so his relationship with the CIO is critical. But it certainly doesn’t end there. The CNO and CNIO, the COO, the CFO, Quality, Revenue, Patient Experience/Marketing and Compliance are all critical relationships. They can be key partners in the CMIO’s efforts, or significant roadblocks if the connections are mishandled.
The lines on the org chart aren’t nearly as important as the relationships the CMIO builds. Yes, it is true that a bad boss can ruin your day in a hurry, and people in the organization will take their initial cues from the lines on the chart. But, the success of the CMIO depends on the ability to successfully navigate the heavily matrixed environment that is today’s healthcare organization.
In fact, I would argue that the CMIO has to know more about how today’s healthcare organization actually works than any other member of the C-Suite, save one. If the CIOs reading this blog didn’t see that list of key relationships and think, “I’ve got all those and could add a few,” I’d be very surprised. And that’s my point — the CIO-CMIO partnership is central to each partner’s success. Whether the CMIO reports to the CIO, to the CMO or some other C only matters if the partnership isn’t working. And lines on an org chart can’t fix it.
Vi and Dick’s Gartner survey also asks the CMIOs what they want their next job to be. Only 3 percent indicated they’d like to be a CIO. Almost 40 percent said they want to stay a CMIO, and about 13 percent want their next title to be “retired.” (One can relate.) I’ve talked to CIOs who are concerned that physician CIOs are a growing trend. I don’t know if that’s true, but I do know that the odds that your CMIO wants your job are very, very slim.
My advice? Go out of your way to make sure your CMIO is successful. It will be the best investment in your own career you’ll ever make.
[Formerly the CIO and CMIO at Children’s Hospital and Medical Center in Omaha, Neb., George Reynolds, MD, is part of the faculty for the upcoming CHIME/AMDIS Fall Symposium, which will be held November 3-5 in Phoenix, Ariz. For more information on the program, click here.]