The growth and expansion of automation into medical practices, ambulatory centers and other sites outside the hospital has led to an increased demand for qualified IT leadership over the ambulatory and medical group side of healthcare. There have been directors or managers for physicians IT services or applications in the past. But the position of an executive or “Ambulatory CIO “ has grown in demand at large integrated delivery systems with employed physicians, academic medical centers, large clinics and physician organizations.
Factors leading to the growth of the “Ambulatory CIO”
Current health system CIOs may have had this responsibility added to their sphere of influence. But in some cases organizations are adding a “new” IT leadership position to oversee the medical group practices/foundation over 100 physicians. Several factors have led to the elevation and demand of this role.
- Tremendous growth of ambulatory/physician practices in last five years
- Increased competition and employment of physicians by healthcare systems
- Creation of separate physician organizations within a health system.
- Selection, and implementation of new complex practice management and EMR systems
- Financial incentives from ARRA and Meaningful Use
Key skills needed to succeed
What I look for in a potential “Ambulatory CIO” background, include some of the following skills and experiences:
- Proven IT leadership in medical group practices
- Effective communication skills with physicians and staffs.
- Executive management, strategic and operational experience skills
- Demonstrated experience and success in clinical informatics related to ambulatory/physician practice environments
- Successful track record of implementation of physician practice management and EMR/CPOE systems in ambulatory/physician practices
- Specific ambulatory EMR/CPOE vendor system knowledge and/or work experience with: Epic, eClinical Works, Next Gen, Allscripts, Cerner, etc.
- Vendor or consulting work which include operational IT experiences in medical groups.
Key relationships and Titles
Reporting relationships and titles for “Ambulatory CIOs” will vary with different organizations, here are some examples that I have run across.
One large Midwest health system hired a “Vice President, IT” over their newly formed large medical group of employed and non-affiliated physicians. The VPIT reports to the CEO of the Medical Group and a dotted line to the SVP IT of the health system. The VPIT has over 25 dedicated IT staff and also uses IT resources from the main health system. The VPIT is part of the executive team of the medical group which consists of CEO, COO, VPHR, CMIO, and CFO. The VPIT implemented a different EMR/CPOE system in the practices, then what is installed in the hospitals.
An academic medical center in the West, formed a separate medical foundation of non-affiliated physicians, hired a Director, IT who reports to the Executive Director with a dotted line to the Deputy CIO of the academic medical center. The Director is part of executive management of the foundation which includes: Executive Director and Directors of HR, Finance, Revenue Cycle, etc. The Director, IT has a staff of about 15 dedicated IT professionals and uses the IT outsources of the hospital. The foundation utilizes the same EMR/CPOE system as the hospital.
Another Midwestern health system formed an employed physician medical group and the SVPCIO of the health system became the IT leader for the expansion of services to the medical practices. The SVPCIO, hired a President/COO, formed a Board consisting of physicians over the medical group, and has an IT support staff of ten dedicated to implementing the same EMR/CPOE system as the health system.
I look forward to hearing about more IT leadership positions as the ambulatory/physician practice environment grows.