As strategic initiatives across IT continue to grow, many are looking to the CIO as a leader. But according to Pamela Dixon, managing partner at SSi-Search, another prominent position is evolving to aid the CIO in the development of new projects. 

"To assist in meeting these challenges, we see the chief medical information officer (CMIO) taking a seat next to the CIO in meeting Meaningful Use objectives – and possibly beyond," she said. "The CMIO's role is not new to healthcare but is rapidly gaining importance.  How the role will evolve is raising some questions for the C-suite."

Dixon helps outline five keys to the evolving role of the CMIO.

1. The role of the CMIO is "critically important." According to SSi-Search's recent study, about 95 percent of respondents felt the CMIO is "critical to the successful deployment of an EHR." Most respondents back up this statement, the survey concluded, with 90 percent of all respondents saying they have hired or plan to hire a CMIO in the near future. "However, the survey reveals C-Suite opinions differ on the reporting structure of the CMIO," said Dixon. "The respondents of the study, across all categories, were evenly divided. Looking specifically at CIOs and CMIOs, we see a conflict." More than half of the CIOs surveyed said the CMIO should report directly to them, she added, yet the other half of respondents believe the CMIO should report to the CMO of the CEO – not the CIO. "A few CIOs and CMIOs offered a doted line reporting structure," added Dixon.

[See also: 10 qualities of stellar CIOs.]

2. Typically, the CMIO is a practicing physician with a strong understanding of IT. The CMIO is typically tasked with leading the strategic positioning, implementation, and support of clinical systems, said Dixon. "The CMIO must understand and translate physician needs while also translating the health system's business and clinical initiatives as well as constraints," she said. The CMIO needs to then communicate how the solutions, including CPOE and EMR, meet those needs, Dixon continued. "The CMIO is key to facilitating collaboration between IT and the clinical community and [is] considered highly strategic to achieving the clinical objectives of the health system."

3. The CMIO and CIO work best as a team. "The CMIO is involved in all facets of the clinical implementations and best practices," said Dixon. Typically, the CIO is focused on budget, IT infrastructure, including security and regulations. "Both CIO and CMIO understand and work together toward meeting the ARRA HITECH meaningful use requirements," she said. "The CMIO may report to the CIO with a dotted line to the CMO, or the reverse."

[See also: CMIOs see roles changing.]

4. A core, clinical informatics-focused team is key. Dixon said a team focused on informatics will play a large part in defining and creating tools that can be successfully implemented and used in a meaningful way. "The purpose of this team is to help answer critically important questions during the design, content development, workflow, ease and speed of use as well as appropriateness of alerts for CPOE," she said. "The [team should] synthesize broad information, which medical staff advisors [should] review and will ultimately be broad-scale presented to all interested physicians in the health system."

5. Physician "champions" and clinical representatives can make all the difference. Achieving the core information Dixon mentioned above requires well-planned and regularly scheduled meetings with, what she calls, physician champions and clinical representatives in all key areas. "The [team] usually involves a range of disciplines: nurses, nurse informaticists, quality management, pharmacists, lab technicians, IT and others who see the value and can make the time commitment," she said. By working together, she concluded the CIO, CMIO, CMO, and the team should achieve consensus across the system, "through thoughtful communication that encourages involvement."