For signs of change in healthcare, look to a smarter, more engaged CIO

With the second anniversary of health reform upon us, we're beginning to hear plenty of perspective from the “usual suspects” – doctors, patients, insurers, hospital CEOs – about the changes they’re seeing so far and what they expect to be the biggest, most significant elements of reform as the implementation dates draw closer.

One of the major themes thus far has been the concept of the blurred lines we are beginning to see take hold between provider and payer as the collaborative care and pay-for-performance begin. While all of these changes give us a good idea of the kinds of market pressures and system-wide shifts that we can expect to see in the future, they don’t tell us much about what’s happening at the ground level – in doctor’s offices, hospital rooms and ORs – for both providers and their patients. 

For the best look at how the sea change shift that is underway in healthcare is playing out at the ground level, there may be no better evidence than the evolving role of the Chief Information Officer (CIO).

Not long ago, CIOs were largely responsible for keeping up their institutions’ computer systems – systems that did not include electronic medical records (EMR) and had little to do with clinical operations. Few of them were C-suite level management, and in some cases, they didn’t even report to the C-suite.

Today, that role has changed dramatically – and it’s about to change a whole lot more.  The learning curve for data management has been greatly compressed and CIOs are going to have to get a lot smarter – real quick. CIOs and the data and systems they manage are at the heart of health reform and the transformation that is just now beginning to materialize. But the evolution of their role in our healthcare system isn’t about the typical increase in responsibility that comes with the increasing importance of technology in business. It’s about an evolving scope of work that is, in many ways, a harbinger of what we can expect out of health IT in the future. 

Now, the majority of provider CIOs report to their organization’s CEO and have a seat at the management table. And that makes perfect sense – because they are responsible for far more than what you might expect. Just think of the promises that have been made to both patients and doctors as part of the national push for EMR. The implementation of EMR systems is about far more than getting computers up and running – it is supposed to herald a new era of improved patient safety, reduced medical errors and most important of all, higher quality of care. And with an increasingly large number of provider CIOs at the helm of EMR implementation and health information management, that makes them partly accountable for the types of care improvements we would once have placed solely on the shoulders of doctors.

As if that weren’t enough work on their plates, CIOs are becoming integral players in provider responses to health reform. As implementation kicks into high gear over the next couple of years, and the market continues to react and adjust to new incentive structures, the shift to a pay-for-performance healthcare system – and the influx of millions of newly insured patients into that system – is going to put data and information management at center stage.

While these folks may not be front-and-center for the stories you’ll read about “health reform at age 2,” they are playing a major role behind the scenes. In fact, if we’re able to say that reform was a success when we reach future anniversaries, we’ll owe much of the thanks to them and how they effectively leveraged the data at the right time in the patient’s lifecycle. 

Jim Bohnsack is vice president of TransUnion Healthcare.