How do the roles of CMIO and CIO co-exist? An interview with Chris Davis of Baptist Health System

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 - Chris Davis
Chris Davis, MD, CIO/CMIO, Baptist Health System

Chris Davis, MD, has been named chief information officer of Baptist Health System (BHS) in Birmingham, Ala., adding the CIO title to the CMIO role he took on when he joined BHS in 2012. Davis had been acting as interim CIO since June.

When originally hired in 2012, Davis was tasked with leading the system’s Epic EMR implementation. Prior to joining BHS, Davis worked at Mercy Health System in St. Louis as a physician informaticist and inpatient CMIO. During his six-year tenure at Mercy he assisted in the implementation of the Epic EMR in 18 hospitals across four states.

He received his medical degree from the University of Arkansas for Medical Sciences, where he also completed his residency in emergency medicine. Following his residency, he practiced as an emergency physician in the Emergency Trauma Center at St. John’s Health System in Springfield, Mo. He holds a master’s degree in medical informatics from Northwestern University and is board-certified in emergency medicine and clinical informatics and is a fellow of the American College of Emergency Physicians. 

He took some time recently to talk with about his career in health IT and the challenges he faces as a dual CMIO/CIO.

You started your career in emergency medicine—how did you veer toward informatics and health IT?

I always had an interest in computers and technology and it really started when I was practicing emergency medicine and my hospital and health system was in the planning phase of CPOE implementation and a big piece of that was standardized order sets. So, I responded to a flyer advertising that the hospital was looking for a part-time medical director for medical informatics, and ended up getting the position.

As we continued to work on the standardized order sets and made some other design decisions along the way, we ended up switching vendors from Cerner to Epic and I ended up transitioning to a full-time role. My first title was physician application coordinator, which basically meant I was an analyst. Later, as we transitioned from implementation to optimization our titles and roles really changed. I became a physician informaticist and then ultimately—before I left Mercy—took on the inpatient CMIO role. 

You were Baptist Health System’s first CMIO. What kind of challenges did that present?

I actually prepared a PowerPoint presentation on this for some of the leadership department meetings I went to, and the leadoff slide was “What the heck is a CMIO?”

So really, explaining what that position is was a big challenge.  The way I like to describe it is that I see myself as a translator between the IT and clinical world. I have expertise in both areas and much like we translate complicated medical problems into a language that patients can understand, I kind of do the same thing with the EMR. You take complicated IT language and translate it to language that physicians and other clinicians can understand.

As I got introduced to groups of subject matter experts and multi-disciplinary teams that we used and relied on and since I lead a lot of those meetings, they kind of quickly understood what my role was.

You’ve been involved in several Epic implementations, including one at Baptist Health. What was that process like as you were starting your role as CMIO?

I had implemented Epic at several hospitals before I left Mercy and it always gets to the point where you are able to anticipate what the next question coming out of a clinician’s mouth is going to be. You get all the same fears and the same concerns, and it’s not going to be any different at other organizations.

There is the fear of the concept of standardized order sets, and the fear of the concept of CPOE and electronic notes in general. You’ll hear, “I’m so busy how am I possibly going to have time to do all of this stuff?”

These are common themes in every implementation I have done and it wasn’t any different at Baptist.

Having gone through it before gave me a lot of credibility. I was new to the medical staff so I had not worked with the staff in a clinical capacity before joining the organization, so the fact that having years of experience implementing Epic in 18 other hospitals before I joined Baptist really put me in a good position to handle all those questions and situations quite well and helped me bring the medical staff along with us on this journey.

How will you make your dual CMIO/CIO roles co-exist?

In many ways I will be wearing two hats. They are two very different roles, but at the same time they are very similar as well.

Before I did took on this additional role I frequently attended the same meetings as our CIO, so people saw that both of these positions are key stakeholders in a lot of organizational decisions and strategies. In that respect, I had been involved in the same conversations with the CIO on a lot of projects already.

The key piece of the position that has been new to me has been the additional responsibility of pure IT that is outside the EMR. These are issues that I did have some understanding of and some education about, but they’re not necessarily what many CMIOs are dealing with day in and day out. Things like storage servers, or having enough bandwidth on your wireless infrastructure. Instead most CMIOs have traditionally been focused on the EMR and EMR implementation. 

My change from medical director of medical informatics to a physician application coordinator to a physician informaticist to a CMIO was really a natural progression. I think the transition to CIO is also natural now that the EMR is live and there is some optimization we can do with the EMR.

There will be many challenges related to optimization, but there will also be challenges involved in taking on more of the responsibility for the strategic vision of the organization going forward, and getting out of that box of me being just the Epic guy or the EMR guy so that I can really understand and see where the organization wants to go in a strategic direction.