Transitioning from one CMIO role to another: A conversation with Michael Shrift

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 - Michael Shrift
Michael Shrift, chief medical information officer, Community Health Network

Michael Shrift, MD, MBA, was recently named CMIO for Community Health Network, a non-profit health system with more than 200 sites of care and affiliates in Indiana and Michigan. He will also be a practicing physician for Community Health Network in the area of consultation liaison psychiatry.

Shrift has long been a major player in the CMIO community, having served as CMIO and vice president, clinical knowledge management, for Allina Health and Hospitals in Minneapolis, and CMIO for Centura Health in Colorado. He took some time recently to talk to CMIO about his new position, his career and about the evolving role CMIOs are playing in healthcare.

Why the move to Community Health Network?

There are many remarkable features about the Community Health Network. Its connectivity across the continuum is nationally known and it has greatly impacted care. Parallel to that, it is known for its patient and employee engagement—there’s a high degree of relationship intimacy here. And they are looking for technology that will maintain relationships rather than get in the way. That’s very attractive.

In that lies a big challenge. We have an exceptional chief information officer who is also chief of knowledge management, Ron Thieme, PhD, and we’re placing a very large emphasis on full technology solutions for end users. It will be a pretty big effort to identify and prioritize the clinical challenges and then bring a suite of usable technologies forward.  Particularly those that involve optimized Epic, which we call Community CareConnect, and on the analytics side. So we’ll have our work cut out for us to implement these tools in usable ways that enhance the value for the end users, the system and our many communities.

You’ve made the move from one organization to another. What’s the biggest challenge in managing that transition?

The biggest challenge is learning the culture [of the new organization], and there is no substitute for just hitting the pavement and meeting everyone from leadership to the frontline clinicians. That’s just the hard work you have to do. Every organization is going to have a different culture—a different focus. Here [at Community Health Network] there’s a high premium placed on relationships, but every culture is going to be different, and it takes some effort to understand it.

Can you talk about one implementation you have been involved with that was particularly challenging?

One of the hardest, and one in which the teams excelled, was the Epic (called Excellian at Allina Health) implementation at Phillips Eye Institute (part of Allina Health). Phillips is a nationally known eye institute and its procedural areas are among the best in the world. They have refined their workflows down to the second and the millimeter, so to implement Excellian in a very high turnaround procedural area was an enormous challenge.

The Excellian and clinical decision support teams did an amazing job of planning and workflow mapping. The procedural-based workflows can be a challenge in Epic and in any EMR, and it was no different at Phillips. They came out with an excellent solution. The work of Chris Menzies, MD, was especially notable. 

You’re going to continue to remain active clinically while serving as CMIO. Why is that important and what are the challenges involved?

That has also been an ongoing discussion at AMDIS [the annual Physician-Computer Connection Symposium held in June] and there are a lot of opinions about it. Practicing is hard to accomplish because CMIOs are so busy, though for most CMIOs it is vitally important to remain clinically active.

One of the biggest challenges is practicing in a way that gives real front-line touch in acute care and ambulatory and procedural areas so that you can know something about everyone’s experiences and also serve as a bridge back to the clinical technology teams. I’ve been lucky to work in those areas and it has helped to be a credible doctor who can communicate with all the clinicians and translate their needs back to the technology teams.

How has the role of CMIO evolved during your time in the field, and how do you see it evolving going forward?

The evolution of the CMIO role was a hot topic at AMDIS again. There are commonalities between different organizations, beginning with implementation, and then moving to optimization and then to value realization. That’s been my journey, and the journey of many others, although within each of these there are different flavors.

As for the future of the CMIO, I see a redoubled focus on quality and safety. Part of this will have to do with the issues of provider/clinician workflow, so being aware of various workflow solutions will be very important.

There is considerable discussion about changes in our patient engagement technologies—a transition from patients using electronic tools such as patient portals episodically to a more continuous use throughout the continuum of care. If the predications are correct, patients will use technology continuously to participate in care, in the exam room or hospital bed. CMIOs will help plan for this future because it greatly affects the quality and experience of care.