CHIME's Meaningful Use Guide Emphasizes C Suite Involvement

Though IT will handle implementation, the College of Healthcare Information Management Executive's Meaningful Use Guide for CIOs webinar stressed the need for leadership by top administrative and clinical executives.

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Three months in the making, and with input from 170 members, the College of Healthcare Information Management Executive's (CHIME's) Meaningful Use guide for CIOs was the subject of a recent webinar, lead by Texas Health Resources (THR) CIO Ed Marx.

Highlighting some of the guide's most salient recommendations, Marx touched on a few key themes that come up again and again when discussing EMR implementation best practices. First off, he stressed the importance of having C-suite and board support for the project. In fact, Marx said EMR implementation cannot be an IT project at all. While it's true IT will handle the implementation of the technology, the "project" must be lead by the CEO and COO on the administrative side, and by the CMO and CNO on the clinical side.

"I do what I can to remain in the background, but engaged," said Marx. "I want to see the rest of the C-suite leading, with them being the face of the project, not IT. Those implementations in which the CIO is the figurehead of the project are headed for suboptimal outcomes."

Communication with those key people is also key, with the CIO delivering regular (at least quarterly) briefings to the rest of the C-suite and board.

"If you are in a situation where your model is IT-centric, or where the C-suite is not engaged, you need to blow it up. That's what we did," said Marx. "We realized that we didn't have the right level of engagement to be successful, so we blew it up and reconstituted it."

In addition to CMO and CNO leadership, he added that the CMIO role is critical -- filled at THR by Ferdinand Velasco, M.D. But even if an organization isn't large enough to warrant that role, Marx advised recruiting a "physician champion, with the majority of their time dedicated to the EHR's success."

One of the best side effects of Meaningful Use, EMRs and CPOE is that they force the creation of standardized order sets. Usually, that creation requires the input and collaboration of all the organization's administration, faculty and medical staff. And, though painful at times, on the other end emerges best practices of care, agree upon by everyone involved with the organization - practices which are automatically followed unless intentionally deviated from.

Marx said standardized system-wide order sets have allowed THR to provide consistent, high-quality care at all its hospitals.

And while Meaningful Use money shouldn't be the only driver for EMR implementation, it's important to move down that road with an eye toward qualifying for the government cash. To do so, CIOs should start thinking about what he called "clinical business intelligence," in terms of what data the government might want as it moves through the program's stages. "Be prepared so you don't have to rush, and think about all the reporting requirements that are going to come out."

Marx was instrumental in contributing to and reviewing the guide, along with George (Buddy) Hickman (CIO, Albany Medical Center), Richard Lang (CIO, Doylestown Memorial Hospital), John Glaser (former CIO, Partners HealthCare, current CEO Siemens Health Services) and Pamela McNutt (CIO, Methodist Health System). Marx also has strong bona fides as an expert on EMR implementation, as THR just brought its 13th (and final) wholly owned hospital live on an electronic record. Overall, the organization has over 90 percent CPOE among its mostly independent physician staff, with roughly 65 percent of those orders being based on standardized sets.
Anthony Guerra is the founder and editor of, a site dedicated to serving the strategic information needs of healthcare CIOs. He can be reached at [email protected]