Investing in the Diagnostician
Chapter 8 Bedside Questions · 9 questions · about 9 minutes
About 70% of hospitals have a CMIO Name but few have the Form (training, funding, positioning, empowerment, staffing, full-time employment), so the Function never runs. Half commitments hide the gap, and the function's return has never been priced, so it is treated as a cost center.
The placebo and the wrong consultant: a CMIO title without active ingredients is a placebo; the right Form (six ingredients) at the right dose produces the Function. The chapter prices the therapy like a patient workup: size of the problem, cost of treatment, return.
Answer as your executive team would, with the evidence in hand. Each question has a factual answer in a system you already own.
Run the six questions (six-condition screen) with the chief executive, not the informatics leader. What is the score, and which conditions failed?
Add a note: where is the evidence, or who owns it?
Name the last thing the clinical technology leader stopped. Silence answers the fourth question.
Add a note: where is the evidence, or who owns it?
Count people already doing informatics work under other leaders (analysts, trainers, documentation specialists, report writers). What would it cost to add a qualified physician above them, and what are you paying them now?
Add a note: where is the evidence, or who owns it?
What did you spend last year on denied-then-paid claims, nurse turnover, agency labor, prior authorization staffing and quality reporting? Are those five numbers on one page?
Add a note: where is the evidence, or who owns it?
What is total technology spend, and what fraction goes to the clinicians who decide what the technology does?
Add a note: where is the evidence, or who owns it?
Are physician informaticists paid for protected time or volunteering?
Add a note: where is the evidence, or who owns it?
What financial impact can be attributed to the informatics program in the last 12 months? If unanswerable, it is not measured and cannot be defended.
Add a note: where is the evidence, or who owns it?
Which losses are curable and which only reducible? If never sorted, start there.
Add a note: where is the evidence, or who owns it?
If the informatics leader left tomorrow, who takes the role?
Add a note: where is the evidence, or who owns it?
A reflection tool from the book, not a validated diagnostic test or benchmark. Your answers and notes stay in this browser unless you choose to send them. Please don't enter patient information.
Adjectives lose a budget battle every time. This is the first version with arithmetic in it.
The Diagnostician, Chapter 8