The AMDIS Connection: The Singularity of the Chief Medical Information Officer

“The singularity” was defined by Ray Kurzweil in 2001 as “a [technological] change so rapid and so profound that it represents a rupture in the fabric of human history.”¹ It is now evident that the arrival of the chief medical information officer (CMIO) on the American healthcare scene represents just such a singularity.

Computers have been used in healthcare in America for more than 40 years. However, successful adoption and integration of information technology (IT) into the practice of medicine has occurred only in the minority of practices and healthcare settings.

With the emergence of the CMIO position in the mid-1990s, the recognition by the administrative, healthcare information services and, importantly the American medical profession that the role of a senior informatics healthcare executive was vital and integral to the provision of healthcare services was clear.

The Association of Medical Directors of Information Systems (AMDIS) was created in 1997 specifically for the clinician with formal responsibility for healthcare and leadership. Our membership, now standing at nearly 2,000, reflects the rapid growth in the industry and interest in the role from academic institutions to private practice.

In the past, recognition of a singularity has taken many years. To the monks scribing medieval texts, the advent of the Gutenberg printing press was not acknowledged as a singularity for more than 100 years after its invention. However, there are a series of events that will probably make the CMIO singularity widely appreciated far sooner. Firstly, healthcare in America is in crisis. Cost of care is correctly identified as completely out of alignment with the value of the healthcare dollar spent. National dissatisfaction with healthcare access, wherein our previously treasured primary-care network has given way to hours spent in overcrowded emergency rooms for all-too-brief direct patient-clinician contact. Adding insult to the healthcare value injury are some of the least impressive healthcare quality and safety metrics in the civilized world.

Simultaneously, effective technology has transformed access to information from the Dewy Decimal System—bottlenecked libraries of yesteryear to the instant information access of the Google generation. Likewise, one major industry after the other—from telecommunications to aerospace—have been improved with the introduction of information systems. Importantly, medical research (e.g. genomics, proteomics, metabolomics) and imaging have been catapulted forward in amazing ways that would not be possible without IT.

Finally, with the advent of the new U.S. presidential administration, the global economic crisis and the recognized contribution of the cost of U.S. healthcare, there is the political and financial will to make the necessary regulations and financial incentives to right and truly introduce IT throughout our healthcare enterprise as well as incentivize its use.

I would be remiss if I also did not recognize the tireless efforts of many healthcare informatics organizations and colleagues in promoting the formalized education and training of the next generation of physicians—the CMIOs of tomorrow—who will actually redesign the delivery, practice and evaluation of American healthcare for the next generation.

These changes have not arrived a moment too soon. The fact that this article is in a magazine titled CMIO can only bring a smile to the lips of all those men and women who have had the vision of what healthcare could be with the right information tools.

A singularity this CMIO is, indeed.

¹ Kurzweil, Raymond (2005), The Singularity Is Near, New York: Viking, ISBN 0-670-03384-7