It may be surprising to hear this at an information technology show, but there's some suggestion here that CIOs will go the way of the dinosaurs. OK, that might be an exaggeration. I don't think my five-year old son will be digging up your CIO's bones when he becomes a paleontologist in 20 years or so. At least I hope he won't!

At any rate, there's been a healthy and useful discussion throughout some of my meetings about the changing role of the CIO. Or more to the point, the need to make health IT to be a clinician-lead endeavor.

"We've been given a sacred responsibility," William Bria, M.D., chief medical information officer at Shriners Hospitals for Children said last night a dinner event held by AHA Solutions. "We need to realign our goals," he said around patient care, not around CMS' goals or incentive payments or other political priorities. To do that, physicians needed to be front and center.

David Muntz, VP and CIO at Baylor Health Care System, and Tom Balcezak, M.D., associate chief of staff at Yale-New Haven Hospital, who shared the podium with Bria concurred. Muntz added that for years the CIO's role has really been the Chief Data Officer. That has to change. Technology needs to provide clinicians with useful information, not just data for data's sake.

"We need to get IT as part of the overall clinical team," Deane Morrison, CIO at Capital Region Healthcare, which runs the 230-bed Concord Hospital. He said CIOs—and the rest of IT—need to essentially let clinicians lead projects and get the credit for successful deployments. It's also imperative to change the focus from an IT deployment to outcomes and improved care, said David Frownfelter, M.D., CMIO at Henry Ford Health System. Both Morrison and Frownfelter spoke during a breakfast sponsored by McKesson. Interestingly, both men said that their hospitals are unlikely to apply for meaningful use incentive money in fiscal 2011 and part of the thinking is making sure that their IT objectives mesh with their overall clinical goals.

The issue of clinician engagement is also coming up with vendors. Some are beginning to recognize the need for practicing docs and nurses to be involved in product design. It saves everyone time and money in the long run, says Angie Franks, president and CEO of Healthland, which sells IT solutions to rural hospitals. In developing its new CPOE product, for instance, Healthland recruited 23 docs from 23 hospitals to be involved in product development from the start. Healthland let the docs hammer out different workflow issues. They used the same process for a nurse documentation system. The process may have added to the product development timeline, says Franks, but it has resulted in a product that won't need to retooled and retooled again.