Moving to an “Industry” Job: What CMIOs and Physician Informaticists Need to Know
By Zachary Durst
As informatics become increasingly important to healthcare and health-related industries, the number of opportunities for physician informaticists such as chief medical informatics officers (CMIOs) and chief health informatics officers (CHIOs) has grown significantly. Gone are the days when physician informaticists were simply the translators between providers’ clinical and technology groups. Today, physician informaticists are making an impact broadly in the areas of workflow, data science, product development, digital transformation and more – in payers, technology firms, start-ups, large public companies and consulting organizations.
Physician informaticists have a lot to offer organizations outside the provider space, says Stephanie Lahr, M.D., CHCIO, president of platform solution provider Artisight. “They understand medicine, the business of healthcare, the evolving role of technology. These are skills that can benefit industry partners from startups to the Fortune 500s of healthcare.”
Physician informaticists “also tend to be lifelong learners who are passionate about adding experience and skills that can change healthcare for the better,” she adds. “This makes them uniquely positioned to add value across the entire spectrum of the health IT ecosystem.” While transitioning to industry carries risk, Dr. Lahr admits, there will always be opportunities for good physician informaticists to return to the provider arena should they want to.
For a physician informaticist thinking about making the move into an “industry” position, there are several considerations to make before fully diving into a search for that one great industry role.
Defining Your Role
While the function and value of informatics is widely acknowledged across healthcare providers, this may not be the case in the organization you are looking to join. Even in large Fortune 500 companies, the understanding of informatics may be limited especially if you are one of the first informaticists they aim to hire. So while you may be reporting to someone who understands the value, it will be incumbent on you to really create and develop the role around you.
For some, this level of ambiguity is not a strength and, in the end, may be a reason to not consider an industry role. However, if you are a leader with the ability to build collaborations, communicate value, garner consensus and drive results forward in an ambiguous environment, then this kind of role in industry may be exciting. Just be prepared to navigate that complexity on the front end of your tenure. “If you want to make the move to industry, you need to understand there might not be the perfect job,” shares Steve Kassakian, M.D., physician executive for clinical informatics at Humana. “It will be a new experience. You will learn more by being flexible on what projects you take on. My experience at Humana has been incredibly rewarding and I think a big part of that is having approached my transition with humility and a focus on listening and learning.”
The very nature of an industry role can vary much more than a typical provider CMIO role today. Depending on the organization, an industry CMIO may be focused on an implementation, the development and deployment of new products, the creation of governance, AI, or a thousand other possibilities depending on the particular focus of the firm. In order to be successful, someone transitioning to industry must be willing to stretch their understanding of what informatics is and willing to take on new challenges they may not have considered. Colin Banas, M.D., chief medical officer of DrFirst, a provider of medication management solutions, states, “At DrFirst I have had the opportunity to provide input on multiple different products and make a positive impact, but I have had to learn the language of the organization and products. In this role I had to do a lot of media training because as one of the physicians in the organization, you become the face of the company. That exposure took a little getting used to.”
Claude J. Pirtle, M.D., M.S., CMIO of Walmart Health, says his role has come with welcome new challenges. “I focus a lot of my time on innovative strategy and care delivery but also remembering healthcare is local,” he says. “Walmart Health facilities provide a range of healthcare services in one convenient location so patients can get the right care at the right time, right in their community. A lot of the work I have shifted to has been applying change management strategies, governance and innovative transformation at scale and ensuring the patient and provider experience is consistent across the entire national ecosystem.”
Whereas many health systems are just now developing their capabilities around agile, many industry organizations have been using those principles for years, or decades. Failing fast is seen as a positive. For informatics leaders that spent a career in a health system where mistakes can lead to adverse health outcomes, it can be a hard transition to make and requires a change in perspective that is not always possible. Know your limitations there.
While industry informatics leaders interviewed for this piece shared that there is a similar pace for getting consensus around a decision, the major difference noted between a health system and industry organization is that many of those decisions are not made through formal governance, but through informal processes and relationships. An informatician must be able to put in those long, tough hours at the front end to understand who the potential stakeholders are and then get their buy-in before rolling out a product or system that is still in beta and will need to continually iterate over months or years. “A lot of applied informatics at the provider is around governance,” says Dr. Kassakian of Humana. “The CMIO is often responsible for creating the structure and managing it. Having that understanding of governance is very valuable, even if governance isn’t explicitly stated on the industry side. One thing at Humana I’ve been involved with is developing and supporting a governance structure, which has been tremendously valuable and that’s transferrable experience.”
For some informaticists, the urge to move to industry is due to a desire to have better work/life balance – no overnight on-call, the ability to take a vacation and leave the phone at home. This can often be true, but you must consider the practice component of your work to be certain. While some industry informaticians are able to build in clinical practice to their work schedule in an industry organization, it is not the norm. This is because the amount of work and need to be agile at your new organization will likely not lend itself to a consistent clinical schedule. An organization needs its informatics experts available at a moment’s notice for client issues or technology concerns. Or to travel to a site for days or longer to meet client or organizational needs.
This is exacerbated further if you are in a specialty that requires consistency to keep your patient load. Other specialties that provide more flexibility give more options for an industry role through doing per diem work, but it will be in addition to your “9 to 5” role. “My organization is supportive of practicing and people are supportive, but you need to figure out how to make it work with your own schedule,” notes Dr. Kassakian. For some, that will be a trade-off that is more than worth it, especially for those looking to step away from practice for any number or reasons. However, for those looking to still practice who may be looking at industry for a lifestyle change, continuing to practice on a per diem basis may make that lifestyle change harder.
One of the biggest shocks to informaticists moving into an industry role is very often the compensation. In a health system, your pay is usually determined by a base compensation and incentive bonus if you are in a CHIO or CMIO role. In industry, if it is a private, PE or venture-backed firm, compensation is likely structured as a smaller base, a bonus and some kind of equity in the company itself for when the organization is sold or issues an initial public offering (IPO). At a public company, there is a base, a bonus and some kind of stock grant involved. Either way, going into industry means there is less guaranteed compensation up front in the form of the base and more determined by the bonus, stock and equity.
The at-risk model of industry can lead to significant upside if the company does well and is bought, holds an IPO or the stock goes up exponentially. But an informaticist looking to make this transition must sit down and understand what level of risk they are comfortable with to determine if this is the kind of move that makes the most sense to them personally. “I say 100% of the time when someone asks me about a move to industry that this is not a rags to riches story,” says Robert Budman, M.D., CMIO of Nuance Communications. “You have to be prepared to take a pay cut and to work hard. The tradeoff is the potential for a more balanced lifestyle, the opportunities and, maybe, growth if you find the right organization.”
Moving to an industry role can be an exciting new career change, one that brings about new challenges and can rejuvenate a physician informatician’s career. Such a move is not without risk, however, as these jobs tend to involve more uncertainty, new work habits and lower base salaries, which can be unsettling for some.
My advice: Ask yourself first if this type of move even fits with your personality and career aspirations. If it does, find out as much as you can about your potential new employer to make sure you have a clear picture of what to expect in this new role. As Dr. Budman says, “I miss giving clinicians tools and helping to empower them to perform better and the comradery, but on the vendor side I get the excitement of working with clients and customers to solve puzzles and see where technology is going in this next generation. Everything is a trade-off and it has to be one you’re willing to accept to make the jump.”