Innovation and the Ever-changing Role of the CMIO with Dr. Nathan Gause

Innovation and the Ever-changing Role of the CMIO with Dr. Nathan Gause

This summer, I got the opportunity to interview Dr. Nathan Gause. I saw how passionate he is about serving his community and developing young African American physicians and scientists.  He has excellent knowledge and a wealth of experience. I felt compelled to write about Dr. Gause and his dual role as an Orthopaedic Surgeon and Chief Medical Information Officer (CMIO) at the University of Missouri Health Care in Liberty, Missouri, a community of just over 30,000 in the suburbs of Kansas City, Missouri.  



With the additional responsibilities of the CMIO role and the job’s evolving nature, do you think the position would eliminate requirements for patient care? 

  I’ve experienced both scenarios during my time as a CMIO. I find that each situation is unique and may require something different from the CMIO role. At the beginning of my time as a CMIO, I needed to remain clinical to build camaraderie with my colleagues. This proved essential as the health system was going through a transition to a new EMR. The medical staff needed to know that every decision I made affected me as much as it affected them.


As time went on and the EMR matured, it became less relevant if I practiced and more critical to perform as a change agent. However, I elected to still practice in a part-time fashion because of my love for orthopedics. I also recognized the importance of a minority surgeon for the community.


What innovation is keeping you up at night?

 Interoperability is a formidable task within itself. However, I’m also cognizant that the topic is a piece of a much larger puzzle. I consistently ruminate over data management and analytics as our repositories grow daily. We are acquiring massive amounts of information. How do we make meaningful use of it to improve the quality of care? That’s a question I frequently ask. I also have a focus on mobile solutions to enhance throughput and agility with patient/provider interactions. 


There is significant controversy in the lack of diversity in the Physician Population and the Surgical community. How do you feel about being a representative? What steps have you taken to grow the community of physicians? 

I’d like to take a quick moment to point out that math has no opinion. In the field of orthopedics, less than 2% of practicing orthopedic surgeons are black. The data is irrefutable. If one takes the time to scan other medical specialties for diversity statistics, the results are comparable, unfortunately. I take great pride in being a representative and purposely remain visible to provide representation in a significantly lacking area. Diversity in background, experiences, and approach to problem-solving is immeasurably vital to the advancement of medicine.

Mentorship is my primary focus to improve the diversity of the medical field. Marian Wright Edelman said, “you can’t be what you can’t see.” I’ve taken this charge personally and make a purposeful, daily choice to live as an example for future medical leaders. As an assistant professor at the University of Missouri, I am involved in a plethora of opportunities to mentor students (high school summer internships, school of medicine admissions committee, boys and girls club of greater Kansas City, etc.). Recruitment by exposure is my strategy to grow the community of physicians and improve the abysmal diversity numbers.


You currently work in a community hospital. Why did you decide to make that move? Have there been any challenges that have accompanied this move? What have the benefits been in making the move?

My current hospital has a loose affiliation with the University of Missouri. I chose to specifically work here versus on the Columbia campus because I believe I can make a more significant impact in the Kansas City area as it pertains to diversity. There is a larger black community in Kansas City, which allows me to make a difference. There have been challenges with the move, as expected. This community hospital is situated in the Northland of Kansas City and is a relatively homogenous environment. As the only black physician on staff, I encounter daily opportunities. Yet, these opportunities are outweighed by the benefit of living in this city and the amount of access I have to make a real difference.


What do you see as the future? 

Not sure I have an encouraging answer to this question. As it stands, I see a difficult future for my children and the generations to come. Systemic racism is pervasive and persistent in this country. With our current trajectory, it will be difficult for my offspring to be successful. Yet, I remain optimistic that good will prevail and the world will become a better place to live in.

From a technology standpoint, I believe the integration of AI will only enhance medicine, reduce medical errors and improve the quality of life overall. However, health care disparity will continue to be a challenge despite our advances if we don’t remain diligent in this area. 



COVID-19 Causes Nursing Home Crisis

COVID-19 Causes Nursing Home Crisis

It is estimated that at least 25 percent of US COVID-19 deaths in the United States have occurred in nursing home and assistance living facilities. Thousands of facilities nationwide have reported cases of COVID-19 among residents and staff. There have been severe staff shortages because many staff are concerned for their safety. Plus, many are unwilling to work in conditions characterized by insufficient testing and personal protective equipment (PPE).

For many facilities, COVID-19 has exposed long-standing issues regarding how nursing home services are managed and financed. The limited financial and staffing structure leaves many nursing homes in a weak position to respond to a crisis such as COVID-19. Ample time for testing, monitoring, isolating and treatment of patients is needed. Nursing home and assistance living facilities depends on Medicare and Medicaid reimbursement. In the midst of the pandemic, neither the federal nor most state governments have made any great attempts to prioritize the prevention and detection of COVID-19 in nursing homes. The large federal mandates and aid packages to support hospitals and other healthcare facilities have largely left out nursing homes.

If nursing home infections can be decreased, the enormous toll on nursing home residents and their loved ones will be lessened. We can win this war against this virus by working as a community to overcome this crisis.


Grabowski, D (2020, May 22). Nursing Home Care Crisis in the Wake of COVID-19. JAMA Network.

Khimm, D (2020, October 27). The hidden Covid-19 health crisis: Elderly people are dying from isolation. NBC News.

Fortier, J (2020, October 26). They Work in Several Nursing Homes To Eke Out A Living, And That May Spread The Virus. NPR News Station.

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