What are the core skills required to be an effective Chief Clinical Information Officer?
Do potential and future CCIOs need to have a deep knowledge of technology and informatics to do the role effectively? Are clinical expertise and leadership qualities more important attributes or do you need all three?
It may be there isn't one right answer...
As leaders of one of the key groups of end users of informatics solutions in the health domain, I would suggest they need to be able to express clearly what the end users want functionally and in timeliness, data content and accessibility. In addition they must be able to communicate with potential designers, developers and deliverers of potential solutions; knowing when they are potentially being 'blinded' with (the latest) technologies or being plied with 'vapourware' or tools which are not fit for purpose. CCIOs and their teams / colleagues need to be able to test robustly anything offered in development or as 'the answer' and to have the organisational backing to say what is not appropriate (or what is acceptable) when they see it.
To be able to address this full agenda they must have a wide knowledge and understanding of the domain and available/proposed technologies and solutions. They need to reassure the public and their organisational colleagues that they (or their team) do have such competences and are taking steps to keep themselves and their teams 'street-wise'.
As a previous poster said - its not necessary to be able to do it, but to know in general about the issue and to trust who does advise them.
Jean Roberts, Director (Standards) UKCHIP
I'd say that CCIOs with the necessary professional standing to be able to influence their peers would, almost by definition, not have pursued a careers that would have allowed them to accumulate "deep technical [IT] knowledge". There are no doubt exceptions to this, and I have met a number of clinicians who do indeed have knowledge of this type. However, in almost all cases they have left the practice of medicine. Put it another way: if deep technical knowledge IS a pre-requisite of the CCIO role, then the shortage of suitable candidates (in this country at least) would undermine the concept, certainly the idea that every trust should have a CCIO.
Health informatics is another matter, though I'm not convinced that expertise in this area is critical to the CCIO role. Two things that I do think a CCIO must have are an understanding of programme management and enterprise architecture - in other words, a grasp of how technology can be mobilised to provide solutions to business problems, in terms of both opportunities and its limitations.
They do not need to know "how to do it" but should know "what it can do". Good judgement and being a hard-headed decision maker would also be useful.
Not sure this is an either/or question in reality... however, most people I've spoken to, if asked to choose between tech expertise vs clinical expertise would go for the latter. The reason? Most people think clinical expertise is more important for ensuring the patient outcomes that are ultimately the point of healthcare
Finding someone who is a good clinician, has expert leadership and communication skills and who is technical is not always easy.
While an individual with all of these attributes would make a perfect CCIO, it is by no means essential for them to have all. They simply need to understand whether the technology that they require to improve patient care and drive efficiency exists.
Suppliers that work closely with clinicians are the ones who have the technical knowledge to help ensure that their visions and needs become a reality and receive wider engagement along the way.
If necessary, CCIOs can be taught much of the technical detail and jargon that they need to adequately fulfil the role. However, being a strong leader with exceptional communication skills, which can be used to level with peers, is something that is far more difficult to teach and should be instilled in any candidate wishing to take on the role.
I completely agree with you. I think Kim Ashall CCIO at the Rotherham is a perfect example of this. She does not pretend to know all the ins and outs of technology but she is a good communicator and has great leadership skills. She can learn as she goes along and it is these attributes that make her a natural CCIO.
I fully agree that the role requires clinical credibility and that comes with a credible practicing clinician. However they also need to be able to understand and promote solutions to information management problems that without some serious understanding of what is where and how it is managed, moved etc will not be fully functional. There is not a need for the nuts and bolts understanding of software. Additionally they will need to have an in depth understanding of information governance and the implications and application of the Data Protection and Freedom of Information acts and their compliance.
Training these staff for the future so that they are there to do the job is currently a challenge as there is as yet no clear career structure or training pathway for them. We are looking at this.
I think it is critical that leadership is both clinical & technical & the 2 people need to be able to work together with mutual respect for one another. NHS IT needs 2 people in the lead role--
1. somebody with a technical qualifications who does this full time--Head of IT &
2. Someone with a medical qualification--a NHS consultant with a passion of Clinical IT--who does this part-time--2-3sessions per week --similar to existing clinical director of clinical specialities--Clinical Director of IT.
I do not believe that a hospital will not find these kind of people. The clinical person should have a term for 3 years. Focus should be on clinical delivery of systems. Rhidian Bramley is a fine example where medical leadership can bring true patient benefits (we have been talking about implementing National Patient Safety Notice 16 for a long time. I do not believe this is difficult. However, Rhidian was able to implement this in his Trust through his leadership--no other Trust in NHS has been able to do this).
Medical Leadership in healthcare IT in NHS may seem costly. However, good leadership by enthusiastic consultants with vision is what NHS really needs & WILL bring about huge savings through efficient systems. Through the years I have seen the huge wastage of millions through NPFIT.
Well done Jon & EHI for continuing this campaign,
Over the last few years we have built quite a lot ourselves in order to solve problems that our core EPR was not helping with. Bedside clinical note keeping and dashboards come to mind. I think having technical knowledge, vision and drive all help to get solutions into place. Technical knowledge also helps to prevent people blind you with untruths like "it's hard to get data out of this database".
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