Experienced health organisations around the world who value IT have recognised that appointing a dedicated clinical practitioner to drive healthcare technology within their organisations can generate greater internal support and end user adoption as well as ensure focus is maintained upon clinical outcomes. This campaign is a step in the right direction for the UK.
Just collecting data is not enough; a CCIO should understand the bigger picture and have a stategy that allows appropriate sharing of information and interfaces to use data intelligently to save clinicians time whilst ensuring patient information aids their treatment and recovery. This data should then allow quicker and easier audit and quality assessment and ensure appropriate payment against contract.
We in IT provide a service to our customers - the clinicians, without Clinical Input there is no Customer requirement specified so how can we possibly ever achieve Ecellence in Customer's eyes?
Realism needs to be brought into the process, with small incremental steps at a local level taking the place of giant national leaps backwards.
The CCIO (CMIO) here in the US, serves to bridge the gap between the IT and clinical sides. More often than not, these members have utilized the systems frequently pushed down to the end-users and experienced the frustrations first-hand. From this frustration they arise to fulifill a much needed role, most often without additional compensation.
It is imperative that health-care organizations, serious about their success in implementing any IT solution, creates a role and fills it with a qualified, competent individual who can guide them through this process articulating the needs of both the clinical and IT technical side. Good Luck EHI! I am behind you too from across the pond.
Clinical leadership of IT is essential to avoid repeating the mistakes of the past and bring healthcare IT into the 21st century.
Delighted to see this campaign receive the level of support it so richly deserves from so many of the Royal Colleges and other professional groups. The change that the campaign will hopefully bring about is long overdue. Well done to EHI for organising.For what it%u219s worth, as a public health doctor and registered health informatician, I fully support the campaign.Better intelligence = better decisions = better healthDr Brendan O%u219BrienUKCHIP Level 3
We at Citadel Events believe that involvement and ownership is key to successful projects. As a recognised leader in the organisatio
Large scale IT projects continue to fail to realise their full potential and return on investment more often than not because clinic
Patient outcomes are being dramatically improved around the world through the effective use of clinical information systems; linking
As director of Dell’s public services division, Tim Sheppard understands the difference that clinicians make to the adoption and use of clinical IT.
Which is why he supports the EHI CCIO Campaign - and has drawn up a job description to feed into the debate about how chief clinical information officers might work in the NHS.
Time for a campaign
Sheppard’s experience lies within Dell in the UK and internationally in hospitals around the world. It started about ten years ago when Dell began to recruit clinicians to its healthcare division.
Their role was – is – to help NHS clients think about technology implementations not as IT projects but as projects that can deliver clinical benefits and improved clinical outcomes. The result was rocketing customer satisfaction.
“It’s a journey we started a long time ago and we have learned a lot,” he says. “We are now in a position where 10% of Dell’s 180 UK consultants are clinicians.”
Simultaneously, he observed hospitals in the US and Middle East start to appoint chief medical information officers as part of their senior management teams. Why, he wondered, were there no such posts in England?
“About a year ago we were considering running a campaign called ‘Where is the chief medical information officer?’ so it is fantastic to see EHI’s brilliant campaign gathering such a broad base of support,” he says.
Working with the evidence
Sheppard and his colleagues have collected evidence about the international experience of CMIOs to develop a job description that could be used by NHS trusts considering similar appointments.
It will feed into work currently being undertaken by BCS Health to develop a sample job description, person specification and other career materials.
“It’s designed to be generic,” says Sheppard. “The role in its practical implementation will be what each trust needs it to be - so the job description will need to be tailored.”
During its development, Dell asked Cliff Morgan, director of critical care, medicine, anaesthetics and theatres at the Royal Brompton and Harefield NHS Foundation Trust and now its de facto CCIO, to review its content. Dr Morgan says the description fits well with his current role.
“I’m not called the CCIO but this is what I do,” he says, stressing that his trust is not a Dell client, so he can be independent. “But I don’t do all of it. I would interpret it as not so much a job description for a person but the different elements that need to be managed by a team led by the CCIO.”
It is about to be used in practice too. Dell has been working with a trust, as yet unnamed, that is on the cusp of appointing a CMIO. The trust will be using the job description and has made available Richard Strong, a pathologist who heads Dell’s health care division, to mentor the new appointee.
Reporting lines
The lessons brought together in the proto-job description are, it turns out, pretty straightforward. Sheppard says the main driver for appointing a CCIO is likely to be a major upgrade to or investment in an organisation’s electronic medical record or a major clinical IT system.
Mary Cooper, a nurse who leads Dell’s healthcare consultancy in Europe and the Middle East, argues that this is the right time for putting in place someone whose job is to lead on IT projects and information use.
“A major IT implementation is as much a cultural shift as an IT project,” says Cooper. “Putting technology in is an ideal time to start thinking about how you want to work differently to become more productive and deliver improved outcomes. This change needs to be at the front rather than a secondary thing.”
Global experience has showed Sheppard that, to be successful, CCIOs need to be credible clinicians who spend at least 80% of their time in the CCIO role in the early stages of a major IT implementation. “It may tail off later but at this early stage, they need to work on this pretty much full time,” he says.
They need to have the backing of the chief executive and to serve as an integral member of the clinical management team, as well as being a key leader in organisational planning as part of the organisation’s leadership team.
Ideally, says Sheppard, the CCIO need to report either to the chief medical officer or to the chief executive. “When we looked at the roles internationally, we found that 40% are part of the chief medical officer’s team which for me seems an appropriate place to be,” he says.
“Another 29% reported to the chief executive, which also has merit if the CEO is trying to drive in particular direction. But about 20% reported to the chief information officer and I would suggest that is probably the wrong place in terms of driving transformational change.”
Making the case
In general, CCIOs have three main responsibilities:
Sheppard is agnostic as to whether a CCIO needs to be a doctor or whether a nurse or other clinician would be as good in the role. It all depends on what the role needs to achieve.
“We have found internationally that chief nursing information officers are often much more focused on driving continual improvement through the use of technology,” he says. “Ensuring clinical adoption and engagement usually requires a doctor.”
Not just a doctor but a highly experienced doctor. Dell’s job description suggests that a CCIO needs over ten years as a practicing clinician, five or more years experience in direct clinical systems and process redesign, and practical experience of using EHRs in a hospital setting.
But are there enough such UK doctors out there? “It’s a good question,” says Sheppard. “I think it takes a particular sort of clinician to go for this role.”
Some of the characteristics are outlined in the job description and include excellent communication skills, ability work collaboratively, ability to analyse complex problems and develop solutions, skilled in needs assessment, knowledge of clinical workflows and knowledge of project management.
“It is important that the chief executive makes this a role that will attract the right people,” he adds. “There is a necessity for chief execs to drive it.”
Which means taking the argument for the CCIO – and let’s face it, this is a person who will not come cheap – to CEOs.
Sheppard senses that CEOs today are more receptive to this kind of argument than they ever have been. “Five or six years ago, there were very few public sector leaders with an interest in technology, The number now is increasing exponentially.”
