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.
There is still some way to go to persuade some people in key positions that Health Informatics is a discrete profession. At the same time, information systems are becoming a more complex and interventional part of healthcare. Translation between technical possibility and clinical need is an important role that CCIO CT/IO pairs can provide. This translation is best underpinned with some common training and professional standards. There is no time to lose in uniting the UK's activities in Health Informatics professionalisation and investing in training, including sub-specialist accreditation.
EHI's CCIO Campaign is something we think has the potential to help move things along in NHS IT, by focusing on the central role that end users, clinicians, have to play in ensuring the success of IT projects and use of information. We think that championing the development of more local clinical information leaders will benefit to local NHS organisations.
Too many past IT projects that have disappointed or struggled have suffered from not having adequate clinical leadership or engagement. Similarly, many projects that succeeded have at their heart strong clinical involvement.
Another problem is that NHS IT professionals and clinicians have often been cast as adversaries, rather than partners, and having experienced clinicians leading on information projects should help overcome this divide.
Clinical information champions and eventually CCIOs are not a magic bullet or panacea, but we hope that it will help build up local skills and grow confidence in the full potential of IT and information to deliver significant improvements in the quality of patient care.
Kim Ashall’s background as a physiotherapist means she comes at the implementation of IT from a “completely different angle.”
“IT should just be another tool to effect change and improvement. It shouldn’t be the driver of change and improvement,” she says, adding that as a non-expert on “gadgets and gizmos” she can ask the “stupid” questions that staff want answered before they adopt new ways of working.
Working on the Meditech implementation
Ashall trained and worked as a physio in the NHS before going on to a management training scheme, from which she graduated in 1997.
After working in various jobs, including the roll out of Choose and Book in South Yorkshire, she was appointed as director of service improvement at The Rotherham Foundation Trust.
In 2009, the trust decided to go outside the National Programme for IT in the NHS and purchase its own electronic patient record system. After a number of delays, the Meditech system is due to go live in the summer.
Part of Ashall’s role has been to work with ten process groups in the hospital that include frontline staff, system improvement representatives and analysts. Some groups represent departments such as A&E or critical care, while some span departments such as order communications.
Their role is to review the functionality of Meditech, consider how its introduction will impact on the processes currently in place, and to influence the reconfiguration of the system. “It’s a bit of: What can it do? What do we need it to do? And what can [we get it to] do?” explains Ashall.
Patients before gadgets and gizmos
When The Rotherham’s director of IT left the trust left in autumn last year, Ashall added IT to her role, becoming the director of service transformation and IT. Alhough she is not officially a chief clinical information officer, her clinical background means she is now doing the same role under another name.
When asked whether, 20 years ago, she ever imagined becoming a director of IT she laughs and concedes “probably not.”
“But I do know what IT can do for you to improve your life both professionally and personally,” she adds. And Ashall believes her clinical background means she always has patients at the forefront of her mind.
“When I go on to a ward, I look at how the nurses are interacting with patients, how the physios are mobilising patients, how clean and tidy it is, then I look at what gadgets and gizmos we have got,” she explains.“It’s about saying: ‘what level of care are our patients receiving and what can IT do to help support that?’”
Asking the not-stupid questions
This lack of in-depth technological knowledge means she can use herself as a litmus test of whether messages about IT are comprehensible before they are disseminated to other staff.
She is more than happy to ask the “stupid questions” and has a rule that - “if I don’t understand it, it doesn’t go out to the organisation.”
Like any professionals, IT experts have acronyms and jargon that is alien to the general public. Ashall says she takes these and “tries to find a language that everybody understands”, reasoning that “if staff can see that I understand it, it is much less threatening.”
“I have been given enormous positive feedback about my position and people are very anxious to know that I’m not going to leave quickly because they recognise that I’m enthusiastic and I’ve got a lot of energy,” she adds. “I want this thing to work and I do come at the implementation of an EPR and IT from a completely different angle.”
Calling more non-medic CCIOs
When she accepted the position, Ashall had never heard of the EHI CCIO Campaign, which was set up in 2011 to encourage every NHS provider to consider appointing a CCIO to lead on IT projects and the use of information to improve patient care.
Now, though, she is a keen enthusiast; and one of the founder members of the CCIO Leaders Network that has been set up to support the CCIOs that are now in place in the NHS in England, and to encourage more to be appointed.
“I’m very keen to promote the idea that a CCIO doesn’t have to be a medic, because I genuinely believe that if you are a clinician you know clinical language, it doesn’t matter what profession you are from and it doesn’t matter to medics what I am either.”
She is also hoping to encourage more women into the role. “I’m absolutely keen to get clinicians involved in IT and to not be scared of IT by recognising that you don‘t have to have an IT background to manage IT.”
Ashall believes the leaders network will be a huge support and will mean she can direct some of her “stupid questions” to others facing the same issues.
As if going live with an EPR is not enough of a task to be getting along with, Ashall is also in the midst of completely restructuring The Rotherham’s IT department.
She may be understating it when she describes her role as “challenging.” “Sometimes it’s incredibly frustrating and it’s such hard work; but I’m loving it,” Ashall concludes.
Register: To add a comment you must be registered.