Effective clinical leadership in information technology is essential, says Linda Davidson
At a time when the NHS is shedding staff and reducing costs, it’s remarkable that a campaign to create a clinical role is gathering support from many directions, including our coalition government.
The campaign encourages all healthcare organisations to consider appointing a chief clinical information officer (CCIO), probably a senior nurse or doctor, but potentially a leader from any clinical profession.
The campaign is organised by eHealth Insider, an online news and information source on healthcare IT, and supported by the Royal College of Nursing, the Royal College of Midwives and dozens of others, including health minister Earl Howe.
As its opening statement says: “When IT projects fail, it is often because they fail to take users with them. When they succeed… it is because they sell the benefits to users and win wider support for change.”
“An organisation with this kind of leader will stand a better chance of success”
No one involved is claiming that appointing a CCIO would bring a halt to the dispiriting list of failed IT projects in healthcare but the indications are that an organisation with this kind of leader will stand a better chance of success.
What is the evidence for that claim? The CCIO role is particularly associated with hospitals in the US, where it has developed over the past two decades, often with two posts: chief nursing information officer; and chief medical information officer.
Typically, they take the lead in representing clinical staff when major IT developments are planned and executed, acting as a bridge between those delivering care and the architects of the new system.
In the UK, the BCS, the Chartered Institute for IT, has recommended the appointment of CCIOs to help achieve the behavioural changes needed to make IT-enabled change happen.
In its response to the Department of Health’s information revolution white paper, the BCS said that the role was needed “to ensure that clinicians lead the demand and use of better information and tools”. It recommended that Monitor should look for the presence of the CCIO role when evaluating foundation trusts’ governance.
Some may see a CCIO appointment as an exercise in shutting the stable door after the proverbial horse has bolted. The National Programme for IT was criticised for failing to engage with clinicians despite some incredibly hard work from its clinical leads. It has been on the wane since the coalition government took office in May 2010 and it seems unlikely that such a lavishly funded exercise will take place again in the foreseeable future.
The need for effective clinical leadership in IT and information management remains, however, and, at a time of austerity, successful IT-enabled projects are more important than ever.
The healthcare reforms envisage a service in which clinicians have access to records and other information they need to deliver integrated care along pathways with a diverse range of providers. This is quite a challenge in information terms.
The admirable mantra of “No decision about me without me” has formidable information implications.
Susan Hamer, the director of nursing, midwifery and allied health professionals at NHS Connecting for Health, summed up the case for appointing CCIOs well: “Bringing information to the centre of healthcare provision is key to achieving our ambition for the best international outcomes of care, where patients are partners and can take more control of their own health. [Appointing] a talented chief clinical information officer, who might come from a range of professional backgrounds, could be one of the key actions which make these ambitions a reality.”
Linda Davidson is a director of eHealth Insider, www.ehi.co.uk, and was Nursing Times editor 1988-92.