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'Clinical IT leaders will make information central to care'


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,, and was Nursing Times editor 1988-92.


Readers' comments (4)

  • What the hell?

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  • This sounds like an excellent idea. Modern IT has revolutionised many areas of life and work, but the NHS, partly due to its size and disparate nature, has lagged far behind.

    Improved IT systems could bring enormous benefits to healthcare workers. For example, we can now view an X-ray a couple of minutes after it's been taken and compare it instantly with last year's X-ray, leading to improved diagnosis and treatment of our patients. Years ago this might have taken hours due to having to wait to receive films.

    All too often, however, these IT systems are awkward to use or don't provide exactly the data we want. Having someone with significant clinical experience involved in the design and implementation of these systems could go a long way towards ensuring that they are more appropriate for our needs.

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  • Really David? It's not that I disagree with you in principle, I don't. But why now? Why, when STAFF NURSES are struggling to find work, when posts are being slashed left right and centre, is yet another manager being hired? Priorities, I think it's called!

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  • I feel we need to adopt a more long-term view of this. Posts are being slashed because of the financial mess we are in. To ensure that we have an NHS in years to come we need to do all we can to work as productively as possible, reducing the amount of time we waste on things like paperwork. Using efficient IT systems and other forms of technology is an essential part of this. I believe that if we take a short-term view and decide to wait for the day when the NHS is awash with money then this type of project will never happen, because that day will never come.

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