Opinion: information management

Why the NHS needs a new generation of chief information officers

Healthcare is in the midst of a revolution, the scale of which has never previously been seen. A focus on the details and politics of the implementation of IT programmes often stops us from seeing just how massive are the changes currently taking place. The availability of information to support individual care and to drive improvements is expanding at an exponential rate.

In order to derive real benefit from these changes, healthcare needs a new breed of leadership focused on strategies and actions to drive change through effective use of information. The leaders of the future
will be drawn from both the IT and clinical professions.

Other industry sectors have recognised the shift in the role of chief information officer (CIO) from that of procurement, networking and infrastructure management to a much wider focus on organisational strategy and development. The healthcare CIO of the future will be a visionary thinker and yet be able to demonstrate strong leadership skills.

Mary Hall Gregg, CIO at Quest Diagnostics explains, “You do have to speak two different languages and you have to understand the technology and how it’s going to create the value, but you have to be able to translate that to real terms and specific to your business and your industry.”

Traditionally the CIO has been seen as a manager of IT infrastructure. The move to operating at the executive level can provide its own challenges, particularly in healthcare. CIOs must establish themselves as colleagues to the executive team rather than subordinates, providing leadership in planning, business growth and strategic development.

The healthcare CIO must define a vision built upon a deep understanding of the value of information in healthcare and its role in underpinning transformation. Focus will be on improved safety for patients, proactive management of resources, activities and workflow, driving efficiency and improved outcomes.

Working with executives, clinicians, managers and support staff the CIO will build a leadership group that will drive change for the organisation as a whole.

It is no surprise that the College of Healthcare Information Management Executives lists: vision setting; delivery of business success; and driving change, as the top three factors to measure success in healthcare CIOs. The CIO cannot act alone and it would be foolish to ignore the powerbase of clinicians within the healthcare organisation.

The focus of clinicians on the direct care of their patients is without question. However, in order to ensure that care is delivered consistently and with the highest quality across the health system, clinicians need to pause and reflect on the value of information-driven reviews of the care process. Whilst a new generation of CIOs will start to drive change within organisations, it is paramount that clinical values are placed at the heart of any such change.

What then is the role of a clinician leader? In healthcare, as in society at large, the currency of the future is information. The power of a leader in this field is held with the ability to innovate, to develop new ideas, new models of working. Such behaviours are not always innate in clinicians, who are generally trained to operate within a strong evidence-based framework.

Steve Jobs, co-founder of Apple Computers noted that “Innovation distinguishes between a leader and a follower”.

Some 20-30 years ago we witnessed how clinical leadership was the driver for change on a scale never seen before. The GPs and informaticians who drove the NHS towards a computerised primary care service were the founding fathers of current-day information systems. As those systems become mainstream it now rests with the clinician leaders of today and the future to articulate a new vision for clinical care, a vision driven by information.

Organisational transformation and clinical process improvements are arguably the most profound challenges any health organisation can undertake as they affect the very essence of healthcare delivery at every level. Sustained improvement will only be gained through a change in culture to one that embraces change, explores new ideas and empowers individuals to drive change. Creating that culture does require a new cadre of individuals to take on the mantle from our informatics forefathers.

Does the NHS have the talent to fill such roles? Absolutely. However, does the appetite exist to make such bold steps for the future, to develop and nurture such leadership? Perhaps that can only be driven from the top.

Dr Paul Whatling, International consulting lead, Perot Systems

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