Unusually for a chief clinical information officer, Dr Jack Barker did not spend his youth tinkering with a ZX Spectrum computer.
Rather, he came to IT as a result of research. “I wasn’t interested in computers at school,” he says. “I really got into it when I was doing some research into occupational asthma.
“There were large number of patients involved and the research was epidemiological. So I had to do some statistics.”
Getting into IT
Today, Dr Barker is clinical director for IT – a job title he says is equivalent to chief clinical information officer – at King’s College Hospital NHS Foundation Trust in London.
He spends just under half his week on clinical IT and other half as a consultant in chest and general medicine, looking after patients on a ward and overseeing emergency admissions of patients with respiratory problems.
He has a broad overview of the contribution IT can make to health and healthcare. “When I came to King’s in 1999, the clinical post was to lead the lung cancer and TB teams,” he explains.
“It was obvious to me that you have to both provide the service and prove what you are doing. We needed the tools to help us run the service and to measure how good it was.
“It was already clear to me that IT was going to be important in terms of running an organisation and making it better so I joined out electronic record board.”
Within six months he was chairing it. Today he is the clinical face of IT, hospital wide and locally with his team’s specialty system for respiratory medicine.
Clinical input on many projects
King’s is one of the most go-ahead trusts in the UK for IT and EHI has reported in the past on developments such as its electronic patient record, e-prescribing and moves to become paperless. Dr Barker is supporting all of these projects.
One area in which clinical expertise is invaluable is in designing forms for electronic systems as the trust moves towards becoming paperless, such as growth charts in paediatrics.
“E-prescribing is a project that just runs and runs,” he adds. Particularly challenging has been deploying the system to ITU and paediatrics.
More recently, Dr Barker has become interested in developing real time information for clinicians. “I think it will be very valuable for people to have real time quality reporting.
“For example, which patients have had their VTE (venous thrombo-embolism) assessments, how long have patients had intravenous lines, are they at risk of developing a hospital acquired infection, have patients had an expected date of discharge recorded?”
He is also interested in handover systems, an acknowledged area of risk for patients, and is working with the Hospital at Night Team to make handovers safer.
On a wider canvas, King’s is part of the King’s Health Partners, an academic health sciences centre that brings together King’s College Hospital, South London and Maudsely NHS Foundation Trust, Guy’s and St Thomas’s NHS Foundation Trust, and King’s College, London.
In February, all four partners unanimously agreed to explore a formal merger – something that would necessitate brining their IT systems together. Dr Barker will be instrumental in developing the strategy.
Working with the IT director
Dr Barker does not perceive any problem with clinical engagement at the trust, but has some comments about clinical engagement generally.
“I don’t think there ever was a problem,” he says. “The problem [a few years ago] was that there were no products to engage with. All the talk was theoretical and about virtual electronic patient records, with nothing being delivered.
“The situation we face now is that doctors almost cannot do anything without engaging with IT. Any modernisation project needs IT input, which puts huge pressure on the IT department, which is constantly being asked to do more than it can actually deliver.”
Dr Barker works closely with the IT team at King’s. All clinical directors at the trust work in partnership with a general management counterpart – in his case, director of IT Colin Sweeney.
Where Dr Barker has a clinical, strategic and solutions development role, Sweeney has a strategic and business role – with an IT department and a budget to manage.
Dr Barker sees this relationship as crucial and is interested in some reports of CCIOs usurping the IT director.
“I think there is a danger that if you have a strong and prominent CCIO, then the chief executive will go to the CCIO and there is the potential for the director of IT to get left out.
“The director of IT knows more about the dynamics of what is going on in IT, and what can and cannot be delivered. The CCIO and the director of IT need to respect each other and not let that happen.”
No CCIO – hospitals are missing a trick
EHealth Insider set up the EHI CCIO Campaign to encourage all NHS organisations to consider appointing a CCIO a year ago.
It is now running a CCIO Leaders Network to support the CCIOs in place and encourage more to come forward; not just from the medical profession or the acute sector, but from many different clinical backgrounds and organisations within healthcare communities.
Dr Barker has been an early and enthusiastic supporter of the campaign. “Can hospitals run without CCIOs? Well, clearly very many of them are,” he says.
“But I would say that trying to run a modern hospital without someone in a leadership position who has both clinical skills and knowledge of what can be done from an IT perspective would be missing a trick.
“It’s very hard to keep closely in touch with what staff are saying and what is going on at the top level if you have not got the right clinician in the right place. Hospitals really need someone who can operate between these two levels.”