Becoming a chief information officer in the NHS is a big step. To recognise this, the Health CIO Network is putting together a handbook for health CIOs. If you would like to contribute to a chapter, or have a great idea for one, then contact Digital Health managing editor Lyn Whitfield.
So you’ve arrived by one of many possible routes at the position of chief information officer in your organisation.
You may not be the most technically proficient person in your team; and in fact you may not be that IT technical at all. But in all likelihood you will be the most equipped to explain some rather geeky concepts to your board members.
In fact, it is crucial that you are able to do this in a way that will mean they will want to invest in a digital future; and sometimes in things that are rather new and not demonstrable elsewhere.
It is not magic, of course. But to explain these sufficiently advanced technologies you will have to be credible, so as not to appear like some modern day snake oil salesman.
You will also need to be confident. Anyone who has been around long enough to be on the board will be well aware of more than one “IT disaster”; and probably has been personally affected by one. Communication is key.
Informatics, as it increasingly seems to be known, has a rather nomadic history in terms of its relationships in organisations. As CIO, you may find yourself anywhere from behind the wheel of a large automobile to living in a shotgun shack.
I have personally operated with finance, HR, the medical director, transformation and - last but not least - directly with the chief executive. Through all of this, if an informatics business case was being discussed at management board or full board level, the director of informatics has been responsible for it.
Even so, you could find yourself exercising that responsibility as a full executive voting member of the board or as the visible nominated lead for informatics, present at all management board meetings with some level of attendance at the board.
Wherever you are in terms of reporting, it is important you create networks so people know where to come for advice, and know how to get a business case - or their idea - off the ground.
In sporting competitions it’s the squad that wins the gold, not just those who are on the pitch. You may find you have to operate from one of many positions, and it will be a key responsibility to communicate well and put informatics front and centre from wherever you may be.
Not all business items at the board are overtly informatics, or have an obvious impact on informatics, yet the topic may still be there.
Sometimes you will find yourself having responsibility for everything that has a wire hanging out of the back or, at the very least, people will look in your direction as these things are being discussed. Because: “Well, it plugs into the network.”
The so called internet of things means almost anything will plug into the network, of course. It is important the board starts to understand there are IT implications for things that are not obviously IT.
This includes new buildings or business cases for which they would not previously have considered IT as an issue. The risk surrounding this gets bigger the further you sit from the board’s main business.
The position alone will not give you credibility with the board – you will need to earn that. There are a number of texts on leadership, such as Stephen Covey’s ‘The 7 Habits of Highly Effective People’. Here is habit five:
Different board members will look for different things in business cases. Other senior leaders in the organisation will need to assist you in influencing others and the agenda. These individuals will include but are not limited to:
There is no set portfolio for a CIO. Therefore you may find you “own” information, information governance, help desk, application support, health records (for as long as they exist). It is fairly certain that IT will be in there, somewhere, of course; but large parts may have been outsourced.
So finding others with the same portfolio might be a rare occurrence. The board will require regular updates on strategy progress, major projects, operational risk and statutory obligations that fall under your brief.
The CIO role should be business-focused, not IT-focused, but you must ensure a balance of investment is maintained so business continuity is not jeopardised.
This means communicating a level of realistic risk profile so the board is happy to maintain an overall investment profile. This might come down to pitching a strategy for four year old PCs against new windows in an old building or a new electronic patient record.
The NHS has internal things it must do as well as external forces, some of which may be political. Your organisation will have a vision and a business plan, and the board must understand the importance of the IT within these objectives.
In terms of external pressure, the board needs to understand how the local and national informatics strategies fit together. For this to happen, you need to be able to knit the informatics strategy with this national agenda and the supplier dynamic.
It is really about telling a story that people can visualize; so form yours - and stick to it. Don’t be afraid to repeat and keep reminding people what they have agreed to.
‘Computer Weekly‘ magazine highlights that 53% of IT leaders report a shortage of people with high-level personal skills in the workplace.
CIOs are needed to decrease the gulf between roles carried out by both IT professionals and non-IT professionals, so as to set up effective working relationships. There are few groups with which it's more important to bridge this gulf than your board members.
Three key points to remember when communicating with the board:
Adrian – Ade – Byrne is director of IM&T at University Hospital Southampton NHS Foundation Trust which, he says, has been working on its IT environment for 15 years.
On his LinkedIn profile, he says its aim is to “build an electronic patient record with full decision support, sharing data across disparate, so-called best of breed systems.” The trust is also developing a patient record and services, built on Microsoft HealthVault.
