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 have just been appointed as a chief information officer. Congratulations: the big seat of digital strategy is all yours.
So what now? Everybody has an idea they would like you to review, and ideas on why your finances would be best employed with their particular project, department or endeavour. Your presence is, of course, essential at every meeting; and there is barely time to collate your own thoughts.
This is almost certainly the story of your first few days within the post, so what should your first steps be? I’d advise looking for a bit of FAME:
Familiarise yourself with your organisation’s existing systems and strategy by sitting down with key clinical leaders and heads of department.
Even if you have been in the organisation for some time, try to view the situation as an outsider. Try to get a clear understanding not just of what your colleagues have systems-wise, but also what they do in their roles.
Perhaps even more importantly, get a sense of who they do it with. Inter-organisation or department exchanges can be rapidly identified, along with the repeat offenders in the world of the CIO: systems and staff that don’t interoperate!
Acclimatise yourself with your local health economy. Even in the most remote areas you will need to deal with other organisations, and explore how your strategy and theirs may synergise or interact. Engage with your local digital and clinical leaders to get a clear understanding of the wider requirements.
Mobilise. But only once you’re familiar with the needs and requirements of your own organisation and the wider health economy. Begin putting your resources into motion, based on the information and observations you have made, as well as the broader strategic picture.
Evaluation is, as ever, key. It is very easy to dedicate yourself and your resources to a specific task, but it is worth regularly going back to the original question or problem, to make sure that it hasn’t changed and this is still the answer.
FAME is the absolute fundamental of a successful CIO. However, if you are reading this you are probably after some more practical support. So let’s discuss some of these points in more detail.
If you have read this far, you clearly haven’t run off screaming at all the all of the homework, reading, meetings and the strategies you need to review. Congratulations again. So how does all this incredibly helpful advice hang together and enable you to lead and shape a digital vision for your organisation and beyond?
Well, think of it like building your house. It is awfully big and awfully complicated and has an awful lot of bits to assemble. However, you do know what you want: warm, dry, with space for cooking and friends.
That seems like a vision of where you want to be, not much different to the ‘Five Year Forward View’ or ‘Personalised Health and Care 2020’ view of healthcare: I want all patient contact to be informed and paperless at the point of contact.
I know what you are thinking: how do I get there? So let’s go back to your house for a moment. Let’s assume right now it’s just a plot of land.
In that statement we have established our current position. We now know where we are currently, but also where we want to be – I have land; I want land with a house.
The healthcare comparison would be my organisation currently has a paper-based system, but would like to be paperless at the point of contact.
So there is our vision of where we are, and where we want to be. However, that is not going to fly when you are sitting in front of your board colleagues. So we need to break the vision into pieces, each of which ideally deliver some benefit.
Let’s go back to the house – last time, I promise. We could look at the foundations and floor: that is something we can turn into a project, producing costs and times. It has a use, as we could store future materials on it.
The parallel would be implement the infrastructure for your network. It has a use in allowing you to start storing information; it is also the vital foundation you will need for your clinical system and so on.
Your vision doesn’t have to define the specific solution to be used; but you have identified people to help you with those things. Have them add the details and specifics needed to bring your vision to the point of being a real and achievable blueprint.
I lied about the house – we need to pop back one more time, to explain the biggest pitfall for us as CIOs.
Your house was great, and then your long lost aunty came to live with you. You had a plan involving two rooms, but the problem you were aiming to solve has changed - and now you need three.
In healthcare IT, things change: national policy, organisational requirements, technological capabilities. The moral here is the 'E' of FAME: evaluation. Always check the thing you’re working on still solves your current problem.
Starting work as a CIO can be daunting. But by following this step by step approach, you'll soon settle in – and start to make a difference. Don’t rush, take your time and don’t forget there are people you can always ask. In the words of Douglas Adams: "Don’t Panic!”
Ciaron has used his experience of innovation within the primary care sector and involvement with several academic research projects to lead the digital strategy for Birmingham NHS CrossCity Clinical Commissioning Group since 2013.
He has recently been involved in the largest desktop virtualisation within primary care to help transform how care is delivered. His career began in the commercial sector working for a primary care system supplier and an international analytical energy consultancy.
