The Garden Shed
Our Chief Information Officer (CIO), Richard Corbridge, recently wrote a blog about being locked in the garden shed and I wondered if part of a Chief Clinical Information Officer’s (CCIO) role is spending time in the garden also – but not locked in the shed, instead down among the weeds.
Recently, I was fortunate to meet CCIOs from all over the world. I was particularly interested to hear about their roles and what they feel it takes to be an effective CCIO. A CCIO is usually a practicing clinician with a core understanding, if not formal training, in technology and/or informatics. The CCIOs I spoke with ranged from those beginning their ICT solutions journey to those on their 12th electronic health record (EHR) implementation – tasked with leading the strategic positioning, implementation, and support of clinical systems.
Translating Clinician’s Needs
All agreed that the CCIO must understand and translate clinician’s needs while also translating the health system’s business and clinical initiatives as well as constraints. The CCIO must then communicate how the solutions, such as an EHR, meet their needs. The CCIO facilitates collaboration between IT and the clinical community and is considered highly strategic to achieving the clinical objectives of the health system.
The CIO and CCIO work best as a close‐knit team. The CCIO is involved in all facets of the clinical implementations and best practices. The CIO is focused on budget, IT infrastructure, security and regulations. Both CIO and CCIO work together toward meeting the needs of the Health system. The CCIO may report to the CIO with a dotted line or the reverse can sometimes be true.
Driving Integrated Care
Developing Information and Communication Technology is a key driver of integrated care in Ireland. The CCIO needs to involve a wide community of stakeholders in defining and creating tools that can be successfully implemented and used to support better care and achieve integrated care. To facilitate this, the CCIO will create, develop, and consistently engage a core clinical informatics focused team as we have done in Ireland with the Council of Clinical Information officers. The purpose of this team is to help answer critically important questions during the procurement, design, content development, workflow, ease and speed of use as well as appropriateness of alerts. The Clinical Informatics Team combines broad information, which other clinicians and other stakeholders will review. Achieving this core information requires well planned, regularly scheduled meetings with clinical champions and clinical representatives in all key areas, the CCIO requiring key influencing skills and strong interpersonal skills. Strong collaborative management style and proven success in change management, team building and decision‐making is cited as essential skills.
One veteran CCIO, explained this as being hard work. He told the story of Ernest Shackleton’s Imperial Trans-Artarctic Expedition on Endurance. Shackleton famously ran an advert in the London newspapers recruiting men for the expedition and likened this to recruiting CCIOs!
I’m sure that all CCIOs agree someone on the Clinical Informatics team needs to be responsible for the detail, the most often phrase used was “CCIOs in the weeds”. From past experience the best designed and tested system will fail if the detail such as knowing the physical workflow for example when choosing your PC location in the clinic or ward.
To me it’s clear that the most important skill is the passion and drive to continuously strive to improve clinical outcomes and achieve integrated care through the use of innovative technology.