The CCIO interview: Toral Thomas, Norfolk and Suffolk NHS Foundation Trust

Today we are talking to Dr Toral Thomas, chief clinical information officer (CCIO) at Norfolk and Suffolk Foundation trust where he works as a consultant forensic psychiatrist. He talks to Digital Health News on why he became a CCIO and the biggest challenges which are facing digital transformation in the NHS.

Why did you become an NHS CCIO?

I’ve spent the last few years looking at how using technology can improve accessibility for teaching and training.

At my last trust I was the postgraduate medical education lead. As part of this I moved our induction online and started creating free online resources for clinicians.

Norfolk and Suffolk Foundation Trust are committed to rolling out e-Prescribing – and I’m a huge advocate for electronic prescribing in terms of safety and utility.

This role seemed a good fit to help the organisation embed e-Prescribing and to improve our digital maturity going forward.

Within your organisation, what is the most significant digital achievement of the past 12 months?

Definitely our electronic patient record LORENZO – it is already improving communication and accessibility across our enormous trust.

Like all EPRs it is very much a work in progress but we have a great team of clinicians and ICT colleagues working together to make it a success.

We were also lucky that NSFT committed to scanning all of our historical paper notes (using e-Windip) giving all of us easy access to historical records from our trust intranet.

What will be the most significant of the next 12 months?

Rolling out e-prescribing to the rest of our organisation.

I firmly believe that electronic prescribing is a lifesaving and essential part of any health ecosystem and there is a lot of data to support this.

What’s the biggest barrier to being a more effective CCIO?

Staffing.

The national workforce crisis means fewer people are taking on greater roles – the more for less fallacy!

I’m not ready to give up my clinical work as I think you can’t be an effective CCIO without it, but trying to find ways to balance the CCIO work with a full clinical caseload is a challenge.

A challenge that I’m hoping technology like Skype can help ameliorate!

What’s the biggest barrier the NHS faces overall in achieving digital transformation?

I think there are three big challenges: confidentiality concerns, interoperability and having a cohesive vision.

Communication breakdowns always come up when things go wrong and I think the NHS needs a way to share data and share it well across sites, disciplines and with other organisations.

I’m excited about a single citizen care record. Our ATM machines can talk to each other so why not our healthcare systems?

If you have one piece of advice for other NHS CCIOs, would would it be?

Stay positive! We live in a world in which people are developing ways to solve problems in creative and non-intrusive ways like the Lifesaving Dot or the Lucky Iron Fish.

Who in the NHS do you admire the most and why?

There are a lot of people doing some amazing work within my own organisation – for example our NSFT child and adolescent service got a very deserved Outstanding in our last CQC inspection for really involving service users and carers in the work they do and our trust culture supports teams to take ownership of their service and try innovative ideas out. I’m also inspired by the work of The King’s Fund – they have some interesting thoughts on the NHS’s digital future!

If you were given £30 million to spend on digital transformation within your trust, where would that money go?

I’d want to split that windfall into two – one part to finishing our e-Prescribing roll out but the rest to go to staff development and training so all the staff I work with, clinical and non-clinical, can study anything they like. Investing in technology without investing in people is ridiculous.

What is the most over-hyped digital innovation in health?

Email! If I could disable the “reply to all” and “cc” functions I would. Like any innovation it is easy to abuse.

It’s not an innovation but I also think the fears around confidentiality are also over-hyped. Your social media accounts are more likely to embarrass you in the future than your allergy status.

What is the most under-rated digital innovation in health?

Service user portals and sensor technology. We are so used to booking everything online it still surprises me that we write letters to primary care and to the people who use our services. We need to be better at harnessing the internet so service users can have safer online forums, see their notes and results and manage their health better. With wearable sensor technology (like the FreeStyle Libre) becoming more and more accessible and more mainstream we need to help people use this data to prevent disease as well as manage it.

And a few non-digital questions, what’s the worst job you’ve ever had and why?

I worked in paediatrics for a while before specialising and that was tough. It is very hard to be objective when you’re working with critically ill children. I think it is one of the toughest specialities in medicine. The only non-medical job I’ve had was in the IT department at my medical school and that was fun – but I’m glad I stuck with medicine!

If you could invite three people, alive or dead, to dinner who would they be?

I’m assuming my friends and family are included (or I’d have them to dinner instead – celebrities are no fun to eat with I’d imagine!). So as additional guests I’d have the Google co-founders Larry Page and Sergey Brin as well as Bill Gates. I have some challenges for them to solve!

What’s the background image on your home computer?

It’s a peaceful mountain scene that comes with the MacBook Air I bought 8 years ago and have never needed to upgrade. If the NHS ever switched to Apple I think we would see an absolute transformation for the better in our productivity and morale.

What’s your favourite piece of technology at home and why?

My iPhone. It’s not the most innovative smartphone but I find it really intuitive and using it is truly painless. I also like the fact that it lets me do so much on one device. Anyone with a smartphone and wi-fi can now create content for a global audience and I think that’s pretty amazing.

If you could have any other job, what would it be?

Medical school lecturer. I love teaching and the ability students have to see things in new ways or ask questions I hadn’t thought of never ceases to amaze me. Also, thanks to Google, it’s impossible not to know the answer to something!

In a film of your life, who would play you?

If Hollywood ever thought the life of a CCIO psychiatrist should hit the big screen I hope they’d use an avatar and all the CGI they could muster! If I was still alive I’d happily do the voice over.