Significant progress has been made in over the past 24 months in the establishment of the chief clinical information officer role within our NHS organisations. However, the model of establishment varies greatly.
Some organisations have one CCIO, some have more than one, and some have a multi-disciplinary function. Forward-thinking organisations have ring fenced funding and included CCIO work in job planning, but some individuals remain CCIO in name only – with little time or support to grow into the role.
Looking to the pioneers
To see what the future may hold for the CCIO community in England, we can look to the US and Europe, which have a much longer tradition of clinical leadership in informatics.
In the US, the chief medical information officer model has been in place for many years. Indeed, at the strategic level we can see that CMIOs are in many cases working at the same level as chief information officers in organisations.
It is an opportunity missed if we do not look at the models and lessons learned from other countries. Many of the CMIOs in the US and Europe have been more than willing to share their journey and this learning will help to inform the future directions and models for clinical informatics.
Looking further into the future, it may be that CCIOs effectively become strategic CIOs. Figures like Elmar Flamme, the chief information officer at Klinikum Wels in Austria provide a possible model for this.
Elmar started as an emergency room nurse and also a sceptic towards informatics. His career journey has led to him being a clinical leader for informatics and now a much sought after strategic CIO. He is now a strategic partner with a number of technology suppliers and has created a number of first of type solutions to clinical problems.
In the US, the CMIO role is typically a board appointment, and in some instances the CIO reports to the CMIO.
Developing knowledge
The development and deepening of the role means that in the future we are likely to see CCIOs training in methodologies such as PRINCE2 (project management); MSP (programme management); and ITIL (IT service management). This will make it easier for CCIOs to understand the full language of projects and of informatics.
CCIOs may also expand their knowledge on the structures of the NHS and the wider context. Locally we have found that education sessions looking at the NHS structure using resources such as The King’s Fund alternative guide to the new NHS have given context.
Programmes such and Code4Health will give CCIOs the chance to learn coding. While it is a mistake to think that CCIOs need to be technically minded, it seems likely that CCIOs will be expected to expose themselves to various technical elements in order to get a greater understanding of technology.
This will only work with the correct culture within informatics. Indeed, where CCIOs are working their sessions away from informatics then valuable communications and knowledge transfer are lost.
Our local learning is that the CCIOs must sit in with informatics and have access to an informatics team member they can talk to regularly. The future will see successful CCIOs integrated with informatics as well as clinical communities, working with mutual respect and communicating across boundaries.
Leadership skills will be essential for CCIOs of the future – they will need to interface and interact with stakeholders within and beyond their organisation.
Their ability to influence and inspire confidence at all levels will be essential. For many CCIOs leadership training may be minimal or non-existent. Successful organisations will invest in leadership training for the CCIOs in order to maximise their impact.
To a new professionalism?
Eventually, we may see a core set of learning for CCIOs, perhaps linked to new informatics professionalism frameworks. We may see growing numbers of university courses aimed at CCIOs. This in turn would give clinicians confidence to step forward into a defined career path.
As the community grows in confidence and knowledge, the ability of CCIOs to provide leadership will increase. Having talked to a number of CCIOs, however, most would want to remain clinical in at least some capacity in order to retain their skills and credibility. Potentially future informatics leadership may be a partnership between CIOs and CCIOs.