Chapter 5 Contents

Chapters

1

Welcome and introduction

An introduction to the Health CIO Handbook, its aims, objectives and intended audience.

2

Informatics professionalism – Dr Gwyn Thomas

Professionalism: what is it, why is it important, and what do you have to do to achieve it?

3

Leadership behaviours – Owen Powell

How is being a chief information officer different to being an IT manager? How do you identify and adopt the new behaviours required?

4

Transition guide to becoming a Health CIO

A transition guide to becoming a Health CIO, what should you expect, what mistakes should you try to avoid.

5

Who are your customers? – Mike Jones

Part one: Who is the customer that the Health CIO needs to serve? It might have been obvious once, but now some sophisticated profiling is needed to deliver a service portfolio to meet their needs.

6

Partnering with CCIOs and other clinicians

How can CIOs most effectively partner with clinicians?

7

Delivering innovation – Catherine Dampney

How do you move from running an IT estate to delivering innovation? Catherine Dampney, the chief information officer of NHS South Commissioning Support Unit, sets out her golden rules.

8

Future challenges

An examination of some of the ‘near future’ disruptive challenges that Health CIOs should think about preparing for; big data, genomics and the digital patient.

9

Breaking through the silicon ceiling

As a successful Health CIO, you have a lot of skills. How do you use them to secure the next step in your career? And what, exactly, do Health CIOs bring to the executive table?

Who are your customers?

By Mike Jones

spotting the customer…

In an increasingly digital world, the role of the IT professional in the NHS is broadening. Increasingly, we find ourselves serving various users and customer groups.

Often, the end user doesn’t pay the ‘IT bill’; yet they still bring with them expectations of having access to the various data and applications they need, and to collaborate and share information using a number of channels (web, phone, email).

Increasingly, users also want access from any form of device (whether that is a personal device or issued by the IT department). Inevitably, this relatively new set of use cases leads us towards cloud based computing and the need to look outside the traditional delivery models of the in-house IT department.

If we are to succeed in meeting this challenge, and differentiating the services of our trust from those of another IT provider, we need to foster a culture that is built on service excellence, with a strong focus on differentiating and responding to various customers in our service offerings.

Many NHS IT professionals pride themselves on their understanding of NHS needs because, in many cases, they are also NHS staff.

What I have found to a be a bit more of a leadership challenge is developing the culture of the IT department to embrace partnerships between the NHS IT team and other, non-NHS IT service providers when delivering services that span the organisational physical IT boundaries.

From the traditional user to a properly profiled customer

For many trusts, service provision has been based on the idea of a ‘traditional’ user. The end-user or consumer of IT and information services is thought of as a member of staff working for the trust, or in the case of a shared informatics service, one or more NHS organisations buying-in services for their staff.

In these traditional service models, the customer is often the bill payer (or has had central funding allocated for the services received). End users consume digital services under a single - or sometimes shared - service level agreement – often with the same measures of service delivery and success.

Typically, service performance will be reviewed annually but reported on regularly throughout the year through an internal governance arrangement, in order to maintain the focus on accountability and performance of the services provided under the SLA.

Traditional service management practices (managing the service portfolio and service catalogue) still have their place, but as things change they need to be blended with digital challenge and digital marketing practices, in order to meet the expectation that IT will ‘just work’ and to put it to use transforming services for patients.

Profiling the customer

A useful framework when profiling customers is something I refer to as the ‘Boston Box’ (derived from a framework proposed by MIT Sloan). In this model there are two types of service value, which work particularly well for the NHS.

The first form of value that a customer can derive stems from accessing and using information to make better decisions. These could be decisions that the patient has to make about their care or that a clinician or manager needs to make when providing or managing services.

The second form of value stems from using technology to work smarter. That is, removing the need for paper based processes, sharing and collaborating using digital, or accessing services digitally.

These two forms of value are then further considered in terms of how they can be applied within and outside the organisation. Starting with a blank sheet of paper, it is a useful exercise to think about customers in these four dimensions:

• Internal to the organisation and where customers would choose to use your digital services to make timely strategic or operational decisions (internal informing)
• External to the organisation and where customers such as patients, public, or other partner organisations can gain value from accessing your digital services to help them access, consume, rate or alternatively plan and coordinate care services (external informing)
• Internal process improvements for harnessing technology and digital information services (optimising the way staff work)
• External process improvements to improve how other organisations and the wider public interact with your organisation (reshaping).

Having reflected on that, it should be possible to complete each dimension with a list of services that would be provided by the IM&T service in each of these areas. There are no right or wrong answers, but this will help focus your service portfolio on where and what form of value your service offerings provide.

An example for some of the services we offer in Northern Devon Healthcare NHS Trust is shown below. In many cases, for example in the case of an electronic health record, the service offering will provide value in a number of domains.

Where this is the case, it is important to consider all domains so that you can profile the various customers who would benefit from the service.

The service portfolio and service catalogue

Having thought about the various forms of value and context in which that value is sought, the next steps are developing and maintaining a service catalogue for each customer. Deriving this takes time.

It requires a continued focus and numerous iterations between customers and IT teams to gain common understanding of what capability the customers are gaining from each service. However, the value that this brings is that IM&T teams are exposed to customers and their needs and gain an understanding of their expectations for successful service delivery.

At the end of this, you should aim to have a high-level service portfolio, which articulates the services that you offer in simple terms and states clearly why the customer uses the service and the value they get from doing so. An example will be presented in part two of this chapter.