Quality of CIOs is blocking the healthcare digital revolution

In the run-up to E-Health Week, a round table of leading figures in healthcare IT identified raising the quality of IT managers, sorting out risk averse procurement and strengthening clinical leadership as key to delivering digital transformation in the NHS.

The Healthcare Information and Management Systems Society (HIMSS), organisers of May’s E-Health Week, hosted the event at the King’s Fund.

Andy Kinnear (pictured), director of digital transformation at NHS South, Central and West CSU and chair of BCS Health, criticised the quality of some chief information officers in healthcare: “My frustration with CIO colleagues has grown. [Too many] are not up to the task or have not invested in their own development.

“We have seen a CIO network emerge nationally driven by the most energised, visible, successful and professional CIOs, and then there is a whole bundle of other folk who are sitting back at their desks never emerging, never really believing that what goes on in the wider world is important to them, never mind engaging with that, not realising that talking locally, nationally and internationally is part of the job. We need to drive up the calibre of those people.”

Trying to define upfront a watertight specification freaks me out

Joanna Smith, CIO of Royal Brompton & Harefield NHS Foundation Trust, spelt out how slavish adherence to procedure was obstructing sensible conversations between managers and vendors: “The procurement process does not encourage me, or even want me, to develop partnerships with vendors. It wants to force me through a process that keeps me distant from the vendors, that doesn’t let me talk to the vendor because it fears that will be unfair. That really worries me.

“I want to be able to work in a safe way with vendors and have conversations. Trying to define upfront a watertight specification for what I want and then go through a process and score at the end of it, and be absolutely confident I’ve got what I want, absolutely freaks me out.

“When you are talking about a system with complex workflow that has got to interact with all the different aspects of how a hospital works, to try to understand that perfectly – the journey of procurement helps you decide what you want. That is not catered for.

Risk averse culture

“There is such a culture of risk aversion in the NHS, where the process has become more important to the NHS than the outcome. Procurement teams believe their job is to conduct a legal process. Of course they should be doing that – but not to the exclusion of getting the right answer.”

Other contributions highlighted that “clinicians are not leading the change, and that is part of the frustration”.

“There should be a layer of collaboration between your clinical workforce and your technology workforce. That leads to better connections with the supplier marketplace because we have clinicians who understand what is the art of the possible.

The failure to engage clinicians in digital development was seen as a major obstacle: “I know many people who have been given the chief clinical information officer job title, but they have not been given the resource to make it work [and told] if you can make it work outside your contracted hours, go ahead and do it.”

This compares poorly with the United States, where many clinicians are funded to lead digital development.

Kinnear pressed for far greater pooling of talent between the public and private sectors: “If we are going to get into truly professionalising chief clinical information officers and their teams then I don’t think we can do that without exposing those folks to supplier management, the vendor community.

“I would love to get to a place where we’ve got mentorship programmes, secondment opportunities to blur the boundary a bit between the public and private sectors and open up professional development. People who come from outside the NHS offers huge value to the organisation because they understand the world in a way that NHS lifers like me don’t get.”

Round table participants
  • Steve Lieber President and CEO, HIMSS
  • Jane Dwelly Director of Strategy, HIMSS UK
  • Andy Kinnear Chair, BCS Health
  • Dr Philip Scott Vice chair, BCS Health
  • Bernard Quinn Director of Improvement Programmes, NHS Improvement
  • Jane Berezynskyj ICT Director, Papworth Hospital NHS Foundation Trust
  • Joanna Smith Chief Information Officer, Royal Brompton and Harefield NHS Foundation Trust
  • Richard Vize Public sector commentator and editor of Health21
  • Alan Brown Sales Manager, Cambio Healthcare Systems
  • Jake Arnold-Forster, Cambio Healthcare Systems
  • Ian Chapman UK and Ireland Sales Director, Imprivata
  • Dr Saif Abed EMEA, Medical Director, Imprivata
  • Tony King Director of Client Engagement, HCI
  • Cathy Fuhrman Industry Manager (International Healthcare), Onbase by Hyland
  • Mark Groesch Regional Manager of Healthcare Solutions, Onbase by Hyland.