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Bringing clinicians to the fore in eHealth

In a recent article in the leading strategic technology publication in the UK, CIO Magazine (www.cio.co.uk/cio-career/chief-clinical-information-officer-salary-job-description-ccio-duties-job-description-3646380/), the role of the CCIO was discussed. It is quite amazing to see the recognition that the role of the CCIO has established globally so swiftly. The Robert Wachter report, published last month in the UK under the auspices of the Minister for Health, calls out the role of the CCIO as now an essential element for any successful digital health implementation, globally. 

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Mr Richard Corbridge

All at once the digital health world has come to its senses and realised that, while technologists and great project management are essential, benefits will not be delivered by IT people without clinical leadership for every project. 

‘Ireland has embraced the role of CCIO and placed it at the heart of the digital health agenda. In Ireland, the CCIO is actually the deputy CIO of the health service’

The CIO Magazine article explained the CCIO role in the NHS as: “A CCIO provides a vital voice for clinical strategy in overseeing the digital technology being implemented in the Trust. CCIOs should communicate and support the CIO and IT team in delivering efficient, cost-effective and adaptable technology products which can meet and improve overall healthcare and the patient journey.”

Ireland’s own CCIO, Ms Yvonne Goff, has a much better and more succinct description I think: “The CCIO role is primarily one of translator. The role takes the ‘geek’ of technology and turns it into the clinical benefit and patient difference that every digital health project has to have at its core.”

In July this year, the NHS named its first CCIO in Prof Keith McNeil. His remit is to help transform the overall strategy of how the NHS uses digital technology to improve patient care. The role of the CCIO Council in Ireland has been in place over a year now with the CCIO sitting on the eHealth Ireland Committee and the senior management team of the HSE Office of the CIO. Ireland has embraced the role of CCIO and placed it at the heart of the digital health agenda. In Ireland, the CCIO is actually the deputy CIO of the health service — this is something I promised I would do at my first HISI conference in November 2014. 

The role of the CCIO in Ireland has become a leader of each of the strategic projects and a role that the acute Hospital Groups have agreed is one that they also need to have in place to ensure that local innovation projects that have a digital focus can also be placed within the eHealth Ireland way of delivering. 

Interesting differences in the CCIO role in the NHS and in Ireland continue to be seen, though. Ireland has created what is best described as a ‘council of the willing’; there are over 210 CCIOs in Ireland across 45 clinical disciplines. The role of CCIO in Ireland is worn as a badge of honour, a role to ensure that funding spent on digital is spent in the right way, on the right things. The CCIOs of Ireland are not paid as a separate role in the most part, with just five of the team having an element of funded ring-fenced time. Where specific items of work are picked up, then the ‘host’ organisation receives funding from the eHealth Ireland function. 

Compare this to the NHS, where the role of a CCIO, according to a Harvey Nash report, earns over £140,000 annually, with one-in-three receiving an annual bonus. 

A 2012 study in the US reported more than 60 per cent of CCIOs and their US equivalents (the Chief Medical Information Officer) are earning over $200,000.

Which is better for Ireland? We are working hard to make the CCIO role a recognised role across the health system. The council of CCIOs, and indeed the concept of the CCIO in Ireland, has been held up by others as a superior model; we have volunteers that daily want to work on digital projects to ensure better outcomes for clinicians and patients. The role has not become ‘bogged-down’ in red tape.  

And yet, we are becoming more and more reliant on the good will of these enthused and excited clinicians. Ireland has appointed and not rewarded the role of CCIO. The health system is reaping rewards of clinical engagement but is yet to recognise the role formally. In the coming weeks, the acute Hospital Groups and the eHealth Ireland team will fix this and the roles will be advertised as roles that are ring-fenced and rewarded. 

One area though that Ireland can yet again learn lessons in is the definition of the role. From the very beginning of the CCIO in Ireland being formulated, the Council itself has insisted that the term ‘CCIO’ be protected — in other jurisdictions, it has been watered-down by the advent of Chief Medical Information Officers and Chief Nursing Information Officers. The clinicians of Ireland have asked that we work hard to protect the role to be a single group, without the clinical hierarchy associated with other jurisdictions.      

The CIO Magazine article went on to consider the reporting lines of CCIOs in the NHS. It said: “In some organisations, a CCIO will report to various fellow executives. According to a report from within the NHS, 39 per cent of Chief Clinical Information Officers report to the Chief Medical Officer (CMO), while 23 per cent report to the CIO and 29 per cent to the senior CEO, depending on structure of the organisation.”

In Ireland, we have ensured the role is part of the digital team, not to subvert the role, but to educate and ensure that the digital team continues to evolve, with benefits driven by clinicians and patients at its heart. 

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