Inside CHIME: Learning Lessons on a Global Scale

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Weinstock 70x70 12.1.16 by Matthew Weinstock
Director of Communications and Public Relations, CHIME

CIOs across the globe face similar challenges, so why not share in the same learning? CHIME recently expanded the successful CHCIO program internationally. England’s Rachel Dunscombe, the first international recipient of the designation, explains why it is so important that the program spread around the world.

Rachel Dunscombe - CHIME’s inaugural international CHCIO

Rachel Dunscombe – first international recipient of the CHCIO designation

Although she’s more than 3,400 miles away from the United States, when you hear Rachel Dunscombe talk about the goals – and challenges – of leading her organization’s health IT strategy, you’d swear that she’s working at the hospital down the street.

Dunscombe is the CIO of Salford Royal NHS Foundation Trust and Strategic CIO at Pennine Acute Hospitals, situated in northwest England, near Manchester. Collectively, the hospitals total nearly 2,000 beds and about $1.5 billion in revenue (£1.2 billion). Salford is an integrated care organization moving towards an accountable care model with integrated community services and social care. Dunscombe’s struggles will sound familiar: finding appropriately-trained staff to meet the challenges of today’s environment, interoperability, adapting to population health, and more.

A CIO for the past four years, Dunscombe was recently awarded CHIME’s inaugural international certified healthcare CIO designation. The international CHCIO exam was developed from the requirements of the CIO role globally and with the participation and input of CIOs from around the world.

In the interview below, she says that the CHCIO designation is a great opportunity for CIOs to continue to grow as leaders and drive change in their organizations, regardless of where they are located on the globe.

 

What are some of the biggest leadership hurdles you face?

For a number of years, to push to digitizing care in the UK was centralized under the NHS National Programme for IT. Although that has ended, it created a vacuum locally where informatics professionals in organizations were not exposed to procurement, supplier management of large contracts or service management of large contracts. As a result, we lack people in the system who can tackle the projects and challenges that we have to take on. In order to address this, we are working to increase the knowledge and competency of those in the system and bring in fresh talent at all levels. This needs to be addressed in order to ensure that the NHS can procure, deploy and leverage the best technologies. I am taking a country-wide lead on this as a member of the National Information Board Academy and Professionalism work streams.

 

How is health IT driving change at the NHS?

From a clinical standpoint, the big change we have seen is the rise of the chief clinical information officer (CCIO), which is similar to the chief medical or chief nursing information officer in the US. These roles have not really existed until perhaps three years ago in the UK. I implemented the first multi-disciplinary clinical informatics team in the UK at Bolton. It included consultants, nursing and therapies. This revolutionised the conversations and moved the organization forward in terms of leveraging the technology and having the true intelligent clinical client.

Technology is allowing us to standardize and optimize pathways to deliver real, measurable clinical improvements. I have been amazed at the reduction in mortality and improved outcomes that can be achieved by simple standardization of pathways. Here at Salford, we will continue to follow this path using the quality improvement methodology that has been used here for many years.

Frustrations still remain, however, that some IT solutions do not provide full Anglicisation, so a lot of time and effort must be put in to make the US product work in the UK environment. This sometimes works against the positive change that the clinicians are leading and is a real challenge.

 

Payment models vary from country to country, but do you see similarities in the issues that CIOs worldwide are confronting?

We are all facing common needs for interoperability and population health. Regardless of your location on the globe, these issues are common. I was talking only a couple of weeks ago about an open source ambulatory system used in Africa which supports interoperability! Our challenge is to make this happen and, as all the work we do with the universities and research clinicians reminds us, the more standard and interoperable we are, the bigger the data sets we can collect to improve healthcare globally.

We also need to deal with the cost and affordability issues of healthcare globally. This is a shared issue where many nations are finding it unaffordable to keep their populations healthy. Two things in my mind will help with this – and I have a sense of urgency with both. First, research that will improve outcomes and optimise treatment. For this we need consistent standardized data. The second is consumer-centred solutions that will allow the population to self-serve and self-care. For this we need to look to other industries that have done this successfully and address user experience and motivation to engage with digital solutions. Standards such as FHIR will also need to be supported and platforms built to create personalised health and wellness offerings.

 

Why did you seek the CHCIO designation? What impact will it have on you professionally?

I sought to become a CHCIO because there was no equivalent in the UK or Europe. I wanted to be part of a profession and also a group with whom I could tackle the challenges of being a CIO. Having met with and worked with a number of the CHCIOs at KLAS, I was sure that this was a route I wanted to take. It opens our international horizons and helps us to learn the lessons globally. As CIO of the most digital hospital in the NHS (as measured by the NHS Digital Maturity Index), it is good to be able to share and learn with your peers who have experience of a similar digitally mature organisation.

The collection of continuous professional development is also another benefit for me. Within the UK, there is no program or mandate for CIO continuous professional development. I’m keen to evidence continued learning and lead by example with my teams.

I think there is a huge amount of interest from international CIOs in certification. CHCIO is a route I think many will consider. In some countries, there are other options such as a certified CIO or chartered professional, but these are rarely health specific. We need to become certified in order for us to gain the respect of our boards and clinical colleagues.

 

What advice do you have for other CIOs who might be on the fence about taking the exam?

If you are looking at taking the CHCIO exam, I would say go for it. The reading list was great. I learned quite a bit and refreshed on lots of things. It also gets you into the discipline of undertaking continuous professional development and planning the areas of learning.

More Inside CHIME Volume 1, No. 31: