What a wonderful in-person Digital Health Week event, this week!! At the late Wednesday afternoon (16h00) session titled: ‘CiLN Panel: Developing the clinical informatics workforce’, there was a resounding consensus that we need executive-level clinical informatic leadership (e.g., CCIO) to:
enable the evolution of health care through the application of their body of knowledge, clinical experience, understanding of health outcomes, and application of evidence based practice . . . [and be] integral to the digitisation of the health sector. - CiLN’s Clinical Informatics Position Statement (May 2020)
Clinical informaticians are uniquely placed to bridge the clinical-technical sectors, to achieve the data & digital Pae Ora aims.
In response to the call for establishment of a national, executive-level CCIO to work in partnership with the CIO, I will:
Kia ora - Johan Vendrig made the case that a CCIO may not be necessary if the CIO and project teams are engaging with clinicians. I’m not sure a compelling counter-argument was made at the time, and I think this needs to be well-articulated to get traction. It is well-articulated here:
Other leading health systems have recognised the importance of the role. One potentially effective way to advocate for the role would be to bring a highly-respected international CCIO to NZ who can articulate the case at the highest levels (“No one is a prophet in their own land”). There will no doubt be some such people in the vicinity at MedInfo in Sydney July 2023, though sooner would be better. This may not be necessary if someone is willing and able to step up now, build the relationships, and articulate the case directly with the support of CiLN membership.
Great work we also lobbied for this from the nursing an midwifery special interest group. essential for the future. Representation at the highest level needs to be MDT not medical centric
I do not believe that lobbying for this position from a group such as this will be either constructive or successful. I realise I am probably in the minority in expressing this opinion, which should not be construed as lack of support for the overall objective. In my experience, corporations rarely respond to these sorts of initiatives in the way you might like them to and are more likely to locate HINZ and its members into a category to be managed rather than listened to. This would be counterproductive for the kaupapa of the organisation in general and this initiative in particular.
As a clinician, and not a decision-maker, what is the best what to influence decision-making then? How can we be listened to, rather than seen as an entity to manage?
I am swayed by my experience with NZMA, where I am deeply saddened by their demise, because there is now a concerning void where I feel the medical profession at large is at strong risk of being siloed between different groups, that most definitely falls into the ‘manage’ category, because it’s just too hard to know who to ‘listen’ to.
Please share @ray, what your suggestion is for the kaupapa of clinical informaticians to be listened to, rather than dismissed as needing to be managed?
I will simply repeat what I said at the forum where this was discussed on Wednesday: We need to show that we can do things that no-one else can do as well. Corporations tend to respond to ideas that can help them achieve what they exist to achieve. In my view this group needs to identify some need that Te Whatu Ora and/or Te Aka Whai Ora has that nobody else can meet, and then find a way to meet that need. If there is a move afoot that no-one here is aware of to appoint a CCIO you don’t need to do anything, except perhaps recommend candidates. If there is not such a move, then first find out why that is. This will I think lead to insights that would be useful in shaping the next steps. It may be that it has never been thought of (which would be surprising) or some other reason that is actionable. I’m sure there is enough mana within this group to get a meeting with key leaders to raise the issue taking a “how can we help” perspective rather than a “you should do this” perspective.
Thank you @ray . .these seem like pragmatic, helpful, and logical suggestions. Unfortunately, it means that me, with not enough mana to get a meeting with key leaders, cannot do much ;( That is, needless to say, disheartening and dis-empowering, but is a reality I accept is the status quo.
So, to anyone on CiLN with the ability to get such a meeting, please let the rest of us know how we can help
Hi, the CCIO question that was asked on the ‘Unify to Simplify’ Data & Digital operating model consultation on WSY.
The response was: "The organisation structure is still being finalised. I agree a clinical lead role like CCIO is essential. I have always seen clinical leadership as part of any health data and digital initiative’. So this appears very positive.
For me this would ideally represent a broader capability of clinical informatics leadership, with its head as CCIO. Underpinning this / supporting this would be a variety of roles to cover the sector.
…Kinda like the CISO is one person for security but they have a supporting structure and group to make it work (as well as tools, processes, funding, etc).
This group could perhaps come up with a position description or responsibilities for the capability, pondering areas such as planning / strategy, RFP involvement, business change, business continuity, communications, …
So, who are these people, as they seem to be the “key leaders” that we need to offer to help?? Who has access to them, now?
From the Poll above, it seems there might be about 10 of us willing to try to put together some ‘advocacy plan’, and very encouragingly from the vote ‘breakdown’, these 10ish people spread across our various disciplines. @NathanK, are you able to see who the people are who offered to help with the ‘advocacy plan’? What are people thinking? should we start a different topic, or keep the ideas flowing here? It is hard to tell whether there is a reluctance to post in this ‘public’ space, or rather we are all too stretched to do more than reply to a Poll, or something else??
Yes I can by pulling it from the database. When do you want / need it?
Unfortunately it was well underway by the time I first saw the poll, so we missed the opportunity to tweak the settings (wipes the data) and make them visible.
Have just occurred to me how I might be able to hack it, but I’ll have to try that overnight (am on night shift anyway) so I can restore from backup if I stuff it up.
We need some group consensus on what we are doing next . . . .look forward to thoughts from others … . but, perhaps, if you can identify users who did say they were willing to ‘do’ something (e.g., plan, letter), we can start a group message?? I’m hoping some feedback might guide us as to where (‘public’ chat here vs more ‘private’ group chat) would be best to discuss actions.
Public Health services are not true corporations. They are the organisation of services to promote or preserve health. Clinical care, be this education, preventative, curative or supportive, is the core business. Not to have explicit and clear multidisciplinary clinical representation at the head seems an anathema to the purpose of Te Whatu Ora and Hira. Lobbying may have been the wrong word but supporting the understanding of the need for clinical staff to see themselves represented at the table and informing decisions is vital for engagement and buy in to new initiatives. This has been demonstrated across the globe and in countless failed IT projects. As Trish Greenhalgh Says, to improve the odds of success, stakeholders must first seek to understand where complexities lie, reduce those complexities where possible, and manage remaining complexities adaptively and creatively. To do this you need clinicals leaders who can pull groups together, harness their skills and ensure a global view. The current noise indicates clinical concern that this will not happen, that we will be given a system that may , or may not meet our need or the loudest and most influential will be heard leaving the rest of us to manage with the poorly considered ramifications.
Ah! That is so refreshing to read!!! YES!!! We are SERVICE providers, not product generators . . . We serve, from the top down. Thus, the top should be serving us, the population, and everyone in-between, including clinicians. To serve, it is all about listening, not managing.
Apologies for being a bit late to the discussion. I fully support this and would be keen to see where I can help. Whilst I understand the concerns raised, we cannot afford to not do something, we do however need to make sure we are speaking the right message into the ears of the right people. We need to identify who we need to speak to and what message is most likely to resonate with them. These functions we are seeking to partner in are core to a functioning and effective health system. As @Yeok notes, they are service providers, providing a service that we as clinicians and New Zealanders, are consuming. It’s about time we partnered with them in decision making. Thanks @emily.gill for starting this conversation.
I understand that is why there is a new clinician/consumer council being formed under @robyn.whittaker . When we formed CiLN it was with a view to provide opportunities for clinical input, this group is a great forum for that. I think the EOI for the council has closed now but presumably this will be a good opportunity for clinician engagement. Having CiLN feeding in to that group I imagine will be the intent.
Agree Ray. My focus in the talk was about developing the Profession as a body. I will post the salient points to me.
The profession can carry on ad hoc qualifications ( often vendors influenced) and based on experience and positions - a lot like IT and other areas. This has its advantages in a fast changing world, where skills adapt to the market - but can lead to a project by project follow the money mindset.
The profession could rely on each clinical regulation authority recognising Informatics as a sub area of that clinical profession. However this perpetuates the thinking and analysis based along those silos
The Profession of Clinical Informatics has its own credentialing process - that is used be the clinical registration authorities and mapped to you Annual practicing certificate. This is what other countries are heading towards and give weight to having “clinical informatics” sign off as all levels
Being a CCIO for a large shared service I can tell you that being on a exec is a whole job in itself, like @ray and @johan said - you are working with team of HR and Logistics and finance to run a corporate and without the machinery to call on for input you are just one person with opinions.
My call is to get this machinery of clinical informatics mature and set up in this country
Should HINZ be this authorising body? @KarenDay@karenblake@chris.paton
Agree with the points that Karl made. Happy to help with discussions about how PG papers, courses, micro-credentials, certificates, etc, could be used to support qualifications for CI professionals that are up-to-date but still regulated by NZQA and acceptable to clinical registration authorities.
