High on a hill overlooking the city centre sits Bradford Royal Infirmary hospital, home of the Bradford Teaching Hospitals NHS Trust. Based in a grey stone house that looks like a vicarage from the nearby Dales the CIO of Bradford Teaching Hospitals NHS Trust Cindy Fedell is guiding a number of projects to connect up and modernise healthcare in Yorkshire, her adopted home.
“The trust is large and people don’t always realise that it is one of the busiest accident and emergency providers,” Fedell says in. The trust serves 500,000 and says it provides further services to 1.1 million. Maternity through to elderly care via intensive and children’s care are provided and there is a strong research arm to the hospital in areas such as eye care, hip fractures and dementia. As a teaching hospital Bradford has simulation centres for the teaching anaesthetics, emergency, obstetrics and theatre where close to real scenarios are taught.
“It’s a nice place to work and the people that work here are local and the staff really act as a team and we really can get things done,” she says. Across from the house that is office to a number of the senior leaders the hospital has a modern entrance as part of major site overhaul that improves accessibility and welcomes the community into a lounge of warm colours.
“My role here is more and more about the transformation and how can technology make a service and a patient better, or a clinician’s job easier. So my official job title is Director of Informatics and IT.”
The informatics part of Fedell’s job title is the bit she is most enthused about. “It is the concept of how clinicians really use technology. I’m big on it as otherwise we end up on the tail end of the conversation,” she says of the informatics element to being a CIO. Fedell believes in the NHS the informatics piece is key to getting the organisation to adopt technology and really use it in a way that benefits them and the organisation. “You can’t expect something to just happen as the risk and pace is too high,” she says of making sure adoption is a joint process.
“It has to be a collaboration and it has to be clinically led with a good collaboration with IT. For example with patient records a key is understanding how a clinician works every day,” she says. Bradford has appointed Dr Paul Southers as its Chief Clinical Information Officer (CCIO) to “promote the vital role clinical staff in healthcare informatics,” the trust says. There is also a senior nurse on leadership team.
“We all work well together and we know our niche and I am sure it is getting things done,” Fedell says. “The CCIO does the selling and the nurse does the making sure. It really has to be peer-to-peer,” she says of how the trio seed a concept, deliver it and then reassure and make sure it is adopted. “When we turn on the electronic patient records (EPR) I expect a demand for more and more,” Fedell says of a rising desire from clinicians for technological services. “Paul as CCIO manages the demand and he fits it into a narrative for them.
“It is a good thing, a huge list of wants and demands is heaven,” Fedell says with a beaming smile of a CIO lucky to be with an organisation that realises the potential for technology to improve the care it gives.
Working as one
Integrating a new EPR is just one of the modernisations that Fedell is managing at present and she says the trust is looking at wider transformation of clinical and operational technology.
“Technology is still seen as a reporting tool,” she says, but Fedell sees the potential for hospitals to integrate clinical and operational technology into a real time set of services. To that end Fedell is involved in a number of groups pushing the boundaries of health technology in areas such wearable, mobile and informatics. “There is a definite evolution and maturity happening.
The EPR roll out is a joint project with the Calderdale and Huddersfield NHS Foundation Trust and Bradford is also part of an eight trust programme to modernise their imaging services.
“It started out as a joint procurement when the National Programme for IT (NPfIT) ends, but then realised that there a transformation opportunities that allows us to do new ways of working. So we are now looking at the opportunities and what are the arrangements. It will change so much and is an opportunity for remote working and flexible working,” Fedell says of the joined up programmes.
Fedell is also Executive Lead on Digital 2020, a board formed to drive the adoption of digital health across Bradford, Airedale, Wharfedale, and Craven through supporting the development, implementation and evaluation of the impact of innovative new digital health technology. Fedell says 2020 is all about working together to co-ordinate around the needs of what is usually one set of patients. “If we all act as one then we are not duplicating.” As part of this programme the 2020 Board surveyed patients in a workshop and found they were surprised that data is not already shared.
Fedell, like a growing number of CIOs in healthcare completed the College of Healthcare Information Management (CHIME) qualification, recently discussed on the Horizon podcast with her peers Nick Hopkinson, Will Smart and Andy Kinnear.
“CHIME really helped me personally. A week long experience and it’s a structured way of looking at how to operate technology. I think it will give the NHS CIOs a boost and helps them get on a level playing field,” she says.
Fedell moved to the UK from leading healthcare in major Canadian organisations such as the Mount Sinai Hospital in Toronto and the Canadian Partnership Against Cancer, also in Toronto. We meet in early spring, heading towards Easter and there’s a chill wind blowing about the Dales.
“What winter, I don’t understand the worry about snow,” she says of the English and their constant focus on the weather an inability to adapt to a change in precipitation.