Never before in its history has the NHS come under finer scrutiny. A perfect storm of the deficit and austerity measures, our aging and swelling population and increased media scrutiny is putting huge pressure on a service that is often taken for granted, but is one of the greatest achievements in modern society.\nThe NHS hasn\u2019t changed in its outlook much since its conception in 1948 \u2013 after all, the drivers are the same, but the world is a very different place. Fortunately, not all of these changes have been to the NHS\u2019 detriment.\nTechnological innovation and increased understanding of how you can utilise information to improve and streamline care and services are now key weapons in the NHS armament, and their role in a future NHS transformed by current fiscal concerns will be central.\nThis view is shared by Dr Geraint Lewis, Chief Data Officer at NHS England who has said that, \u201cIn the coming years, the NHS Five Year Forward View is set to revolutionise the way we deliver high quality care for all and data will be at the heart of that transformation\u201d. This was echoed by Health minister Jeremy Hunt in his mandate for hospitals to go digital by 2020 as he notes that technology will be the saviour of the NHS.\nThis presents a unique challenge, or opportunity, into the hands of NHS CIO\u2019s. How do you take a service with its routes in post war Britain and ensure that it will survive for generations to come? Strategic vision and the confidence to see complex, sometimes difficult plans through to the very end are key attributes of a 21st century NHS CIO. Strategy is often dictated by Whitehall, but it is up to the CIO to translate that wider strategy to the ground level information systems \u2013 you have to have vision and stamina to be able to do that successfully.\u00a0 Strategic decisions take more time and sometimes require a bit more upfront investment, and are definitely more difficult to execute in the short term, as the benefit is in the long game.\nWe recently completed a project with BridgeHead Software to install an enterprise-wide archive for all imaging data, regardless of where the image was generated or how it was saved originally. This was driven by our strategic approach to making all data easily accessible to clinicians at the point of care - key to realising our vision of delivering the Five Year Forward View and other strategies, and more recently the National Information Board all of which call for accessible, comprehensive and shared information across the health economy.\u00a0\u00a0 The objective being to present a fulsome set of data to be used in the here and now, to analyse backwards and enable better planning for the future. In addition, this vendor neutral archive allows us the flexibility to future proof for new types of images, both still and moving, as technology used in directly providing care to patients is ever-increasing.\nWe must also not forget our obligation, in this time of information sharing, to protect that same information as its guardians.\u00a0 Moving from multiple stores and future-proofing for new technologies allows us to execute our obligation with confidence.\nThe role of the NHS CIO is moving closer and closer to those in private industry\u2013 Board understanding and support for information and technology strategies is imperative \u2013 otherwise you will fight an uphill battle that will likely not even see strategic decisions being made. Strategy has to be married up with the long-term approach from everyone on how we do and will deliver care to really understand and appreciate technology decisions.\nAs we move towards implementation of the Five Year Forward View, the strategic use of information in the NHS will become much more widespread. Central to this is the timely provision of data and information. It would seem absurd to store data locally within departments pertaining to patients, so that radiology images could not be shared with cardiology or with paediatric cardiology for instance, yet this is what happens. Only by having a central data store, that can hold images from any vendor and then make them available to any application, can you move towards the vision for a truly integrated health service for patients.\nThis is the opportunity for CIO\u2019s in the NHS and wider health sector \u2013 to make small, strategic steps to improve data management accessibility to applications so that patients for generations to come will benefit from joined up and improved services, at a reduced cost.