IT AS A CURE

What are the biggest challenges for CIOs?Getting the basics right first is the main challenge. Our clinical teams rely on the uninterrupted flow of information and technology to treat patients in a timely fashion. It is up to my team and me to ensure the information management and technology services are appropriate, consistent and reliable.In healthcare, as is the case in most other sectors, the customer is central, so my second challenge is to bring people together, within our organisation and across organisations. Often sharing information is the only way we can tie these organisations together around an individual person or patient.Another key challenge is to help my clinical and service management colleagues decide on what the appropriate level of investment is. For quite some time the IT industry has over-promised and under-delivered when it comes to business benefit and outcomes. A shared understanding of the problem we are trying to solve is crucial, followed by selecting the appropriate solution to address it and to measure the benefits of what we have committed to deliver. Keeping it simple is probably the biggest challenge of all!What are the traits needed to be a CIO?Good communication skills are a must-have; closely followed by a consultative approach. Having all the answers is seldom the way to the right solution, but asking the (stupid) questions is. You need to recognise that pen and paper is information technology too, and combine that knowledge with the specific opportunities that computers, software and services can add. Some solid business management skills are a must-have, and last, but certainly not least, picking the right team in order to have the skills and attitude to make things happen. What is the most difficult aspect of ICT for your organisation and why?I would say that in the health sector the biggest challenge is dealing with the diversity of requirements of a highly varied and fragmented sector. Within the District Health Board (DHB) we have approximately 70 business units, each with an annual turnover of $10m to $20m. They vary from community services, highly specialised clinical teams, a very large ‘restaurant’, a large ‘hotel’, hi-tech theatres, labs and radiology teams, etc. In addition we work closely with many family doctors, community providers and rest homes that operate within our district. To top it off, we are now increasingly integrating these systems across multiple districts or regions.There is very little (too little) standardisation of clinical and business process, which means standardisation and integration of IT solutions is a daunting task indeed.In addition the clinical teams are rapidly becoming more and more reliant on IT systems for clinical service delivery, but the underlying investment in IT infrastructure and services hasn’t increased accordingly due to capital and budget constraints. Although many of our systems are expected to be up 24/7, services are often provided on a ‘best efforts’ basis, which is not really good enough in terms of what the clinical teams need from us.What projects are you working on right now that excite you the most and why?I am very excited about the Auckland DHB’s performance improvement projects. Clinical leaders are working closely together with Lean Six Sigma experts to reduce waste, improve clinical quality and standardise processes to deliver better patient outcomes. The more this type of approach drives our future investment in clinical processes and IT solutions, the more likely they will be successful.I am also excited about an emerging project in the shared care planning space that will enable clinical teams across multiple organisations to collaborate more effectively around the care for a patient.How have you accommodated web 2.0 and social networking practices in your IT setup? Web 2.0 is still an emerging concept in health. It has huge potential in the way clinical teams and patients will collaborate around their care plan. Some initial pilots related to mental health services for young adults have already shown this is an effective way to engage with various patient groups.How mobile is your workforce and is this a growing issue for you?Mobility is growing fast in relation to providing community services to patients, enabling clinicians and support staff to work on the go, and also to enable certain teams to work from home in areas such as clinical transcription and clinical coding of health records. Our clinicians often work across multiple organisations and want to access clinical systems from wherever they are. For this reason, identity management, single authentication and interconnectivity across multiple DHBs and other health organisations are key issues to be solved.In general, what do you think is the most pressing ICT issue at present?For us it is a combination of affordability and reliability, and this is closely linked to the need for more standardisation of clinical processes across the health sector to enable systems and services to be shared. We need to reduce complexity to enable us to invest in more resilient solutions that bring clinicians and patients together across organisations. More standardisation will also allow us to innovate more effectively by deploying good ideas more quickly and consistently across the health sector.What role do you think the government should play in ICT? In health the government has recently taken a much more active leadership role in ICT which is generally well received. The key drivers require some strong leadership to bring the different organisations together and drive development and adoption of standards. The recently established National Health IT Board has made a good start with facilitating more effective collaboration in the sector.What is the most exciting thing happening in ICT now?My son’s iPod touch! The wave that the iPhone and iPad are creating sets a new standard for user interfaces that the next generation of users (and patients) will expect to see in future clinical and business applications. I am concerned, though, whether our legacy software vendors and limited budgets will allow us to react quickly enough to take advantage of this revolution with more simple and visually driven software and user interfaces – it is difficult to make things simple.What will be the next big thing in six months’ time?As one of my regional CIO colleagues would say: “I would expect to be donkey deep in the establishment of regional and national shared services of some sort”.If you could have one ICT item to make your business run smoothly, what would it be? A system that would translate clinical management information into decisions that can be carried out in real-time at the point of care; ie: it would inform clinicians and patients alike to help them make decisions that are in the best interest of the patient as well as the wider organisation and health sector. (I’m not sure why John Lennon’s ‘Imagine’ is ringing in my ears when I say this!)Did you always want to work in IT?I did my degree in business information management. In the late ’80s this was still a fairly new area, trying to bridge the gap between the business manager and the computer geek. I love the variety of this role, particularly in healthcare and the DHBs where a wide range of professions come together with a common cause.If you didn’t work in IT, what would you be doing?Maybe I would  try and set up a small business, just to see if I could do it – I have the deepest respect for the many New Zealanders that have managed to create a business, employ some people and enable them to make a living from  it.