The ladybird guide to explaining difficult things is something that as a parent I wish we all had a copy of, after all the word why and how are every three and six year olds favourite words!
In the last three months I have been involved in quite a few presentations. I was asked by manager to help him deliver a presentation as a ‘double-act’, a way to try to brighten up a message that doesn’t always excite everyone for some reason, the digitisation of healthcare!
Working in technology and healthcare at the same time means that we have twice the complexity, twice the TLAs (Three Letter Acronyms) and twice the very clever people to engage with.
Explaining complex messages to build engagement is all part of the job if we are to be successful digital professionals. This got me thinking what are the two most complex messages I need to explain; I think the ever-increasing size of data and the almost comical words the industry has adopted to describe these is one and the ever-increasing counting-horizon is another, but more on the second one later!
So, data sizes; what on earth is a Zettabyte other than something that is huge! Recently I heard data described using rice as an analogy, and at last I could begin, and I really do mean begin, to understand just how big, big-data was. Lets start at the beginning, if a BYTE of data is represented as a grain of rice then we can, loosely, get to a KILOBYTE being a cup of rice which in turn makes a MEGABYTE 8 bags of rice. To get us to the GIGABYTE then we would need three lorries full of rice! It just gets a little silly after this though, the exponential growth of data now starts being represented by 2 container ships equalling a TERABYTE the whole of Manhattan Island being a PETABYTE and the whole of the UK three times over being a EXABYTE. So back to the original question, a ZETTABYTE is the Pacific Ocean full of rice!
Whilst this is a loose story it puts a new perspective on a concept that has been perpetually hard to describe and understand, something that I now need to think of in every presentation I give, after all that question, ‘What is Genomic sequencing in two sentences please?’ is bound to happen soon and I don’t know the answer!
The second complex message comes back to what I have been heard called the counting-horizon. We now talk about millions and billions like we understand what they are, my son knows that soccer players are worth millions for some reason but doesn’t really understand the difference between that amount and the amount I pay for buying a packet of match attacks. Yet do we really understand that counting-horizon, there are six zeros in a million but what does that mean. Next time a football player is sold for 30 million I have a new trick to explain to my son what that ‘actually’ means.
There are a million seconds in 12 days! My sons favourite player is Messi, he is valued at $340 million or 4,080 days, which is older than my daughter!
There are a billion seconds in 31 years and a trillion seconds is 31,688 years, which almost becomes impossible to contemplate! The race is on for the first Trillion Dollar company but will they also have the longevity of their worth, I wonder, will Apple, Amazon and Alphabet be here in over 30,000 years from now!
One of the roles we have been talking about in the recent presentations is the role of story teller, good stories need good analogies, after all Captain Underpants, my sons latest bedtime read has been nearly banned in the USA for inciting disobedience in young adults, surely an analogy for the current political/media relationship over there!
Enjoy your ready in 60 seconds uncle Ben’s rice dinner!
It was 2:45am when I was woken to go on deck for the hardest watch of the day: 3am-6am. That brief moment between waking and dressing was important to know what gear to wear. Quiet, easy motion indicated warm clothes and wooly hat. The violent lurches of the boat and a loud rush of water overhead meant I’d be clambering into all the protective gear I could find: drysuit, harness, lifejacket and sea boots.
This was near the Grand Banks, an area of shallow water off Newfoundland that were rich fishing grounds but dangerous in a storm. It was during the last part of a transatlantic sailing race in September 2000. We had crossed the chilly Labrador current and were closing in on Boston having started in Southampton a couple of weeks earlier.
When had been tracking the weather forecasts showing a storm would pass as we planned to cross the Grand Banks. We evaluated the options and decided sailing South to remain in deeper waters was safest. We prepared the boat and ourselves for a difficult 24 hours and raced on. We were all tense, but we were ready.
These days the challenges I face are in the world of health IT. As I work in the Acute Delivery function of the Office of the CIO, I spend my time with managers and leaders in health figuring out how to travel the journey to more effective, efficient and safe services. These decisions are rarely straightforward, involve incomplete information, unforeseen consequences and significant uncertainties; much like the challenges I faced with my crew-mates crossing the Atlantic.
The Project Management Institute publication “Navigating Complexity” describes what constitutes a complex project:
These characteristics are present in many of the projects I’m involved in, day-in, day-out. Introducing technology to support patients and health professionals is usually broadly welcomed. But when the simplicity of pen and paper is replaced by the complications of structured data capture and formal workflows there are many challenges to overcome. Dr. Tony Shannon, a health informatics leader with Ripple, has shared many insights from complexity theory and how they help understand health systems.
As I work with hospitals and hospital groups to plan their IT investments into the future, there are many additional characteristics of complexity in play. Decision-making with imperfect information, ambiguity, and developments in the policy environment is decision-making under pressure. Nonetheless, decisions must be made.
The process we follow uses these approaches:
Nationally, a lot of effort has gone into developing a clear, coherent and costed view of an Irish Health system enabled by the Electronic Health Record. Part of being clear about where a hospital group intends to use IT, is to be clear how the EHR will enable their part of the health system.
Equally important is knowing the current infrastructure, systems and capacity of the hospital group. It’s more than just technology. It’s about understanding how the people involved in health IT can further contribute to health transformation.
The third part of the approach is to chart a course towards the desired future, identifying intermediate waypoints and milestones along the way. This involves making difficult choices about how to apply precious resources and skills to start and complete projects that will bring the organisation towards the vision. Small gains build to big wins for our health professionals, for our service users and for our communities.
The PMI guidance is valuable and describes the competencies required to manage complexity.
There is no one formula that assures success. Choices have to be made with incomplete information, with an uncertain landscape and unknown risks. Establishing the way forward requires collaboration between health IT experts, clinician leaders and service management.
When we skirted the Grand Banks in September 2000 we were making the best decisions possible with imperfect information. There was a storm we couldn’t avoid, but we planned ahead and we were ready for it; we battened down the hatches, we ate early, we shortened sail, we kept each other safe and we adapted to the conditions that came. With a mixture of exhaustion and relief we emerged out of that storm unscathed.
Thankfully there are few days in the office as dramatic as a storm on the Grand Banks. But the challenges we deal with on ordinary days are just as important. They require skill, perseverance, and good judgement. Patience, teamwork and communication are essential. And always with an eye on the forecast and horizon…
First published in CIO Magazine in August 2016. A collaboration with Elaine Naughton in the writing and development of this idea, a huge thanks to Elaine for this.
In the excellent Steve Jobs biography by Walter Isaacson, he describes a discussion between Jobs and Steve Wozniak where Jobs is explaining to Woz that the role he plays in Apple is that of an orchestra’s conductor, here to get the best out of the team, to ensure that they play in harmony and deliver to the listener the most inventive and yet classically rich vision of the original design. This conversation is said to have taken place after a strong ‘debate’ just before the launch of the iMac itself, Woz described by Isaacson had just exclaimed to Jobs that he was neither designer nor engineer and therefore did not really warrant or justify the recognition he was getting as the ‘re-saviour’ of Apple.
Is the creativity of the conductor the real line to success in IT leadership? After all the ‘band plays on’, or at least tries to, whether there is a conductor or not. Even as early as 1998 Jobs was describing, I think, what the modern CIO now needs to be, although maybe we now need an evolved model from conductor to DJ or rock and roll front man.
Why does the analogy and the model need to evolve? Well, in times gone by, the IT leader would have sought out the best in class people he needed. Much like creating an orchestra of around 30 talented artists, the Leader had to be the best that the orchestra could afford and then the conductor had to make them fit into the team, not always an easy job. The ‘prima donna’ persona of the highest calibre technologists is not always easy to integrate into a high-performing team after all. This then, perhaps, is where the evolved model comes in.
The leader of a rock band enables the band to “jam” develops a structure and order to remain in time, and chooses a rift as well as creating a tune as they play. Maybe this roll can be best described as the start-up innovator of the music scene. A band always needs a front man – someone with a vision for the sound they want to achieve and the charisma and charm to wow an audience, the band may play on if the front man leaves, but rarely as successfully; what would U2 be without Bono? or the Rolling Stones without Jagger? Queen without Freddie? Perhaps the best real world example of the rock star digital leader is Larry Ellison of Oracle, truly a front man if ever there was one to be seen in digital leadership. The owner, founder, creator and beating heart of the Oracle empire, whilst no longer leader in name still very much the charismatic front man of the brand and indeed, band!
An orchestra, on the other hand, follows a very strict plan and each of the upwards of 30 members (over 50 for a symphonic orchestra) knows exactly what they need to play and when, whether it is solo or synchronised with their team (by virtue of the score). Only the conductor knows the full score and reads all lines simultaneously, knowing who to call on and who to bring in exactly when they are needed for the orchestra to continue playing in harmony and in time, and for soloists to have their moment to shine. A digital leader in the style of the conductor does just this. The danger here though, is if only they know the full picture, keeping everyone focussed takes a huge amount of energy and enthusiasm. Many public sector digital leaders are of this style (often by necessity) as the full picture is in reality always being altered and reconfigured a small amount by the political leaders and paymasters.
The conductor’s role is an art form and a talent, while being a very technical job. Take the conductor from this and time signatures slip, the musicians become discordant and eventually chaos ensues. Just as with Jobs and his temporary departure from Apple, as conductor of that orchestra he was never truly replaced and therefore for a time the music was not what the audience needed to hear. The creativity, in the sense of innovation of the music, belongs to the composer rather than the orchestra or conductor; with this in mind maybe we need to see the digital leader as composer and conductor more often!
A DJ, unlike the conductor or rock band front man, can take the best work of a much wider variety of stars, mould them together until they find the right mix and then play it for the audience. The DJ doesn’t have to integrate the full character of the artist just that moment of excellence where the beat fits or as the very wonderful NetFlix original puts it, ‘When the Get Down arrives’! A modern successful digital leader then is going to be a DJ! If we consider the ‘gig economy’ to be the future in digital then this kind of character and behaviour is likely to become even more prevalent when building successful teams. The magpie-type ability to bring all the best bits together for one moment of excellence that then can be repeated.
We believe the skills of a DJ are also key traits of a transformational leader: someone who motivates and energises their employees to get behind a transformation strategy, creates something that has been written about many times before, the creation of a fan base if you will!
The styles of these three analogies allow us to consider the nature of digital leadership. There is a mix of two key styles here, one is transactional the other transformational. The conductor is transactional, planning, organising and controlling. The DJ is transformational challenging and changing organisational culture, coaching and developing people, creating a climate of trust, establishing a long-term vision. The front man perhaps mixes both styles dependent on the need of the audience or band members, an ambidextrous style that is agile and responsive as startups require to be.
The analogy can continue in a number of ways beyond just the parts of the mix. A DJ brings with them the theme and the end point they are trying to get to, much like a high performing digital leader needs to, they start with the end in mind. Also, the DJ needs to be aware of the change in trends, evaluate them and consider how to adopt them into their fabric, so much learning of how this is done from both professions; I would love a temporary job swap!
The Jobs autobiography also describes the moment that Woz and Jobs first met from Woz’s point of view, “We first met in 1971 during my college years, while he was in high school. A friend said, ‘you should meet Steve Jobs, because he likes electronics and he also plays pranks,’ so he introduced us”
Jobs and Woz learnt they had so much in common, and yet were so different. The wonderful “Small Data” book by Martin Lindstrom references a Harvard Business Review article by de Swaan Arons, van den Driest and Weed called “The Ultimate Marketing Machine”. The article suggested that there are three types of people needed to make a marketing company successful, they are:
Think people – Who focus on data and analytics
Do people – Who have responsibility for content, design and production development
Feel people – Who are all about consumer engagement and interaction
I wonder if the modern digital organisation can apply this exact same logic as has been done here for the marketing team. The types of people the IT leader needs to bring together are defined less by their technology specialty and more by the person type they act when they are in a delivery focused team. Back to Jobs and the Apple empire, the success of the original swathe of ‘i’ products has always been put down to two elements, one, Jobs own meticulous eye for detail and two, the design standards of the team under Sir Jonathan Ive. If we overlay the commentary from the article in the Harvard Business Review referenced above and the conclusions that Lindstrom himself makes on this article we start to see that the way this team has been successful is by ‘minding the small things’ by being a team that is led by a digital orchestrator but exists as a team that can deliver empathy together, to the benefit that is trying to be attained.
A modern, successful leader needs to be a strategist, a “front-man (or woman)” AND be able to conduct a complex set of teams in a harmonious way – or at least empower capable section leaders (upper strings, lower strings, woodwind, brass, percussion) to do so on his or her behalf.
The theories of Lindstrom in Small Data will blow your mind, you regularly turn a page and laugh at the conclusion he has made and how it applies so completely not just to modern marketing ways of working but to how the right digital function needs to deliver. Whether as leaders we are badged as CIOs, CDOs, Conductors or DJs we don’t care, we just want to be able to make IT work.
…… as a post script we really do care! Two IT leaders were involved in the creation of this article, one of us wishes they had taken the path of enlightenment and become the superstar DJ of their dreams the other is progressing from playing second fiddle in a growing orchestra to becoming a conductor and leader of a great band.
First published in HIMSS engagement and integrated care…
At the 2016 EU eHealth week in Amsterdam a number of commentators made an example of the clinical and patient engagement coming out of Ireland around the digital health landscape. This from a country that until recently had made little impact on the health IT area due to past systemic underinvestment and a lack of agreed direction.
In the last 18 months Ireland has rapidly began a programme that it describes as its Knowledge and Information plan. The programme sees Ireland learning from the success and errors of other jurisdictions with an expressed desire to ‘leap frog’ other countries and put information at the heart of its healthcare reform agenda.
Richard Corbridge is the Chief Information Officer of the health service in Ireland and the Chief Executive of the entity the Irish government has formed to achieve its digital ambition, eHealth Ireland. One of the first appointments made after its formation was to put in place a Chief Clinical Information Officer, this role was awarded to Yvonne Goff a radiographer by clinical background and now Ireland’s technology professional of the year. We asked both of them to comment on the recent success Ireland has had
Yvonne Goff wanted to comment first on clinical engagement,
‘It has been over twelve months since the Council of Clinical Information Officers was established with the aim of bringing together clinicians and practitioners to guide the successful delivery of eHealth solutions across the Irish healthcare system. The council is composed of clinical leaders from diverse backgrounds including, leaders, academics and suppliers, the CCIO has expanded to a network of over 200 members across many regions and disciplines.’
Richard Corbridge added,
‘The number of engaged clinicians in Ireland has been a key to the success of several projects in 2015/16 and continues to be the bedrock that we build engagement upon. It has been commented on that over 200 CCIOs is a large number and we have been asked how can they be so engaged? The reason why is the absolute desire to make the eHealth agenda work and deliver for patients and clinicians. The CCIO in Ireland has been formed to provide not just an advisory group but a clinical leadership workforce.’
The CCIO in Ireland is able to highlight the importance of collaborating with clinicians to ensure projects can be designed, developed, and delivered successfully.
In order to build an understanding of the benefits and implementation capability needed for an Electronic Health Record; eHealth Ireland is investing resources into three clinical project areas – epilepsy, hemophilia, and bipolar disorder. These projects are known collectively as the Lighthouse Projects, each are clinically lead and the CCIO collaborates with a number of other academic and charity organisations in order to advance and deliver these important projects, all in one year.
As well as building the clinical engagement Ireland has had to rebuild its technology function, up until early 2015 it was a function that was able to deliver local excellence but had not been able to work as a single national system. Under the new function of eHealth Ireland and the Office of the CIO the function has evolved to become a truly national set of functions. The CIO has achieved this through a continuous engagement process, adopting digital solutions to engage the staff who are located throughout Ireland. The team has used a wide range of tools to continue to evolve this engagement. Richard Corbridge described these different tools and initiatives,
‘The first thing we had to do in this space was to bring staff together for a face to face, something that in nine years that had not happened, we agreed to facilitate this happening twice a year and so far these have gone extraordinarily well with teams having the opportunity to present their projects and a series of guest speakers ranging from a futurologist through to an academic on the theory of communications. This has galvanized engagement from within, inspiring staff to take control and further drive engagement. New projects have been started by staff such as #eHealthmoments an enterprise facilitating staff to connect on a deeper level using digital technologies and Quality Innovation Corridor (QIC) Programme an initiative to open up innovation pathways through which clinicians, in collaboration with eHealth Ireland expertise, can seek seed-funding for creative digital solutions and assistance in deploying these.
However he does then go on to describe how different solutions have also been required to keep building on the engagement and enthusiasm,
‘We have recorded video interviews, and podcasts some of which have been broadcast live featuring all of the senior management team. We have used animations and story boards extensively to build a level of knowledge of each project and have used these to facilitate a wider understanding for all citizens of what it means to create a digital fabric in health that is needed to achieve a truly integrated healthcare system. One of the health system in Ireland’s core vision statements is to be transparent, social media engagement has enabled an explosion in this area. Project leaders and team members have embraced this vision and really built networks of people willing and ready to engage. It was a real shock to the system to see leadership openly engage through the use of social media; however it has now become a normal solution for communicating, which has truly been inspirational for the health system.
The continued evolution of communications with the CCIO group has been equally important to Yvonne Goff who explained why,
‘To me it is hugely important that the CCIO group continues to grow, expand and diversify to ensure that they are best placed to deliver for Ireland. The building of relationships with other CCIOs, advising appropriate direction for best practices around procurement and adoption of eHealth solutions is our reason for being.’
She went on to say how this engagement has been achieved, ‘the CCIO recognises that one of the most effective ways to engage and collaborate is through social media and digital networking. The twitter handle @CCIO_IRL is used regularly to communicate with clinicians, health informaticians, and other interested stakeholders. The CCIO also regularly take part in discussion and discourse on social media and in the CCIO discussion forum. The CCIO successfully hosted #irishmed Twitter hour resulting in its second busiest hour generating nearly five million impressions. The CCIO come together once a quarter as a group and are embracing digital solutions to ensure that the most can be gained from each meeting.’
Yvonne Goff then summarised with the rallying call, ‘the CCIO is making a positive and lasting difference to Irish Healthcare. And through discourse, collaboration and important projects it is committed to working together in order to implement clinically lead solutions that improve the quality of healthcare and the well-being of Irish citizens.’
The two leaders of the Irish healthcare IT revolution clearly have engagement as a priority, Richard Corbridge went on to round off by saying, ‘we need to take the whole system on a journey, we have managed to create a great environment for clinicians to become part of the team, we need to do the same for citizens and patients, the eHealth Ireland committee recently tasked us with recruiting a patient to the key governance function of Ireland which will be a great starting point for person centered care to truly come to fruition.’
He finished by saying, ‘a friend recently used the phrase ‘legitimate theft’ when describing the sharing of best practice, Ireland has done this to create what it has put in place, the offer is there for any jurisdiction to come forward and reuse what has been developed here, shared learning is a great way to ensure we all have the best engaged staff we possibly can have.’
To contact eHealth Ireland about this, why not do so via social media, @eHealthIreland is their twitter handle and they will definitely come back to anyone wanting to know more.
Thursday 25th of May 2016, The eHealth Festival rocked the stage at the Future Health Summit in City West. No festival would be complete without some audio visual fireworks and with this in mind, we opened with a powerful music video painstakingly produced by Elaine Naughton
The video, which wouldn’t have been out of place at the MTV awards, showcased different countries where music legends such as Bowie and The Beatles and neatly segwayed to all the countries where eHealth Legends came from. These countries included Estonia, Botswana, UK, Denmark, Spain, Australia and I have an honorable mention to my own Northern Ireland. The scene was set for the day: High energy and involvement would be the recipe for a succesfull day. Twitter handles were provided so anyone could tweet the speakers and ask questions using the hashtag: #eHealthFestival. Notably, we were trending in Ireland within the hour.
The speakers for the day embraced the festival theme and played the part of rockstars by choosing their own song to enter onto the stage. Musical references were dotted throughout the presentations some of our Rockstars-for-the-day even dressed up in festival gear to present.
First up to speak was Tony Shannon and Andy Williams from Answer Consulting. They spoke in detail about the critical state of health around the world and how effective sharing of information can mean better care for the patient. Andy spoke about how transformation is needed in digital health and it is his belief that a huge transformation will happen in 5 years or less. He spoke about the importance of open source and the growth in demand witnessed in just the last year alone. Richard Corbridge reiterated their thoughts and argued that health spend is actually an investment for the future rather than just a short term budget item.
The next rock star on the bill was Andy Kinnear. Andy gave great insights from his learning in the digital transformation journey in Bristol. The countless benefits they are reaping now include the amazing research opportunities that become available through a shared network. When I asked Andy about how to create a culture that encourages innovation, he replied that“ You need to create a spirit where loyalty is with the people you serve – the public not the organisation. You should reinforce this mind-set that all you do is for the patients.” It is heartening for me to see that this is exactly what eHealth Ireland are doing by putting their patient: at the centre.
Naomi Fein from Think Visual took to her new found rock star status like a duck to water as she ran up and down the stage interacting with the audience. I have had the pleasure of working with Naomi on a few projects and she is truly inspirational. Naomi spoke to us about leveraging empathy to create clarity. She took everyone through an interactive process ensuring that any plans that we make are truly impactful. The message must be “memorable, actionable, and shareable”. To ensure this we need to start this (planning) process before we communicate by asking –
If we can do this with empathy for our audience it can give us fresh insights, new language and clearer priorities. Naomi’s fiinal piece of advice was: Before communicating, it is imperative to separate between what is true but useless, and what is relevant. This last point was particularly poignant because I feel that often times, we ourselves are overawed with too much information.
Joanna Smith, CIO of Royal Brompton Trust was next up and she set the scene by entering to The David Bowie number “Changes”. She spoke about her experiences within digital transformation in health. She had a lack of engagement at the beginning of her journey as they had no strategy or plan. Joanna used the analogy of growing a garden and how they had to strip everything away, draw up a plan and get the basics right before they could change their system. The now familiar theme of the patient being at the centre was spoken about again and how important it is to have easily accessible and user friendly technology. Joanna also argued that patients should be widely informed as they are interested in these technological advancements. Joanna echoed the importance of building relationships: a common theme from all the speakers and how she felt that one of the biggest challenges is managing change and trust. She gave some great advice on picking your battles, knowing when to give up and knowing when to push a head. In my own experience, this sound advice could apply to many things in life, including raising children.
Julie Bellew and Brian Canavan from the HSE were late additions to the bill after the successful launch of #eHealthMoments. I have had the pleasure of working with this team to develop this idea. It is based on the premise that internal communication is central to how an organisation is run. Up to 70% of Organisational change fails and one of the more commonly cited reasons for this failure is poor communication. This internal communication is truly engagement from within and was developed when both these members of staff were inspired at an All Staff Day in March. The concept is based on “Hello My Name is” created by Kate Grainger. Each member of staff can make a short video clip about who they are and what they do. These clips are uploaded to a private forum created for these staff. Previously there was no real link between the staff as they are traditionally dispersed throughout the country and rarely get to meet. This provides everyone the chance to introduce themselves, put a face to the name and get to know a little bit more about each other. Julie and Brian want to change people’s opinion of the HSE and want to make it fun as they do it. I was sitting beside a few of the speakers at the time of this presentation and they loved it. They took pictures and said it was an initiative they were going to bring back to their own organisations and was so simple but extremely effective.
After lunch Richard Gibson, research director at Gartner spoke about personalisation with healthcare and the importance of patient engagement. He explained how simple technologies like websites can help engage by providing information and portals connecting patients with their information. Richard spoke of many cool technologies that provide great advantages to the user such as fitness trackers, sleep wristbands, devices that keep track of your habits and home diagnostic stations: All technologies that are revolutionising how we live our lives.
We had the lovely Amanda Neylon up next, who danced onto the stage with the song “What a Feeling” from Flash Dance. Amanda was in charge of the digital transformation of Macmillan Cancer Care support. She told an inspirational story about her journey there. The purpose of the organisations was to support people and help them take control of their situation. To do this they took a huge amount of paper information and made 50% of it available through digital services. Social Media put digital at the heart of the organisation. She echoed Naomi by stressing that “you must understand your audience” and through this understanding they segmented their audience through behaviours rather than demographically. Amanda also spoke about the importance of collaboration, iteration and evaluation through all the different stages. Her final word was to be brave and allow people the opportunity to grow through experimenting with what works and what doesn’t. If things don’t work the first time around, simply move forward and try something new.
Clare Sanderson (@IGcom) from IG Solutions was our final presenter and was representing the security and governance side of the festival. She also spoke around the importance of engaging with the public early and informing them on each of the stages you are going through. There is great opportunity to learn from other people’s mistakes by being up front with patients about where their information is going. Research conducted by The Wellcome Trust found that people generally didn’t know where their information is going. Clare spoke about a really interesting concept called Citizen Juries. During this process people hear case studies around the use of data by health care professionals. This process proved that the more information a patient has around the digital transformation, the more positive they are about it. Clare also pointed out an extremely important issue: that there should be explicit consent and the right to object. I asked Clare about the best ways to do this and she gave some interesting ideas such as having the issue as a story plot on popular TV shows. Maybe we could ask Richard’s agent to arrange a cameo on Fair City.
The finale of the show was a panel discussion with the A&R personnel namely vendors – Cerner, CSC, IMS Maxims and HCI. Richard asked the panelists to sell to the audience on why their company should be the one to push forward this transformation in eHealth. Many of them touched on the fact that Ireland could be built as a centre of eHealth excellence and the importance of the integration off different systems. They echoed the importance of being engaged with patients early and ensuring that they go through the decisions with you, putting healthcare back into their hands and also the belief that data sharing is a common sense approach.
Richard rounded up the day with the reiteration that community is an area often forgotten yet it is crucial to the development of eHealth. He spoke about delivering everyone in the HSE a digital identity and how the HSE is opening up to innovation through eHealth Connect and The Quality Innovation Corridor (QIC). This was a very positive end to an extremely positive day. I spoke to a number of people after the event and they were delighted with the festival there was great energy, enthusiasm and optimism around the future of eHealth in Ireland. It really is amazing to have been part of this day and I want to say a big thank to Richard for giving me the opportunity me to co-host the event with him. I look forward to seeing how the ehealth transformation continues to evolve in the near future.
For more information on what is happening in eHealth in Ireland go to www.eHealthIreland.ie
SPEACIL THANKS to Blathnaid Cluskey who is interning at the HSE she is a Communications Student at DCU. She has a strong passion for media and using it to connect with different audiences and helped ensure that it was possible to create this review of the day.
It’s better for everyone – the brand, the customer and your organization.
I attended the biggest social media marketing conference in San Diego recently and its clear the tempo and direction of social media is changing. If you thought the digital age had been and gone, well you are gravely mistaken.
“This is the fastest change I’ve seen in social media in eight years.”
Michael Stelzner, Founder of Social Media Examiner and Social Media Marketing World and author of Launch
Social media is here to stay. Let’s establish that fact first. But more than that it is growing in prominence, relevance and even necessity for many organisations – public and private, for profit and not-for-profit.
Social media is not just for kids, for egotistical bloggers or for celebrities or big brands. It’s for everyone and in my own mind especially for public sector organisations. I believe social media is a fundamental way in which we communicate and is relevant to all industry sectors.
In the past year I’ve introduced social media strategies into policing, religious and educational organisations – none of which are interested in making profit. The core objective for each was to enhance their existing work and to align with their business goals through their channels of communication. Let me give you an example when I worked with the policing organisation they expressed the need to communicate with all their stakeholders on urgent messages and in real-time social media provided them with the perfect channel. Another example is educational organisations who wanted to appeal to prospective students by showcasing the experience of attending their college. They knew their target market and that social media is where they could have conversations with them.
There is no place for excuses in pursuing a social media strategy.
“You don’t have a choice of whether to do social; it’s a case of how well you do it.”
Erik Qualman, Social Media award-winning author and strategist
I recently attended a doctor’s appointment and was pleasantly surprised to find out that he was on Twitter and an avid an enthusiastic user of it. Following my consultation I followed him and in actual fact it’s been one of the most useful follows for me in recent months.
During my consultation he was describing my ailment and proposed treatment, based on current research and the results of studies. Now if you are like me, when I’m in a medical appointment, much of it can go over my head and once outside the door I’ve forgotten most of what my doctor has said.
I was anxious to get to the root of my problem and even more anxious to get a speedy remedy.
Later that night I went on Twitter and searched his Twitter history only to find the source of the research he had mentioned during my consultation, the stated remedy and links to much more relevant information that I began to read.
It resulted in me taking more charge of my ailment, researching it in my own time, and being more encouraged to commit to his prescribed recommendations. So I asked myself? Why can’t all medical, educational and public sector employees communicate on social media to benefit the customer just as profit making companies do?
I know there can be challenges to all companies engaging in social media such as an understanding into what social media is, policies or procedures that need to be in place that prohibit its use and even fear of how to handle a crisis or conflict.
However I really do believe that it’s time to hand over the reigns of social media to your staff. Take full control away from your PR advisor and empower your team with knowledge and skills. I understand that this takes time and in a lot of cases training. But how can you be more human if your social networks are being run by bots or PR advisors only?
You are in a people-centered job and conversations are at the heart of it.
So how does a large, conservative and reluctant organisation such as the HSE get their staff front of screen on social media – consultants, GPs, nurses, radiographers, and administrative staff?
You simply begin to work on creating a culture that espouses transparency, connectedness with patients/customers and a realisation that social media is and will be a fundamental way in which we communicate, just as email was when it was mainstreamed in the mid 1990s.
Using social media the HSE can succeed in so many ways, from customer satisfaction to reduced in-bound calls, to greater participation in their health roadmap to closer relationships and greater transparency.
I remember working as a broadcast journalist in a local radio station and learning the importance of being engaged and involved in stories that affect your company. In helping to tell the story I sought responses from relevant organisations and even with a ‘no comment’ response, the story was still broadcast but without the voice of the company.
That worked to a certain extent years ago but now and in health there are already citizen journalists (patients with recording devices and voices on Twitter) so ‘no comment’ won’t fly anymore. This is not an option anymore for organisations, the culture has to change.
I strongly believe its now about conversations as opposed to comments. Wouldn’t you like to let the world know how hard your staff work, how committed they are and what the HSE does for this country?
The day will come, but why wait? I think it’s great to see the HSE taking control of their own future with their #eHealthHour and #IrishMed that they are involved with. I encourage them to continue with their digital journey and get more social. We as customers want and expect it and I suspect many staff and managers do too. You just need the ‘how to’ and well that part that can be learned.
About the author
Joanne Sweeney-Burke is a communications professional having worked as a broadcast journalist, PR practitioner and lecturer as well as CEO in various business roles.
She is CEO of Digital Training Institute and is dedicated to bringing individuals and organisations into the digital age with her consultancy and training services. She is the author of Social Media Under Investigation, Law Enforcement and the Social Web, which takes a forensic look at how police forces are using social media. She is currently writing her second social media themed book.
Joanne is a regular speaker at major social media and digital marketing conferences including Social Media Summit (Dublin), Big Data Retail Analytics Forum (London), SMILE conference (social media, the Internet and law enforcement – Phoenix, Arizona) and Digital Citizenship Summit (Bournemouth University). She has also taken to the TEDx stage in Omagh.
Follow Joanne on Twitter @tweetsbyJSB
Add her on Snapchat jsbsnaps
In healthcare we have landed on the moon many times with small steps for man and giant leaps for mankind. Data is the next big Neil Armstrong moment for healthcare!
In 1853, Florence Nightingale started what we know today as the modern profession of nursing. Interestingly she also helped popularise the graphical presentation of statistical data. Was this the initial lunar landing for data in healthcare?
In 1895, Wilhelm Rontgen’s invention of the x-ray made a giant leap forward in the history of medicine. For the first time ever, the inner workings of the body could be made visible without having to cut into the flesh of a patient.
Another 40 years on in the late 1920s, Penicillin was discovered by Scottish scientist Alexander Fleming, revolutionising the medical treatment of infections.
If one were to ask Christian Bernard or Louis Washkansky, a 54-year-old grocer, suffering from diabetes and incurable heart disease if this 40 year cycle of giant leaps in healthcare are anything to go by and you will get a resounding yes. After all Bernard was to revolutionise the clinical consideration of the art of possible with the first ever heart transplant which benefited Mr. Washkansky who bravely stepped up as the first recipient in the world.
Bringing modern computing into the 40 year cycle of healthcare has been more of a challenge it would seem; advances in the home PC were transformational during the 80’s and 90’s in the way we live our lives and transact our work and yet are still heading towards that same exponential change for healthcare.
40 years on brings us to today [and the next few years]. We are ready for the next small step for man and giant leap in healthcare. In today’s modern healthcare system we continue to have incremental improvements and technological advances that have measurable benefits to society, bringing us into a healthier state. But it is data and its use that will bring about the next giant leap forward.
The use of data is on the brink of taking electronic medical records, genetic information, and wearable data and transforming it into information that will support decision making and the development of new technologies that will change the way we care for our patients.
Here in Ireland we speak about our ‘grand ambition’ to allow the patient to truly control their health data by 2020.
Subra Suresh, president of Carnegie Mellon University, says with the use of information and data; “we will move from reactive care to immediate, proactive prevention and remediation, from experience-based medicine to evidence-based medicine, and to augment disease-centred models with patient-centred models.”
Imagine a time when a graduate doctor will not only have the six years medical training and their immediate supervisor’s knowledge at their disposal to treat a patient but the capabilities from millions of lines of data to support diagnostic decision making, the art of the possible with the phenomenon we call cognitive computing. The transformation of the data to information will provide suggested diagnosis based on test results, information gleaned from the patient but may also prompt further questions or tests that might aid in a refined diagnosis.
Imagine a time where a patient can provide a full medical history to any healthcare practitioner across the globe by simply allowing access to their health record stored in the cloud. Where a patient can see who has viewed and added to their record anywhere and at any time.
We don’t need to imagine these scenarios, early adopters are already realising the bright future data is providing in healthcare.
Kaiser Permanente has fully implemented a new computer system, HealthConnect, to ensure data exchange across all medical facilities and promote the use of electronic health records. The integrated system has improved outcomes in cardiovascular disease and achieved an estimated $1 billion in savings from reduced consultations and lab tests.
Blue Shield of California, in partnership with NantHealth, is improving healthcare delivery and patient outcomes by developing an integrated technology system that will allow doctors, hospitals, and health planers to deliver evidence-based care that is more coordinated and personalised. This will help improve performance in a number of areas, including prevention and care coordination. (The big-data revolution in US health care: Accelerating value and innovation Basel Kayyali and David Knott. http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/the-big-data-revolution-in-us-health-care )
The future is bright and the future of healthcare is data. The future of patient care in Ireland is certainly bright as we develop Information Services and the eHealthIreland structures to truly turn data in the system into information that can, with care be used to change the way in which care is delivered to the patient and the population of Ireland.
In February 2015, our new CIO Richard Corbridge asked me if I would take on the challenge of leading our drive to build Projects, Programme & Portfolio Management (PPPM) division, within what would become the new Operating Model for the freshly renamed Office of the CIO.
After our conversation, it took me all of 5 minutes to get into the mind-set of transformation, and before going home that evening, I’d already begun to jot down ideas – a lot of which are still current, although thankfully in a much more refined way (I like to think!) In fact I got into the new role so quickly, I’m not 100% sure that I ever properly got back to our CIO to say “Yes”!
Anyway, since then it’s been a spring and summer of increasingly frenetic – yet focussed – activity, as the Office of the CIO went through its transition to the new structures described within its Knowledge & Information plan. During that time, plans have been put in place, communicated, refined, and executed, all while keeping the show safely on the road.
For me it’s a time of great optimism, and I’ve been really impressed with the open-mindedness and enthusiasm which I’ve encountered during my engagements with our existing projects staff. That’s not to say there’s no scepticism within our organisation towards what we’re trying to achieve– but even that scepticism should be viewed as healthy and positive. We can’t all be wide-eyed optimists; there needs to be a balance of naivety and experience, and together those two traits can push us through the bigger challenges ahead – transforming how we work, how we ensure the benefits are fully realised, and how we measure ourselves.
I’ve used the corny phrase “the department of change” a couple of times to describe, in part, my vision of this new PPPM organisation; corny it might be, but it really is how I see it.
Our challenge is not only about ensuring that our projects are properly planned, scoped, resourced, and that they fit the strategic, tactical or operational needs of our organisation. Neither is it only that our programmes have a vision, a direction; an end state to reach. In fact, it’s all of those, and much more.
Above all else, for me, this challenge is about ensuring that the investment made by the Health Service in modern technology will deliver the value, the return – the Change – that we all know is necessary to transform the capability of the Irish Health services.
12 months ago at the inaugural eHealthSummit in Croke Park in Dublin, I was asked to speak at the Locknote panel on the challenges for eHealth and the Implementation of the eHealth Strategy in the next 12 months. Top of my wish list for enabling the eHealth Strategy was the implementation and availability of the IHI and IHPI for use in Ireland. I outlined that it was the single biggest barrier to enabling the eHealth strategy to be fully realised. I was delighted to sit as part of the attendees at this year’s conference to hear that the IHI system had gone live and that the HSE had a seeded database of individual health identifiers for every patient in Ireland.
On reflection on the last 12 months since the first eHealthSummit was held, I believe that a phenomenal amount of progress has been made in the area of eHealth in Ireland. The establishment of eHealth Ireland along with the publishing of the Knowledge and Information Plan giving us a roadmap for the next 5 years is exactly the type of progress that I felt was needed in order for us to achieve the goals of the eHealth Strategy. There is real enthusiasm and a renewed energy in the industry as a result of the transformation that is happening in the HSE. There is significantly more involvement from industry and academia in the plans for the future. There were several examples at this year’s conference of the really good work being done both in Ireland and other European countries such as Scotland, Finland. The implementation of the EHR in Temple Street University Hospital along with the National Rollout of electronic Referrals across Ireland along with the availability of dates for when all hospitals will go live with electronic referrals before March of 2016 show that real progress is being made.
There was much discussion from the floor and observations from clinicans that there is a real and practical need to enabling the sharing of information across the Health service and to utilise what’s currently available both within the Health service and from industry partners. It was acknowledge by Ciaran Ryan of the ICGP that GP’s have very good systems and electronic patient records in their practice and that they would love to see further sharing of and access to information across the Healthcare industry in Ireland. The inclusion of the National Healthlink Project as part of the future IT Architecture vision in the Knowledge and Information plan shows a real commitment on behalf of eHealth Ireland not to rip and replace systems that are performing very beneficial services but to utilise and expand them to meet the future needs.
Reflecting on the years progress both from the standpoint of the National Healthlink Project and from the eHealth industry in Ireland, I feel we are positioned in a much stronger place with some of the key enablers now in place for significant movement in the right direction in the coming year. I look forward with renewed enthusiasm to reflecting on even more progress between now and eHealthSummit16 as part of the Senior Management Team of the Office of the Chief Information Officer as I begin my journey on enabling the Access to Information function as outlined in the Knowledge and Information Plan.
I hope that Dougie Beaton, and the rest of this years Locknote panel get their “Dear Santa’s wish list” and can reflect on similar progress in the next 12 months.
I feel privileged, as a clinician, to be on the senior management team of the Office of the Chief Information Officer (OoCIO), a member of the eHealth Ireland committee and the coordinator of the Council of Clinical Information Officers (CCIO).
The responsibility of these roles is somewhat onerous but this is counterbalanced by the advantages of having a practicing clinician sitting at these tables making decisions about information. I believe that having the correct information at the right time is as important as the availability of the correct medicines to treat patients.
My main role, currently, is the coordinator of the CCIO.
What do we do?
It is my hope that by establishing a culture of collaboration and openness that we will reach the eventual goal of knowledge and patient information securely shared by those who need to see it. Recipients of healthcare will have access to their own health record and will have oversight of those who are accessing it. I feel that this alone will empower patients to take more responsibility for their own health and make informed decisions about their own care as they will be provided with choices. It is hoped that this access to knowledge will improve the health of the population as a whole.
Where do we start?
We need to make sure that the goals of clinicians and the goals of the HSE and our Department of Health are in line and that the electronic solutions that we approve and help to design will deliver high quality, safe and effective patient care.
How will we achieve this?
An integrated approach is needed to make sure that the IT solutions purchased and those ones we already use work together to allow those in receipt of care to travel through different settings, eg from GP to hospital to specialist care and back again and for their up to date health information to travel with them.
To reach this level of care, there will be have to be changes to the way we currently operate as clinicians. Some of these changes will provide instant advantages to clinicians and patients, others may take longer to pay back and it may be to the population as a whole and not to individuals. We need to take advantage of this change opportunity to gently steer fellow clinicians to more efficient models of care in some instances, to build in standards regarding information at the procurement stage and to incorporate emerging best international practices and national guidelines into pathways of care.
We do not underestimate the significance or the magnitude of this change to process and technology but we do hope to lead it in tandem with the national clinical care programmes and the entire OoCIO, guided by the director general and the minister for health.
If you want to learn more about the CCIO community in Ireland then:
Follow them on twitter @ccio_hse