The eHealth Ireland Eco-System was a year old last week, a great achievement for the team to go from the germ of an idea to the formation of a self-supporting Eco-System that has seen the meeting of many ideas and organisations that have been able to be another hand on the tiller, steering the eHealth Ireland agenda.
As part of the birthday celebration meeting we have invited a different keynote speaker from a background outside of health, Niall Harbison, founder of Lovin’ Dublin, inspired the audience with his vision for an integrated Health system. Niall opened his presentation with a slide stating “The world is changing so fast” he brought the audience through a whistle stop tour of what it means to be in Social and Digital Media today in 2016 with a great emphasis on being mobile first.
Niall told us that over 90% of traffic is now via mobile. He spoke strongly on the importance of engaging with our stakeholders through different social media platforms such and commended us on our use of Twitter Hours and our transparency agenda for developing relationships.
Niall spoke about how we all need to be content masters. It’s up to all of us to inform our stakeholders in a way that interests them about what we are doing. It was refreshing to hear Niall speak about what he believed would be the future of health. He spoke about what it was like to not be clinically informed but that he would like to be able to see a future with telemedicine, where he can see a doctor when it suited him, where it suited him and be able to get his prescription sent to him electronically. Niall spoke about how he had great respect for all involved in health and their movement to digital.
He spoke about Apple and how even they, being a multi billion dollar innovation dynasty, have difficulties in mastering this market. The fact that we are trying to digitize something so large and disparate is a challenge and how its often much easier to start with nothing, he likened it to “herding cats”.
This is why he believed that the health innovations would actually emerge from countries where there is nothing currently there. Where they can adopt technologies and build new solutionsquicker. He also pointed to the fact that we can’t believe our stakeholders don’t want or expect this service or will not be able to use it and spoke of the quick adoption by taxi drivers of technologies such as UBER and Hailo and how people would have presumed that taxi drivers would never have adopted that technology
Niall spoke about where health was and asked us to consider what it would be like to pitch Health delivery as it is today in Ireland to Warren Buffet as a business idea, what investment did we think we would secure. If we can’t secure the idea of delivering health as it is done today then just maybe the answer could be a digital revolution was the noise left ringing in many peoples ears.
Niall finished on reiterating his first slide “The world is changing so fast. When will it happen to health?” and an inspirational quote from Michael Jordan;
“I’ve missed more than 9000 shots in my career. I’ve lost almost 300 games. 26 times, I’ve been trusted to take the game winning shot and missed. I’ve failed over and over and over again in my life. And that is why I succeed”
When experts from a wider digital field listen and speak to health audiences it always brings a refreshing and different challenge to what we think and do. Imagine being able to reform health at the speed of an organisation like Lovin’ Dublin has been able to form and become a house hold name. All through my own career I have pushed hard to ensure that we can learn as much as possible from other business arenas in health, after all the facts and figures from various studies point to health globally being way behind other businesses so there is clearly going to be something new to learn.
The eHealth Ireland agenda is not unique, but, it is now moving at a rate that requires a different type of support to see it succeed, one straight out of the innovation and new thinking kit back. In the words of Bob Wachter at a recent Kings Fund event,
The purpose of digitisation is not to digitise, but to improve quality, safety, efficiency and the patient experience of healthcare.
With that ringing in our ears we are ready for the next year!
The consumerisation of technology was to be solved by two mega trends: BYOD and gamification. If we could exploit these two things then every person in every organisation would become an IT super user overnight and we could even do away with some of service needs by being reliant on the fact that IT was owned by the personality of the organisation. Five years later, many BYOD strategies were written but we still see two mobile phones in the hands of most management teams, particularly in the public sector where the idea of BYOD was just too hard. As for gamification, we see it more and more appearing in how consumers are persuaded to be part of a collective but it still hasn’t quite changed the thinking of many delivery functions.
But that is changing. Take my area, health. BYOD to the monitoring of your health and wellbeing is here now, an explosion waiting to really happen. When one adds the gamification of those devices, the fitness regime as a competition really will start to alter the way health and preventative health in particular is handled. Never before have we seen a series of technology expressed trends come together to begin a revolution in one area:
BYOD – The patient has their own device and is willing to use it to capture fitness data, monitor long term conditions, and provide real time updates.
Wearables – The patient wants to be able to leave the confines of healthcare delivery, move around and still know they are getting well or staying fit. Wearables, whomever pays for them, will get the patient out of the care setting sooner, safer and more efficiently.
Analytics – The ability for complex medical data to be understandable to non-medics is here and on your own device. The amount of apps for health is huge and all with some analytics capability making the concept of BYOD to your own healthcare even more appealing.
If we consider the next stage in the BYOD to be COPE (Corporately Owned Personally Enabled) and apply this to health and the availability of prescribed devices that allow the patient to turn the delivery of health and wellbeing activities into a competitive, gamified process, then maybe this will become the next frontier.
A short blog on my views on digital leadership in eHealth and the wider environment…
It’s all in the words…
Organisations looking at how to modernise healthcare through the deployment of digital solutions are in the process of falling over themselves to get the descriptions and the words right. Recently I have seen two articles published, one refers to health informatics dropping the ‘e’ from eHealth to gain engagement and another refers to persuading doctors that they do not ‘need’ digital health as the first step to engagement in technology.
If we are to deploy digital solutions into the way health is provided to a whole country then the winning of friends and influencing people is clearly a giant leap to be made. The possibility of procuring something against an outcomes basis is now a reality and the describing of technology and its impact on the delivery of healthcare is the way to get the most engagement in this process.
The challenge of leading a digital revolution to a group of people who either know more (or best) or want to know nothing is a leadership challenge not unique to health, so what lessons are out there that health can learn from?
Number one is openness I think, let us get the plan out there, share the outcomes, or better still inspire the outcomes to be described to the technologists by the people who will use the digital solutions. The next has to be the trickiest, get rid of the technobabble, but, still keep the innovation descriptions, and that is so very difficult. A technologist understands the terms and doesn’t want to lose them, a none techie will be turned off within two sentences of talk of Cat5 cables and HL7 translations.
To try to get over this we are banning the phrase ‘the business’. We are trying, and it is going to be hard, to place the delivery of digital health solutions within the healthcare system, removing the IT conceived opinion that it is IT and ‘the business’. Simple things like having a single point of contact for different areas of healthcare provision all the way up the management structure will help us do this.
We also are trying to turn clinicians into fans, not users! To a clinician the term ‘user’ can mean something quite different and needs a large amount of careful treatment! If we can turn clinicians into fans of what technology can do for them then engagement will become easier to make use of and benefits quicker to release.
The psychology of digital leadership looks set to run and run but still comes back to some basic principles, get to know the customer, engage them through personal relationships and build trust, sounds easy really, but with a single language it will be a whole lot easier!
Currently a large part of my team seems to live for delivering demonstrations of our new system, it is set to go live in the next few weeks and the team are out and about building an understanding across the organisation of what it will replace, what it will deliver, and how it will be used, almost a pre-training overview. A heart warming moment for me as someone who has been moving this system forward for three years, is the ‘Oohs and Aahs’ the system gets when an end user sees what it looks like and how it works. It looks good!
Some of the local systems now deployed in the NHS are neater, kinder on the eye and generally much easier to use than some of the monolithic national systems of yester year. Local configurability is an expectation in the systems deployed but is treated as a nice to have. My observation in the last year is that the successful systems that build a user base quickly are those that allow the user to make it work for them, allow them to make it be how they want it to be.
Lets consider the UI of an everyday item. No two iPhones are the same, everyone has a different theory as to how they should group their apps, what should be on the first screen, what constitutes a utility and should the music app really be in the same folder as the video app! There are even web sites and small ‘cults’ devoted to the set up of the iPhone UI. So why wouldn’t we expect the same of the systems that support us to do our job. Configurability of systems (local and national) means that the user owns the system far more, and ownership leads to the user considering the system to be their own, which to me indicates that the use of the system is placed at the center of the delivery of benefits.
As well as going live with our new major system that the organisation has fallen for we have also taken onboard these principles of a better UI and are applying them to the Clinical Research Network App Centre. The App Centre is a single place where all of the applications relating to the management of information for research can be found. Continuing with the theme of crowd sourced delivery utilised to gain a rapid release of the Open Data Platform we have tried hard to take on board a varied selection of opinions on what the best UI for the solution would look like. And the whole point behind these solutions being labeled as Apps is the way they can uniquely be configured to fit each users regular needs, much like the UI of the iPhone.
What is the most famous UI, the book maybe? And yet how to save a page in a book is equally debated and maybe even disagreed over as any modern UI. Are you a page-turner, a spine breaker, a number writer, a scrap of paper placer or a bookmark keeper? Personally if you borrow a book of mine then do try to be a bookmark keeper, but it’s a personal preference. That takes us back to the iPhone, the ability to configure the UI is what wins the user base over. A lesson it would seem that Qlik have learnt well with their new solution, not a replacement for Qlik View, more a step into a more varied market. However for us though, as an organisation that delivers a great deal of BI on Qlik, Sense is a giant leap that helps hugely as it puts some of the UI creation back in the hands of the user, and when you have spent time striving to make users fans of systems this goes a very long way!
Linkedin showed me a comment a couple of connections had shared in the last week, ‘If you need to explain the UI then you haven’t created a UI!’ It struck me as being a quote or phrase that we needed to apply to the configurable UI ‘set’. Whilst the ability to create and configure UI seems to be important it has to be easy to do. Both Apple with the iPhone and Qlik with Qlik Sense have done this, they have been able to make a configurable UI that is so intuitive that any user can start to deliver a system for themselves with their own personal benefits at the center of it.
So, if the book is the most famous UI that has a configurable nature that the fan can change then from now on in all our systems need to emulate this to truly gain acceptance, adoption and drive the release of real benefit. Welcome to the new world of clean, configurable UI.
POST SCRIPT – So maybe the book as the original UI is wrong? In a bar in DC and it would seem that the oldest UI is more likely to be the ‘drink’! The lady in the next bar fly seat would like such a specific drink I needed to take notes, and yet the bar man, the developer of the UI, never even blinked, he turned and began to make the….
‘Hendricks and Vodka, super super cold, extra ice, no zest with a lemon and lime, and I mean don’t put the zest in! When its together can you bring it here to be mixed, I need it to be really mixed!’
Thats a definition of a UI requirement!
The race for the truly smart home is on, when your fridge can create your shopping list on your phone. It can add to that list as your friend takes the last cold beer, advising you which supermarket to call at on the way home from work to pick up the best value replacement! Then the Internet of Things has become truly valuable.
This isn’t science fiction, this is here now, the Palo Alto company Nest Labs are now making the API behind this and other smart home solutions available ranging from kitchen appliances to the smoke detector and thermostat.
As your home starts to build an IQ what will the impact be on clinical research? I have been wearing the Jawbone Up since February, researching my own sleep versus activity and trying to hit the magic goal at least five in every seven days. The correlation between sleep and activity is clear, however I guess I didn’t need the Up to tell me that if I did lots then I needed more sleep! What is interesting is how that data can be added to with information about location and food consumed, the ease of keeping a food diary to understand the impact on sleep is now there and I now know to avoid cheese for a good nights sleep and that if I am away from home I can expect no more than four and a half hours sleep on the first night.
In a recent Gartner study it was reported that by 2020 there would be 30 billion connected devices worldwide. An IDC report indicates that there will be 212 billion ‘things’ connected to the Internet by 2020! McKinsey have been looking at the value that the size of this market could bring to the global economy, they have a suggested value today of $2.7 trillion against the market place that they define as the Internet of Things, by 2025 they suggest that this could grow to $6.2 trillion. All of these numbers make me shudder though, they seem to be equal in their impenetrable hugeness in a way to some of the big data numbers are.
Then you ‘throw in’ the iWatch in 2015, if it becomes as ubiquitous as the iPhone then many millions of people globally will be recording all manner of health information every day and perhaps making it available without the difficulties of consent to organisations that Apple believe are appropriate to be delivering research.
Tele-Health, eHealth, Tele-Medicine, terms that have been used interchangeably for years without a real leap forward in the beneficial impact they can make on the provision of health care. However as the Internet of Things truly takes hold these terms do come into their own and at last begin to put in place the building blocks to release benefits.
The concept of the Internet of Things breaks down an equally powerful social concept of the Digital Divide particularly for health and clinical research. After all ‘things’ is used as a definition largely to demonstrate how ubiquitous the internet will be, the digitisation and therefore connection of so much ‘stuff’ reducing if not removing the much maligned divide. As the next generation (and what will we go to after generation ‘Z’ I wonder?) takes to the digital world and the next generation of researchers and clinicians become qualified we will truly see an empowered citizen world wide.
Earlier this year I got involved in the creation of a piece of work called ‘The last train to Data-Topia’. In this we described a world in 2030 where research and health care went hand in hand. As the ‘Internet of Things’ moves from being part of the catch phrases of the famous consultancy firms and becomes more related to the reality of what can be done with technology the impact on clinical research can truly begin to be explored, not as science fiction, but as a reality.
eHealth and an easier path to clinical research really has become a possibility if the right ‘Things’ can act as the catalyst needed!
Following on from the guest blog last week I have been reflecting on the success that has been made of the work done in the collaboration space throughout the NIHR and in particular my part of the organisation the CRN.
Having taken a giant leap down the collaborative platform route the NIHR is now starting to understand what a networked organisation with a capable platform designed for collaboration underneath it can achieve.
Collaboration is the watchword across my organisation, it will save time, effort, money and all of these drive efficiencies for the delivery of clinical research and enable the organisation to increase its scope of research and improve quality. However the implementation of a new platform is not what has driven this change. It has been the catalyst, but just a small taster of what additional collaboration can be achieved to support clinical research in the UK is the driver. As a team of people we are a network. The very nature of our organisation encourages us to share: ways of working, content, even the load!
We accepted the challenge to implement what we tongue in cheek called the ‘Google-Verse’. The challenge was o do this quickly for core functionality and release some basic benefits, then, making some of the periphery elements available as the year went on adding to the benefits delivered. Many months into the challenge the platform is now delivering rewards to the organisation. It is slowly changing the culture of the organisation away from a focus on email as a collaboration tool, moving it to a place where the capability to share workload is the common practice.
In the case of our organisation we truly have an example of technology acting as the catalyst for behavioral change on mass. The availability of tools to collaborate has started to influence behaviors not just when the teams are using these tools, but to start to create a culture that looks for the place to collaborate first. We have been able to get a ‘virtual’ Business Intelligence Unit (vBIU) up and running over the same period of time, and we can put some of the acceptance of this down to the willingness of the organisation to collaborate on so much of the work we do.
There is also an element of the organisation coming together in the face of ‘adversity’. In this the adversity is the simple volume of work and pace that it is now looking to deliver on.
However, as we empower the network to consider the benefits they could get from the solutions we have deployed we also created a group of people who are so enthused by the benefits that technology can bring that there is a risk, it’s a nice risk for a CIO, but a risk that needs to be managed. This risk is that the enthused start to destroy the excitement through the eulogy they speak. What do I mean though? Its like when the Grey album first leaked out on the internet, the world loved it, no matter the genre of music they ‘lived’ in it seemed to touch everyone, but because everyone was talking about it the enthusiasm for it began to wane. As I re-visit it now its still a piece of musical genius!
However back to collaboration (and a step away from Jay-Z and the Fab Four).
Collaboration to create success, I believe this is driven by a good leader and built upon solid tools and foundations. I have written before about this programme of work not being led by technology but by the delivery of a networked workforce and the development of that structure, that, as we come to the point where we can close the implementation element of this programme down it is clear this is how we have achieved such significant business change through the implementation of technology.
Earlier this yeah I volunteered to project manage a migration project that would affect everybody within the Clinical Research Network (CRN). The project brief was simple, to migrate over 500 accounts from the traditionally deployed email solution to the new NIHR Hub built on the Google collaboration platform.
Fairly straight forward I thought!
It quickly became apparent that there was a lot more to this project than to simply confirm user account details, migrating the data and let people loose in the wonderful collaborative world of Google. To begin with it was a challenge confirming who the users were, if they needed an email account or even who the host employer was?
Then we began to speak to people about how they used their email. That was an eye opener! It should not have been, I have never worked anywhere where I have been told how to use email everybody has a different idea, lots of different ideas! Some people store emails with massive attachments within their email account, others archive every email going far back (in some cases) as far as 15 years and some opt to save them locally on their machine or on a network drive.
A lot of work and education to do then!
Like any transformational project some of the affected people understandably didn’t want to change, “I really like out Outlook” was an actual quote for a lot of people. To counter this we did a fews things:
It worked! The sceptics and resisters were won over by their colleagues who were empowered as change champions, giving credibility to transformation that would be hard to drive forward otherwise. Demonstrating the new product for people so see what they were going to get was also very effective, reducing the fear of the unknown.
The big day arrived and we did have a few teething issues but our migration partner and change champions were on hand to swiftly resolve the vast majority of issues. Within days people settled in to the quirks of Gmail, quickly learning new ways of working and drop-in sessions continued to be offered to help support the workforce.
For most people the Hub is a now vital tool for their day-to-day job. Gmail has been well established and the initial resistance to change has withered away.
People are using other features such as Google Docs, Google Forms, Drive, sites, groups and forums to communicate and collaborate with all sorts of people from within the NIHR and beyond, seeing the benefit of collaboration tolls in the world of clinical research.
Tasks that once took a huge amount of effort and generated large volumes of email traffic and documentation can be done simply on Drive with minimum fuss.
Polling people or collecting info can now be done on Google Forms or via the forums in Google Groups, meeting can be arranged within the NIHR across one shared calendar, Google Groups can also be used to manage workflow, replacing clumsy spreadsheets and email trails. Google Sites is being used to quickly create information and communication portals across the NIHR.
The list goes on, growing as the appetite and appreciation for the NIHR Hub grows too…..
Collaboration has become the word of the year for clinical research in the NHS because of this ‘simple’ project.
Cpt. Nixon: What do you think I should write these parents, Dick? Because I don’t know how to tell them their kids never made it out of the goddamn plane.
Richard Winters: You tell them what you always tell them: their sons died as heroes.
Cpt. Nixon: [cynically] You really still believe that?
Richard Winters: [pauses, considering] Yeah. Yeah, I do. Don’t you?
Cpt. Nixon: [chuckles, uncertainly]
Conversation from Band of Brothers (TV Mini-series)
If you’re struggling to understand what possible link there could be between the deaths of paratroopers in a World War II dramatization and managing an IS Programme delivery, it might help if I try to put in to context what Captain Nixon is having to deal with.
Captain Nixon is not just fighting an enemy in the air or on the ground; he is also fighting an overwhelming sense of frustration. Like many projects and programmes we all work on, the war, his personal war, has gone on longer than many thought it would – many were told it would. Casualty numbers are rising, battle lines are growing – yet it is down to the likes of Captain Nixon to keep morale high. He has to tell the parents of the fallen that they didn’t die in vain. That the allies will deliver on their promise of bringing the war to a successful close.
OK, so no one dies delivering a programme. Not intentionally, or at least not because a rival programme wants the ground they occupy. Yet there is a certain sense that, well, you do have to sometimes provide a message that not everyone wants to hear. This may be viewed as a sanitised version of what you could say, what Captain Nixon really wants to say. It’s not to lie, far from it; but more so to keep motivation up, forgive my own dramatization, for that final push.
Whilst we are not writing letters home, we do write communication briefings on a regular basis. Often the message takes the form of the previous message and “corrects” it slightly. It repeats the objective whilst conveying a sense of accomplishment since the last time you were in touch. If it does alter the timelines of the previous message – war will not be over by Christmas, but we should be there in January – it has to reiterate the belief that: a) we’re nearly there and b) don’t give up on us now, we will deliver the programme you need.
You really still believe that?
Yeah. Yeah, I do.
Of course we do. There’s no denying that it can become frustrating penning a new communications release shortly after sending out the previous; updating timelines or informing users of, well, we never use the word delay. But then it is very much part of the job; part of managing those issues and expectations and transforming them in to an honest assessment of where the programme is and how it will impact those on it; especially those waiting for its outcomes (generally outputs of each project – in this case a new system).
Thankfully our news, good or bad, only ever relates to new life – a new system, a new project, a new objective. We should never lose sight of the fact that each of those three are bound to change and that those changes will impact our customers. This is why we write to them; why we continue to communicate.
What do you think I should write?
The only thing you can do is write the truth; in a language that is easy to understand – using words that have meaning. That is how you keep the “folks back home” motivated in to believing that you will deliver on your promise. That is why you communicate in the first place.
Prioritising for a CIO in the current industry climate and at the speed of technology innovation is probably the hardest task for a modern CIO. Every new initiative and trend warrants some prioritisation, and there will be a champion for each new concept somewhere in your business that feels their choice should be your number one priority.
The capability to prioritise is as much about stakeholder management as it is about managing delivery. Expectations of IT delivery and its capability to provide innovation and disruption remain high in any business, with that in mind a CIO needs to be as transparent as possible in handling the setting of priorities to ensure that expectations on delivery are set at the correct level.
In our business the ability to be involved in the prioritisation of Information Systems delivery has been made part of corporate governance. If the Design Authority has approved the delivery of a project or the adoption of an initiative then the next stage is for this to be passed into a service management concept that we call the Pipeline Planning Group (PPG). The PPG meets regularly and reviews all delivery against a set of criteria including the requirement from the organisations board. This allows the whole business to impact upon Information Systems delivery in two ways; firstly it is now involved in the decisions to take forward new innovations, and at a business change level, can move forward early and quickly in ensuring that the adoption of systems delivers defined business benefits. Secondly it also enables the business to clearly understand the demands on a limited Information Systems capability from all parts of the organisation.
Implementing this wasn’t comfortable for me as the CIO, I have a strategy I want to implement and priorities that I have set, and now I have allow the PPG to change the order I have created. However once I got over this I have enabled this stakeholder group to truly have influence over direction which in turn has made the journey to implementation easier. The PPG has a role in accepting the Information Strategy as well, in fact not just accepting it but helping shape it and ensure that it delivers for business priorities that are current as well as setting the horizon for innovation.
Avoiding management by committee was also considered in the creation of the PPG. What is the make-up of such a group that allows it to work without it becoming a ‘talking-shop’? Getting the business leadership to buy into the concept was essential, and to do this did require the Information Systems professionals to relinquish some ‘power’. Business leadership needs to do as the description says and provide leadership to the business, and that needs to include the delivery of Information Systems and related innovation and disruption. With these two elements in mind the creation of a term of reference for the group was easier to bring to the fore. Being part of this group for the business leadership had to provide them with further opportunity to lead the business, as long as this was the case and the PPG was where the decision making power sat then the group become a truly functional part of the information systems governance.
Putting the PPG in place and making it part of the corporate governance of Information Systems in a public sector influenced organisation has been a great win, in a world where priority can be set by initiative titles, ‘Digital First’, ‘Mobile First’ and ‘Cloud First’ to name but three, the PPG allows the business based decision making to have at least equal standing in setting the operational and strategic agenda. The creation of this has at last brought balance to delivery priority and has ensured that everyone is on the delivery journey together from the beginning.
The 1st of April meant so much to our organisation this year! A complete change in how we manage the delivery of clinical research in the NHS goes ‘live’. No fuss, no trumpets, it simply comes into being: a change from over 100 contracts across the NHS to just 15, a change that sees a network of organisations empowered to deliver and take ownership of clinical research delivery still further.
For the area of the organisation that is tasked with delivering information systems to support research what does this mean? Well, firstly ‘big bang’ go live, something you are ‘taught’ to avoid at all costs needs to be done across multiple integrated systems for go live of the new structures, all at the same time on the same day! Changes to the data models, reference data, workflow, user based access controls, task labels, reporting infrastructures, web site addresses, you name it there is an IS component in there that needs to be changed as the clock ticks over into midnight plus one on the 1st of April.
Protecting ‘the business’ capability through this transition was something the team were tasked with managing, and rightly so. In a business where information is the foundation to what we do, this is a clear priority, the delivery of what we do needs to continue and performance needs to be maintained through any change.
The team has a strategy that by and large sees best of class solutions deployed across the infrastructure and therefore maintaining integration whilst delivering new systems is no easy ask. The control the team have applied to this is through the sharing of resource and a single model of understanding of the changes, not to mention some well placed business understanding and support. We are very lucky in that we have a development team that have an in-depth understanding of our business, our data structures and business needs. As a team the developers were able to get close to the business and the change programme to build a series of specifications in conjunction with the Business Analysis team. Not quite Agile but a hybrid model where the developer was able to translate the requirements directly with the business.
The 1st of April came and went, not completely smooth but the impact of many changes to the systems deployed was kept to as bare minimum as possible. The project and service wrap around the systems deployment was effective and we got to the 3rd of April with the ability to say all systems are live and functional for the new structures. Lessons learnt were how the team worked, how it got close to the business, and maintained that level of interaction throughout and also the level of interaction during go live, keeping all the key stakeholders informed and able to support and react if and when any issues came up.
All in all not an April fools day trick, just a really good result that will continue to be built upon over the next few weeks as any issues are reported, understood and fixed with cutover satisfaction at the heart of the delivery.