Partnerships and dancing…

Originally edited and published by www.digitalhealth.net reproduced here ahead of the Digital & Informatics Team at Leeds away day in July. Partnerships applies just as much to the team as it does to the age old ‘vendor’ relationship.

What do you need from the perfect dance partner? Someone with the same ear for a rhythm as you, someone that doesn’t tower over you, someone with strength and grace in awkward situations, someone who can stand up to a change in beat, or someone who will help when you miss a beat. All descriptions that a healthcare CIO needs to apply to building the perfect relationship with their commercial digital partners.

As an analogy does the search for the perfect ‘strictly’ partner help when picking the digital delivery partner, lets us look and see by considering the different ‘dances’ we have on offer:

Argentine Tango; is characterized by its hold embrace and complex leg and foot movements. It is an improvisational social dance that is truly a dance of leading and following.

Represented by a digital delivery partner that follows your every move no matter how complex the delivery is that you are trying to achieve. This type of partner, in the new agile environment of what is asked of digital in healthcare, needs to be able to improvise within a plan and deliver at a high speed, in a structured and planned manner. The risk with this kind of partner is that you as the digital leader either have to be leading the ‘dance’ at all times or if the partner wants to lead in this style of delivery they will be driving your organisation to their beat which comes with risk as your organisational goals and the digital benefits you are striving to achieve will have to be closely aligned to your partners throughout the relationship.

Ballroom Dancing; is a form of partnered dance that has pre-defined steps following strict tempo music, such as waltz, quickstep and foxtrot.

If your digital partner fits to this analogy then you have created a very structured but perhaps rigid partnership. Both you and your delivery partner know what is needed of you every step of the way; you are working closely on delivering against contractual elements that are clearly defined and well understood or at least a delivery plan that you have both worked hard on to ensure has wins for both parties included. The area of concern here would be the ability to react and work off plan together may take time. Creating the next steps in the new ways of working will not always meet the needs of a modern business change project, whilst that could be described as a failing the original plan will be delivered. This is ok if it is all that you need and therefore working in this way will be perfect for you both.

Contemporary dance; is not a specific dance form, but is a collection of methods and techniques developed from modern and post-modern dance

This style of partnership requires a true relationship to have been developed, one where a high level of trust has been put in place, after all you are about to embark on a journey that some will think is a little odd. Few digital delivery partnerships have been able to achieve the level of trust to work in this way, however if it can be put in place it will bring a surprising amount of success for both parties, a relationship that can be reaction driven and therefore drive an agile response to problems can be achieved through working in this way. The level of sceptism from the ‘audience’ though will be high for the success of the partnership and it is likely the partnership will be under constant observation from a governance point of view to test its validity as an ‘art form’. Conversations about delivery of digital in a post-modern world have been raised over the last couple of years a number of times, this way of working with partners perhaps is the way to see this come to a place where we, as digital leaders, can truly understand how this would work and indeed even what it means.

Jive; is a social dance that can be practiced to a broad range of popular music, making it highly versatile, which adds to its appeal. It is easy to learn and has simple footwork, making it accessible for beginners, but it is tricky to master.

Jive as an analogy for delivery partnership is perhaps best used for those quick partnerships that are only in place for the term of a single delivery focus. The partnership is easy enough to learn and create and is driven by the tempo of the delivery. No lasting commitment needs to be made to the partnership if all that is required is a successful and sharp delivery, but if this is to be maintained longer term and the pace of delivery kept up then a strict set of performance metrics need to be put in place to ensure the pace can be maintained longer term by both partners. A jive relationship will be tiring for all partners, a new level of contractual sustenance will need to be created to enable the relationship not to ‘flag’ as it gets tired of the pace.

Salsa; is in 4/4 time in two bar phrases with a pause on the 4th and 8th beats, which gives a quick-quick-slow rhythm. In classes a choreographed sequence is generally taught, but in practice it is an improvised dance.

Salsa can be described as a sales driven digital relationship. The initial excitement of the contract being signed and the new relationship created will give those early deliverables a focus; a shared impetus to deliver almost jive like, however without collective improvisation as the relationship matures the speed of delivery will slow down. This can be beneficial in creating quick wins and then moving to a more considered and managed relationship as long as the slowdown in delivery does not hit a stop. Improvisation of the relationship in after sales behaviour can ensure that this relationship continues to evolve and is successful.

Tap Dance; is an example of a non-partnered dance that is generally choreographed, with one or more participating dancers.

Going solo to deliver but in tandem with others is perhaps the best way to utilise this as a learning example. Maybe the Local Health and Care Record Exemplars (LHCRE) are a good example of five tap dances being performed around the country. Each of the cohorts will now be trying to create their own tap dance, the original choreography being provided by NHS England and the beat and shoes provided by NHS Digital and others. Each LHCRE cohort will be able to have an element of choice in the type of shoe and outfit they decide to wear but when the dance is the performance the music and choreography will have to be the same for the System of Systems approach to deliver across the country.

We need to be awake to the style of partner we are choosing for the dance, we need to be able to live with different ‘dance styles’ as part of our eco-system of partnerships as the same style will not work for each project nor each partner we choose. True success will come when we have picked the right partner for each type of dance we need to deliver and we know how to move seamlessly from style to style.

Grab your partners by the toe, let’s go do the Dozy Do, or as the legend that is Sir Bruce would say, Keep Dancing!

Leeds Digital Interns

What does a soap factory, a hotel laundry, a cheese processing plant and a builder’s merchant have in common? They were all places that I learnt my ‘trade’, and somehow I became a CIO in the health service!

Yesterday was a great day for the digital team in Leeds, for the second year running the team interviewed for student placements for the summer. Six bright young things part way through their education in all things digital science came to meet the team and to work with us to decide if the digital team in Leeds is the right place to come and trial the skills they have been learning all year.

So over the next couple of weeks we will welcome; Daniel, Daniel, George, George, Alice and Reece to the team. A gang of Computer Sciences students who have a passion to do something good with their newly developed knowledge, to quench their thirst to try what they know in the ‘real world’! The exceptional thing that made me jump for joy though is that these 25ish year olds all wanted to be in Leeds for one key reason; they wanted to do good with the knowledge they have learned, they wanted to give back, the wanted to deliver return on the reputation that Leeds Teaching Hospitals Trust has built.

So much is written about the lack of faith that our future stars will have in the organisations they choose to work for and yet here I was faced with six stars of the future, all six of them looked ready to burst with enthusiasm. We delivered a presentation to them first, a bit of who we are and what we do, then another super star, Gareth Edwards one of our informatics nurses showed them what working here was going to be like. One of those age defining moments happened though as our amazing Informatics Nurse used a screen image of a computer game form the 80s and a computer game from now to show the difference in expectation that digital consumers have now. One of our candidates exclaimed; ‘My Dad used to play that game’, the sadness with a wry grin that swept over all of us in the room had to be seen to be believed as we realised just how fresh and ready for the challenge these new guys were going to be! But poor Gareth.

Much has been made of the Leeds Way, Davina Mcall has even explained it to Phil and Holly! When you see the Leeds Way ‘infecting’ new people into the organisation though is when you realise how well as a trust we have built this culture. After three hours with the team, in an assessment type scenario these guys were smiling, laughing and most importantly of all making amazing suggestions that we simply had not thought of. The assessment was a paper based affair, ‘think through how you would build the patient consent for surgery form?’ Remove the paper from the equation.

Now, lets just jump back a moment these are six students with no healthcare experience, the ideas they came up with, the references they were able to make to how people use technology, the way they really were appreciating the difference between digital transformation and IT really, truly blew my mind.

Thinking about colours, size of font, language, sensitivity about information recording, data protection, data ownership, access controls, the physicality of kit, the nature of the form; and most importantly the human nature of what was being considered. All came up in a 30 minute paired task!

So, we now have six new inductees into what we are and what we do; my promise is that their ‘summer job’ will not be like mine was; I won’t simply leave them to do the rubbish jobs, I will try to inspire them, I will try to send them back to their next year with a story to tell and if I can help influence a tiny little bit of the next generation of people who do what we do then crikey I am going to love this summer!

The #LeedsDigitalWay just started to create its next generation.

AI a shiny thing or the next loop in the evolution of digital healthcare.

In 2001 AI was ‘just’ a Steven Spielberg film; in May 2018 it is being described by many as a solution too so many ills within the NHS.

On the 21st of May the Prime Minister provided the NHS with her view on the way Artificial Intelligence could revolutionise the delivery of care for patients with Cancer, Dementia, Diabetes and Heart Disease and by 2030 save 50,000 lives. Grand claims and grand plans and a new direction for government. One that focuses on a digital art of the possible although certainly to leap from paper records in vast wire cages and trolleys as an “ok” solution through to AI as an opportunity for the delivery of care is no mean feat, but a goal we can try to play our part in.

The following day Satya Nadella the Chief Executive Officer of Microsoft gathered CEOs and CIOs from digital business from across the UK to discuss what the team at Microsoft described as “Transformative AI”. The CEO used a quote by Mark Wesiser the prominent scientist of Xerox and the father of the term ubiquitous computing to open his presentation,

The most profound technologies are those that disappear. They weave themselves into the fabric of everyday life until they are indistinguishable from it.

This is where we want our EHR to get to!

The conversation continued to try to deliver the fundamentals in AI. Data is what feeds and teaches AI, it provides the fuel to grow to learn the what and the how.

Collecting more data therefore will educate AI more quickly; the next horizon is to make the nine billion micro-processors that are shipped every year become SMART devices. The micro-processor in your toaster, your alarm clock, your motion sensor light can become part of the data collection capability that will be responsible for our education of AI. The sheer growing size of data is something well documented, the creation of data will have reached a new horizon by 2020 and will look something like the figures below:

  • A SMART City – 250 Petabytes a day
  • SMART Stadium – 1 Petabytes a day
  • SMART Office 150 Gigabytes a day
  • A SMART Car 5 Terabytes a day
  • Your Home 50 Gigabytes a day
  • You 1.5 Gigabytes a day

20 Billion SMART Devices will exist in the world

(8 bits to the byte, 1,024 bytes to the kilobyte, 1,024 kilobytes to the megabyte, 1,024 megabytes to the terabyte and 1,024 terabytes to the petabyte) The average mobile phone now has 128 gigabyte; the first man went to the moon on a computer that had less memory)

So much data to educate the AI of the world, the insights that could be gained are incredible.

The journey from what we know as an IT enabled world to a digital world sees the move from ubiquitous computing to Artificial Intelligence as a pervasive way of life and then on to a world where we live in a multi-sense and multi device experience.

The impact on the relationship between us and technology has evolved in how it is perceived; technology was ‘simply’ a tool, initially as AI evolved it worked for us as a subordinate and as AI evolves still further it will become more of a social peer in how we consider what it can offer us in healthcare. The most common Christmas present in the UK this year was one of the voice activated assistant, people all over the UK are now having chats with Alexa, Siri, Cortana or simply saying Hey Google to find out some fact that just alluded them or to ask for a simple task to be done.

The original concept of distributed computing (or cloud) gives us the ability to create the computer power and data storage that is needed to evolve AI capability. Distributed compute adds IT complexity, it is now our job to find ways to tame the complexity by ensuring consistency and a unification of experiences, this applies more to digital healthcare than any other ‘business’ as we try to utilise digital as a way to standardise the delivery of care as much as we possibly can.

The definition of Artificial Intelligence is said to have been first coined in 1956 in Dartmouth, the journey from this definition now includes the term Machine Learning first applied to algorithms that are trained with data to learn autonomously and more recently since 2010 the term deep learning, where systems are enabled to go off and simply learn beyond a set of specific parameters. The art of clinical practice, the need to have a human touch though is well understood in healthcare. This is why more and more AI in healthcare is referred to as an ability to augment the delivery of care, AI does not deliver a solution to offer less clinicians in the service, what it does is remove the need to have clinical time spent on anything other than patient care, AI offers the opportunity to increase the human touch. A further quote reinforces this in the book The Future Computed;

In a sense, artificial intelligence will be the ultimate tool because it will help us build all possible tools.

Eric Drexler author of Nanosystems: Molecular Machinery Manufacturing and Computation (1992)

The journey to AI in our world is getting quicker. The journey to AI being successful is best measured when the different components of it reach parity with us humans;

  • In 2016 AI became able to see to the power of us, and passed the RESNET vision test with 96% able to see 152 layers of complexity.
  • In 2017 AI became able to understand speech to the same degree we can the 5.1% switchboard speech recognition test.
  • In January 2018 AI was able to read and comprehend to the same degree as a human passing the SQuAD comprehension test with 88.5%.
  • In March 2018 AI became better than a human at translation, now able to translate in real time successfully to an MIT measure of 69.9%.

The road to an AI augmented world though is about amplifying human ingenuity; AI can help us with reasoning and allow us to learn and form conclusions from imperfect data. It can now help us with understanding; interpret meanings from data including text, voice and images. It can also now interact with us in seemingly natural ways learning how to offer emotionally intelligent responses. A Chat Bot launched in China now has millions of friends on across multiple social media channels, it has learnt to offer help to its ‘friends’ that are demonstrating symptoms of depression, phoning up friends to wish them good night and offering advice and guidance on sleep patterns but in a very human way.

Gartner have reported that the ‘business opportunity’ associated to AI in 2018 is now worth $1.2 trillion! Suddenly AI is the new Big Data which was the new Cloud Computing, which was the new mobile first. All of these terms have had hype but have all in reality brought a new digital pitch to our business strategies and our lives.

Great Ormond Street Hospital in partnership with UCL is leading the way in AI application into healthcare with several projects delivering startlingly real results.

Project Basecode: Transcribing speech in real time and utilising AI capability to add information to spoken word dictation capture.

Project Heartstone: A device for passing messages, verbal and video to patients of GOSH that may be too young to have their own Smart Phone, the device can be expanded to offer services to children who may be deaf or blind.

Project Fizzyo: Puts in place gamification to the delivery of breathing physiotherapy for children with Cystic Fibrosis and captures the information for the clinical record offering analysis as it goes.

Sensor Fusion: Creates perhaps the most immersive AI elements in healthcare today, recording events throughout the hospital, offering machine learning developed advice and data driven descriptions of events as they occur.

At Leeds Teaching Hospitals Trust we have created a platform in the form of our Electronic Health Record (EHR). With this platform we can now begin to consider how this clinical push for AI and the difference it can make to patients lives and the way we work can be achieved in a carful and considered way.

This digital revolution can make a real impact on Leeds; the patients, clinicians and staff enabling us to provide the care we want to provide following the Leeds Way principles with digital as a supportive backbone.

If you want to know more or have an idea as to how you could help in this area get in touch with us via @DITLeeds

International menu of interoperability…

First published on www.digitalhealth.net

When you are on holiday do you play that ‘why?’ and ‘what if…’ game? For example in the USA on a recent holiday we were chatting about why foods are called different things in different countries. A quick poolside thumb poll had the list below as differences between the UK and USA, and we are sure there are more:

  • Zucchini and Courgette
  • Egg Plant and Aubergine
  • Garbanzo Beans and Chick Peas
  • Arugula and Rocket
  • Cilantro and Coriander
  • Scallions and Spring Onions
  • Chips and Crisps
  • Fries and Chips

The only excuse we could come up with for why this happened was timing. These food stuffs were perhaps discovered at around the same time across the world and therefore no name was ever right or wrong, just more timely and geographically rich. The experience of being in a different country and seeing these new words for the same things adds a little nature of the exotic, particularly when the country speaks the same language (kind of).

But these differences speak to the single largest challenge that faces our digital health menu today: the challenge of interoperability and integration. When we talk about the delivery of a new healthcare paradigm we speak of the delivery of integrated care, a care delivery experience that places the patient at the centre and has no boundaries. But to achieve this requires information to mean the same thing to all those involved in its delivery. Where this isn’t possible we put in place a perpetually repeating health system; one where learning the parameters of a situation, of an illness, of a prescribed cure are repeated at each gateway to a different healthcare system. We don’t want an exotic patient experience we want an efficient and safe experience.

The journalist Geoffrey Williams once said, “You can’t understand one language until you understand at least two.” Goethe went even further claiming, “He who does not know foreign languages does not know anything about his own.” Moving healthcare delivery to a system-wide approach is the goal of over 50 (locally driven) digital initiatives in the NHS alone. The goal of an integrated health and care record is to provide access to, and translation of, multiple care languages. The pressure facing healthcare systems across the world today will only be resolved through integrated approaches that enable health and social care to work together to manage the front and back door to every major acute hospital in the system. A busy Accident and Emergency Department is no longer the problem that the acute hospital can resolve on its own, it is a system-wide issue that the geography has to resolve together. Access to information will unlock this resolution, but first we need to enable the way we refer to the healthcare to be shared.

For the last two decades sharing information between care settings has been a digital goal. In the late 1990s Hampshire became ‘famous’ for the delivery of an exemplar record sharing environment, linking access to information recorded in the ‘Exeter System’ to information in GP systems, to aid the delivery of healthcare regardless of the setting. The largest issue that stunted growth of this early pilot though was the quality of the data and the ability to index the information. The need for a common identifier across health systems was raised and the NHS Number mandated by a target date. It’s a shame that this would not be the last time the NHS number was mandated by a target date…

Jumping forward to 2017, the Irish health system delivered a unique EU-wide identifier for the delivery of healthcare to its citizens. Huge effort was put into delivering this in an agile manner at a limited cost, and today the number exists and is available but its actual implementation in healthcare delivery itself remains very patchy. We can also look at an example in Leeds today too. Having spoken to other healthcare jurisdictions, the Leeds Care Record has become well known throughout Europe as an example of local systems working together to achieve something quite remarkable. The Leeds Care Record is a platform that enables integration at a level beyond almost anywhere else in the NHS. Over 35 systems are able to share information in a controlled, secure and legitimate fashion. 111 GPs also benefit from having access to what is recorded about their patients’ hospital visit. They also share key elements of the GP record with the healthcare delivery system throughout the geography. And that word is where the Leeds Care Record does fail; it works for the geography of Leeds and so this isn’t integration, this is interoperability. In Leeds, information is shared through the same platform but the reference points for the delivery of care remain in the same ‘language’ of the originating care setting. The reliance is on the interpreter and their own understanding of the information.

Culture plays a huge part in how we create an interoperable health care system which digital supports. In his book Culture, Terry Eagleton tries to define what culture means to organisations. He has four areas that he believes are most relevant to creating the right culture: values, customs, beliefs and symbolic practices. None of these particularly speaks to a standardised way of operating and therefore, if we believe in culture being how we make things happen in an organisation, then interoperability will always be an area we strive to achieve.

In the same book Eagleton, who is from Ireland, notes that the postbox, an original integration tool, donates civilisation. However the fact that Ireland has painted its mailboxes the famous Ireland green denotes a culture, a difference to others. In Leeds we have many gold postboxes, a legacy of the London Olympics, when gold medal winners had the postbox closest to their home town painted gold as an honour. Again, culture flouting a standard.

As quickly as we can, we need to begin to agree nationally (and why not even globally) if we are to achieve integrated or interoperable healthcare systems. The standards to do this exist in so many ways already. Digital health doesn’t need changes to be made at the mega-vendor level, the systems need to adopt the standards and then innovate to exist in a ‘system of systems’ approach.

Maybe we need to use Eagleton’s four cultural reference points as starting points to creating a joint understanding of where we need to get to.

Values: The value of having integrated care has been made clear for decades. Digital leaders are still at the begging bowl though, seeking funding to deliver the necessary platforms that are required to enable information sharing. Information is now becoming more complex, faster in the way it changes and more encompassing of the healthcare experience and value needs to be placed on the innovation needed to achieve a truly interoperable healthcare system.

Customs: Local customs need to be protected but somehow we need to move from the clinical system paradigm. You know the one, where the clinician you have engaged loves the idea of a single system across the hospital, they feel it’s a great idea, but their additional one special system still needs to be protected as well. This has become known as the ‘one plus one’ clinical system and in a hospital it means we have one system, plus one for every adventurous clinician in the hospital.

Beliefs: We need the healthcare system to stand up for the belief it has in the delivery of integrated care. That belief will drive the ultimate understanding of what a system of systems digital solution can provide.

Symbolic practices: Perhaps in the NHS this is about to happen with the launch of the Local Health and Care Record Exemplars funding and a platform to enable lessons to be learned, standards to be tested at local levels (of five million population) and a real drive from the centre and from the ‘spokes’ to truly achieve this.

There has to be a hook to the original Bevan statement about the creation of the NHS, “Healthcare free at the point of contact”, so now we need data ‘free’ at the point of contact and this can only be achieved if we all have the same reference points.

Now, can I get some fries, I mean chips, I mean crisps, I mean home fries…

A great loss…

With great loss comes a new degree of responsibility, the world of science has lost not just a great thinker but probably the biggest inspiration of the last century. The loss of Stephen Hawking at 76 years old is a sad day for anyone who has been inspired by his writing, his speaking even his presence, to think differently, to consider something beyond the normal and then to try to persuade others that the idea you have could become a new normal.

In 1970 his work on Black Holes moved us closer to understanding not just the science of how we are here but placed our minds in a position to understand the why. By 1974 he created a unified theory that combined general relativity with quantum mechanics, the next phase in computing, the Quantum Computer would not have been possible without this work. Satya Nadella wrote in his recent book that the best way to describe Quantum Computing and its impact would be to take a description of the Twilight Zone and apply it to a new world;

You’re traveling through an other dimension, a dimension not only of sight and sound but of mind. A journey into a wondrous land whose boundaries are that of imagination. That’s the signpost up ahead – your next stop…

The Twilight Zone by Rod Serling

Perhaps that is what professor Hawking really wanted us to do, travel with our minds to a new dimension.

By 1979 he had outlived his doctors predicted life expectancy by a decade. He was never going to give up challenging clinicians throughout the world by his sheer act of will to continue to exist. He outlived the clinical prediction of his existence by 47 years, he himself described those years as borrowed time he had to pay back.

In 1985 he found a new voice, one that he never wanted to loose despite changes in technology, one that became a trademark for a new intelligence. By 1988 A Brief History of Time was published, a real science book that would remain a best seller for four consecutive years and in 2018 will probably make many peoples hot lists of the year again. A Brief History of Time popularised science, physics and the art of describing complexity in simple terms to people who at school would not have ever been an achiever in science, me included.

If we find the answer to (why we and the universe exist), it would be the ultimate triumph of human reason – for then we would know the mind of God.

A quote straight from the best seller to me revealed the continuing battle inside Hawking to truly reach everyone and help them understand the meaning of life, above and beyond the Life of Brian definition.

1999 arrived and a pop culture icon was born; one of the worlds favourite ‘real’ characters on the Simpsons, his own TV series, a guest appearance on Star Trek the Next Generation and even a voice over on Pink Floyd’s album Division Bell, perhaps a higher accolade than D:Ream!

In 2004 his thinking on Black Holes continued however he proved that even the greatest can change their mind when he proclaimed loudly that he had altered his findings on what happens to information that ends up in a Black Hole, the theory that it flows to other universes was born, the dreams of every Sci-Fi geek came true.

Most recently Hawking asked the whole human race to take care when investing in theory around Artificial Intelligence, investing in a black box of uncontrolled knowledge needs to be done with some moralistic compass and control.

For me though Stephen Hawking was more than the sum of these parts, his voice, his uniqueness and the way he engaged generation after generation in what the world could be through science, through change and innovation is what his legacy will be

So remember to look up at the stars and not down at your feet. Try to make sense of what you see and hold on to that childlike wonder about what makes the universe exist.

RIP Professor Hawking, you rock!

If only IT were free.

Originally published in the BJ-HC (British Journal of Healthcare Computing)

A change has to come to organisations perceptions of digital, not what it can do, not even that its focus has to be business change, no; the biggest change that needs to be considered and understood is that digital costs money.

In healthcare we seem sometimes terrified of the actual cost of digital. Digital failure is often related to the cost, the big headline figure is used to sensationalise a failed project. Have you ever seen a headline that describes the cost that going to digital has saved? Think back to the 1990s, booking a holiday, going to the bank, buying some music, all aspects of life that digital has changed for ever and clearly not only more convenient for ‘you’ the consumer but more efficient for the business delivering the consumer need. And then think how quickly that change has happened. The speed we now are at to get to the magic 50 million users is fed by the investment not just in the digital element but in the change that is required, 62 years to get to 50 million cars; 5 years for PayPal to achieve the same and only 2 years for Twitter to get there.

The political nature of so many healthcare systems means they loathe to invest in digital; after all the need to build a new hospital or recruit new nurses is far easier to explain to the citizen (the voter) than the promise of a more efficient and safer digital health system. And yet, show a patient the medical records room of a large hospital and then take out your phone and ask that patient which format they would prefer to see their care delivered on. I am guessing the answer will always be I want a digital system. A study conducted in Ireland in 2016 showed that if every citizen were to provide an additional 17 Euro a year to the healthcare system for the next 10 years then the system would move from a paper based system to an integrated and open data based provision. When asked over 60% of citizens wanted to vote for the project, one famously taking to the stage and asking why does an EHR even need a business case, surely it is like saying no to world peace to say no to a digital fabric for health.

Some of the largest digital organisations in the world profess to be coming to the digital health market for philanthropic reasons, and the sentiments are always well described, none of these organisations has moved to giving away their solutions and intellectual property quite yet though. Global economists predict that by 2030 GDP in many countries needs to double to cope with the ever increasing healthcare costs. In 1955 there were 2.8 billion people in the world by 2025 six billion people will need a healthcare system of some sorts? In 2025 we expect the word to be around eight billion people and average life expectancy will have gone form 68 today to 73 in 2025, awesome figures and yet terrifying for those of us that work in healthcare. How will we cope, particularly with ‘crisis denial’ and a fear of investing in modernisation.

In the last 150 years, according to a Gartner presentation at this year’s CIO Symposium, the healthcare industry has created more value than any other business, if you push the outputs of healthcare through a cost and value system we really do deliver. But health costs money, it’s not free at the point of care! If we link the value that the system delivers back to Berwick’s triple aim of 2008; improve the patient experience, improve the clinical experience and create greater productivity and lower the per capita cost of care, then it becomes clear quickly that digital has to be a global investment point to achieve these grand aims. And yet digital is a separate business case time and time again.

If only IT were free? Or better still if only we could find a way to build the system perception of the value of digital. Even the promise of digital appears to cost money in so many jurisdictions, although I think we could track even that cost back to a lack of investment. To spend on digital requires not just the investment in the purchase itself but also the investment in proving the case before hand, and yet, how many digital healthcare business cases have come to fruition. Please do not misunderstand what I mean here, I am not suggestion a free for all, but, we insist that a digital decision should take a defined and obstructive amount of time, digital moves too fast for that to be the normal that we work to in 2018.

The return on investment needs to be clear for an investment in digital, but what of the new phenomena driven by Ted Rubin the American digital marketer, a return on relationship (RoR). A digital leader in healthcare needs to now push hard for the governance functions they are working with to begin to believe in a return on the relationship. A digital governance function needs to build trust in digital leadership to the point where the legacy of over engineering permission to invest is released to the digital leadership in a similar way to the HR Executive is empowered to deliver a talent solution for an organisation.

Investment in digital needs to be the catalyst for health system transition from ‘Repair Care’ to a truly transformed ability to deliver healthcare and it can only be empowered to become that catalyst through investment. As digital leaders we need to get better at expressing the way digital can move the system dial from simple enablement on to truly optimizing the system to one where digital will have some of the answers to huge issues like winter pressures and the healthcare system can transform through the presence of digital.

There could be a tactic to use, straight out of the Start-Up mentor handbook; ideation of the new value paradigm. A new digital value that we as digital leaders need to describe; a working value equation that can add to, in a different way, the understanding of the change that digital will make to the provision of healthcare. We as digital leaders need to identify and provide for the health risk cohort to prove our worth, oh, and of course save money. Digital creating value in healthcare could be as much to do with digital taking appropriate ownership of the description of the digital agenda and this can then aid in bridging the value gap that exists in our colleagues’ minds! This does rely on us getting right the clinical ownership, the business engagement, the change management and transformation agenda, hence the use of ideation, explain what it could look like when the investment delivers for the patient. Using ideation as a process will enable us take our systems through the thought process that gets it to an understanding of the future; moving from innovation to development to actualisation.

In the EU today we have 2.5 million doctors and 4.8 million nurses, the beating heart of our system and the delivery function of what we do! But, digital needs to not be considered as a back office to this. As we move to a place where the life expectancy goes form 83 years old (2017 in Japan) to an age that we struggle to compute then the equity of health care delivery needs to be built upon a digital way of working or the system can’t cope. Equity of service means we need to balance some hard numbers, the average 70 year old’s healthcare today cost $3,956 per person globally whereas in the USA the same person would cost $9982. Some of that investment (globally) has to be made in digital or we will stand still, and standing still in healthcare will mean failing whole populations of people.

So the ‘call to arms’ on this has to change. Digital in healthcare is the new utility, we need heating, water and light; we need digital too to deliver healthcare. The new ask is to move from the begging bowl; there for the scraps in the good times and a move on to the polite but considered statement of what cannot be done without digital. After all IT isn’t free!

 

CCIO Leadership Styles.

Originally published by DigitalHealth.net

Since the publication of Robert Wachter’s book in the spring of 2015, the idea of clinical engagement in all that is digital health has been pervasive. But before ‘the’ book and over the last decade at least, I have seen a plethora of different styles adopted for the role of what we now call Chief Clinical Information Officer (CCIO).

The styles that can be adopted by CCIOs clearly work in different ways to match the culture and needs of the organisation alongside the benefits these digital projects are trying to achieve. The organisation in which I am now working, Leeds Teaching Hospitals Trust, has some amazingly talented clinicians with significant interests in many aspects of digital. As a Trust we are about to embark on the expansion of the CCIO role, creating a clinical leadership team of three, with individual responsibilities for:

  • Nursing and AHP
  • Academic, Research and Innovation
  • Clinical and Medical

The three CCIO roles will now be supported by nominated and clearly identified staff throughout the clinical service units (CSUs). The clinicians across the CSUs will act as the focal point for engagement in each of the CSUs throughout the trust. Also the creation of the office of the CCIO across Leeds Teaching Hospitals Trust will ensure promotion of the CCIO role in a way that facilitates a real width of clinical engagement, not just at the trust itself, but across what is becoming more and more referred to as the ‘place’.

Clinical engagement in digital is like pasta. There are so many different ‘flavours’ and ‘types’ and picking the right one is dependent on the digital ‘dish’ you are creating around your system. Many pasta types have regional variations and some have different names in different languages, for example ‘rotelle’ is called a ‘ruote’ in Italy and ‘wagon wheels’ in the USA. Let’s take three types of pasta and see if we can make this analogy work for the CCIO role:

  • Spaghetti – A long thin cylindrical pasta.Italian in origin, which translates into ‘thin string or twine’.
  • Rigatoni – Medium to large tubes with square cut ends. Italian in origin and translates as ‘large lined ones’, usually served in large quantities.
  • Cavatelli – Small pasta shells that can be described as looking like hot dog buns. The Italian name translates as ‘little hollows’, however there are 27 different names for this type of pasta.

In the last few years the model for clinical engagement in the digital agenda has transformed hugely. I remember discussing how to ensure that the initial delivery of the National Programme for IT’s Summary Care Record needed to be clinically led and this was way back in 2006. The amazingly driven Dr. Gillian Braunold pushed every part of the technology team so hard, often to the point of distraction as the need for clinical engagement was so new to us. But more than a decade later her style and her ideas for how clinical engagement can be achieved are really coming to the forefront as examples of the best ways of working. The concept of complete clinical ownership from an early stage of any digital project was something she championed way back in the early 00s.

The clinical engagement in place for the Summary Care Record was not seen as a CCIO role, more the twine that held the whole programme together. Certainly as the first sites went live the programme would have failed in its initial goals if it weren’t for the clinical engagement that had taken place. Clinical engagement in this case had to focus not on the benefit to the clinician impacted, the GP, but on the patient benefit and the longevity of the record of care, beyond system verticals. Dr. Braunold, even as far back as 2006, was talking about the fabric of information needed to offer the best care for patients, regardless of clinical setting, which is perhaps our earliest example of a digital fabric being raised.

This type of clinical engagement is epitomised, I think, by Spaghetti, due to the long twines of connectivity. In many ways the way spaghetti also has popularised the ‘dish’ also draws comparisons to what Dr. Braunold did in those early days.

To deliver business change in healthcare we need to engage our customers and they need to co-define the art of the digitally possible. At a recent presentation one of my CCIOs in Leeds put a statement up on a slide that I fell in love with:

“Dear clinical teams, please come to us with problems not solutions, then we can help fix your problem together!”

Clinical engagement in an acute hospital can often fall into the 1+1 story. The engaged clinician completely agrees that a single source of truth for clinical information is necessary throughout the organisation as long as their specialist and favourite application is also to be accommodated. That’s why in 2014, in Ireland, the health system had over 3,000 applications and in Leeds today I have over 300.

This influences my next example, which to this day I think is a brilliant illustration of not just engagement but full scale leadership. In 2014, the Cork region of Ireland decided to push forward with digital referrals from GP to hospitals. This project not only needed clinical engagement but clinical leadership of a kind, to that point, not seen in Ireland when it came to digital.

Joyce Healey, a physiotherapist, volunteered to lead the project and took it from the germ of an idea to a fully functioning solution, initially embedded in GP systems and then on to the possibility of integration into hospital systems across the whole country. The strength of the clinical leadership though is what is important here. Joyce not only took on ownership of the clinical engagement but the leadership of the project itself. It was agreed not to have a national project manager in its earliest days as the lead clinician suggested that the best way to truly ensure the project remained clinically focused was to actually be at the ‘coal face’ of the project.

The work here then calls back to the pasta analogy in that the sheer pervasive nature of the CCIO work in this project made sure that clinical engagement drove success. Lasagne delivers the meat filling with a layered approach to holding the dish together, maybe this is the best example we can use here, holding a superb dish together through a structure that worked well and ensured that the core elements of the ‘dish’ arrived where they needed to.

The development of the CCIO function in Ireland followed a similar path to the eReferral project. A council of clinicians was created under Joyce and then added to with successive and successful CCIOs. The initial style of ensuring that clinical leadership was apparent in everything the team did and this became a key part of the way of working for digital across the whole country. By the end of 2017, there were over 300 CCIOs in Ireland. This number has been criticised in some quarters as the vast majority of them did not have ring fenced time to act in this role, but, the nature of the way they were appointed into the roles has seen them enabled in being local clinical leaders for all things digital and they have become powerful and enabled as an influential voice for the digital health transformation across the country. The large group now created, and the way in which they line up to offer their expertise and advice, also works well with the Rigatoni pasta analogy, the sheer volume needed to create the dish!

I wonder who is the most influential CCIO in the business today? Who is the most famous pasta dish? For me it has to be the person described as ‘THE’ digital nurse: Anne Cooper. I worked with Anne for a while in the National Programme for IT and saw her vision for what clinical leadership should be, her vision of ‘card carrying’ NHS professionals ensuring that large digital programmes were successful, flows way back to the early 2000s. What Anne embodies different to so many CCIOs though, is her ability to not just represent the clinical need for digital inspired change but also her ability to translate from digital to clinical to citizen and patient speak. The Cavatelli pasta dish is known by 27 names throughout the world, let’s face it digital health and care programmes have so many different names for the same benefits that we are trying to deliver that perhaps Anne’s style is easily analogous to this type of pasta.

There are so many clinicians in the digital leadership business today and so many CIOs that truly now believe in the CCIO role; not as a nice to have but as an intrinsic element to achieving success. Professor Joe McDonald in his role as chair of the national CCIO leaders’ network in the NHS posted to social media in the run up to Christmas;

“A CIO isn’t just for Christmas, also without a CCIO a CIO is like one hand clapping.”

This new way of thinking reflects the views of almost every CIO I have spoken to in health and care recently. We are asked to collaborate as digital leaders but without a CCIO we will struggle and probably fail. The new ways of working that CCIOs bring to the digital agenda ensure that we are no longer moving to the digital bleeding edge without at least a clinician on hand to patch us up!

The NHS Digital Academy that Rachel Dunscombe is leading the creation of fits to this analogy too. What Rachel and the team are doing is setting up the Master Chef and cooking school for CIOs and CCIOs throughout the NHS. It feels like at last the opportunity is there for us all to learn from every Gennaro Contaldo there is and begin to truly build little Jamie’s Italians throughout the NHS!

All power and ragu to the CIO CCIO relationship!

 

 

 

 

Change the reaction…

Last night was a great night out in ‘sunny’ London, for me a return to the Jazz Café in Camden, a place I used to love, a place I frequented many times. But, the last time I was there was for the final goodbye gig of a band I loved, Ben and Jason around 2003.

So much changed after that gig, I moved jobs, houses, and relationships changed, and then a devastating thing happened, the person I shared Ben and Jason with, the person who taught me so much became irrevocably depressed, I am ashamed to say I do not know why but stepping into the Jazz Café last night brought back some amazing ghosts of an amazing man. Music can do that to people can’t it!

The gig last night was a live remix by a collective called Blue Labs Beats, they took Guru’s seminal Jazzmatazz volume one and reimagined it live on stage; and then the song Sights In The City came on with the lyrics;

Sights in the city got people cryin.. Sights in the city got people dyin..

It was a long time since my friend had popped into my head but this week there seems to have been a lot of commentary on men who commit suicide, maybe that is why when this Jazzmatazz classic song came on I could almost see him stood there, taking photos, enjoying being at a moment for us that we were sure we would never forget, and yet no matter how good the moment, we did forget it.

A statistic for you, the biggest killer of men under the age of 45 in the UK is suicide. Here’s another fact 6,000 lives were lost in Britain due to suicide in 2016 and three quarters of those deaths were men!

Why does the black dog, that horrible black cloud land on a man’s back with such intensity, and why oh why do we not deal with the assistance that is needed in a proper, human way? A man feels blue and too often the phrases of anti-masculinity are rolled out; “Don’t be a big girl’s blouse”, “Boys don’t cry”, “Man up” all are common pieces of advice to a man who opens up and says I need help.

I have yet to read any evidence that explains why men are hit by depression harder than women, I am not even sure they are, I think what actually happens is a woman knows how to seek help, a man is conditioned to handle it on their own. In fact, the Mental Health Foundation claim that in England, women are “more likely than men” to be affected by the most common mental health issues. And yet men take depression to the further place so much more frequently than women. This highlights the issue that suicide is such a pressing consequence for us to understand and find a new way to assist every man who reaches out.

This week I commented on social media that lad culture has gone; it’s a decade since Loaded magazine meant something, even FHM is no longer here, and yet we seem unable to move away from how we treat emotions as men. A drunk friend who needs helps warrants a joke that he is just being a lad. Why do we think this is funny still!

I want to be part of a change, I want to be clear that it is ok to be a man with emotions, and if a man, a friend, an acquaintance, a colleague needs help then we have to learn how to be there in the right way for that person.

Back to the memories, going to Jazz Café last night enabled a ghost or two to be put to rest, but it woke up in me a real desire to see what I can do to help, I don’t want the language we use to be a part of the problem anymore.

Since that final Ben and Jason gig the world has changed, and yet being there last night it struck me that so many things haven’t changed. I want to know that if a friend were to come to me with an emotional issue that I would react better now, in a way that would help, in a way that is informed in a way that did not need to consider the gender of the person seeking help.

Ben and Jason’s Everybody Hold Hands With Everybody Else sums up where I wish we could get to;

Dying man, aching hands, fallen to the floor, drowning man, hold his hand, pull him to the shore, back in your hair again, always my heroine, it’s getting harder to bear, you’re not a friend to me, if you come down to me, I’ll never take all your air.

 

RIP PMR

 

NB – This blog has been written quickly, apology’s for any grammar or spelling mistakes in there, I will get back and fix these later.

2017 Review of the Year

Well folks, its that time of year again, a reflection of 365 days; things that have happened, things that that I’ve heard, things that I’ve watched things that I’ve learnt.

My very own review of 2017.

This is the fifth time I have been able to do a review of the year, take a little time and reflect on what has happened to me over 12 months. As I looked back on 2016 I commented that I thought it had been a quick one, where has the time gone, this year seems to have evaporated in front of my very eyes.

One change that has happened that I would never have predicted at the beginning of the year was that I would be writing this blog back in Leeds, back in my home county, my home city. The decision to leave Ireland was not an easy one, but I have written about that already on here. Being back in Yorkshire with family and friends is a heart-warming change. As part of the planning process for coming back to Yorkshire my wife commented how strange it is when you travel, how you can wake up on one day a member of a great team in Ireland and within 24 hours migrate to being part of something quite new. Well, we are a month into something quite new and indeed something we have done before; maybe it’s the best of both worlds, it doesn’t feel like going back but more a forward leap of faith to try and test the next part of tomorrow.

I certainly dare not even try to predict what 2018 holds for us. I was lucky enough to meet Gus Balbontin (of Lonely Planet fame) this year. Gus was adamant that every time we create a plan a fairy dies, so, 2018 will be my attempt to do less plans, more simply considering what to do next and less dead fairies! And, if you ever see Gus on a list of speakers at an event go see him, so inspirational in so many ways, energy, storytelling, sheer will of determination to make you understand his message, awesome!

Travel has played a huge part in 2017 for me, a dream holiday at what will now become a habitual holiday time for us happened in February. A few days in Bangkok followed by two amazing weeks on Phuket. I never did the whole backpack traveller thing; I was too ambitious to get my career started! Being in Bangkok blew my mind, probably in less than 10 minutes of being there. Temples, lady boys, practically free bear, live food choices, huge market places and the most expensive glass of wine I have ever had all featured in a very short time in Bangkok. We were then on to the relaxing part of the holiday on a very sunny Phuket. It really did allow my brain to recharge but after a few days of that learning the basics of Thai boxing, heading to Café Del Mar on Phuket and then following in the footsteps of Leonado De Caprio were all new adventures and highlights, experiences that made it the holiday of a life time.

2017 was also the year of some formal activities too, becoming a god father was an amazing experience, the fact that two wonderful friends and people I feel I have known forever want me to help in the upbringing of their very beautiful second daughter was amazing, and leading a reading at the service was a highlight of the year. Setting me up for another formal event in a few short months, my brother and his amazing fiancée decided that I would be the right person to be their best man in August 2018. I guess a prediction I can make is that the review of 2018 will feature some stories from the stag-do in Las Vegas and the wedding in August.

I have had the great pleasure, as I have had every year, of working with some new amazing people, but in particular this year I properly got to know the team at Leading Social, a driven, aware, capable and unbelievably creative bunch, led by the ever up and ‘at’em’ Jamie White and the calmest and most considered side kick ever, Emma Klyne. When you meet an organisation like Leading Social and it becomes a partnership so quickly it always fills me with enthusiasm for what the future will hold.

Only one trip to Ibiza beats this years, and that one is unbeatable. But this year everything went so well, seeing Hot Since 82 and Purple Disco Machine, making it to some of the best day time dancing in beautiful sunshine with a lot fun scenery made for a great holiday, so much that the dates are booked straight away to repeat the experience.

When I first started writing this yearly review it focused on lists of music, the songs of the year, and yes I can’t not do that for my own piece of mind, but perhaps most interesting this year is the sudden re-emergence for me of albums, sets of music played in the order that the artist originally intended for the youngsters out there! New music by the likes of; Kolsch, Kink, Bicep, Terrence Parker, Jesse Rose, George Fitzgerald, LCD Soundsystem, Hercules and Love Affair, Honey Dijon, Anja Schneider, Maya Jane Coles, Purple Disco Machine and Emancipator have really given me something to look forward to when the release date came around, all recommendations for your listening pleasure.

Live music is still part of every month, and some of the best nights out have been gigs this year; James Vincent McMorrow in the grounds of Trinity University, Go Go Penguin, U2, The Happy Mondays, Loyle Carner, King Krule and Fatima Yamaha have all been part of the live experiences this year. Perhaps the best though was seeing Air at the Beatyard festival on a very very wet day in Ireland, one of those bucket list bands I had to see.

So one of the things I have done every year since 2003 is pick my songs of the year and keep them as a play list to go back to and enjoy, this years top 40 goes something like this:

  1. He Is The Voice I Hear – The Black Madonna
  2. Say Something Loving – The XX
  3. No CD – Loyle Carner
  4. Grey – Kolsch
  5. oh baby – LCD SOundsystem
  6. Chinatown – Liam Gallagher
  7. Don’t Waste Another Minute – Terrence Parker
  8. Cola (Elderbrook Chilled Mix) – CamelPhat & Elderbrook
  9. Scars – DJ Shadow
  10. Yom Thorke – Kink
  11. Devil In Me (Fatboy Slim Mix) – Purple Disco Machine
  12. Moving On & Getting Over – John Mayer
  13. Big Picture – London Grammar
  14. Beautiful Day – Due Du Soleil
  15. Human (MJ Cole Remix) – Rag ‘n’ Bone Man
  16. Araya – Fatima Yamaha
  17. Promises – Sonny Fodera
  18. Try A Little Tenderness – Sandy Rivera
  19. All Goes Wrong – Chase & Status
  20. Grease – Flo Morrissey & Matthew E. White
  21. Wonky Baseline Disco Banger (Luke Solomon Live Disco Revision) – Red Rack’em
  22. You Don’t Know Me – Jax Jones
  23. By The Ports of Europe – Benjamin Clementine
  24. Hello? – Tensnake
  25. Searching (Jazzuelle Remix) – Fred Everything
  26. Old Kisses – Dan Michaelson
  27. Andromeda (Purple Disco Machine Remix) – Gorillaz
  28. Glue – Bicep
  29. Grant Green – Mr. Jukes
  30. Cloud 9 (Purple Disco Machine Remix) – Jamiroquai
  31. Final Credits – Midland
  32. Lose Your Love – Joe Goddard
  33. Eden – Johnny Lloyd
  34. Theme From Q – Objekt
  35. Elvissa – Marquis Hawkes
  36. Grass Is Greener – Phonique
  37. It’s Just A Game – Danny & The Champions of the World
  38. Light You Up – Luke Solomon
  39. Real Life – Duke Dumont & Gorgon City
  40. Far Too Good – John Smith

The way taste changes, evolves and grows I find fascinating. Ireland changed my music taste, radio friendly pop music crept in, I am interested to see what being back home in Yorkshire does to it in 2018, certainly the gigs we are lining up would suggest a continued interest in those melody driven dance songs.

If we are going to do the songs list we may as well get the films (and TV Series) list up too;

 1 – Wonderwoman 6 – The Sinner (TV)
 2 – La La Land 7 – Logan
 3 – Stranger Things 2 (TV) 8 – 13 Hours
 4 – Hacksaw Ridge 9 – Passengers
 5 – Arrival 10 – American Gods (TV)

I’m not always sure these were released truly this year but they landed on my screen this year and I enjoyed them a great deal. I stopped myself from adding Defenders and The Punisher and Luke Cage as well, that could have been a step too far. The second season of The Get Down did it for me as well but for some reason nobody else seemed to enjoy it the same, don’t you just hate that when your programme gets cancelled before it gets to some sort of fruition.

Being named as the number one CIO in the CIO100 was such a great moment in the year for me. The CIO100 is something I have been involved in for a few years now; being number 15 the very first year and the party that we threw the next day back at the organisation I worked for will stick with me forever. Being there at the front of the book was a wonderful recognition this year. I loved ‘giving’ the Oscar speech as well, making sure I didn’t forget the people that put me there, one day there will be a way of awarding the team of a digital organisation without so specifically calling out one person.

The after party that was arranged was pretty cool, one of the smallest clubs in London, in an old Gents loo with the most amazing dancing on stage, and me, in my celebratory state almost making it back-stage instead of outside will go down in my own stories of legend. The year kept being quite award driven though, a big surprise was a new category at the eGov Awards in Ireland, being announced by my Minister at the time as the winner of the Net-Visionary award was pretty cool.

Perhaps the best of the awards though was in early December at the Talent Unleashed awards. An award across the whole globe judged by Sir Richard Branson and Steve Wozniack, they decided to give me the award for the things that had been achieved in digital health in Ireland; most disruptive digital leader, it was such a great night in the museum of London and felt like a nice personal ‘round-off’ to three years in Ireland working with a wonderful team.

Meeting new people has an impact on all of us, in 2016 I met Fabian Bolin from War on Cancer, in 2017 I was able to invite him to a stage I was hosting, hearing his story touch people as it had done me a year earlier was a great moment. Disease and cancer in particular continues to touch so many people, we all have a story that makes an experience personal, to hear Fabian speak puts a new context on what we as individuals can do about it. In the job I do I try to talk to teams about being in it for the mission of making healthcare systems ‘right’, people like Fabien are the true inspiration for this as a way of being, a definite highlight of the year, a man who gave me so much courage through the year.

Talking of courage and teams; Wannacry as a highlight? Well in Ireland it was! Leaving Galway after a series of meetings a call came in from the NHS alerted us to the fact that something quite serious was about to happen. Those couple of hours gave Ireland the opportunity to get ahead of the curve and protect the boundaries of the system. I have never been prouder than on the Sunday hearing the roll call of people involved working so hard to do a job they did because they cared so much. It made for a busy weekend, TV and Radio and generally ensuring that everyone in health knew what to do when they touched a computer over those few days was something we now put down as a significant effect on the way Ireland came out of Wannacry. The team achieved the plaudits they deserved and for a short while the health system was seen as a leader in all things digital in Ireland.

Traveling for work became a part of the job in Ireland a part that was enjoyable although not always actually seeing much of the places I went to; Brussels, Malta, Barcelona, Estonia, London, Belfast, Richmond and Seattle all featured on the passport stamp in 2017. Perhaps the most fun travel though was the Maternity Digital Challenge; three cars in a challenge to visit every Maternity unit in Ireland (19 Units) in 24 hours and at the end of it publish a digital strategy for maternity services. The fastest piece of policy ever in Ireland and one that if acted upon fully will truly change the way maternity services are offered across the country.

The great thing about the travel side of what I do is obviously meeting people and the connections that then brings. Social media is a huge part of maintaining these connections, in 2017 a great many new connections have been made, the ones I continue to learn most from or truly inspire me on an almost daily basis include;

 1 – @MattHaig1     6 – @MrDanWalker
 2 – @ValaAfshar     7 – @DrJessicaBarker
 3 – @MuziekGeluk     8 – @Pnolan99
 4 – @Nickisnpdx     9 – @Rosarii_mannion
 5 – @TedRubin     10 – @evankirstel

 

In 2018 there will be a new set of lists of the digital health leaders to follow coming out of Ireland and indeed HIMSS will be publishing their 50 global leaders, having featured in the Huffington Post social media lists I really think this is a great way of getting in touch with a different set of people that can expand what you know and what you want to learn. In the case of @Nickisnpdx and @MuziekGeluk I have met two people who genuinely have changed my life views. Two others in ‘the business’ that are also worth a follow are: @UKPenguin and @Andy_Kinnear, real digital health heros in a half-shell!

Life views get changed by events and people, Manchester and the impact the horrible events of that evening had on so many people will always now bare a mark on me. I love live events, and now they will always be a thought that goes out to those people that were harmed by the horrors of what happened in Manchester. I went to see Professor Brian Cox just days after Manchester, the odd calmness to the delays, the new acceptance of a normal that has come to us is quite scary. Professor Cox provided almost a eulogy for me in the way he delivered his ‘set’, how we are all human beings here on this planet for reasons unknown and yet so many people seem to be set here to destroy all that is good. In the wake of Manchester many people tried hard to stress the need to simply spread love not hate, I wish that would continue to hold strong in 2018.

You can tell you are getting older, not just by the amount of grey hair but by a change in the what you love to do when you go out. For me this year new restaurants have played a huge part in my entertainment; Tickets, Social Eating House, Amuse, Hang Dai, Punch Room, Café Del Mar, Blind Pig, Mulberry Garden, Tattu, Cats PJs and Headrow House have all made a difference to the nights out I have enjoyed.

I have managed to get to the Café Del Mar on Ibiza, Barcelona, Thailand and Malta (Although Malta is a ‘fake’ version) and I am lucky enough to be adding Miami to the list in a couple of months, which just leaves Dubai. Amazing music, super food and normally some pretty cool entertainment make the Ibiza version of Café Del Mar still up there in the top places for me!

One of the last things I got to do in Ireland was a little dream come true, speaking at a literary festival. Something Wicked is a little crime writing festival in North Dublin and I had the great honour of speaking at it on the threats of Cyber Crime and how the world is changing through digital. It was a superb audience with a lot of smiling faces and great discussion and questions after. I would love to do it again in the future I enjoyed it so much.

Being back in the UK re-opens one of my other favourite pass times, shopping! With Vivian Westwood, Jeffery West, Pretty Green, Paul Smith, Jigsaw, Hip, Ok Comics, All Blues Co. and so many more wonderful shops in Leeds Saturdays (When Barnsley FC aren’t at home) are going to be fun and have been already since getting back here.

My last two memories of Ireland and 2017 are people based, my parting gift from Roisin Doherty was my very own certificate of my Individual Health Identifier, seeing that on paper and it being able to be used to aid in the delivery of my care is a great achievement for a small team of dedicated and inspiring leaders, none more so than Roisin who I can safely say is one of the most accomplished Project Managers I have come across and I know will go on to do amazing things in the digital health space, a definite highlight of 2017.

Last but not least was leaving Niamh, my trusted sidekick for only a couple of years but leaving someone who has helped you so much was difficult, we joked in those last few days about the importance Niamh has played in the success of eHealth Ireland, for those that are still involved on the Green Isle, it was no joke, Niamh is the centre of that world and intrinsic to its success. Working with someone who simply gets what you are doing was a great part of 2017, a lot of laughter was shared.

So here we are, on the verge of 2018. A new team, a new goal, a new environment and a new outlook, last year I leapt into 2017 with a new motto; We can achieve, we truly can.’ I was full of vigour for not doing things like we always have, doing something different.

2018 is going to be the year that I work with my new team and try hard to;

‘… change what we do to change who we are.’

Small changes, small moves of the behaviour dial is all it takes to make a difference when the team you are part of is as good as what I have inherited here in Leeds. The culture I now work within can and will be our advantage in 2018 and I want to be part of the changes we each make more than anything else. After all as Bob Dylan says, ‘There is nothing so stable as change.’

We are in the year of the Rooster, so every morning I will try hard to wake up with the call of the Rooster ready for the next new challenge!

Bring on 2018, but thanks for the fun 2017.

Becoming the new boy…

Becoming the new boy again is always a nerve wracking event isn’t it? Remember the first day at school, new faces, new places and new ways of working? I am in week three of being the new boy in Leeds and I have never joined anywhere that worked so hard to make you feel welcome and part of the team as much as Leeds does; and at a pace that is quite extraordinary.

Induction would send the fear of dread into many a health IT person. Fire safety, manual handling, corporate values and orientation… ’Just let me get to the job,’ most of us would be screaming inside, after all we came here to do this job, we don’t need persuading anymore. But not one single new staff member can start within the organisation without attending, therefore induction it is.

So the Monday morning comes around and just like the first day at school I have my best new tie, my new note book, my new pen and I am ready for anything. Coming back to what you know, Leeds, the city, means that one of my best friends is there to meet me for a coffee before the induction begins. But straight away it feels different. New colleagues come up to say hello and welcome, before the (what I thought would be scripted) induction even begins and straight away it made me, the new inductee, realise, hang on, this isn’t a scripted event, this is real people with real values, and actually, OMG, everyone really does care!

Entering a room with around 50 other new starters immediately creates something of a new collegiate group of professionals. We are in this together and in time to come we will remember starting on the same day. No matter what our role, the people in the room are connected to one new thing, the care of patients at Leeds and The Leeds Way.

A lesson in Leeds is the first part of induction: what is there to be proud of? Firstly you are already blown away by the sheer size of the hospital, and this is one of several sites. Then it turns out parts are over 250 years old. Remember the amazing work of Kate Granger. Personalising and making human the interaction with people who work in healthcare is also part of induction. Every one of the people on induction are using the ‘hello my name is…’ introduction line, instilling straight away the human nature of Leeds as an organisation.

The culture of the organisation is impressed upon a new person on day one. The brand of ‘#TheLeedsWay’ is distilled down to the key vision statements, not simply posters for all to see but real values that you quickly realise permeates everything that the team is here to do.

Leeds hospitals needs this team work, as the next realisation is just how busy the hospitals are. That week there had been between 550 to 600 discharges a day. If you didn’t realise before induction then it comes home quickly how important it is to every part of the organisation to be at the frontline of healthcare in the NHS, as Leeds is the centre for so many care initiatives, transplant scenarios and specialist care. As a new person working here you get the importance quickly of The Leeds Way and the Leeds Improvement Method in place across every job. Every ‘asset’ the trust has is asked to understand how to make the care journey of a patient a better experience.

Delivering care costs money, around £3m a day, and with over 1.5 million patients every year, you begin to build your own scale for the size and complexity of my new organisation.

Every induction group meets the CEO and gets to hear first-hand the vision for the future and understand how he believes every hand in the room is involved in building the Leeds Way. The leaders in the room also get to meet the Exec Team, truly making sure that the Exec Team is asked by every member of staff to model the values of the organisation.

I have worked in a number of health organisations over the last 20 years, yet never have I felt part of the team as quickly as I have at Leeds. The Leeds way of delivering induction means that I am a team member quickly and can help deliver the goals of the organisation as quickly as I possibly can.

Joining Leeds really does feel like joining a new way, #TheLeedsWay

 

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