Well 2016 was a quick one, that’s for sure. That phrase, where has this year gone, never held so true.
This is the fourth year of writing my blog and the fourth ‘year in review’ I have been able to do. I have always enjoyed doing this, each year I get chance to spend a little time looking back on the fun things, the work things and the changing things that have happened. The first year in review I did was 2013, I started that blog piece by apologising for talking social for once rather than work, this year it feels like the opposite, 2016 has been a great year for focusing on work, so for those that ‘tuned in’ just for the social lists sorry, there may be a bit of work stuff this time around.
As far as years of change go the world feels a bit like it has all gone a bit ‘Stranger Things’ and is on the upside down, politically, with Brexit and Trump it’s hard to know what will happen next. It was quite an amazing if somewhat unsettling night to be in Barcelona as Trump was announced as victor, being invited to an American party in the basement of a hotel to celebrate the nature of democracy rather than the political victor will always remain with me, even if it did make it a very very late night.
So what have I really done this year, a huge amount of really enjoyable work and social experiences in Dublin that’s for sure. Last year when I look back at the review of 2015 I was still finding my way around Dublin, I feel that it has become a city I understand so much more in 2016, and yet I know I have explored a very small proportion of it and against a back drop of a certain bubble of experiences and relationships. Mulberry Garden, Delahunt and Taste at Rustic Stone have to go down as three of the best meals I have ever eaten out in any city anywhere, and yet the old faithful P.Macs, Fallon and Byrn and 37 Dawson’s Street still get a revisit on a regular basis. The warm, dark atmosphere of all three bars, the amazing tunes, super cool (and friendly) staff and the quality of the food and drink leave these three places still a little untouchable, although four new ones for me, Number 22 at the Majistorium, House, Chelsea Drugstore and Sophie’s are starting to bring great, fun memories that at least add to the choices when visitors arrive.
The two highlights of the year though both have me on big stages with loud music playing, that hankering after being a super star DJ keeps coming back I guess!
First, the Future of Health Summit in May. A whole day of me and a great friend being in charge of a huge stage. The theme of the day, a music festival, every speaker coming on to their favourite song ever, an intro video with the music turned up to number eleven as the back drop, a bright new shirt all of which resulted in a very big grin by 17:45 as the stage closed. The comment on social media though was wow, how can the team turn eHealth into something a-kin to a music festival at a conference, and enable learning in a fun environment! The next day being whisked off to do my first live radio in Ireland was also pretty exciting too.
The second highlight was on an even bigger stage, with one of the world’s biggest names in technology. I was invited to present the journey we had been on to Satya Nadella the CEO of Microsoft at the Microsoft Tech Gathering, and it was quite the experience with a few thousand others watching that’s for sure. Being able to drop a Nas quote into the presentation, come on to a Star Wars themed animation and finish up with Fedde Le Grand made for another big grin even if the nerves were so much more a jangle before I went on, luckily the odd friendly face in the audience stopped me from falling off the edge.
A giant leap away from all the crazy work were two very different holidays this year, a wet, windy and icy cold Wild Atlantic Way in, yes August, was the first. Who would have thought a beach as beautiful as some of those in the Clifden area could work regardless of the most unseasonal weather I have ever experienced, my nose froze, it was August! The second was a return trip to the in-laws in sunny Turkey, not a sprout in sight, just lots of sunshine and my own chance to be the Villa’s pool side DJ, pretty damn awesome. I also proved to myself that water truly does inspire creative writing as I wrote a blog piece remotely with a colleague that ended up being published far and wide, all this whilst stood in the pool, the wonders of modern technology and connectivity!
In June I met a team of people who would have a significant influence on our approach to how we work. The team at Leading Social brought the inspiration that is Ted Rubin to Dublin for the second time in 12 months. The first time I saw Ted present I was awash with ideas that came from his mouth, vilification that our approach was a valid one. To be asked to share a stage with him for an afternoon in June was amazing, and still the phrases, ‘return on relationship’, and ‘just be nice to people’, hold true to what we are trying to do, all within our need for agility and a results framework that we have set ourselves.
July gave me an opportunity to be emotional on stage, well not really but it happened anyway! I have spent this year being very proud of each and every deliverable, each and every member of the team, a hot evening in July I was asked if I would be interviewed ‘live on stage’, the event was called a Journey of Disruption. Much taking of the mick happened as the posters went up, an evening with Richard Corbridge they read, I thought of trying to play the guitar again and thought better of it! The evening was a complete sell out, standing room only! And then the emotion leaked out as I told the story of ‘Hello My Name is…’ just a week after the amazing Kate Grainger had passed away, and indeed the emotion did leak out with my story of the work that our very own Epilepsy Lighthouse project had achieved. What was awesome was when a bunch of ex-colleagues and particularly my Mum got in touch the next day to say she had listened to the podcast of the event and had enjoyed it too, you can’t beat your mum being proud can you!
I still love live music more than any other ‘cultural’ experience, this year I made it to; Disclosure, Stone Roses, Michael Kiwanuka, James Blake, Jack Garret, Jamie T, Guy Garvey, Bruce Springsteen, Steve Mason, Ben Watt (with the god of guitar in the modern age Mr. Bernard Butler), St. Germain, Jenny Green and the old faithful Field Day and Forbidden Fruit, Ireland has made my musical taste more diverse that’s for sure. The sound and atmosphere at Michael Kiwanuka was the best I have ever heard, it felt like a 1960s gig in a sweat box in the USA, amazing! The experience of Disclosure in a wet and muddy field in Ireland was something else, again the sound was exceptional with the bass actually moving your hair and teeth! Memories of Ian Brown singing I Am The Resurrection unfortunately were proven to be better than the real thing when I looked back on the evidence the next day, but, hey, you pay for the experience though don’t you!
Since 2002 I have collected my top ‘20’ songs of the year, it used to be 20 because that’s what would roughly fit on one CD, the demise of the CD has led to the list growing. 2015 was 29 songs that come back as a lovely play list memory of the year. I have tried hard to get the list down in numbers, lets see how many it is to end this year. This list is in ‘creative enjoyment order’, not anything else, here are my songs of the year:
1 – It Could Never Happen – Fink D’Void
2 – Nocturnal (Disclosure VIP Mix) – Disclosure
3 – 1973 – Beth Orton
4 – Gradually – Ben Watt
5 – Am I Wrong – Anderson .Paak
6 – Freak Like Me – Lee Walker & DJ Deeon
7 – Shivers (Honne Remix) – SG Lewis
8 – Lazarus – David Bowie
9 – Planet Sizes – Steve Mason
10 – Can’t Get Over You (Sandy’s Blackwiz Mix) – Sandy Rivera & S-Man
11 – Rising Water – James Vincent McMorrow
12 – Initiate – GoGo Penguin
13 – Do It Right – Martin Solveig
14 – Worry (Anderson .Paak Mix) – Jack Garratt
15 – Bad Habits – The Last Shadow Puppets
16 – Flip A Coin – Marquis Hawkes & Timothy Blake
17 – Sign Of The Times – Jamie T
18 –Silver – Fakear
19 – You’re A Man Now, Boy – Raleigh Ritchie
20 – Nothing Like This – Blonde & Craig David
21 – Black Man In A White World (Ghetto Gettysburg Address) – Michael Kiwanuka & Nas
22 – This Is How It Feels – Richard Ashcroft
23 – Dancing On My Own (Cassius Remix) – Robyn
24 – Day To Day (For 6 Days a Week) – L.A. Salami
25 – Never Be Like You (Disclosure Remix) – Flume
26 – All Four Walls (Maya Jane Coles Remix) – Gorgon City
27 – Set Me Free – Herizen Guardiola
28 – Sweet Dreams – Freaks
29 – I Hope (1-800 Mix) – James Blake
30 – Operator (DJ Koze’s 12” Extended Mix) – Lapsley
31 – Stranger Things – Kyle Dixon & Michael Stein
Thirty one songs, I hope my inability to reduce the songs to a more manageable length of list is more a reflection of the quality of the music this year than my new found indecisiveness. To me yet again it feels like the diversity of music in Ireland has drastically influenced the songs on the list, there are some major pop music themes curtesy of FM104 here in Dublin as well as the usual smattering of singer songwriter types and some super songs to make anyone get up and dance. I can’t wait for some of the new music being promised for next year. I’m already, excited for The XX new album after hearing just two tunes as well as more from SOHN, Loyle Carner, Bonobo and Fred Everything. The BBC predictions for next year are always an exciting prospect on the 1st of January.
Three of the songs of the year were inspired by television programmes, and for a long time that number was bigger with the theme tune to Suits sitting in there as well. There has been much talk of TV taking over from films in its cultural reference point, certainly for me the NetFlix in(ter)vention has been a revelation, more than Uber, AirBnB or the usual go to disruption descriptors. One great thing about NetFlix is it is bringing back that TV sharing moment, not the going into work the next day after an exciting weekly episode but the comparing of where you are in the series, the care not to reveal plot lines and the tantalising ability to still talk about TV shows is back again.
So here are my top ten most recommended TV shows of my year (not necessarily new this year):
1 – The Get Down 6 – The 100
2 – Stranger Things 7 – Daredevil
3 – Suits 8 – Designated Survivor
4 – Luke Cage 9 – How To Get Away With Murder
5 – Jessica Jones 10 – Agent Carter
Yet again reading fiction has suffered at the hands of work, and just like last year I really want to change that next year. Social media and the ‘need’ to engage with it has had an impact on the books I have read in 2016 so much it makes me feel a bit sad, but I also need to think of the fun and the knowledge I have been able to build from this change. Meeting two people I have read this year was exciting, Gina Neff and her study of why we have become so interested (obsessed) with self-tracking and Martin Lindstrom the author of my book of the year, Small Data were both inspiring meetings. Getting an hour with Martin to just hear his thoughts on all kinds of stuff was such a treat, understanding his views on what we can do in our industry gave us so much to take forward into 2017.
My top books of this year are:
1 – Small Data by Martin Lindstrom
2 – Nutshell by Ian McEwan
3 – The Risk Pool by Richard Russo
4 – Astronauts Guide To Life On Earth by Chris Hadfield
5 – Self-Tracking by Gina Neff & Dawn Hafus
Its been the busiest year of my career, three things in particular have changed how I view what we do. The amazing success we had with the Innovation Showcase in Ireland showed me just how much I want to keep moving forward but it also alerted me to the fact that the public also want us to keep striving to meet the agenda of building a better health service head on. Seeing so many schools come to the event and get excited about the possibilities of what we do made me realise just how long the journey we are on will be, but, how once we get there, digital health will in fact become simply the normal.
The impact on my own feelings of the maternity system go live in Cork in December surprised me. In 20 years in health technology there have been some ups and downs, as there is with any job I guess, but, the go live in this amazing hospital and the commitment, engagement, will power and care the staff involved showed made that weekend and the impact of that system the most important thing I have been involved in over those 20 years. A nurse 7 hours after go live saying to me she has no idea how she did her job before the system was implemented filled me with confidence that what we are doing is the right thing and most importantly the right way to go about it.
The final of the three events was an odd one. In May having been away from my seat at the table to check why my colleagues had disappeared for so long at the Irish Tech Awards, I was walking back through the main room and seeing an old picture of me on the screen, it scared the living daylights out of me. To then hear my name announced as person of the year was one of those moments in time when everything stands still! I was so proud to receive the award but the whole time knew that without the great team around me that none of what we have been recognised for in 2016 would be possible without them.
Anyone of a certain age has become that bit more mortal this year; the loss of Bowie, Prince, Lemmy, George Martin, Leonard Cohen, George Michael, Carrie Fisher and so many more talents has made us all look at where we are a little bit more and consider what is the mark we want to leave. What can we be proud of ‘doing’ the most!
I look back on the way this part of this blog has evolved over the last four years. It used to be a list of the fun experiences, but, this year more than any year before it has become part of a reflection on the way I want to be and what I want to achieve, the way we want to take forward the goals we set ourselves has become that bit more important to each of us.
Time, apparently, is limited! In 2016 I have tried to squeeze every last moment out of every single day.
Talking about psychology recently with two friends they commented separately that child psychology asks us to celebrate the ‘art’ of trying rather than success, I agree, but…
… if we want to truly achieve the goals we set ourselves then 2017 will be the year of trying even harder, celebrating every single success along the way, making friends from colleagues and truly achieving as a team that understands why we do what we do. I say all this not with the lens of ‘imagine a world where we could’, but with the knowledge that the team is capable of this, a truly great start to the year knowing that is the case.
A new moto for 2017, ‘We can achieve, we truly can’, maybe linked to something to do with time actually being mortal rather than the usual never ageing, timeless phrases, this could be a good rallying cry for me for the work and the social elements of life in 2017!
We want to do so much, we have only time that is allowed, so let us stop promising, thinking and considering and lets really do what we think is right and give it our best shot, and lets make it fun along the way too!
Welcome in 2017, its going to be the best yet…
First published in CIO Magazine in August 2016. A collaboration with Elaine Naughton in the writing and development of this idea, a huge thanks to Elaine for this.
In the excellent Steve Jobs biography by Walter Isaacson, he describes a discussion between Jobs and Steve Wozniak where Jobs is explaining to Woz that the role he plays in Apple is that of an orchestra’s conductor, here to get the best out of the team, to ensure that they play in harmony and deliver to the listener the most inventive and yet classically rich vision of the original design. This conversation is said to have taken place after a strong ‘debate’ just before the launch of the iMac itself, Woz described by Isaacson had just exclaimed to Jobs that he was neither designer nor engineer and therefore did not really warrant or justify the recognition he was getting as the ‘re-saviour’ of Apple.
Is the creativity of the conductor the real line to success in IT leadership? After all the ‘band plays on’, or at least tries to, whether there is a conductor or not. Even as early as 1998 Jobs was describing, I think, what the modern CIO now needs to be, although maybe we now need an evolved model from conductor to DJ or rock and roll front man.
Why does the analogy and the model need to evolve? Well, in times gone by, the IT leader would have sought out the best in class people he needed. Much like creating an orchestra of around 30 talented artists, the Leader had to be the best that the orchestra could afford and then the conductor had to make them fit into the team, not always an easy job. The ‘prima donna’ persona of the highest calibre technologists is not always easy to integrate into a high-performing team after all. This then, perhaps, is where the evolved model comes in.
The leader of a rock band enables the band to “jam” develops a structure and order to remain in time, and chooses a rift as well as creating a tune as they play. Maybe this roll can be best described as the start-up innovator of the music scene. A band always needs a front man – someone with a vision for the sound they want to achieve and the charisma and charm to wow an audience, the band may play on if the front man leaves, but rarely as successfully; what would U2 be without Bono? or the Rolling Stones without Jagger? Queen without Freddie? Perhaps the best real world example of the rock star digital leader is Larry Ellison of Oracle, truly a front man if ever there was one to be seen in digital leadership. The owner, founder, creator and beating heart of the Oracle empire, whilst no longer leader in name still very much the charismatic front man of the brand and indeed, band!
An orchestra, on the other hand, follows a very strict plan and each of the upwards of 30 members (over 50 for a symphonic orchestra) knows exactly what they need to play and when, whether it is solo or synchronised with their team (by virtue of the score). Only the conductor knows the full score and reads all lines simultaneously, knowing who to call on and who to bring in exactly when they are needed for the orchestra to continue playing in harmony and in time, and for soloists to have their moment to shine. A digital leader in the style of the conductor does just this. The danger here though, is if only they know the full picture, keeping everyone focussed takes a huge amount of energy and enthusiasm. Many public sector digital leaders are of this style (often by necessity) as the full picture is in reality always being altered and reconfigured a small amount by the political leaders and paymasters.
The conductor’s role is an art form and a talent, while being a very technical job. Take the conductor from this and time signatures slip, the musicians become discordant and eventually chaos ensues. Just as with Jobs and his temporary departure from Apple, as conductor of that orchestra he was never truly replaced and therefore for a time the music was not what the audience needed to hear. The creativity, in the sense of innovation of the music, belongs to the composer rather than the orchestra or conductor; with this in mind maybe we need to see the digital leader as composer and conductor more often!
A DJ, unlike the conductor or rock band front man, can take the best work of a much wider variety of stars, mould them together until they find the right mix and then play it for the audience. The DJ doesn’t have to integrate the full character of the artist just that moment of excellence where the beat fits or as the very wonderful NetFlix original puts it, ‘When the Get Down arrives’! A modern successful digital leader then is going to be a DJ! If we consider the ‘gig economy’ to be the future in digital then this kind of character and behaviour is likely to become even more prevalent when building successful teams. The magpie-type ability to bring all the best bits together for one moment of excellence that then can be repeated.
We believe the skills of a DJ are also key traits of a transformational leader: someone who motivates and energises their employees to get behind a transformation strategy, creates something that has been written about many times before, the creation of a fan base if you will!
The styles of these three analogies allow us to consider the nature of digital leadership. There is a mix of two key styles here, one is transactional the other transformational. The conductor is transactional, planning, organising and controlling. The DJ is transformational challenging and changing organisational culture, coaching and developing people, creating a climate of trust, establishing a long-term vision. The front man perhaps mixes both styles dependent on the need of the audience or band members, an ambidextrous style that is agile and responsive as startups require to be.
The analogy can continue in a number of ways beyond just the parts of the mix. A DJ brings with them the theme and the end point they are trying to get to, much like a high performing digital leader needs to, they start with the end in mind. Also, the DJ needs to be aware of the change in trends, evaluate them and consider how to adopt them into their fabric, so much learning of how this is done from both professions; I would love a temporary job swap!
The Jobs autobiography also describes the moment that Woz and Jobs first met from Woz’s point of view, “We first met in 1971 during my college years, while he was in high school. A friend said, ‘you should meet Steve Jobs, because he likes electronics and he also plays pranks,’ so he introduced us”
Jobs and Woz learnt they had so much in common, and yet were so different. The wonderful “Small Data” book by Martin Lindstrom references a Harvard Business Review article by de Swaan Arons, van den Driest and Weed called “The Ultimate Marketing Machine”. The article suggested that there are three types of people needed to make a marketing company successful, they are:
Think people – Who focus on data and analytics
Do people – Who have responsibility for content, design and production development
Feel people – Who are all about consumer engagement and interaction
I wonder if the modern digital organisation can apply this exact same logic as has been done here for the marketing team. The types of people the IT leader needs to bring together are defined less by their technology specialty and more by the person type they act when they are in a delivery focused team. Back to Jobs and the Apple empire, the success of the original swathe of ‘i’ products has always been put down to two elements, one, Jobs own meticulous eye for detail and two, the design standards of the team under Sir Jonathan Ive. If we overlay the commentary from the article in the Harvard Business Review referenced above and the conclusions that Lindstrom himself makes on this article we start to see that the way this team has been successful is by ‘minding the small things’ by being a team that is led by a digital orchestrator but exists as a team that can deliver empathy together, to the benefit that is trying to be attained.
A modern, successful leader needs to be a strategist, a “front-man (or woman)” AND be able to conduct a complex set of teams in a harmonious way – or at least empower capable section leaders (upper strings, lower strings, woodwind, brass, percussion) to do so on his or her behalf.
The theories of Lindstrom in Small Data will blow your mind, you regularly turn a page and laugh at the conclusion he has made and how it applies so completely not just to modern marketing ways of working but to how the right digital function needs to deliver. Whether as leaders we are badged as CIOs, CDOs, Conductors or DJs we don’t care, we just want to be able to make IT work.
…… as a post script we really do care! Two IT leaders were involved in the creation of this article, one of us wishes they had taken the path of enlightenment and become the superstar DJ of their dreams the other is progressing from playing second fiddle in a growing orchestra to becoming a conductor and leader of a great band.
When a member of staff offers to put you in a shed at the bottom of the garden for the next 12 months, what does it mean I wonder? So far my time in Ireland has taught me so many new phrases. Most hilarious was learning what being ‘put on the long finger’ meant, however today on the eve of our all staff meeting the concept of asking the leader of an organisation to go and hide in the shed at the bottom of the garden for a little while I thought was uniquely Irish, turns out its not. It’s perhaps a bit unique to the style of CIO I aspire to be.
The all staff meeting occurs twice a year. It has become traditional to try to pull together a blog post for each of these on the eve of the event that sets some of the tone or theme for the day, gives us something to reflect back on and adds a bit to the conversation as the day progresses. The theme for the staff event this time is quite simply ‘Delivery’. We have had ‘Transition’, ‘Transformation’ and ‘Connectivity’ and now we move on to the ‘pointy end’ – delivery as a theme!
Delivery style applies nicely to the concept of the leader of any organisation being put at the bottom of the garden for a little while it would seem. In just under two years the team has moved mountains, to completely re-structure a function and put in place a national focus that organisations like the World Health Organisation are giving Ireland credit for. The credit for making this happen goes to every member of the team though.
But, when the team offer a ‘deluxe shed’ for a few months to the leader it is time to stop and ask why. Strategy and delivery go hand in hand. A CIO needs to be able to do both simultaneously, Grand plans badly executed will not change the way healthcare is delivered in Ireland nor will rushing at a problem head long without a vision in mind. It is well documented and in the public domain the distance Ireland has to travel with digital health. It has become a little too easy to move quickly without always the consideration needed for keeping the whole team on the same path.
One of the key principles as we moved to transition and transformation of the team was ‘don’t break anything’. We haven’t, but maybe on some days it feels like we have come really close. We are currently operating a resourcing style probably best described as robbing Peter to pay Paul. Not ideal and maybe one of the reasons why a proportion of the team wish I was away in the garden shed for a short while. A further principle though when we started this journey was to keep delivering new things, not to go away with a long term plan that had no new early benefits to the delivery of health. That requires a balance of strategy and operational delivery that isn’t always there for technology teams in health but Ireland has been able to make this work better than I have seen anywhere else.
The most successful of teams are really hard to create. They certainly do not come together ready formed and need a plethora of different elements to make them work. Sport is littered with examples where teams do not equal the sum of their parts and the results simply are not there. Take the difference in commitment from this year’s soccer Euros. The most telling moment of sport TV for me over the summer was a comparison of the Ireland and England team getting off their team bus. The England team exit in ones, big Beats headphones on, no interaction, and no conversation just 12 super stars in perfect isolation. Cut to the Ireland team, talking to each other, gesturing at the stadium, practically hand in hand ready to meet the challenge. The team in white had one of the worst sporting performances ever and the team in green one of the best ever, in my view. Certainly as we head to the qualifiers for the World Cup I am hoping my adopted home allows me to be one of the #BIG rather than a miserable man in white.
The leaders of these two teams had very different sheds. England seemed to have a shed that was strongly built, just a small window and an appointment system to come in for a look with edicts passed under the door every couple of hours about what to do. The analogy for me of the Ireland shed was more of a gazebo, open access, everyone able to see what was happening, to share ideas and move the whole structure easily moved around.
The need to deliver is a pressure the team has to try to handle daily, and that pressure comes from an unwavering pride in what is being attempted. The team has embraced the concepts of the new operating model and is trying hard to make it work often in the face of some adverse conditions, but each small success moves us one notch further towards creating a digital solution that can tangibly make a difference to the way health care is delivered in Ireland. The need to keep delivering, to prove what eHealth Ireland can do, is with us all the time. No matter each success, the media will always find a story that does not play the positive element of digital health. Whether it’s the fact that the wider eHealth Ireland eco-system has sought guidance from an organisation that is globally recognised as a ‘digital-first’ organisation (and for writing about restaurants on that platform) or that eHealth Ireland has pushed hard to be part of the NHS CCIO/CIO councils, these elements do not serve the organisation well in the width of the Irish conscious and perceptions of what is being delivered. And yet they do serve the ability to deliver well!
Camaraderie has to be a big part of how the team works, and that can’t be forced to occur. We are trying lots of different ways to create small eco-systems of support. The amazing initiative from the team around eHealth Moments starts to really put new and exciting opportunities in place. A safe place where the team can share experiences, ask for support, get to know each other or simply understand the many projects and services that are delivered, all on one platform where staff are able to introduce themselves with this now world changing words…
Hello my name is…
I can’t wait to see the way this will bring the team together, and after all, as a digital organisation dispersed across the country, we should absolutely use the tools to hand to achieve improvements to the team culture.
Dare we ever try to emulate the three musketeers’ motto in eHealth Ireland I wonder? It is cheesy but a very good friend used to have it on his email signature, ‘All for one and one for all’. We are trying to get there. I know there will be some of the team who read this who are not sure if they really fit into this, and yet I am committed to get everyone in that shed with me, that’s the style of CIO I want to be!
Times continue to be exciting. An old boss of mine in the National Programme for IT was fond of saying to staff as she passed them in the corridor, she speed walked everywhere,
‘No one said it would be easy, everyone said it would be worth it.’
So rather than just putting the leadership (or worse just me, I need some help) in the shed at the bottom of the garden, who wants to join me, we can break the rules, change the rules and support each other in being committed to delivering, we can strive to keep the positivity and sometimes ignore the negativity.
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!
Thursday 25th of May 2016, The eHealth Festival rocked the stage at the Future Health Summit in City West. No festival would be complete without some audio visual fireworks and with this in mind, we opened with a powerful music video painstakingly produced by Elaine Naughton
The video, which wouldn’t have been out of place at the MTV awards, showcased different countries where music legends such as Bowie and The Beatles and neatly segwayed to all the countries where eHealth Legends came from. These countries included Estonia, Botswana, UK, Denmark, Spain, Australia and I have an honorable mention to my own Northern Ireland. The scene was set for the day: High energy and involvement would be the recipe for a succesfull day. Twitter handles were provided so anyone could tweet the speakers and ask questions using the hashtag: #eHealthFestival. Notably, we were trending in Ireland within the hour.
The speakers for the day embraced the festival theme and played the part of rockstars by choosing their own song to enter onto the stage. Musical references were dotted throughout the presentations some of our Rockstars-for-the-day even dressed up in festival gear to present.
First up to speak was Tony Shannon and Andy Williams from Answer Consulting. They spoke in detail about the critical state of health around the world and how effective sharing of information can mean better care for the patient. Andy spoke about how transformation is needed in digital health and it is his belief that a huge transformation will happen in 5 years or less. He spoke about the importance of open source and the growth in demand witnessed in just the last year alone. Richard Corbridge reiterated their thoughts and argued that health spend is actually an investment for the future rather than just a short term budget item.
The next rock star on the bill was Andy Kinnear. Andy gave great insights from his learning in the digital transformation journey in Bristol. The countless benefits they are reaping now include the amazing research opportunities that become available through a shared network. When I asked Andy about how to create a culture that encourages innovation, he replied that“ You need to create a spirit where loyalty is with the people you serve – the public not the organisation. You should reinforce this mind-set that all you do is for the patients.” It is heartening for me to see that this is exactly what eHealth Ireland are doing by putting their patient: at the centre.
Naomi Fein from Think Visual took to her new found rock star status like a duck to water as she ran up and down the stage interacting with the audience. I have had the pleasure of working with Naomi on a few projects and she is truly inspirational. Naomi spoke to us about leveraging empathy to create clarity. She took everyone through an interactive process ensuring that any plans that we make are truly impactful. The message must be “memorable, actionable, and shareable”. To ensure this we need to start this (planning) process before we communicate by asking –
If we can do this with empathy for our audience it can give us fresh insights, new language and clearer priorities. Naomi’s fiinal piece of advice was: Before communicating, it is imperative to separate between what is true but useless, and what is relevant. This last point was particularly poignant because I feel that often times, we ourselves are overawed with too much information.
Joanna Smith, CIO of Royal Brompton Trust was next up and she set the scene by entering to The David Bowie number “Changes”. She spoke about her experiences within digital transformation in health. She had a lack of engagement at the beginning of her journey as they had no strategy or plan. Joanna used the analogy of growing a garden and how they had to strip everything away, draw up a plan and get the basics right before they could change their system. The now familiar theme of the patient being at the centre was spoken about again and how important it is to have easily accessible and user friendly technology. Joanna also argued that patients should be widely informed as they are interested in these technological advancements. Joanna echoed the importance of building relationships: a common theme from all the speakers and how she felt that one of the biggest challenges is managing change and trust. She gave some great advice on picking your battles, knowing when to give up and knowing when to push a head. In my own experience, this sound advice could apply to many things in life, including raising children.
Julie Bellew and Brian Canavan from the HSE were late additions to the bill after the successful launch of #eHealthMoments. I have had the pleasure of working with this team to develop this idea. It is based on the premise that internal communication is central to how an organisation is run. Up to 70% of Organisational change fails and one of the more commonly cited reasons for this failure is poor communication. This internal communication is truly engagement from within and was developed when both these members of staff were inspired at an All Staff Day in March. The concept is based on “Hello My Name is” created by Kate Grainger. Each member of staff can make a short video clip about who they are and what they do. These clips are uploaded to a private forum created for these staff. Previously there was no real link between the staff as they are traditionally dispersed throughout the country and rarely get to meet. This provides everyone the chance to introduce themselves, put a face to the name and get to know a little bit more about each other. Julie and Brian want to change people’s opinion of the HSE and want to make it fun as they do it. I was sitting beside a few of the speakers at the time of this presentation and they loved it. They took pictures and said it was an initiative they were going to bring back to their own organisations and was so simple but extremely effective.
After lunch Richard Gibson, research director at Gartner spoke about personalisation with healthcare and the importance of patient engagement. He explained how simple technologies like websites can help engage by providing information and portals connecting patients with their information. Richard spoke of many cool technologies that provide great advantages to the user such as fitness trackers, sleep wristbands, devices that keep track of your habits and home diagnostic stations: All technologies that are revolutionising how we live our lives.
We had the lovely Amanda Neylon up next, who danced onto the stage with the song “What a Feeling” from Flash Dance. Amanda was in charge of the digital transformation of Macmillan Cancer Care support. She told an inspirational story about her journey there. The purpose of the organisations was to support people and help them take control of their situation. To do this they took a huge amount of paper information and made 50% of it available through digital services. Social Media put digital at the heart of the organisation. She echoed Naomi by stressing that “you must understand your audience” and through this understanding they segmented their audience through behaviours rather than demographically. Amanda also spoke about the importance of collaboration, iteration and evaluation through all the different stages. Her final word was to be brave and allow people the opportunity to grow through experimenting with what works and what doesn’t. If things don’t work the first time around, simply move forward and try something new.
Clare Sanderson (@IGcom) from IG Solutions was our final presenter and was representing the security and governance side of the festival. She also spoke around the importance of engaging with the public early and informing them on each of the stages you are going through. There is great opportunity to learn from other people’s mistakes by being up front with patients about where their information is going. Research conducted by The Wellcome Trust found that people generally didn’t know where their information is going. Clare spoke about a really interesting concept called Citizen Juries. During this process people hear case studies around the use of data by health care professionals. This process proved that the more information a patient has around the digital transformation, the more positive they are about it. Clare also pointed out an extremely important issue: that there should be explicit consent and the right to object. I asked Clare about the best ways to do this and she gave some interesting ideas such as having the issue as a story plot on popular TV shows. Maybe we could ask Richard’s agent to arrange a cameo on Fair City.
The finale of the show was a panel discussion with the A&R personnel namely vendors – Cerner, CSC, IMS Maxims and HCI. Richard asked the panelists to sell to the audience on why their company should be the one to push forward this transformation in eHealth. Many of them touched on the fact that Ireland could be built as a centre of eHealth excellence and the importance of the integration off different systems. They echoed the importance of being engaged with patients early and ensuring that they go through the decisions with you, putting healthcare back into their hands and also the belief that data sharing is a common sense approach.
Richard rounded up the day with the reiteration that community is an area often forgotten yet it is crucial to the development of eHealth. He spoke about delivering everyone in the HSE a digital identity and how the HSE is opening up to innovation through eHealth Connect and The Quality Innovation Corridor (QIC). This was a very positive end to an extremely positive day. I spoke to a number of people after the event and they were delighted with the festival there was great energy, enthusiasm and optimism around the future of eHealth in Ireland. It really is amazing to have been part of this day and I want to say a big thank to Richard for giving me the opportunity me to co-host the event with him. I look forward to seeing how the ehealth transformation continues to evolve in the near future.
For more information on what is happening in eHealth in Ireland go to www.eHealthIreland.ie
SPEACIL THANKS to Blathnaid Cluskey who is interning at the HSE she is a Communications Student at DCU. She has a strong passion for media and using it to connect with different audiences and helped ensure that it was possible to create this review of the day.
A year ago we were invited to be involved in the Future Health summit for the first time. We built a house as the theme for the event, from blue print to decoration eHealth experts from across the EU used the story of creating a new build as an analogy to describe how eHealth Ireland could build on the foundations it was putting in place to create an eHealth system that could deliver a digital fabric for health in Ireland.
A year later and we have a different theme this year. The eHealth Festival has been pulled together, imagine the process of moving from foundations to a woven digital fabric throughout the country and the complexity of doing this, we have landed on an analogy for this too, putting on the mega festivals across the world, Coachella, Glastonbury and Electric Picnic. Surely a task with a long term view, a success criteria that includes immediate success and bringing joy to millions of people. The team are working hard to put on the festival all day on Thursday.
The eHealth Festival is a truly global affair, taking lessons and experiences of digital health from across the globe and applying them to the plans for Ireland. The first stages will be to consider what it takes to find the right festival site and theme, applied to the delivery of eHealth this section will focus very much on how to set the vision for the future as thoroughly as possible. A number of key speakers with NHS experiences will provide us insight into how engagement was gained at a plethora of sites with very different focuses ranging from a wide ocal geography coming together to adopt a standards based approach to the adoption of an open source model across a major cities record sharing approach and on to a major London hospitals insistence to get it right and not ‘simply’ follow the model brought to bear before.
Every guest speaker has been set a number of music festival themed challenges over the day too, ranging from the slightly different event photograph to a whole series of theme songs being picked; some of the music could get loud! Picking the theme songs has been an important part for each of the presentations as it will reflect the theme of where the presentation goes, so listen out for that.
In keeping with the way eHealth Ireland has evolved over the last year there will be some focus on the way we engage on technology in health as well. One of our partners Think Visual will be able to provide a different insight into how to engage clinicians and patients in a different way, using pictures and visuals to create a journey for them to join us on. This promises to be an exciting look into the art of the possible in this area.
Our focus has been on health care and a somewhat traditional version of health care over the last twelve months, the ability to deliver a new paradigm of research capacity with digital health must not be forgotten, nor must the citizen choice in how this occurs. With this in mind we have a speaker with a huge amount of experience making a health charity digitally capable, the lessons we can take from this I am sure will set the agenda for us in this space.
As with last year we have tried hard with the theme and the brieif to speakers to keep the ‘sales pitch’ presentations away, at the eHealth Festival it would be like the Darkness reforming! But, we need to create relationships with the vendor community over the next year that is a for sure! So in keeping with the festival theme the vendor community will be putting on the record label A&R man guise and trying to encourage us to understand why their label is the one of choice, why they are the Factory Records of the 1990s and not the SAW of the 1980s.
To round off the day we have a speaker by very popular demand, an expert in information governance, information security and getting the handling of data right. Asking a lady from Liverpool to speak on the theme of securing a festival is always going to be a little dangerous so expect some fun to round the day off.
As with any great festival there will be a few secret unannounced shows too by way of a couple of announcements that should set a tone that is exciting for the next twelve months, initiatives with internal and external focuses.
All that really will remain to say is… Put Your Hands Up For Detroit – All will be revealed!
On days like yesterday I am so pleased I am a bit of a music geek, I love making musical lists, the best 75 songs of Bowie, the best 10 Stone Roses songs and yesterday morning way more important than any list ever before, the best 50 Prince songs. The day the world lost Prince is the day I have never wanted to listen more to his amazing music, in an order that takes us through all the bests…
Best singer, best guitar player, best pianist, best drummer, best funk, best classic rock, best old school RnB, best rude song and best bat dancer!
Prince was (is) my first musical hero, live on tape, in films, in interview or with his abstract and ever changing views of digital he change my world, no actually he changed the world!
What is best, the home made anthology of songs, the record label chosen greatest hits or the one the ‘person in the know’ pulled together? Since the age of thirteen I have been somewhat obsessed with the compilation tape as a concept. Technology has evolved and now it’s a playlist I can share but the question remains, how do I pick the 20ish best songs to listen to in any given situation?
Two compilation tapes made for me by friends at school created my obsession. One of my best friends, John, made a series of compilation tapes called, ‘See Inlay Card For Details.’ The creativity John would put into these compilations that he delivered sporadically into the group of friends to share around was phenomenal. They would include songs by German metal bands, the Penguin Café Orchestra, soundtrack pieces from spaghetti westerns and often a bit of Bowie. The entertainment with this series though was the running order as much as anything, John almost wilfully subverted the style of the mix by throwing in something that jarred with the previous song, no one could nod off when listening to a John mix. Years later the Chemical Brothers would pretty much make their fame from this strategy!
The other was a tape from a chap called Saul. A mix so artfully created it changed my listening habits. Saul was one of the sixth form common room cool kids, he made me a compilation tape of Madchester mixes, 808 State, Happy Mondays, Inspiral Carpets, North Side and the like. Perfectly written in tiny writing so you knew what you were listening to, I wanted to recreate the experience for others from that day on.
So going to new places as a young adult the mix tape became my way of making friends. My best friend even mentioned this in his best mans speech, that his first real conversation with me was me brandishing a mix tape (CD) for him and him stating I never really liked ‘band music’!
Traveling a little each day is the perfect opportunity to listen to snap shots of different music, be it a new band, a new EP from a tried and tested love or a mix from some Ibiza bound DJ and despite technology changes I still hold my iPOD and the shuffle button dear.
April and May of 2016 are months with quite a lot of travel for work and pleasure and therefore I have been spending more and more time trying to create playlists for different journeys. For me it’s not just about the songs either, the whole play list needs a structure, just as John and Saul ‘taught’ me.
So here I am on a flight for a lovely holiday thanking my lucky starts that months ago I thought I needed a playlist with ‘THE’ 50 best Prince, I think this list will be played a lot over the next 4 days on holiday, even if the lovely lady wife doesn’t get that Batdance is actually a really cool song!
When the compilation used to be burnt to a CD there was the catalyst for a little self-regulation as you only had so much room on each piece of media. Now with the playlist the compilation can be even more sprawling, but if its for an event then it still needs a structure, as if you were curating the music or acting as a DJ. I do see the parallels to this and the building and developing of a team.
In the last few days two members of the senior management team in Ireland have been recognised by the Tech Excellence awards in their short list as IT professionals of the year. The team see these two people as the hit songs of the moment I guess, whereas other members of the team are absolutely the old school classics. For every Get Off or Breakfast Can Wait there has to be a Purple Rain or a 1999!
Creating the playlist of the team is essential, it has taken eHealth Ireland over a year to work out the playing order but in the last three months it has felt more and more like we have got there. The strengths of the team as a whole are so much more important than the one hit wonders. Much like a playlist we can see the team has come together because the progression of the experience has started to make us all smile. That sounds odd I know, but the team meeting is now an experience of support and constructive challenge where it doesn’t matter if it is one of the complex projects being discussed or an issue in business as usual the team can and will pull together over it. And this has to be a credit to each individual moving part.
The next few months are full of excitement that’s for sure, the eHealth Festival in a few weeks will see the application of a wider musical theme as we work with partners to deliver the first technology in health conference with a theme based around a musical festival, some have suggested we must be a little bit crazy to try to do this, but, I have always believed it is about the story telling and if we can get that right then people will engage.
In the last few days it has become clear to me that we haven’t taken all of the staff on a journey, yet! But I want to keep making the compilation tapes and try and get that right! Everyone has a theme song I think, and part of my challenge as a business leader first and CIO second is to discover the theme song for each person…
…. Make it easier for me, leave your theme song in the comments below and lets create a mix tape for eHealth in Ireland!
And in the immortal words of the man himself, “Dearly beloved we are gathered here today to get through this thing called life… “ A rallying call, lets do more than get through this thing called life, lets become a single compilation tape of excellence.
Originally written for and published by Horizon Business Innovation
The role of CIO is more and more about leading a team, and a team of diverse skills and capabilities at that. Healthcare CIOs are used to the term multidisciplinary team, it is intrinsic to integrated care delivery one of the key benefits of technology in healthcare, however the term can equally be applied to a team of IT professionals.
Leading a group of professionals with diverse backgrounds, motivators, knowledge and skill is one of the most important aspects of the CIO role I think. In December 2014 I was lucky to be given the opportunity to lead the digital healthcare function in Ireland. I inherited a team of around 290 directly employed staff and around 300 indirectly employed. As a team it was a group of people who cared passionately about the capacity, capability and function of IT at local levels but had not come together as a single function for many years.
One of the first tasks of the new role then was to bring together these local teams and build ownership of a national vision, a new operating model. By March 2015 the senior management team were able to unveil the route to the new operating model and begin transition, this was marked by the first ever all staff meeting. Bringing together all staff from across the country seemed like a simple but ambitious thing to do, particularly as the team had not done this ever before. The conversations for the day needed to be inspirational and we needed to use the team to make clear not just the new operating model but also the benefits of this. Bringing clinicians to the stage was the best way of doing this at this early stage and certainly the organisations national director for integrated care had the audience really understanding why the new operating model was necessary. The same event was also used to spark an interest in new technology with an Expo type area demoing diverse sets of technology from face recognition to drone tech to wearables.
By September of 2015 the route to a transitioned organisation had been completed, but in reality at this stage the most of what had happened had been a movement of the deck chairs on the deck of the big ship. Everyone now understood their new role but few people had moved to actually doing the new role. This led to the second all staff meeting being put in place, this time not just for staff directly employed but for all people working in healthcare technology across the country. The theme of the second meeting would be transformation and both the Director General and Secretary General of the Department of Health were able to open and close the event. The theme of transformation was illustrated by a number of conversations ranging from the new CIO of a major bank in Ireland talking about technology teams to the futurist view of a technology communicator and broadcaster. The engagement and enthusiasm created in the room was phenomenal and for the first time technology people in health were given ‘permission’ to go forward and innovate, to make mistakes on the way and to be more agile. The transformation process was really given a tremendous kick towards success.
So with transformation now underway it became clear that the engagement of the team throughout the country at a personal level would be of the utmost importance. With this in mind we altered the structure of the Senior Management Team Meetings making them fortnightly and moving them around the country so that as a team we were both visible and available to the organisation. We have a theory that if we can make the senior management team more accessible and more transparent in what it is trying to achieve then we will be able to take the team on the journey with us more easily, transformation to the new operating model was not going to be achieved overnight.
Motivation of a team that has delivered through the adversity of a huge financial downturn and crippling underinvestment in technology and personal development was never going to be straight forward. Meeting staff face to face and delivering open and transparent messages was to be a clear way to try to deliver for the team. Considering Maslow’s hierarchy of needs seemed to be a validation of the effort that needed to be applied. Taking an idea developed and evolved since the 1940’s and then applying this to a team of people in 2016 seemed uncomfortable at first but it has brought rewards and provided a framework for the change we need to make. Certainly we now feel we are trying to deliver on the top three elements of the hierarchy, provide belonging and reason, create an environment where staff can assert their own esteem and finally enable the process of self-actualisation to take place.
The use of social media as an engagement tool is not everyone’s ‘cup of tea’ (maybe that should be pint of Guinness after all I am in Ireland now not Yorkshire). For the very first all staff meeting we created a hashtag to be used internally for all team engagement, #ONEeHI. The SMT and speakers were asked and cajoled to engage on twitter using the hashtag and slowly but surely the identity of all engagement has moved to the hashtag, the latest all staff meeting has even simply become known as the hashtag itself. As we strive for the level of engagement and transparency that we need though we have been able to use social media to make each of the team real to those that want to engage in this way. Social media is not used ‘simply’ for these events but throughout the year as a way to ask questions at any time, as a way to see what thinking is happening where in the team and to simply make real the people that are involved in the changes.
We are a healthcare IT function and one of the next stages of the transformation was to begin the process of real clinical engagement at all levels. As a CIO and CEO of a health technology function I strongly believe that once the transformation has moved us to a platform that we can deliver upon more of what we do needs to be clinically led. So with this in mind as well as creating the single digital function for health we also started to create a clinical engagement function that became known as a Chief Clinical Information Officers council. We also appointed the lead role of this function to SMT to bring us the clinical diversity as part of the leadership team a decision that is bringing huge rewards to how the team functions and delivers.
With this in place and a promise in 2016 of bringing around 50 new resources into the team the next all staff meeting was in early March of this year. Over 300 people descended on Cork to hear conversations about connectivity, the need for us to make connections across the team to ensure that transformation really did become the way in which we worked. The first thing I had to do though was to apologise, we had made promises around new roles back at the September session that we had missed dates on which was a huge shame however being transparent and open around the process to get these roles into the team certainly gained us a level of understanding and engagement that we really needed. Again the Secretary General and Director General opened and closed the event with clear and exciting statements of support for what technology was doing in health and Director General urged the team to celebrate its success but be mindful that success brings more expectation, a powerful statement for a leader of such stature to make to the wider team.
The experience of physically bringing the team together in the days where technology connections are so powerful is still one I strongly believe has been hugely influential in the success of our transition and transformation. We have also used the technology available to make real connections through blogs, web-ex, podcasts, video, social media and animations but nothing has been more powerful than a room full of people who are enjoying the connectivity they are having so much that they are not even aware that lunch is being served and its time to go eat!
If you want to know more about the events have a look at the social media #ONEeHI or consider having a read of the three blogs that have been created ahead of each event at richardcorbridge.com or simply get in touch maybe even see if you can sneak in at the back of the next event in Galway in September!
In healthcare we have landed on the moon many times with small steps for man and giant leaps for mankind. Data is the next big Neil Armstrong moment for healthcare!
In 1853, Florence Nightingale started what we know today as the modern profession of nursing. Interestingly she also helped popularise the graphical presentation of statistical data. Was this the initial lunar landing for data in healthcare?
In 1895, Wilhelm Rontgen’s invention of the x-ray made a giant leap forward in the history of medicine. For the first time ever, the inner workings of the body could be made visible without having to cut into the flesh of a patient.
Another 40 years on in the late 1920s, Penicillin was discovered by Scottish scientist Alexander Fleming, revolutionising the medical treatment of infections.
If one were to ask Christian Bernard or Louis Washkansky, a 54-year-old grocer, suffering from diabetes and incurable heart disease if this 40 year cycle of giant leaps in healthcare are anything to go by and you will get a resounding yes. After all Bernard was to revolutionise the clinical consideration of the art of possible with the first ever heart transplant which benefited Mr. Washkansky who bravely stepped up as the first recipient in the world.
Bringing modern computing into the 40 year cycle of healthcare has been more of a challenge it would seem; advances in the home PC were transformational during the 80’s and 90’s in the way we live our lives and transact our work and yet are still heading towards that same exponential change for healthcare.
40 years on brings us to today [and the next few years]. We are ready for the next small step for man and giant leap in healthcare. In today’s modern healthcare system we continue to have incremental improvements and technological advances that have measurable benefits to society, bringing us into a healthier state. But it is data and its use that will bring about the next giant leap forward.
The use of data is on the brink of taking electronic medical records, genetic information, and wearable data and transforming it into information that will support decision making and the development of new technologies that will change the way we care for our patients.
Here in Ireland we speak about our ‘grand ambition’ to allow the patient to truly control their health data by 2020.
Subra Suresh, president of Carnegie Mellon University, says with the use of information and data; “we will move from reactive care to immediate, proactive prevention and remediation, from experience-based medicine to evidence-based medicine, and to augment disease-centred models with patient-centred models.”
Imagine a time when a graduate doctor will not only have the six years medical training and their immediate supervisor’s knowledge at their disposal to treat a patient but the capabilities from millions of lines of data to support diagnostic decision making, the art of the possible with the phenomenon we call cognitive computing. The transformation of the data to information will provide suggested diagnosis based on test results, information gleaned from the patient but may also prompt further questions or tests that might aid in a refined diagnosis.
Imagine a time where a patient can provide a full medical history to any healthcare practitioner across the globe by simply allowing access to their health record stored in the cloud. Where a patient can see who has viewed and added to their record anywhere and at any time.
We don’t need to imagine these scenarios, early adopters are already realising the bright future data is providing in healthcare.
Kaiser Permanente has fully implemented a new computer system, HealthConnect, to ensure data exchange across all medical facilities and promote the use of electronic health records. The integrated system has improved outcomes in cardiovascular disease and achieved an estimated $1 billion in savings from reduced consultations and lab tests.
Blue Shield of California, in partnership with NantHealth, is improving healthcare delivery and patient outcomes by developing an integrated technology system that will allow doctors, hospitals, and health planers to deliver evidence-based care that is more coordinated and personalised. This will help improve performance in a number of areas, including prevention and care coordination. (The big-data revolution in US health care: Accelerating value and innovation Basel Kayyali and David Knott. http://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/the-big-data-revolution-in-us-health-care )
The future is bright and the future of healthcare is data. The future of patient care in Ireland is certainly bright as we develop Information Services and the eHealthIreland structures to truly turn data in the system into information that can, with care be used to change the way in which care is delivered to the patient and the population of Ireland.
So there we were, three lads at the back of Mr. Carter’s British History class, Richard H, Richard C (me) and Gary. This was going to be a two year support friendship to ensure we passed a GCSE that to me was important as at that stage in my life I thought I was going to be a teacher, and a teacher of history to younger kids no less!
What was odd then is the debate that would start once a week about which band was best, Richard H was U2 (Cheering at the back I assume), Gary was Queen and I was Simple Minds. The back cover of our History books at the age of 15 would have the co-joined S and M for Simple Minds on mine, a crudely drawn Claddagh was on Richard H’s and poor Gary had to make do with trying to draw the iconic Freddie pointing to the sky from Live Aid.
The quiet debate when we were supposed to be doing small group work on whether the Archduke Franz Ferdinand’s assassination had caused world war one would often turn to which band was best, and which would stand the test of time.
Bands could transition but could they transform.
Our team comes together today (17th of September) for the second time in 2015. The key themes are the completion of our organisational transition and the move to a transformed organisation, as well as an exciting look at the art of the technologically possible in healthcare.
So what lessons can we learn from Bono, Jim and Freddie and the debate that we had on the back row of History class?
Transition is the easier of the two tasks that ensure a reformed approach to IT delivery is in place. Transition can be as simple as moving the ‘deck chairs’ on the ship deck, but truly transforming the way the team delivers requires a whole lot more. I have to now concede to Richard H, U2 are the only one of the three bands that has stood the test of time and transformed themselves time and time again. How has Bono, the Edge and the other two pulled that off, where Jim in particular simply didn’t? By looking at the whole picture I would suggest U2 have understood the change in taste, adapted and continued to deliver. They have understood how technology impacts on what they do and have embraced it, gaining the benefit and only rarely getting it wrong, and when they do get it wrong, correcting the mistakes and continuing to transform.
What is the goal of transformation? For me, first and foremost it is to create enthusiasm. If you think of the elements as an equation:
Transition/Transformation X Development = Enthusiasm
I guess we can say the square root of this equation is improved delivery capability! We now embark on transformation though in reality.
The new teams are in place and the route through those teams to ensure safe and agile delivery is mostly designed. The challenge we now face is how to move from our very own Rattle and Hum stage to Achtung Baby and onwards, and the journey we need to take our fans on with us.
The journey as always is grounded in the concept of not breaking anything on the way. This has been written in red marker on our transition plan since January of this year, and we know it is a challenge. In the reforming of a team with such a significant responsibility as well as new important and innovative tasks to complete, it is clear we have to protect the service we have put in place. Unlike U2, we can’t afford the controversy and perhaps publicly perceived failure of Songs of Innocence.
The protection from this then is our new Service Management function. Much is written about the function of service management in the delivery of technology. When the NHS embarked upon its huge transformational National Programme for IT it invested heavily in service management before the first system even went live. A criticism from the delivery team inside this programme was often that the service delivery function did anything but deliver, and we must be mindful of learning from this, creating a relationship that facilitates interaction between the programme functions and service management that will not only support delivery but drive it forward.
My own ambition is to perhaps to take the best of Queen, Simple Minds and U2 and create a new super group. The super group will have the drama, captivation and live capability of Queen, the brutal honesty and life lessons of Simple Minds and the ambition, creativity and intelligence of U2.
If Simple Minds could start life as Johnny and the Self Abusers and U2 came together first as The Hype then I am certain it will be acceptable for us to initially come together as HSE IT then transform in to eHealth Ireland with a new culture created, not by the positioning of a new name in a new font but by a vision, plan and the enthusiasm of a great set of band members!
We are still creating that fan base of what we do after all, and transformation is a tool for keeping an audience interested, but at some point the transition has to reach its culmination and the delivery of the product needs to be complete. At this point we need an answer to a key question that the record companies of our three analogy setting bands must often ask, “What next?”.
The delivery of technology into health needs to be less about technology and more about business change. We talk a great talk on the subject of business ownership of projects. I have said as CIO that I do not want us to own any projects by 2020 and that we should not even be seen as anything other than a function of healthcare delivery in Ireland by this time. That then gives us a raison d’etre for transformation:
‘Commodity providers to business change champions’
This then becomes the super group’s album title!
The three of us at the back of history never did settle the debate. I would hazard a guess if we came together again now we would probably allow nostalgia to colour history and empower us to think that at a snap shot in time we were the ones that were right. I do know all three of us moved on. As tastes changed, evolved and transformation of what we needed occurred then we looked for different solutions.
If we define success in any way through, it is what the fans want, and U2 still can sell out any tour anywhere in the world in minutes. I hope everyone who needed a ticket got one for November’s excitement here in Dublin!