The Long View is a Radio Four programme hosted by Jonathan Freedland where he uses stories from the past to increase understanding of current affairs and events. At Rewired tomorrow (25th of March) we are reusing some of the format, bringing heroes of past digital healthcare to the stage to shed a light on the lessons we can learn from the past and ensure we stop making the same mistakes time and time again. Why do we study history? I remember a teacher once saying to me, of course the answer was to do things better in the future!
Are we looking at heroes of digital as an example of the changes in the digital market place for health care today? If we are maybe it’s not an Alan Turing type hero we need (full genius style) but in-fact a mind more akin to Professor Richard Feynman, his famous four productivity strategies included;
The Feynman way of working may be the best approach for leadership in the digital health and care arena that we could adopt.
“The only way to deep happiness is to do something you love to the best of your ability.”
And the heroes of digital health that take to the stage with me tomorrow are the embodiment of that quote. Professor Gwyn Thomas, Andy Williams and Beverley Bryant all overachieved (and continue to be huge parts of) the grand digital healthcare plan. They also applied the Feynman further principles of trusting in knowledge through teaching and taking others on a journey with them and trusting in people as friends and colleagues, not as competitors and antagonists.
Trying to shape the face of the next hero of digital health care is a challenge. We could try to use the Hasbro game Guess Who to create the ‘picture’ of the new hero we all need to step up to the front. Does it feel like the change is just about to come over the hill though with NHS X and a minister and team that seem to ‘get it’ so maybe we don’t need a Guess Who, more a guess how!
Although a hill that today has hidden Brexit shaped traps that could scupper all of our ideas and plans. We need that Long View vision of the future enabled by the lessons of the past to truly give us the blueprint we strive for. When we came up with the game we had a long list of the digital heroes of the past that we wanted on stage, Richard Grainger, Katie Davies, Nigel Bell, Gordon Hextall and Tim Kelsey all made that long list, but hero is a strong word and not everyone could agree to be on stage described as a hero.
“… but we’ve always done it like that!”
In Ireland, as Chief Information Officer I pushed hard for the removal of the culture of not trying something new. I even asked that the council of Chief Clinical Information Officers adopt the famous quote from US Navy Rear Admiral Grace Murray Hopper’s as their vision statement in year one,
“The most dangerous phrase in the English language; we’ve always done it that way!” became a way of trying every day to change the paradigm, a way of simply pushing harder to do something differently, sometimes simply because it is different it worked.
Looking to the past does not mean do it like that again, it means consider what happened, learn what needed to be done to get it right and avoid the mistakes that were made. We are rightly so concentrating on blueprinting the success at the moment, we do need to be careful not create one size will automatically fit all environment. My heroes of the past in digital and business didn’t simply take the blueprint and press copy, they tried hard to reapply with the lessons they learnt and make sure others could see how to apply and learn next.
My heroes from my reality today include; Tony O’Brien for his calm considered leadership. Jonathan Sheffield for his vision and steadfast refusal to take second best. Russ Branzell for demonstrating compassion as a leadership trait in the face of global influence. Kevin Holland for showing that expertise is a leadership trait best served shared. Gwyn Thomas for delivering the most inclusive organisational change a person could experience. Carrie Armitage for ensuring that the team around the leader is the most important. Phil Randles for never guarding his knowledge. Rachel Dunscombe for being all of our Messi. Andy Kinnear for leading us from the dark ages to the light. Molly Gilmartin for bringing an approach to innovation that others are just too frightened of. Gary Venchuk for teaching me when to swear appropriately. Ted Rubin for inspiring magical thinking on reputational importance. Amy Freeman for taking knowledge and constantly learning more with a goal of doing better. Sarah Moorhead for caring so much about the next person in the queue and frantically finding a way to take them with her. Dan and Chip Heath for delivering the most amazing stories and Frank Buyendijk for being my own stage presence inspiration.
Then I consider the Leeds team I am part of now and know as I look around we have a group of people that embody the long view in everything they do, a Chief Executive, an Exec, a Chair a team of digital professionals like none I have been able to work with before supporting a clinical team who learn lessons and apply them every day and can and will deliver with the patient at the centre of every moment of the day.
Heroes from a different reality and how the impact on our style is interesting as we head to London for two days of being Rewired. Seeing old faces is always a new inspiration and that’s whether we are laughing together in a social environment or listening intently to the latest story Rewired will bring us together for the first time in 2019 as a group of professionals who know how to do this, we just need to collectively move the blockers out of the way. The nations CCIO Dr Simon Eccles will undoubtedly remind us why we need to do this and why we need to do it in a better way, no jam for tomorrow but the reality of today.
Heroes of tomorrow, aspirational people who we know we can follow, stand up at Rewired and be counted because inspiring the next generation should be all of our most important job!
We could be heroes, just for one day, (or maybe at least the two days of Rewired)!
What is one of the most wicked problems in large organisations seriously adopting digital today? Many digital leaders would say it’s the challenge that Grey IT brings, and then some board members would turn to them and say what is Grey IT?
Digital functions the world over have adopted a multitude of phrases to describe a core issue that manifests in many ways and for many reasons. Grey IT is ultimately the organisation voting with its feet (or its projects) and buying and implementing technology without going through any digital function or digital governance. It’s a problem with its genesis in technology teams not meeting customer demands and the consumerisation of technology. There is an element of being careful what you wish for. In the 1990s technology leaders bemoaned their business functions for not being engaged in digital transformation, often the National Programme for IT and its perceived ‘failure’ within the NHS is accredited to the lack of business engagement; and now here we are a decade later complaining that the business is so engaged in digital solutions that they can deliver this stuff without digital teams getting involved.
The management training catch phrase of the 1980s, “Don’t bring my problems bring me solutions” needs to be turned on its head, when the business has an issue the ask now needs to be; “Come to me with your problem and lets together come to a solution for it.” This will be a first step to avoiding the Grey IT issue getting any worse, but once instigated the digital function now needs to be able to react to all the issues that are brought to the door, quickly, and in an agile manner that truly delivers on defined customer needs.
I propose that Grey IT is often so rife in large public-sector organisations because of two key reasons; a capacity to keep up with the now consumerised technology delivery that is possible and an often-backward view of innovation that comes from the business by digital professionals. The expectation that digital innovation can only come from those within technology rather than those at the cutting edge of business delivery has to be reconsidered by us, the digital leadership of any organisation! Sometimes the customer does truly know best!
We must combat these two root causes of this if we are to remove the negative outcomes of Grey IT’s existence. Technology outside of a decent governance capability is ultimately dangerous for business and healthcare delivery in particular. Grey IT does just that, delivers a layer of technology that does not have any governance to it. The real manifestation of Grey IT in the NHS today is often seen 12 months after the initial project go live, when the bill for the second year of the licence arrives or the need to upgrade becomes obvious and the technology professionals are called to assist. Worse still Grey IT becomes clear the day the system built, supported, procured and run outside of IT doesn’t work anymore, suddenly Grey IT falls back to its base colours, black and white, whose problem is it and who is going to fix it!
My organisation has been on the receiving end of one of the worst outcomes of Grey IT, many years ago we suffered a significant outage in the digital systems that were used in the Pathology Lab. Whilst the solution had been bought through a governed and appropriate manner it had not been taken into the technology team within the trust it had been developed, evolved and supported by keen and enthusiastic users, but a workforce that had moved on, had a higher priority (patient care) or simply had forgotten how to do stuff was left supporting a solution that was on legacy infrastructure. So when a server went pop, a disc array went AWOL and a back-up was missing disaster struck. This is all stuff the good book ITIL teaches digital professionals to avoid, but once the grey mist has descended upon it even the good book couldn’t help! All that the technology team could do in this case was take control of the recovery and work hard to ensure that the right lessons had been learnt and applied to the future.
I think we are looking at a plethora of different types of Grey IT that all need a different solution; Feral IT, Guerrilla IT, Shadow IT and traditional Grey IT.
Feral IT for me starts as a digitally led project often a collaboration, an exciting chance for the digital team and the ‘business’ to work together to come up with a solution. It gains ground as it delivers benefit but slowly drifts away from good governance, often because the project is so successful. Over time though the project will grow and its delivery focus and the team will change, as that happens the digital governance of the organisation can break down and the project is then being delivered outside the parameters of good governance.
The key to making Feral IT work is to ensure that the governance of the project is grounded in the foundations of the digital agenda, organisations are often looking for agility and a start-up culture to enable innovation to happen, but innovation becomes scalable only when a rigour of governance is applied. As digital leaders we should try to encourage the agility that this type of project culture offers, but it is also our role to ensure that the foundations of decision making and corporate risk management are clearly understood. It is tricky in a new decade where digital is a consumerised product, building an understanding of why we the digital function of an organisation needs to be continually part of the decision making in this kind of project can only be achieved with the right style of engagement, one that at least can light a candle next to the consumer style digital capability now available to everyone.
Guerrilla IT is a phrase that best describes the technology project that has been actively hidden from an organisations digital team, a project that has wilfully been created outside of governance for so many possible reasons. Guerrilla warfare was a phrase first coined in 1808 to describe the Spanish resistance to Napoleon, Guerrilla IT is an identified need that a team has understood and has been unable to get help with the delivery of, at this point the business function decides to go ‘rogue’ and deliver it anyway.
In the NHS today Guerrilla IT exists for many reasons but I would suggest the key reason is an inability to make the national solutions that have been delivered work in the way that locality needs them to. When we have Guerrilla IT projects we need to understand why they exist, much of the reason will often be traceable back to the nature of the solution being sought by the business to the problem and the digital functions inability to react in a way that achieves the desired outcome. The use of WhatsApp in the NHS is possibly the best example of a Guerrilla IT project, organisations have been saying for more than five years that this platform should not really be used inside a healthcare environment, and yet every day that I am in Leeds I see and hear of staff using it in ways we have actively said it shouldn’t be used. Why, because it achieves a need, it is easy to use and it’s a consumer product, and in reality, alternatives to its use are very new to the digital fabric of healthcare. The same could be said for ERS, there is a desperate need fro the NHS wide booking system to offer a ‘many to many’ booking capability, hospitals refer to hospitals! And yet it doesn’t and therefore department after department has its own growing digital solution to enable the digital transfer of information about patients moving from hospital to hospital, we have to fix this!
Shadow IT manifests often from the digital team, when disagreement exists in strategic direction, standards to be adopted or simply in the procurement of a system. Digital professionals can be a real pain, we all know best, we all know our subject matter and sometimes this can boil over into a Shadow IT project. A project that is delivered against the wishes of the governed decision and with an intention to compete with a decision made. Shadow IT will often be kicked off with good intentions; a project just in case the agreed and governed solution misses a deadline or as a risk mitigation to functionality delivery, but sometimes the project is started because it is a ‘pet project’ of a leader of the organisation, digital or otherwise. Shadow IT can be a useful mitigation to risk, but needs the same level of governance, risk management and rigour applied, it needs to be managed as a project that has goal of being there just in case and should not be tolerated as a vanity project because someone with the digital function is unhappy with a technology decision that has been taken.
Grey IT becomes the collective term for these issues, all shades of grey, successful in some ways in delivering user defined need but with risks to the business that need to be quantified and mitigated against. Removing Grey IT has already become one of the wicked problems, maybe we should accept that we can’t remove Grey IT from what we do, but we should look to understand where it is, why it is and what the risks are to us. There is also an element now of learning from the collective Grey IT projects and understanding better how to avoid them starting up, and that I think is about understanding the investment decisions that are required to initiate a digital project and the engagement needed to enlighten everyone in decisions being taken.
Investment and the return it brings has to be part of the equation in the answer to the ever-present Grey IT problem. Investment in infrastructure for healthcare needs to have a digital element in the same way as the investment decision would call for electricity, heating and light. In 2015 KPMG Ireland called out the need for the fourth ‘utility’ for the building of the National Children’s hospital in Dublin to be digital, it wasn’t, and we now see a furore in the media as the whole digital backbone of a brand new hospital is going over budget because its digital element was expected by decision makers to be run as a Grey IT project. Misunderstanding or on purpose I am still not sure but I do know that the digital team across the project, the ‘centre’ and the department were clear that the hospital had to be a digital hospital and yet the return on that investment was not judged to be worthwhile capturing properly and openly, IT costs money, when will we learn!
We are asked to consider the Return on Investment (ROI) that digital makes when we build a case for spend, perhaps the key to removing the plight that is Grey IT from digital health care could be to start to consider a different set of terms more strongly, what if we considered the Value on Investment (VOI) instead? Let’s not pretend anymore that investment in digital in healthcare anywhere in the world will ever return money back to anyone’s budget, capacity and demand are so ‘topsey turvey’ right now that no amount of digital innovation will return investment, what it will do though is increase efficiency to bring us closer to the demand need, increase quality to bring us closer to the required need and bring a new interest back to the daily roles to deliver a new enthusiasm for what we do. If we all consider the VOI together then just maybe no one would want to set up their own little Grey IT project anymore because we would all be heading towards the same increased value curve.
So we move from ROI to VOI and start to build the case for change in a different way, we still are missing a piece of the colourful puzzle that will be laid over the top of Grey IT though. Return on Reputation (ROR) was a phrase I first heard uttered by Ted Rubin a digital marketing expert and social media evangelist, Ted suggests that the way to building reputation is by building the network of believers and doing this by being ‘nice’. Quite an American ‘thing’ to want to do I guess but there is something in this I think. Digital functions all over the NHS have not adopted any form of ‘Del Monte’ attitude, we are quick to say no, we are quick to say get in line we have a prioritisation process you know! When we do this without listening, we do two things, we set the preference for our customers to understand that its quicker to ‘go elsewhere’ and that we are not part of the team, we are ‘another’ corporate function, maybe even an overhead, with our own benefit blocking agenda. If we adopt Ted’s principles then we should be more open to listen, more transparent in what we will do once we have listened and allow the ‘business’ to work with us to decide what to do first, second and third. The return we would all then get from this is an improvement in the reputation we have.
Grey IT is here now and no matter how big your One IT (insert other corporate programme name here!) is that you are instigating to remove it you won’t without attitude and aptitude change in the digital functions of healthcare. Change is hard to make happen but we have to make it happen, as a journey we are on not as a demand dictated to the system we can become one transformation function for the NHS.
Bring out the problems, let’s work together to create new ideas to solve them and then lets seek the right way of describing the investment and the way we are all going to deliver this together, let’s create joint solutions to problems we consider to be joint as well.
Somehow let’s make digital first be a way of working together that is about innovating for the future not simply concentrating on tomorrow.
NB If you ever see Ted Rubin on an agenda at an event you are at, go and see him speak, one of the most inspiring speakers I have ever had the joy of seeing, he changed my outlook and I still quote him years later, ‘just be nice!’
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…
Twice a year I have the great honour of being able to bring the eHealth Ireland team together to spend a day thinking. No, really thinking!
The team spend every working moment executing and delivering, to grow our influence and ensure the needs of the healthcare system are met. To create connections the team needs time to think. Being allowed to not concentrate on just the execution for a short period of time, to consider approaches, to build knowledge and absolutely most importantly to create connections, is essential to the success of my organisation.
The theme for the event in the spring is connectivity, if you hadn’t guessed already! In the very wise words of those denim clad rascals from the late 90s the Stereo MCs,
“I’m gonna get myself, I’m gonna get myself, I’m gonna get myself connected”
How to win friends and influence people by Dan Carnegie was written in 1936, and yet Ted Rubin a man who I think is the most influential social media marketer in the world today describes this as the most important book in modern digital business, why, because it truly describes what a connection is! Dan Carnegie describes how to connect with a 100 people in a successful career, we now look to connect with a 100 people a day to grow our community of influence, and yet, Carnegie’s book is still applicable to the strategy, tactics and benefits of doing this.
Wherever you are right now look around you. Stop what you are doing and take a look, how many connections are within your glance? In a world where we talk about the connected patient and connected healthcare delivery have we really considered how connected the delivery agents of eHealth need to be. The country of my residence is described by many as the most socially connected country in the world, in the words of Kevin Bacon,
“I know a man, who knows a man, who knows a man, who knows a man….”
eHealth Ireland and the wider team are coming together to explore how this connectivity can bring value to all that we do. Knowing a man who knows a man means we have access to a wealth of knowledge that far out paces individual experiences. Imagine the connections in a team of 300 people, the community of reach that can be achieved by empowering personal connections.
We are technologists on the most part and therefore connectivity and networks can have a dual meaning. Often the technology definition will rise to the top of this, and yet we are coming together as a team to create a community. The great Ted Rubin mentioned above defines the difference so eloquently,
Network = Personal Reach
Community = Reputation and Responsibility
He has created a great story around how a community can change the default narrative to the point where we stop discussing Return on Investment (ROI) and start talking about Return on Relationship, he has even launched a successful hash tag (#RonR)around this, he asks followers to stop worrying about what’s next and start executing on what’s now.
He poses that a connection is made from reputation, and the width and consistency of that network is what will lead to the creation of a community. eHealth Ireland has a delivery agenda defined through to 2020. This agenda can flex based upon the benefits that patients in our community feel they need to see available to them and through a clinical feedback connection put in place by the Chief Clinical Information Officers council. The team responsible for the delivery though is growing and now needs to truly come together as a community of interest, another IT term repurposed for the development of the team.
Connections and the age of influence is where we now head as an organisation, weekly someone will stop me in my tracks and exclaim that they have not heard of eHealth Ireland, what we are building or how is the team structured, this just when we think we have got this connectivity thing sorted and that communications is something we are good at. Even our own committee has asked that between now and June we consider more creative ways of connecting with the public of Ireland to get the message across.
How to get this right though seems to come back to the personality of connections. On a recent flight to London something strange happened. The City Jet Captain came to see the passengers before take-off in person, he came out to say happy Saturday and welcome aboard, simply put he came to make a personal connection.
How does that make you feel, certainly more valued as a customer, this wasn’t a by rote learnt speech it was his attempt to make us all realise we are all human and the interaction between customer and company should be a real connection built upon trust. Interestingly the flight was delayed on the tarmac and yet as a customer I felt that my new ‘connection’ would be working hard to get us off the ground on time.
The ability to nurture the relationships we have as colleagues is not always easy. We are scattered around the country and have a ‘day job’ to deliver upon. And yet the return on relationships for the organisation is formidable. Take the recent #IrishMed hour on twitter, whilst not a personal face to face connection a truly inspirational and very frantic hour as hundreds of patients and clinicians from across the globe came together to advise and pass opinions on how Ireland should implement an EHR. Over four million impressions in one hour over twitter against just four key questions was the highest rating yet for #IrishMed hour. The connections though that this began to build were the real outcome, not the volume and numbers of tweets. The relationship with IPPOSI through the co-hosting of the twitter chat is now a ‘friendship’ between two organisations.
Clicking a button and following a person is not creating a connection. As citizens of the internet we need to take back the word Friend from social media and consider how we make this word work for connections we need to make, how do we do this, through building trust? As a leader I have always valued accessibility, openness and transparency particularly. I have always wanted to connect with my team at a level that allows us to work together against an agreed an agenda. Its not always straight forward to make this happen but as a leader I am trying. Certainly events like the #ONEeHI event allow us to make these connections that we value so much
A community is defined by the relationships created I think, any IT delivery function has to have clearly defined hand over points between departments to be successful, I pose to the team at the next meeting that the silos that exist in our organisation can be broken down through the creation of a community.
The success of clinical research in the NHS in England has been built upon the concept of networks and connections for many years, even the organisational name reflects this, Clinical Research Network. The careful removal of command and control functions from wider organisation took time, but eventually the organisation has earned its autonomy and is a network of resources with the same goal but against different therapeutic specialities. As a vision to aspire to this works well, the idea of earned autonomy proliferates through the new health structures of Ireland too, and as we now move away from a geography based delivery function towards national support and delivery functions the concept of earning autonomy can apply even more so, after all we want that engagement and inventive nature of each and every member of staff rather than a command and control automation.
Peer to peer relationships across functions become learning sets and sharing sets. A supportive function has to be the goal of our transformation programme. We have an operating model that we all agree on, we don’t yet have the full complement of resource to achieve this but we do have a chance to begin the journey.
The biggest hope and wish though is that the eHealth Ireland team does really become a connected team and at the first all staff meeting of the year everyone feels empowered to make the connection they need to.