CIO50 2020 #19: Stella Ward, Canterbury District Health Board and West Coast District Health Board
“My team has worked on projects that have been designed from the start to be scalable and others that were purpose-built as regional applications – and the lesson has always been the same,” says Stella Ward, Chief Digital Officer at the Canterbury DHB and West Coast DHB.
“If you start by designing a solution from a technical perspective, however good your solution, it’s pretty much doomed to fail or at the very least, it’ll meet resistance every step of the way.”
“Health is, and always will be about people” says Ward. “Start with the people and find out what they need and why they need it – and use that time to build trust and those conversations to build relationships.
“It’s vital to involve people every step of the way – from scoping, to design, to test environment, through product refinement and on to production.”
A recent example of this at Canterbury DHB was the rollout of the Outpatient Scheduling Tool that supports planning and resourcing of Outpatient Clinics.
This involved an agile project methodology and was a product build based on what the users needed and tested until they were happy with the minimum viable project, before going into full production. This tool is now used to support around 500,000 clinics, says Ward.
Another example is the max HR self-service portal. Ward says max has taken the innovation previously used in caring for patients and deployed this to care for employees.
“Technology is used to take admin heavy tasks and automate them, freeing our people up to focus on what value they can add,” says Ward.
In 18 months, the Canterbury DHB has delivered 41 digital services ranging from simple to complex such as recruitment and onboarding. “We’ve completely reinvented our HR operating model to reflect the new work and value we need to deliver,” says Ward.
She says technology has also transformed the way their Orderlies operate. Orderly Mobile sees Orderlies armed with mobile devices, enabling them to accept, respond to and fulfil work requests on the go. This means our staff can now make requests for orderly services online and orderlies receive and complete tasks which are tracked on a smart phone app, she states. This app has delegated close to a quarter of a million tasks in the first year.
Paper-lite initiatives achieved by using hand-held devices are also being adopted by Doctors, Nurses and Allied Health staff. Canterbury DHB in partnership with Sense Medical developed the Cortex app which provides digital progress notes accessible from point-of-care devices (iPads) so that the care team has immediate access to accurate information about patients. The application provides clinical notes, team and individual task management, and direct access to test results. Stella says the rate of uptake has risen rapidly as the users start to realise the benefits, with the number of Cortex notes created doubling to 16,000 per week in the five months to February 2020.
Canterbury DHB has also trialled technology to help patients communicate with their care teams, through a pilot using DeloitteASSIST. This voice activated patient call button ‘hears’ and processes a patient’s voice command, automatically prioritises requests and relays them to a tablet in the nurses’ station. Ward says this pilot was one great example of how we work partnership across the organisation to make work better for our people so they can focus on caring for our patients. “We know that when work works better, care works better” remarks Stella.
Taking advantage of emerging technologies to drive innovation and deliver value is a strong theme at Canterbury DHB Ward says. A key anchor deliverable reflecting this direction is the rollout of Canterbury DHBs Cloud Transformation Journey. This will make our computer services faster, more secure and more reliable while reducing IT operating costs long term.
Canterbury DHB is underway with moving data, applications and other business elements to the cloud. The first application interRAI, used to assess an older person’s care needs, has been migrated and is now operating as a cloud-based application. The DHB hosts interRAI for about 4,000 users spanning the South Island, four Northern Region DHBs (Northland, Waitematā, Auckland and Counties Manukau) and for all the residential care facilities and healthcare providers in those regions.
“We have also been going through an operational transformation as part of our Cloud Business Office and, as such, building capability in ‘everything as code’, DevOps and Agile”, she says.
Working together to make care work better
Ward credits the Executive Team at the Canterbury DHB and the West Coast DHBs for their commitment to the long-standing vision of an integrated health system, with the patient at the centre.
“That vision is firmly embedded in our culture of clinically-led innovation,” she says.
“I work closely with my colleagues on the Transalpine Executive Team to ensure we have a good shared understanding of the organisations’ priorities and deliver solutions in partnership that meet those needs,” she states.
“As part of this I’ve been working on finding the best balance between resourcing what we need now and developing new digital tools to improve efficiency and business outcomes.”
“I can then in turn share these with my Team so that what we do delivers the most benefit to patients and our people and finds the right balance between resourcing everyday applications, and innovation.”
Ward had worked as a speech language therapist and then moved to technology deployments before taking on executive roles in the health sciences sector.
“With my clinical background and my affinity with technology as an enabler, I feel I can relate well to the users of technology, as well as the teams who can make it work for them,” she states.