Perhaps the most striking thing about Sabrina Walsh's achievements at Queensland Health is that her chief information officer role there was her first job in IT. Most CIOs work their way up through the ranks of their IT departments to get to the top, but Walsh took an alternative path. Originally trained as a psychologist, she worked in Queensland Health for a number of years and ended up managing hospitals and health districts rather than following the clinical path.
When the departmental CIO role came up in 2004 she jumped at the opportunity to take control of an IT function that needed a firm guiding hand.
"I'd sponsored several very significant IT projects in the past," she says. "I guess it was becoming evident that if Queensland Health was going to progress with its reform and improve its services, as all health services have to do, the information side of it really needed to be addressed.I thought that was a reasonable challenge to take on."
Reasonable might be an understatement. Walsh acknowledges the department's IT function had some problems, with information managed by several divisions. "It was very fragmented," she says.
The department was also struggling with a long-running upgrade to public hospital patient management and clinical software systems. That upgrade, begun in 1999 and with software provided by vendor TrakHealth, was bogged down in problems and had already cost tens of millions of dollars.
Walsh herself had the IT industry's own brand of black magic to deal with, grappling with technical terms that at times can seem designed to confuse outsiders. "I was on a very steep learning curve, there's no doubt about that," she says.
However, she says this particular problem is not uncommon in management roles in general. She attacked it head-on by putting a very capable team around her.
"I used to say to people when I was a hospital CEO that I didn't know how to do surgery, but I did know and have respect for all the people that did do all the different jobs," she says.
"In a sense, in IT it's a bit the same. It's a team effort. The CIO role is a leadership role, but at the end of the day it's the team that gets you there. My team could explain to me what I needed to know very quickly, and I put a lot of effort into trying to learn what I could as well."
Three years down the track, Queensland Health's IT function is very different.
Walsh resigned from the department in late June, concluding what she describes as her stint in a tough gig. Her permanent replacement, high-profile Queensland Transport CIO Paul Summergreene, took up his new position on November 19.
However Walsh, who is combining some consulting work with renovating her home, has left her successors what could be described as a much cleaner house.
About 18 months ago she achieved her first major goal: The transformation of technology service delivery within the department, a project which brought 1000 staff into a new organisational structure.
More recently she was successful in obtaining significant funding to support a major five- to seven-year e-health strategy that the department had developed with the assistance of Deloitte Touche Tohmatsu.
While Queensland Health was allocated $150 million in the state's budget in mid-2007 to fund technology initiatives in 2007-08, Walsh says that in effect the department would have about $650 million to fund its long-term e-health strategy over the next four years.
In early August the department issued a major request for tenders for one or more commercial partners to help it develop new statewide e-health systems over the next five to seven years. This initiative was begun after Walsh made the hard decision to terminate the previous project driven by TrakHealth, despite the reality of legal action against the department.
Walsh attributes her success on the two major initiatives to different factors.
With the re-organisation of the department's technology service delivery model, she says it was important to have a clear vision of how the IT function needed to change and being very persistent about pushing that vision.
"Making big organisational changes is often not popular," she says. "Unions don't like it. Some of your customers don't like it.
"To some extent we had to centralise and standardise the IT services, and whenever you do that, some customers think they're not going to get as good a service as if they had their own little local IT group."
Walsh says she also brought in smart people with experience in other industries to assist. "I think an industry like health tends to be fairly internally focused," she says. "It thinks it has to solve things in a health way. I was interested to know what other industries did."
However, building the e-health strategy and attracting government funding for the initiative took different skills.
Walsh says she wanted to escape from the paradigm which often allocates funding on a per-project basis. She says that after an international study tour she realised that e-health projects were only succeeding in sites which had invested in them over 12 to 15 years. "It's not something that's going to happen overnight," she says.
Walsh's approach to the strategy doesn't mean giving up risk management and incremental steps for a big bang approach. But it does mean looking beyond simple projects to a more sophisticated, long-term approach that considers process, people and information management change alongside previously hyped silver-bullet style approaches that focus on vendor software solutions.
Crafting the strategy and attracting funds necessitated getting central government agencies on board, she says, as well as ignoring pressures from vendors and a demand to overpromise on a quick-fix solution.
The CIO says she found her background in health useful because many of her challenges related to the business and not purely to technology.
How did she manage to get all this done while keeping the lights on in the day-to-day running of the department's IT function? She says that she does have a Blackberry addiction but that the real productivity help she received came in the form of her personal assistant.
One positive outcome of Walsh's experience at Queensland Health is that it may help inform and guide the next generation of Australian CIOs. With other collaborators she is in the preliminary stages of planning a book about IT and health. It should make for required reading.
Career highlights
* Long-term career in Queensland Health in various CEO and other roles.
* December 2004: Appointed CIO.
* Secured funding for eHealth and ICT infrastructure strategies ($850m indicative investment plan over 5 years) to enable health reform.
* Completed a transformation program with initiatives to improve processes and technology.
* June 2007: Resigns from CIO position having reformed model of technology service delivery and initiated a new statewide e-health strategy.
© Fairfax Business Media
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