Counties Manukau Health’s strategic goal is to accelerate district-wide transformation to help its communities gain 300,000 healthy years of life by 2020. There are three interlocking Mission Statements for healthy whanau (families), healthy communities and healthy services.

“Reflecting these missions, we targeted future investments where they matter the most to our communities and will have the most beneficial outcomes across the patient and whanau,” says Sarah Thirlwall, director of strategic ICT transformation.

The Healthy Together Technology programme was established to lift the organisation’s digital capability with four core focus areas.

She says these are:

1. Stabilisation – Implementing a number of improvement projects to strengthen our existing infrastructure and networks and upgrade our core applications to supportable version. This gave staff a greater level of confidence in their IT systems with reduced outages and improved performance. The improvements also positioned the organisation well to respond to cyber attacks and phishing emails.

1. Digital Capability – Implementing new solutions to collect more of our information in a digital format. These solutions such as electronic ordering of Radiology procedures, electronic charting of patient vital signs, strengthen the quality of data collected as well as improve efficiencies through data integration, mobile device usage (tablets, computers on wheels, smartphones, free WiFi) and safety of clinical procedures through system generated prompts and calculations.

1. Modernise platform infrastructure – CMH has worked alongside our IS service provider to procure and implement a secure citrix mobile platform, Mulesoft Integration Engine and API manager. Work is now underway to complete a Clinical Data architecture and implementation approach.

1. Data management and analytics – an active programme is underway to implement data management practices and governance and develop an analytic investment roadmap.

“An equally significant part of the Healthy Together programme has been working with our community healthcare providers, trialing with nine medical practices new ways of working. This included how technology can support accessibility to medical care through patient portals, efficiencies with electronic referrals and effectiveness of care through the use of shared care planning tools and multidisciplinary team virtual training and clinical case meetings using advanced video conferencing tools.

“These are all now in use and an active programme is in place to extend their functionality. Community nurses have been provided with mobile tablets to access and collect data in the field reducing the need to return to base and referrals to community services is now organised around a central coordination and triaging service increasing the coverage and access by patients in their own home to the correct specialist staff,” Thirlwall says.

Innovations within the programme were varied and included trialing a consumer mobile app and two smart devices, one for Diabetes and one for Chronic Obstructive Pulmonary Disease. A current trial with a major international supplier is a mobile heart monitor with Bluetooth connection to a smart device (phone or watch) and continuous readings sent to the cloud. Algorithms are then run against the readings that provide alerts and diagnostic support to specialists , at the moment within the organisation, but potentially anywhere in the world.

Thirlwall says as the director strategic ICT transformation she needs to work across the executive leadership team to understand their business drivers, technology requirements and measures of success. Communication is best face to face and once the strategy and investment plan was established delivery updates were provided by the usual formal channels to the executive team and the District Health Board as well as informal updates at various stakeholder meetings.

“Personally I operate with professionalism but openness at all times, Thirlwall says. “Updates in person needed to be real and frequent to show that I was addressing issues raised or seeking additional support in a timely way. Individuals in the team have had to be resilient and adjust to unexpected findings or external influences.

“Overall I encourage the team and the executive leaders to ensure they are aligned in their messaging, be courageous to make the tough but informed decisions and be relentless in the pursuit of meeting the needs of the customer, who in healthcare is ultimately the patient and their families.

“For such a large transformational programme across the hospital, home and healthcare providers in the community a consistent schedule of engagements in required throughout the life of the programme. This includes blogs and videos on our intranet and digital newsletter, presentations at staff forums, monthly newsletters, website with a link from organisational intranet page, attendance at consumer councils when we have a specific topic of interest, notice boards and live demonstrations in the staff cafeteria.

Thirlwall says she is always aware of ensuring mindful engagements when at work.

“This is about being fully present in a conversation,” she says.

“With so many distractions in the technology world it is hard to have a conversation without an interruption from a text, phone call, lost train of thought. When time is so short it is easy to give instruction via email rather that actually engage an individual or group.

“I continually try to practise this and when I do, I find the experience so much more rewarding for all involved. It is respectful to those present, information is retained and we are more likely to act on what was agreed.”