Shayne Tong says the Auckland District Health Board continues its journey that began in 2018: “To change our culture and hit refresh as a team and with our customers”' to ensure we have the data and digital capabilities to achieve the ADHB and Northern Region DHBs’ strategic objectives in the 10-year Long Term Investment Plan.

This, says Tong, continues to be a top focus of the Data and Digital team at the Auckland District Health Board.

He says the change involved restructuring the leadership team to include members coming from outside the health and public sector.

“The primary driver was to bring in ‘fresh’ innovative thinking and experience with a stronger focus on data, analytics and digital to ensure we transform into a data driven, digital healthcare system over the next three to seven years.” 

The leadership team, he says, is also part of a “once in a generation” opportunity to make a significant contribution in the healthcare transformational journey with the other DHBs in the Northern Region.

Their focus over the past year is on strengthening the DHB’s capabilities around digital acceleration, advanced analytics, data science, and interoperability.

“We also implemented a dedicated data and digital lab space outside the hospital to foster new and innovative ways of working [co-design, design thinking, lean six sigma and agile] to drive data, analytics and digital innovation initiatives,” says Tong.

Geo-spatial digital twin hospital

He and his team have been involved in a range of initiatives using new digital technologies, ranging from pilot to full deployments.

One of these is the creation of a hospital digital twin using drone 3D imaging and 360 degree photography technology. 

He explains Microsoft Azure created a 3D virtual digital twin of the entire hospital where spatial data is gathered, digitalised and integrated into one single digital twin for ADHB.  

The digital twin is used to find a better experience for staff, patients and whanau, predict and automate staff movements, simulate clinical workflows to improve patient care, reduce the cost of care delivery, staff training and on-boarding.

Another project, the 3D printing hub, gives clinical and non-clinical staff access to 3D printing experts, segmentors, engineers and designers, helping them improve patients’ lives and hospital environments.  

There are now five 3D printers in the 3D lab and a basic desktop 3D scanner. There are two different areas of 3D printing – 3D printing for innovative and leading practice patient treatment that will positively impact patient treatment and outcome and 3D printing for equipment replacement and replication, hence significantly lowering the cost to serve.

Clinical telehealth is another focus, with Zoom digital conference being extended for clinical consultations and multidisciplinary meetings.

Tong says telehealth clinics are being held regularly in some child health services such as paediatric gastro and neurology. A TeleDOT (Directly Observed Therapy) is being used for remote monitoring of patients taking medication for tuberculosis.

The DHB has also implemented robotic process automation (RPA), automating the e-referral manual processes with a software robot.

This is expected to bring significant operational benefits by saving staff time from manually entering data. Tong says there is a significant list of areas where RPA will be implemented.

Cloud analytics, artificial intelligence and machine learning models using on premise data science servers provide the foundation for a range of projects. 

One of these is the Integrated Digital Operations Centre (IOC), which provides real time hospital “at a glance” in the cloud, for data-led and evidence-based decision making for the staff and patients. 

Tong says with their large volume of sensitive data sets, they needed an on premise and cloud “compute” capability to build out algorithms and data science models.

This was the backdrop for the implementation of an on premise data science service with significant graphics processing units (GPUs) to complement their cloud capability in Azure and AWS.

ADHB has likewise developed an AI and machine learning strategy and outreach campaign to bring greater awareness of the power of AI in healthcare and opportunities within ADHB. 

Related to this is the establishment of a data science governance group “to ensure effective controls are in place to manage the mainstreaming of this exciting capability”, says Tong.

Concurrent Regional and National sector leadership

As chief digital officer at ADHB, Tong is also involved in the Northern Region DHBs’ senior executive team, as they work towards the regional 10-year Information Technology Strategic Plan.

Tong explains the greater goal is to create a regional integrated digital healthcare ecosystem.

This ecosystem encompasses more than a quarter of New Zealand’s population (1.8 million people) covering four district health boards (Northland, Waitemata, Auckland and Counties Manukau); 14 hospitals; 26,000 staff; 3,100 beds; 86 operating theatres and 360 community health sites.

Tong is chair of the Regional Data Design Authority. He explains this is a capstone initiative to ensure that the vast volumes of both structured and unstructured data is effectively optimised to achieve data-driven and evidence-based health management. 

At a national level, Tong is the representative CIO for Northern Region DHB CIOs and is a member of the National DHB CIO Leadership Forum. 

In this capacity, he works closely with executive colleagues at the Ministry of Health, Ministry of Business, Innovation and Employment and Government Chief Digital Office.  

Enterprise agility 

Tong highlights the people component of their digital business initiatives. 

He organises monthly IT town hall meetings called ‘All Hands’, a conference call with the entire data and digital function to provide feedback on progress and successes for the month.  

“We are in the process of changing our data and digital operating model in IT to be more aligned with a Spotify model where opportunities will exist across those functions and operate tribes, squads and chapters,” says Tong. These changes will be scaled at all levels this year.

Across the organisation, the DHB continued and matured its enterprise Agile product management and value streams. 

They created cross functional clinical, operational and technology teams around – Planned Care (improve elective surgery performance), Length of Stay (improve patient flow and reduce patient length of stay), and Outpatients (reduce outpatient visits). 

All these changes are contributing to significant cultural change and employee value proposition improvements at ADHB, says Tong.

He is sharing their experiences with his counterparts in the other Northern Region DHBs and nationally that are also moving to Agile, digital platforms.

“Focus on people to drive outcomes and value,” says Tong on a key lesson he can impart as an ICT executive who has worked across sectors including finance, energy and manufacturing. 

“It’s all about the people,” he states. “Ensure people buy into the vision and purpose, ensure co-design of outcomes and set people and teams up for success.”  

“Provide strong leadership and direction, and most importantly be authentic and empathic as no one person is the same,” he says. 

“Don’t make assumptions around people... Because you will be wrong!”