IT leaders must drive efficiency with data while fostering diversity of thinking
The Irish health service’s IT capability is between three and five times smaller than it needs to be, and chronically underfunded.
That was the stark message from Health Service Executive CIO Martin Curley at the Irish Computer Society’s Leaders Conference 2018.
“We need to undergo a significant effort to improve our IT capability,” Martin Curley, HSE
Using Gartner figures as a context, healthcare organisations have around 3-3.5% of overall staff as IT resources, which compares with just 0.25% for the HSE. In spending too, the proportion of overall spend for the service compared to that on IT is less than 1%. By contrast, the Revenue Commissioners spends about 10% on IT.
“We need to undergo a significant effort to improve our IT capability,” said Curley.
Key contributors
He identified of key contributors to the current state of capability of IT for the health service. Firstly, years of chronic underfunding, coupled with chronic understaffing has meant that not only is there a lack of technology and infrastructure, but there is an inability to attract or retain skilled staff.
Curley said the service must look to key partner vendors to compensate for these deficiencies.
A capability assessment has identified the priorities for improvement in IT were service and quality, organisation and people, value governance and data and information.
Curley cited what was termed “Moore’s Law for healthcare” where a graph of capability had cost on the x axis and quality on the y. The goal, he said, was to “stay left and shift left”, meaning that greater value was derived for every euro spent, driving efficiency and reducing costs.
He added that in these efforts, the question must be asked whether a healthcare system is about making sick people better or keeping well people healthy. The answer to this question would set priorities for investment and development. An example would be encouraging healthy lifestyles and vaccinations etc, which have the effect of keeping people healthy and, therefore, out of the system.
IT alignment
As organisations invest in healthcare, with IT achieving alignment, not just support, value for spend improves, he argued. He cited the example of diabetic foot ulcers (DFU).
The incidence of amputations as result of DFU is up to 10 per week in Ireland. Despite their incidence being 70% preventable, DFU patients occupy more than 110 beds per night in Irish hospitals, with an average stay of 15 days.
Curley said that home kits that weigh, photograph and upload images of afflicted areas can allow diagnosis and propose care plans, reducing hospital stays and amputations.
Data allows active management and diagnosis, said Curley, as well as early intervention to reduce and eventually eliminate amputations altogether.
Diversity of thinking
Diversity in organisations is to be encouraged, but it is not just about having more women or broader demographics.
This was a key assertion from serial entrepreneur Raomal Perera, consultant, and adjunct Professor of Entrepreneurship, INSEAD.
Perera said that as an entrepreneur, he rarely paid attention to academics, or at least not until they asked him to teach.
He said he realised that “When you are working hard at something, there is a lot you miss on the subject.”
However, when he examined his own experiences, as well as those of other successful organisations, he found that adaptability, inclusiveness and openness were all vital to success.
Diversity, he argued, is vital for organisations dealing with and adapting to change. Adaptation requires being open to new ways of thinking. Without diversity among the people of an organisation, there can be a tendency towards group think that can lead to disaster. He cited the example of Nokia, where the CEO rounded out his speech announcing its sale to Microsoft with “we didn’t do anything wrong, but somehow, we lost”.
Diversity, Perera argued, means being able to trust someone and support their ideas, even when that thinking is different to your own.
“Diversity is about thinking differently,” he asserts.
However, he said leadership must at all times be empathetic, providing understanding for these different points of view to allow people to express them confidently.
This diversity of thinking in an open environment will encourage innovation. However, Perera disapproves of innovation groups, saying that they can lead to silos away from the people at the coal face, dealing with real customers and real issues.
Fostering creative thinking
Finally, he said that we need to foster creative thinking, which is currently being stifled in our education system. He cited a NASA study which found that 98% of 4-5 year olds were categorised as creative geniuses, meaning they were capable of coming up with new, divergent and creative approaches to problem solving. However, by age 10, this had dropped to 30%, and by 15 to 12%. By adulthood, said Perera, this fell to 2%.
“Our education system is killing creativity,” said Perera.
It is up to us as leaders to encourage innovation and creativity within organisations, because ultimately, that is what will allow us to be adaptable as organisations. He said.
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