Thinking Differently & Doing IT Differently

John Thornbury

Director of ICT

Agenda • Outline of the challenges facing the trust

• Defining, measuring, analysing, improving & control – Delivering the Service

• Continual improvement and service development – Transformation

• Environmental & cost savings

• What we are doing – Transformation with IT as enabler

The Trust Is Not Fit!!!

• over indulged in the good times

• bought premium brands

• lack of realisations of what we have done

Challenges

• Economic Crisis

• £20B saving

• Commissioning agenda - QIPP

• Increased quality

• Customer focused

• Improved productivity

• Cost Improvement Programmes

Large agenda , not enough resource do

we give up NO!

What can we do

• Exploit ICT

• Think Lean

• Link with CIP’s/transformation/QIPP

• Think improved quality

• Unified approach

• IT must be an enabler not a leader

• HOW using following process

ICT and Service Alignment To support Knowledge Driven Healthcare

Darzi Review - Principles

It takes a three-pronged approach to developing information systems:

• delivering better, safer care through supplying information to support care processes and sharing information across organisational boundaries, including social, independent and voluntary sectors;

• empowering staff by giving the means to assess of quality and effectiveness of care through better research planning and management; and

• empowering patients, service users, carers and the public by providing better information on services, online access to records, and involvement in decision making.

IT Strategy - Principles

• Appropriate and aligned to the business needs

• Fit for purpose

• Provide value to the organisation

• Be energy efficient and cognisant of carbon foot print impact

IT alignment with Service Requirements

• “Information technology and business are becoming inextricably interwoven. I don't think anybody can talk meaningfully about one without the talking about the other.”

• “The first rule of any technology used in a business is that automation applied to an efficient operation will magnify the efficiency. The second is that automation applied to an inefficient operation will magnify the inefficiency.”

Bill gates

Objectives of Strategy Robustness Managing Constantly-Changing Content Global Knowledge Management Responsiveness

Personalized Delivery Instantaneous Response 24x7 “Worldwide” Availability Single point of entry (password/Data)

Scalability Internet Scale Fault Tolerant Terabytes of Information

Trust Current, Accurate Global Content Secure Content

Strategy components

ICT Strategy

Enabling

Architecture/

Infrastructure

Supporting

Care Delivery

Facilitating

Improved

Communications

Corporate

Business

Support

Quality

And

Management

Information

Enabling

Processes

Inform

Quality and

Management

Information

Corporate Business

support

Collaborate

Enabling

Processes

Facilitating Improved

Communications

Connect

Supporting Care

Delivery

Enabling Architecture

Infrastructure

Knowledge Driven Strategy

Delivers Seamless integration

Business & Clinical Processes

WWW

Health

Professionals

Patients

Transformation is key

Integrated Business

Plan

National & Local Drivers

ICT Strategy Transformation Requirements

ICT Work

Programme

But keep the message simple across the organisation

Four Steps to Success

Diet

DIET

• Project definition

– Aims and objectives

• Measures of success

– KPI’s

• Service baseline/review costs

• processes

• Benchmark

• Agree and sign off with timescales and responsibilities

Step 2 - Exercise

EXCERCISE

• Implementation plan

• Reviewing current processes

• Getting right resources aligned

• Project management/ project structure

• Monitoring performance

Step 3 - Coaching

COACHING

• Getting control

• Keeping on track

• Changing culture

• Reinforcing behaviour

• Ensuring right skills

• Customer reviews – especially clinician

• Continual feedback

COACHING

• Deliver what clinicians want- fast dog

Step 4 - Results

RESULTS

• Cost savings e.g. reduced paper, reduced travel, reduced LOS a

• Environmental benefits- carbon footprints

• Increased productivity

• Improved quality

• Satisfied customers(clinicians and patients)

Enough about theory a real example

• Implementation of Unified Communications across an economy with BT

Positioning

The NHS White Paper

„Equity and Excellence: Liberating the

NHS‟

outlines the need to make the shift

towards a more patient-centred NHS;

giving patients more choice and control

Highlights information as key to better

care, better outcomes and reduces

costs.

Need to do more with

less

Increase in demand for

care services

Increased pressure on

budgets

More care needs to be delivered in

the community & homes

More efficient ways of

delivering care is required

Business Drivers

The business qualities demanded in response to market drivers

Positioning – enabling the future

Moving from here….large, complex, high cost

To here….smaller, efficient, innovative and productive

How ?

Key themes

• patient centric

• well governed

• joined up

technology

Appropriate information

• at the right time

• in the right place

• for the right people

• to make the right decisions

Affordable

Supports the:

• White Paper expectations

•“Information Revolution”

• Regional and local needs

Positioning – working differently

• We need to provide care in different ways, by: – reducing hospital admissions

– delivering services closer to patients homes

– improving clinical decisions and enable patient choice

– providing real time access to the clinical record at all points of care (pathways)

Positioning – working differently

• Some facts: – 370 million patient contacts with the NHS each year,

84% of those contacts are “face to face”, and account for 98% of total contact costs.

– Shifting to higher quality and lower cost channels like telephone, web and self care will transform the way healthcare is delivered over the next decade

– What about how we just communicate and meet, what opportunities exist there?

Don’t do the same job better, do a better job!!

How can we as managers and leaders, influence a change in

working practice?

UCC offers an effective alternative

What is UCC?

• Unified messaging – Bringing voicemail & email

together accessible from phone or PC

• Integrated Communication – Bringing telephony, mail & messaging

together with call origination and receipt from PC or phone

• Unified Collaboration – Real time communication, context (content),

status and device relevant (single and multi-party)

What is UCC?

Impacting the bottom line

Today’s communications experience

Sources: Sage Research 2006

At least Monthly 35%

…Results in lost time, delays

and missed deadlines

Daily 75%

…Unable to reach

coworkers on first try…

Daily 52%

…Have to use multiple

methods of reaching

coworkers…

Up to 6 types of devices

Communication devices

and apps proliferating…

47% travel at least once per month

Employees

increasingly mobile…

least

Voice, data, video, mobile and fixed worlds converging

Separate networks, devices and

applications

Converged networks, devices and

applications

Voice

COMMERCIAL

● Customer care

● Billing

● Contracts

TECHNOLOGICAL INNOVATION

● Networks: PSTN, TDM,

IP, GSM, 3G, Wi-Fi

● Devices: mobiles, desk

phones, softphones

SERVICES

● PBX features

● Call waiting

● Call forwarding

● Call transfer

SERVICES

● Email, Calendar, IM

● Vertical applications

● Bespoke applications

COMMERCIAL

● Customer care

● Billing

● Contracts

TECHNOLOGICAL INNOVATION

● Networks: PSTN, SDSL,

DSL, Frame Relay, MPLS

● Devices: Laptops,

Desktops, PDAs

CONVERGED SERVICES

Mobilizing applications and processes:

Applications that are network optimised and independent

CONVERGED COMMERCIALS

Commercial alignment: Fewer contracts, bills and points of

contact across converging voice and data services (mobile and fixed)

CONVERGED TECHNOLOGY

Access to optimum network using device of choice:

Network & application agnostic devices with seamless

transfer between networks

Connecting

people, process,

information

and business

Empowering dispersed

teams

with workspace

Portals and

conferencing

Unifying business

communications

and applications

Enabling and mobilising

Workforces

…empowering and enhancing employee, partner, and customer

relationships…

UCC has the power to deliver better healthcare

Tangible benefits of Unified Communication and Collaboration

Organisations using unified communications clients saved an average of 32 minutes per employee, per day, because presence technology enabled staff to reach one another on the first try.

A presence enabled workforce

Use of soft phones realised saving of £60k per annum in in mobile and long distance charges. Mobile workers saved 40 minutes each day, enjoyed greater communications convenience, and generated annual productivity gains of 3.5 days per year through

business continuity impact.

Productivity / business continuity

Organisations using unified messaging reported that employees saved 43 minutes per day from more efficient message management, while mobile workers saved 55 minutes per day.

Unified messaging

using integrated voice and Web conferencing reported a 30% reduction in expenses (by making integrated conferencing capabilities available in-house and on-network) and reducing carbon footprint

Web conferencing

Sage Research Jan 06

Business Scenarios #1 What OCS was is being used for:

• COO to Direct reports 1-2-1 “tele-conferences” Reduced carbon footprint – no need to travel

Better than just audio conference

Immediacy – can be done there and then if required as well as scheduled

• Being able to “see” if someone is available and how best to contact them and/or being automatically notified when some one is free, and or on the phone. Reduced use of voicemail and voice mail tag

Saves you time – allows you to prioritise your work around people’s availability

• Geographically Agnostic working – work from where you want.

• In an office environment you see “by line of sight”, OCS through presence, IM, video and video (all in one place) gives some of the rich collaboration experience back

• Frees staff to work (more productively than before) from a wider selection of locations, including home. Work/life balance, productivity and diversity benefits

Business Scenarios #2 • Replace the company “mobile” phone.

OCS becomes your “mobile” phone. Your computer becomes your phone. This allows the removal/reduction of company mobile phones for certain roles.

Reduction in mobile telephony costs

•Dial in conferencing OCS provides multi party audio conferencing

• IM federation with key partners and suppliers Shortened customer support process

Improved service from suppliers (improved issue resolution)

Better customer satisfaction from customer for supplier (Win:Win)

•Senior Management to PA Collaboration –> Improved working productivity through use of IM (can send message and get quick answers even if Manager or their PA are on the phone)

The Promise of Unified

Communications (Health)

A hospital doctor would like a second

opinion on an MRI scan, but he is unable

to find a consultant, and doesn’t have

access to other consultants currently at

home.

Result?

Patients get diagnosis delays, and the

hospital bed is still unavailable.

Hospital staff are frustrated

Patients do not get the treatment they

deserve.

Is there a better way?

The Promise of

Unified Communications

There is!

The doctor can see from his Unified

Communications Interface that

consultant Mr Chan is on a call, so

sends him an Instant Message. Mr.

Chan sees he is wanted, and ends his

call.

The doctor shows him the MRI scan via

a video link to Mr. Chan‟s home PC, and

they videoconference to diagnose the

patient‟s problem.

The dark spot is an MRI artefact, and

nothing to worry about.

The patient is discharged, the bed is

regained, the doctor and patient are

happy, and can see another patient

Summary

Office

workers

Mobile

workers

Office/site

roamers

Home

workers

Service Quality

Supporting Patient Care

Effective use of Technology

So how does this support QIPP?

• Improved quality of care – MDT meetings consultant links into main meeting from

home – Advice sort in timely manner and no aborted contacts

• Innovation – Solution is innovation – Users thinking up new way of using

• Productivity – Clearly improve efficiency and effectiveness – Financial saving

• Promotion/partnership – Reduces carbon footprint

Executive/Board monitoring of Transformation

High Level Benefits

Enablers B1 Improvement

in Patient Care

and Safety

B2 Reduction in

inefficient

Administration

Staff working

B3 Increased time

to care in Clinical

Staff working

B4 Reduction in

time spent

Auditing

B5 Opportunity to

expand locations

for clinical

services

B6 Increased

throughput in

Care Settings

B7 Standards are

met or exceeded

B8 Cash release

of benefits

Develop new working

coalitions

3A 2A 3A 2G 3A 3A 3G 3R

Collaborative working 2G 1G 2A 2G 3A 3A 3G 3R

Involvement of Key

stakeholders

3G 2G 2G 1G 1G 1G 3G 3R

Process Mapping 2G 3R 3R 3A 3R 1G 3G 3R

Training Programmes 2G 3R 3R 2G 1G 1G 3R 3R

e-Prescribing 3G 1G 3A 3A 2G 1G 3A 3R

eZ notes 3G 3A 3A 3A 3G 3R 3A 3R

eZ notes forms library 2G 3A 3A 1G 1G 2R 3G 3R

Whiteboard 3G 1A 3R 1G 1G 3R 3A 3R

ICE Order Comms 3G 2G 3R 1G 2A 1G 3A 3R

Digital Dictation 2G 3A 3A 1G 2G 1G 2A 3R

Bluespier 3G 3A 3A 3A 2A 2A 3A 3R

Infrastructure 3A 3A 3A 3A 3R 3R 3A 3R

Electronic Repository

System

3A 2A 2A 2A 1G 1G 3A 3R

Self Checking Kiosks 2G 3A 2A 1G 2G 2G 1G 3R

Changes in working IT

en

ab

lers

Questions and next steps