Supporting the transformation of health services through digital

Jane Carolan, National Director of Health Business Services discusses transformation, shared business service models and innovation.

Outlining the creation of Health Business Services (HBS) in 2013 as the result of a government-led initiative to “organise and supply internal support services more efficiently and effectively whilst freeing up organisational capacity to concentrate on core, frontline and other health and social care functions”, Carolan says that the consolidation and streamlining of the business operations that are used by multiple parts of the organisation has presented huge opportunities of transformation, to the point where almost everything HBS do now has a digital component.

Carolan admits to any early-stage perception that digital transformation was something to be undertaken and led by IT specialists but adds: “We quickly learned that it was business owners themselves who have the best insight and knowledge about what their needs are in transforming their business, that they need to work in partnership with the Office of the Chief Information Officers and its IT specialists.”

The National Director states that recognition of the magnitude of change which would be achieved through collaboration with their ICT colleagues also informed the need for a clear strategy for their ambitions, where that fitted into the overall ambition of the Health Service Executive (HSE) and with what “Ireland Inc. was trying to do”.

Outlining the journey that HBS is on, Carolan highlights that their first strategy from 2014 to 2016 achieved 85 per cent implementation but adds: “The 15 per cent that we didn’t implement were all of the digital components. Amidst great progress in other areas, there was a challenge for us in implementing our digital transformation elements.”

The 2017 strategy, which runs to the end of this year incorporates projects and programmes in each of what Carolan describes as the SAMR ladder, an evolutionary map which starts at substitution (replacing something or someone with a digital solution, through augmentation (functional improvement on top of substitution), modification (significant task redesign) and redefinition (the creation of new tasks previously inconceivable).

“All of these interventions are necessary as we look across our digital journey in HBS we have programmes and projects which fall into each of these categories. What’s really important to us is staying open to the small, as well as the big, digital opportunities.”

Carolan details progress in six areas where major transformation is ongoing. The first is around robotics, with the National Director stating that rather than being the future, robotics is very much a current tool being used by HBS.

“We currently have several proof of concept projects underway working in partnership with the Department of Public Expenditure and Reform. For our kind of business, robotics is a no brainer but our focus most be on how we land these projects, where we land them and what we utilise them for.”

Three pilots carried out by HBS in robotic process automation processes in 2018, including in the areas of finance (hospital income debtors collation and reporting), HR (leaving process) and HR (Garda vetting consent logging) have brought about a combined efficiency saving of 720 hours of working time equivalent per month.

“The results are exciting,” says Carolan. “We see real opportunities through the introduction of robotics to facilitate our staff to bring more added value and to deliver better output.”

The second area surrounds customer relationship management (CRM) and a move to ensure continued excellence in business relationship management. Carolan says that bringing this intelligence into HBS ensures that they are not making repeat mistakes and are fully aware of customer needs and demands.

Talking about the six areas in general she adds: “None of these implementations are simple. They are multi-year implementations, most of them with targeted full implementation of five years.”

What’s really important to us is staying open to the small, as well as the big, digital opportunities.

One of those multi-year implementations will be the introduction of a National Integrated Staff Records and Payroll service to enable a single source of truth for staff records and allow a self service portal for staff to access information. The scheme will take learning and technology from the failed Personnel, Payroll and Related Systems (PPARS), originally commissioned in 1999 but suspended amidst findings of poor performance and manageability. Discussing the challenge of “fast-forwarding” the current system, Carolan says: “The journey we are embarking on is estimated to take around five years and is following on from a decade of neglect of back office systems within the health service. We are starting from a low base.”

Another long-term project is that of HBS Estates, a major digital transformation which will enable a single source of truth for over 6,000 sites/buildings, management, maintenance, construction and medical equipment. HBS are in the process of issuing a tender for a national estates information system following on from what Carolan describes as core work of assessing and taking learning from international best practice before implementing a plan on a “green field” area.

An area of transformation that is well underway is the digitisation of HBS’s national distribution centre in Tullamore. The centre, which predates the creation of HBS, has been expanded and continues to improve on digital opportunities. The digital distribution system is 70 per cent implemented across the country and has brought about a saving of at least €6.3 million in clinical nurse time and demand reduction, a figure which Carolan highlights is a conservative estimate. HBS are currently planning for a further hub in Dublin to drive further efficiencies.

Lastly, Carolan highlights the creation of an Integrated Financial Management System (IFMS) which aims to upgrade and join financial systems nationally for a centralised view of financial data, allowing reports. She adds: “The HBS are custodians of a huge volume of data to the point where we currently don’t have the capacity to mine it all, use it and inject it back into the system. How we best do this will be a challenge for us going forward.”

Concluding, Carolan says that while digital technology may be a facilitator of service transformation, it is not the sole driver, instead she points to a large role for the process side of transformation and an even bigger role for culture an organisational change.

“We started off by looking at our ICT colleagues to tell us what transformation to have and where to have it but we’ve been on a journey and we now have a better understanding of digital’s potential and how we can drive it internally. Culture has always been an important element for us and from HBS’s creation we have sought to mobilise our 1,500 staff in innovation and to equip them with the knowledge that what they are doing is having an impact on wider health services.”



Barry Doyle

Since graduating with an MSc in Geographical Information Systems (GIS) in 1994 Barry has worked as a GIS / IT professional and business consultant in various roles in both the public and private sector in Ireland. With over 13 years’ experience working as a Project Leader in the Irish Local Government Sector Barry has been responsible for leading and delivering various innovative projects at both a Local Authority and Sectoral level with a particular focus on Digital Transformation, Geographical Information Systems, Information Management and Open Data.


Prior to joining Galway County Council in November 2018 Barry championed, defined and led the Digital Transformation Programme in Roscommon Country Council with the overall aim of embracing opportunities presented by ongoing advances in the digital technologies, broadband availability and capacity, and Cloud based enterprise solutions to transform how the Council provides services to, and interacts with, the citizens it serves. In line with this Barry completed a Special Certificate in Designing Innovative Services with Cork Institute of Technology in 2018.

 

Gemma Garvan

Gemma Garvan is Director of Informatics at St James’s Hospital in Dublin which last year became the first digital acute hospital in Ireland, which is the start of a landmark change for how care is delivered.  Gemma is an experienced Health Informatics Leader with a demonstrated history of working in the hospital and health care industry.  Prior to taking up her role at St James’s Hospital in 2018 she was Head of Access to Information at Healthlink. Gemma began work as an analyst programmer with The National Healthlink Project and moved into a project management role over a decade ago. Gemma has a BSc in computer science and software engineering and an MA from Trinity College in Dublin.

Barry Lowry

Barry Lowry is CIO for the Department of Public Expenditure and Reform, a position he was appointed to in 2016. He is tasked with delivering the Public Service ICT Strategy. Prior to 2016, he spent almost 35 years in the Northern Ireland Civil Service (NICS) on work ranging from the programming of mainframe computers to operating as a team leader in the design of client server systems. For the five years prior to his appointment, Lowry was the director who oversaw the establishment of ICT shared services in NICS. He also operated as the Head of Profession for ICT. In 2011 he was voted the Northern Ireland IT Professional of the Year by his associates.

Aileen McHugh
Kieran O’Hea

A native of Cork, Kieran O’Hea is Leicester City Council’s Head of Smart Cities, where he is leading the implementation of a Smart City Strategy that is city-needs led and demand-driven. He was formerly Chief Digital Officer of Brisbane, where he led the development of the city’s digital economy strategy. Before focusing on city strategies, Kieran led the development of digital strategies for a number of government agencies in Dublin. He has also worked for the European Commission, developing funding programmes in the area of digital content.

Donal Spellman

Donal

Tim Willoughby

Tim Willoughby is Head of Digital Services and Innovation at An Garda Síochána. He was formerly CTO of the LGMA, with over 20 years in a number of Senior Management and Technical Roles in the Local Government Sector. He has been working in the Public service for almost 28 years. Tim has a Civil Engineering Degree from TCD and a Masters in Innovation from the University of Ulster.

Moyagh Murdock

Moyagh Murdock has been in the transport sector for over 20 years in various capacities. Currently, Moyagh is the Chief Executive Officer at the Road Safety Authority. In her early career she spent 10 years in the airline industry having worked at Bombardier in Belfast as an aircraft systems engineer. She was then Chief Operating Officer for Bus Éireann having joined the Company in 2007 as the Deputy Chief Mechanical Engineer with responsibility for the fleet maintenance and garage operations. In 2012 she was awarded an MBA from Dublin City University (DCU) and holds a Certificate of Professional Competence in Road Transport Operations Management.

Caron Alexander

Caron Alexander is Director of Digital Shared Services at the Northern Ireland Civil Service.  She has more than 30 years of experience in the UK public sector.  Caron is responsible for providing ICT shared services to 27,000 staff, for the NI citizen portal www.nidirect.gov.uk and contact centre services, delivering the NI Digital Transformation Programme and driving forward the NI Open Data agenda.  Previously Caron held a number of senior technical, programme and change management roles in the Northern Ireland Civil Service.

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Michael Redmond
Michael Redmond is Chief Operating Officer at the Office of the CIO/eHealthIreland. A highly experienced leader within eHealth and Digital, Michael has a reputation for delivering results, driving excellence and building capability in each and every one of his career roles to date. Hugely experienced across the public sector, he is known to be acutely customer focussed; his strategy of simplifying the digital agenda resonates with the C-suite, staff and the general public alike. As COO, Michael manages the largest ICT investment budget in the whole public sector. Also a qualified and certified CIO, Michael studied Computer Science at Trinity College Dublin.
In 2008, Stella founded Annertech, Ireland’s leading open-source digital agency. Since its inception, Annertech have grown to become the "go to" Drupal experts in Ireland and work with a variety of clients in both the private and public sectors. Stella is an active contributor to the Drupal open-source content management system, and maintains many modules including Commerce Realex, Commerce Donate and Code Review. She is a member of the international Drupal Security Team, and was recently chairperson of the Drupal Ireland Association.

Dominic Byrne is Head of Information Technology with Fingal County Council and has 26 years’ experience working in IT.  He holds a Degree in Information Technology and a Masters in Internet Systems.  He is responsible for managing the provision of IT services in Fingal County Council and his current interests include Digital Government, Smart Cities and Civic Tech.  He is a member of the Smart Dublin Executive Committee and the Public Bodies Working Group on Open Data.