As healthAlliance CIO, James Allison leads the management and oversight of the four Northern region district health boards’ (DHBs) shared information systems.
Allison and his team manage one of the largest, most complex ICT enterprises in New Zealand.
The team supports 26,000 DHB employees who in turn provide services to 1.8 million New Zealanders, making it by far the biggest health region in the country.
Unprecedented population growth, rapidly changing demographics, high demands on the health dollar, and accelerating technological change have necessitated a step change in the region, says Allison.
In response, healthAlliance and the DHBs are embarking on one of the largest technology-enabled transformations in the New Zealand health sector.
Utilising proven transformation practices, Allison says the goal is to modernise the region’s vast and ageing ICT enterprise and prepare it for a rapidly advancing digital future – one that joins up systems and health information.
Its foundation is the region’s Information Systems Strategic Plan (ISSP), developed in collaboration with Northland, Waitemat?, Auckland and Counties Manukau DHBs and primary health customers.
The ISSP will simplify the complex layers of applications and use digital technologies, BI, analytics, and APIs to support the region’s future models of care, he says.
“Aligned to the Ministry of Health’s Digital Health Strategy, it will ultimately deliver a smart, sustainable, patient-centred and digitally-enabled healthcare system for the region and its people.”
Building foundations for the future
The strategy and its roadmaps of the ISSP are completed and the plan is well into delivery, he says.
He says the team’s Stabilisation Programme has shored up key infrastructure and improved systems availability and reliability which provide a solid base for transformation.
As a result, service levels have increased by 32 per cent, ICT outages have reduced by 85 per cent and their duration cut by 47 per cent. Call abandonment rates on the service desk have reduced by 66 per cent and customer satisfaction is up 10 per cent, says Allison.
Northland DHB’s 25-year-old patient administration system has been replaced and Counties Manukau and Waitemat? DHBs’ clinical portals have been upgraded and merged.
The regional Clinical Portal will eventually link all four DHBs and form the largest patient information ecosystem in New Zealand.
Allison says privacy and security have been enhanced across systems. A Chief Information Security Officer role has been embedded into healthAlliance, while a sector-first 24×7 security operations centre is enabling the transformation to progress faster, safely.
The transition to All-of-Government mandated as-a-Service solutions is also ongoing, with Infrastructure-as-a-Service and Telecommunications-as-a-Service as key building blocks.
IaaS will see most of the DHBs’ legacy infrastructure moved to cloud-based solutions, futureproofing their platforms.
From a user perspective, it’s not uncommon for clinicians to have to log on and off multiple applications up to forty times per shift, notes Allison.
Unified endpoint management and identity and access management solutions will solve this by making access to applications easier while enhancing security. Importantly, it will free up more time-to-care for clinicians.
Trials are underway for the clinical workspace of the future; a modern connected system with ‘tap-on tap-off’ capabilities that will save even more time, especially for the many who work across more than one DHB.
Accelerating digital enablement
Better sharing means better caring, says Allison.
A cloud-first approach is enabling the region to move to more modern solutions that improve access to health information.
He says a gamechanger is the recently implemented API engine that will enhance information sharing and interoperability. “This landmark project will accelerate the DHBs’ digital transformation.”
APIs, combined with a new health information platform designed to improve data sharing even further, will help make the patient/clinician experience more seamless, regardless of location.
Together they elevate the user experience, lower costs and improve efficiencies, he states.
Allison has backed his team’s DevOps CI/CD approach which is dramatically improving the speed and quality of delivery.
Automation has reduced testing times from weeks to minutes, and the regional change cadence has reduced to bi-weekly sprints. Allison’s endorsement of DevOps and containerisation is seeing apps delivered into production far more efficiently.
Additionally, a new telehealth service is tackling the ‘tyranny of distance’ in the region by providing digital access to health services for people in remote areas.
Creating a customer-centric culture
Allison, who is part-M?ori, retells a proverb that has held him in good stead over the years when talking about what is required to make meaningful and lasting change such as the one his team is working on.
“Me mahi tahi t?tau m? te oranga o te katoa – we must work together for the wellbeing of all.”
In line with this maxim, he and the team have taken a collaborative, clinically-led approach to the transformation.
“We work closely with sector stakeholders, including DHB executives and boards, PHOs, the Ministry of Health and other government agencies and industry partners. Everyone needs to be on the same page to ensure collective success,” says Allison.
They also work with the region’s frontline clinicians. Internally, Allison works with the healthAlliance executive team, board and senior leadership team to overcome obstacles and drive progress through. He reports directly to healthAllliance CEO Myles Ward, which makes this process easier.
In executing a transformation of this scale and complexity, the organisation has also had to transform itself.
Central to this is integrating an agile culture across not only in projects but in our daily operations too, says Allison.
Allison plays a direct role in diversity and inclusion programmes at healthAlliance. He sits on the company’s Women @ healthAlliance steering group and is a member of its Women in Tech working group.
A career lesson for Allison, and one he takes great strides to impart to his teams, is to “always walk in the customer’s shoes.”
Just like the healthcare professionals his teams serve, he makes sure that his staff understand their duty-of-care to the people in the region. “Theirs is no ordinary IT job,” he constantly tells them.
He assigns staff to go to the hospitals to see first-hand the pressures their customers face, or invites clinicians to speak to them how technology is critical to their work, and the impact when it doesn’t work quite so well.
“We are all working together towards a better, more efficient health system with lower cost of delivery and faster, more accurate and secure information at the point of care on any device, anywhere, anytime. That’s our aim.”