CIO50 2019 One to watch: Tony Carpinter

“We have implemented a number of small initiatives, which extend our digital reach,” says Tony Carpinter, chief information officer at NZ Blood Service.

These are not radical innovations, he says. “The objectives usually relate to improved efficiency and safety.”

“Innovation comes around the edges,” he states.

The blood industry is unusual in that, except for the United States, most countries do not operate in a competitive model, says Carpinter.

But because blood services often share information across jurisdictions, innovations are communicated well, picked by other equivalent organisations, and become best practice.

“Obviously, beside the flow of physical products, there are flows of digital information which are just as important, both for business and clinical reasons,” he says.

Over the years, more and more automation has been introduced, producing more digital data that can be used across operations.

One example is managing prescriptions for immunoglobulin products. These are expensive manufactured products that are used by the DHBs to treat patients with immunodeficiency and related diseases. Previously this process involved several parties, and was heavily manual and paper based.

Now his team has created a portal as a platform that suits the mobile nature of clinicians and more accurately captures data for clinical decision making and review.

Clinicians are able to answer the relevant questions and request the product from mobile devices. There would be more timely reviews of these requests and reduced paper records.

He says the portal is now in use within a large district health board, with positive results. The portal will be rolled out to other DHBs in upcoming months.

As this is another application for clinicians, important aspects include usability, user onboarding and the training process, he says.

“We have a number of lessons learnt from the initial rollout and these will be revisited before the next round.”

Another project they are working on is the “smart fridge” concept.

This allows a large hospital blood bank to control the issue of blood products from a fridge in a separate smaller blood bank. A low-cost and low-tech pilot is now operating so that the concepts and processes can be developed, before they invest in a more high-tech solution, he says.

“The sort of changes that we are making in these areas don’t bring major direct benefits to NZBS and its users. However they save time, improve quality and improve processes in the network of health-sector organisations which we serve,” says Carpinter.

He says another example of extending the flow of information is advising blood donors when their donated blood has been transfused to a patient. “This is powerful reinforcement for the altruistic gift of blood to NZBS.”

“These innovations have to fit into complex, regulated environments, where safety is essential, so they tend not to be disruptive. The value that they deliver is usually via incremental process and service improvements.”

Culture and collaboration

Carpinter cites the importance of building a strong culture among the IS staff. The NZBS team is based across the country, so they hold daily standup meetings and use Microsoft Teams to communicate.

We provide good support for training and, with a relatively small team, there are good opportunities to be exposed to a range of issues and projects, says Carpinter.

He says the team is very diverse in terms of nationalities, with representatives from 10 countries, but, in terms of gender, is male-dominated.

A personal experience highlighted to him the importance of building and nurturing a great team.

After years of having his heart condition monitored, the cardiologist told Carpinter he needed a heart valve replacement. This is a routine procedure these days, but still counts as a major surgery for the individual concerned, he says.

His surgery was followed by two months of recovery. There were various complications which led to three further admissions to hospitals and an outpatient procedure.

Carpinter was able to see the sector he was working in from a patient bed.

“I gained personal experience of gaps in information flows that still need to be addressed, particularly between the public and private sectors.”

When he returned to work part-time, he found a good deal of change had happened during his absence, as well as some immediate issues he had to deal with. The year had also included a review of the IS function.

He has since recovered fully from the surgery, and is enjoying the challenges of his role at NZBS.

He says there are lessons learned from his unplanned sabbatical, that ICT executives should also consider as they lead in the digital economy.

“From a health perspective, it was really importantto have a knowledgeable supporter alongside me when there were clinical updates and decision points,” he says. “There is always a real risk of misunderstanding and a small risk of clinical error.”

“More generally, I found that I needed multiple support systems in place beside the standard medical ones. My systems covered physical, emotional, and personal support. Some people would include spiritual support in this list.”

Carpinter says he had a knowledgeable and caring employer, who encouraged him to take a gradual, measured approach to going back to work.

“I did not put too much pressure on myself to immediately get to the level required. I trusted the relevant people to keep doing some of my work when I returned. I also accepted that changes had happened and work practices had evolved, so I didn’t attempt to return to the status quo.”

“We have a good team culture, so theIS team was able to move between doing without me, finding new ways of doing things, and then accommodatingmy return.

“If you don’t have a personal experience like mine, someone on your team probably will have health issues at some stage. Do handle them with care, and don’t assume that things will take care of themselves.”