CIO50 2019 #10: Shayne Tong, Auckland District Health Board

Shayne Tong joined the Auckland District Health Board (ADHB) as chief of intelligence and informatics, a reflection of the focus of his role which is equivalent to chief information officer.

But over a year into the post, he restructured the IT leadership, to establish new capabilities.

“We ‘hit refresh’ with my team and customers established new capabilities, to ensure we were set up to achieve both ADHB and Northern Region’s strategic objectives over the next two to three years”.

“My role also changed to chief digital officer, with a stronger focus on digital and data to ensure we transform into a data-driven, digital healthcare system.”

Thus, his 100 staff are now assigned to different ICT functions – digital transformation delivery and project team, digital innovation and enablement team (cloud and digital platforms), advanced analytic and data science team (cloud analytics, artificial intelligence, machine learning, natural process language), data team (strategic and operational), Information security and IT risk team, business intelligence and solutions team, clinical and business application team and clinical customer engagement team.

They work with over 100 staff on outsourced IT functions delivered by healthAlliance.

Tong says the CDO post is a strategic leadership role within ADHB and the Northern Region DHB which is working to deliver a more regional integrated healthcare system.

The operations encompass 1.8 million people covered by four district health boards; 14 hospitals; 26,000 staff; 3,100 beds; 86 operating theaters and 360 community health sites.

Over the past year, he has laid down the foundations to achieve the massive digital transformation plan for the region.

He established the new digital solution teams to drive data and digital innovation, whose members include advanced analytics and data science teams. The team is also developing a dedicated data and digital lab to drive data and digital innovation programmes.

Another programme involves the establishment of an integrated digital operations centre (IOC) with real time hospital “at a glance” in the cloud.

The IOC will provide real-time visibility and inform data-led decision making for both staff and patients. Additional dashboards are being built for hospital 24×7 operations teams.

The IOC was the first product created by the enterprise agile product management and value streams at ADHB. It was also the first “product” value stream created for ADHB with a co-located clinical and digital team, and product owner.

“We kicked off this value stream with a four-week design thinking and visioning exercise before defining the IOC backlog and minimum valuable product,” says Tong.

His team has also deployed robotics process automation, automating 8 out of 70 e-referral manual processes. This process saved up to 10 hours of manual entries per day.

He says the team has also implemented digital automation, workflow and mobile app solutions for business and clinical manual processes using Microsoft Office365, PowerApps, Microsoft Flow and PowerBI.

“Much of 2018 has been about setting the digital foundations, teams and templates so we can scale in 2019,” he explains.

They have worked on a raft of digital tools that they developed as a template that can be reused and scaled for similar workflows.

One of these is the digital operating room scheduler and mobile app to automate manual off-system processes for scheduling and booking operating rooms.

The team also worked on the Digital Safety Audit Mobile App which will automate manual data capture. The Resident Medical Officer (RMO) Digital Handbook and Mobile App (clinical) was developed to digitise PDF medical handbooks.

Tong says the RMO handbook is critical for junior doctors to provide safe medical care for patients. The old PDF versions were not updated regularly. It was also difficult to find information in this format.

The digital handbook makes it easy to update content, and has a digital search and favourite capability, says Tong.

Like the other projects, the digital handbook template will be used for other critical documents such as the Anaesthesia Handbook, CVICU Handbook and Auckland Regional Public Health System Protocols.

“We have a backlog of opportunities for 2019 and a digital team in place to develop additional clinical automation and workflow tools,” he says.

Tong says his team is also working on a range of programmes around cloud analytics, artificial intelligence and machine learning models.

One of these is the Variance Response Management (VRM) artificial intelligence solution developed to predict changes to hospital ward staffing levels to maintain safe staffing levels depending on ward acuity.

This data solution is critical to maintaining Care Capacity Demand Management (CCDM) levels and also provides key insights into the “at a glance” dashboards for the Integrated Operations Centre (IOC).

They have also developed the AI platform proof of concept using KenScii AI platform on Microsoft Azure for Care Variation, Utilisation and Hospital Operation.

The KenSci AI has a machine learning model library and assembly with visualisation, reports, alerts and APIs that will allow us to accelerate our AI journey in 2019, he says.

“We will be able to use pre-built healthcare AI models without having to build the models ourselves.”

Tong presents to the board and a main theme of his recent discussions is the importance of thinking of data as a strategic asset. “We have a long term investment plan and IS strategic plan, but if we want to transform into a data driven digital healthcare system, we need to have a Data Strategy that supports our strategic objectives,” he states.

Tong’s responsibilities extend beyond the DHB.

He is a member of the Regional IT Governance Forum and chairs the Regional Data Design Authority.

He shares the team’s strategy to ensure they have the right people, technology and culture that will enable them to lead through the organisation’s data-driven strategy.

“We are thinking differently and doing differently by introducing new ways of working, such as design thinking, product management, agile principles and enterprise value streams,” says Tong.

The team was also restructured to build out new data and digital capabilities. This has already provided opportunities for three people to move out of their traditional roles in IT and into new capabilities.

“We are also in the process of changing our data and digital operating model in IT to be more aligned with a Spotify model where opportunities will exist across those functions and operate tribes, squads and chapters,” he adds.

“As an IT team we also worked together around our culture and behaviours, particularly around the one team one culture, our guiding principles, our purpose and determined the things we are passionate about.”

He says they also introduced agile product management and value streams concepts outside the ICT teams.

“This has been a huge success in bringing clinical and IT closer together,” says Tong. “All these changes are contributing to significant cultural change in ADHB.”

He explains his continuing emphasis on the importance of working collaboratively across the organisation, and with the greater region.

“You have to build relationships and networks and influence to get the outcomes that are aligned to strategic objectives,” he says, as an important component of leadership.

“It is making sure there is that strong strategic alignment, that we have got a shared common purpose and direction, and then mobilising people and teams up for success to execute those objectives.

“You have to use your key learnings in different ways of working, particularly around agile, to bring business and technology teams closer together,” he concludes.