CIO50 2019 #9: Stella Ward, Canterbury and West Coast District Health Boards

The CDO role evolved as part of the Canterbury DHB and West Coast DHB executive management teams.

Stella Ward started as the inaugural CDO in March last year providing leadership to the Canterbury and West Coast Transalpine Information Services Teams.

Prior to this she was Executive Director ICT and Innovation and the Executive Director of Allied Health, Scientific and Technical.

As CDO, Ward has a strong affinity with technology but more importantly she maintains that, “In support of the patient-centric, integrated health system vision, my role, first and foremost, has a clinical [patient] focus”.

“Our aim is to bring to life technology and system solutions that support opportunities to improve the patient journey and enhance clinical and operational effectiveness, thus releasing more time for patient care.”

“My success depends on making sure the business and the DHB Information Services Group have a good mutual understanding of need, capability and potential.”

Stepping up as CDO

The role necessitates working closely with clinical and functional executive colleagues (People and Capability; Planning, Funding and Decision Support; Finance and Corporate Services) to define and implement the policies, protocols and processes necessary for the integration of all patient, people and financial data.

This collaboration with her colleagues – the Executive Director of Finance, the Chief People Officer, and Deloitte, saw the implementation of the ServiceNow platform which dramatically improved responsiveness to staff requests.

Through the platform, staff have become more engaged in accessing the services they need from human resources, and it significantly reduces the avoidable frustration of not knowing how to get the right support.

She says that many of these projects are borne from partnerships across the health sector.

“Working with big hitters in information technology like Orion Health, Deloitte and Pegasus Health, Canterbury DHB’s own technical experts have been able to create a suite of health software that has boosted our ability to work as an integrated system, providing more efficient and effective patient care,” says Ward.

She says the DHB now has an integrated platform for the South Island, utilising Orion Health’s technology and interoperable with several other key application providers that have either been developed by the Canterbury Health System or procured from vendor partners.

This integration has enabled the implementation of the South Island Patient Care Information System (SI PICS) in Christchurch Hospital Campus and Ashburton Hospital at the end of 2018 following successful delivery at Burwood Hospital and Nelson Marlborough DHB.

This system replaces three outdated patient administration software systems in Canterbury, with two of them being more than 20 years old.

Ward as Executive Sponsor of SI PICS says “This is one of the largest health software programmes ever undertaken in New Zealand – certainly in the past decade”.

Ward says that when new technology is introduced change management is one of the crucial areas technology and digital leaders have to manage.

“Change management and getting people on board is often at least as important as the new technology you are seeking to introduce,” she says.

She finds the best approach is to accept that change is never easy.

“If you want to build trust there’s no substitute for having everyone in the room, even if it’s a virtual room, and you need to provide opportunities for the system user to have meaningful input into design and implementation,” she says, adding, “Always have a plan B.”

She says pre-and post-implementation considerations include having a strong stakeholder management (especially clinicians); and the importance of change management and business process redesign.

“I have learned that technology as the enabler must be the focus, rather than the programme deliverable of replacing old tech with new tech.”

Driving innovation

Ward is also the Executive Lead for Innovation. Canterbury DHB has created the Via Innovation model to encourage designers of smart tech to partner with the health board, says Ward.

In exchange for their brains and expertise, they get to road-test their product in a real and demanding environment,” she says, on what could be a model other organisations can follow.

She says the partnership has led to at least three projects using disruptive or emerging technologies that were tested for the Canterbury Health System.

The first, Celo, is a secure mobile device-based app that allows information to be securely exchanged between clinicians and incorporated into the central health record.

“While all information held about people is sensitive, because of the nature of the information held, privacy is especially important in health” says Ward.

“We developed Celo in response to the increasing use of mobile devices for both clinical and business applications and the risk associated with using them to share or store sensitive information,” explains Ward.

The app ensures no data is held on the device itself, so a lost device doesn’t put patient information at risk. Celo can now directly add information to the central electronic record.

The second, Cortex, is another mobile app designed for use at the bedside.

It creates a single set of electronic notes and enables tests to be ordered, tasks to be assigned and workflows to be created without leaving the patient’s bedside, she says.

Cortex resolves the issue of independent sets of notes made by various members of the care team, only sometimes being shared and all too often misunderstood or lost.

Information in Cortex is always legible, can’t be lost and ensures the right information is available to the right people at the point of care, she says. The benefits to the patient are multiple, but Cortex eliminates many of the human errors that are known to cause patient harm, enabling safer, better-informed care, says Ward.

The third, ScOPe, is an application that was originally designed as an administrative tool to assist surgeons with post-op reports by creating a core set of information from which data could be extracted, as needed, for each report. This reduced duplicated effort by surgeons, giving them more time for patients.

Ward says ScOPe also gives the team accurate visibility of when an operation is likely to finish so that staff and patients aren’t kept waiting and are ready just in time, meaning less downtime between procedures.

In addition to these projects, Ward says, the district health board is using virtual reality in an increasing number of ways, from creating realistic patient care scenarios in a clinical simulation environment, to helping prepare patients for treatment or a scan that might otherwise be more stressful, to wayfinding or virtual tours of facilities.

“We now have data to show improved outcomes and patient experiences through the use of VR, most recently through helping prepare children for MRI scans,” says Ward.

The MRI machines can be noisy and intimidating, making it hard for children to keep still throughout.

“By using VR to walk children through the experience before the actual procedure, they are much more settled and we’ve been able to significantly reduce the use of sedatives,” she says.

Medical imaging is also used to augment student training in their clinical simulation suite, making practice scenarios “more real”.

The DHB has also been using drones to get footage of major redevelopments.

“We benefit from a bird’s eye view to give a true sense of scale for these projects, “she says. “This has been particularly valuable in allowing busy staff to virtually visit facilities.”

The DHB is also looking at using 3D printing for medical use. One such project involves surgery for neonatal babies.

A team at Christchurch Hospital is 3D printing models of babies’ chests to train surgeons for a life-saving procedure for oesophageal atresia. The latter is a congenital abnormality that affects 1 in 4000 infants.

The project is a collaboration with Toronto University which supplied the software to measure the surgeon’s efficiency in the simulation.

“Healthcare is a complex area and technology is fast becoming both an enabler and disruptor of how we work. I’m so excited about how we embrace this change to improve how we deliver care to our community,” says Ward.