The CDO role evolved as part of the Canterbury DHB and West Coast DHB executive management teams.\nStella Ward started as the inaugural CDO in March last year providing leadership to the Canterbury and West Coast Transalpine Information Services Teams. \nPrior to this she was Executive Director ICT and Innovation and the Executive Director of Allied Health, Scientific and Technical. \nAs CDO, Ward has a strong affinity with technology but more importantly she maintains that, \u201cIn support of the patient-centric, integrated health system vision, my role, first and foremost, has a clinical [patient] focus\u201d.\n\u201cOur 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.\u201d\n\u201cMy success depends on making sure the business and the DHB Information Services Group have a good mutual understanding of need, capability and potential.\u201d\nStepping up as CDO\nThe 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.\nThis 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. \nThrough 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. \nShe says that many of these projects are borne from partnerships across the health sector.\n\u201cWorking with big hitters in information technology like Orion Health, Deloitte and Pegasus Health, Canterbury DHB\u2019s 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,\u201d says Ward.\nShe says the DHB now has an integrated platform for the South Island, utilising Orion Health\u2019s technology and interoperable with several other key application providers that have either been developed by the Canterbury Health System or procured from vendor partners.\nThis 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.\nThis system replaces three outdated patient administration software systems in Canterbury, with two of them being more than 20 years old. \nWard as Executive Sponsor of SI PICS says \u201cThis is one of the largest health software programmes ever undertaken in New Zealand \u2013 certainly in the past decade\u201d.\nWard says that when new technology is introduced change management is one of the crucial areas technology and digital leaders have to manage.\n\u201cChange management and getting people on board is often at least as important as the new technology you are seeking to introduce,\u201d she says.\nShe finds the best approach is to accept that change is never easy.\n\u201cIf you want to build trust there\u2019s no substitute for having everyone in the room, even if it\u2019s a virtual room, and you need to provide opportunities for the system user to have meaningful input into design and implementation,\u201d she says, adding, \u201cAlways have a plan B.\u201d\nShe says pre-and post-implementation considerations include having a strong stakeholder management (especially clinicians); and the importance of change management and business process redesign. \n\u201cI have learned that technology as the enabler must be the focus, rather than the programme deliverable of replacing old tech with new tech.\u201d\nDriving innovation\nWard 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.\nIn exchange for their brains and expertise, they get to road-test their product in a real and demanding environment,\u201d she says, on what could be a model other organisations can follow.\nShe says the partnership has led to at least three projects using disruptive or emerging technologies that were tested for the Canterbury Health System.\nThe 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. \n\u201cWhile all information held about people is sensitive, because of the nature of the information held, privacy is especially important in health\u201d says Ward. \n\u201cWe 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,\u201d explains Ward. \nThe app ensures no data is held on the device itself, so a lost device doesn\u2019t put patient information at risk. Celo can now directly add information to the central electronic record.\nThe second, Cortex, is another mobile app designed for use at the bedside.\nIt 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\u2019s bedside, she says.\nCortex 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. \nInformation in Cortex is always legible, can\u2019t be lost and ensures the right information is available to the right people at the point of care, she says. \nThe 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.\nThe 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. \nWard says ScOPe also gives the team accurate visibility of when an operation is likely to finish so that staff and patients aren\u2019t kept waiting and are ready just in time, meaning less downtime between procedures. \nIn 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. \n\u201cWe now have data to show improved outcomes and patient experiences through the use of VR, most recently through helping prepare children for MRI scans,\u201d says Ward.\nThe MRI machines can be noisy and intimidating, making it hard for children to keep still throughout. \n\u201cBy using VR to walk children through the experience before the actual procedure, they are much more settled and we\u2019ve been able to significantly reduce the use of sedatives,\u201d she says.\nMedical imaging is also used to augment student training in their clinical simulation suite, making practice scenarios \u201cmore real\u201d.\nThe DHB has also been using drones to get footage of major redevelopments. \n\u201cWe benefit from a bird\u2019s eye view to give a true sense of scale for these projects, \u201cshe says. \u201cThis has been particularly valuable in allowing busy staff to virtually visit facilities.\u201d\nThe DHB is also looking at using 3D printing for medical use. One such project involves surgery for neonatal babies. \nA 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.\nThe project is a collaboration with Toronto University which supplied the software to measure the surgeon\u2019s efficiency in the simulation.\n\u201cHealthcare is a complex area and technology is fast becoming both an enabler and disruptor of how we work. I\u2019m so excited about how we embrace this change to improve how we deliver care to our community,\u201d says Ward.