Delivering Improved Outcomes from ICT Investment in Health


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Murray Milner
National Health IT Board
(Thursday, 9.30am, Forum Room)

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Delivering Improved Outcomes from ICT Investment in Health

  1. 1. Delivering Improved Outcomes from ICT Investment in Health Murray Milner Chair National Health IT Board PREPARED BY
  2. 2. Today• Success Factors• Regional Leadership• Governance-district and regional• Regional Delivery Organisation• Programme/Project Governance• Essential Leadership Skills• Conclusion
  3. 3. Background to Success • I have been involved in large ICT projects for over 40 years • Successful delivery of ICT projects is common to any sector, the principles are the same • My most recent experience has been with the Central Region • Success requires powerful governance and leadership
  4. 4. Critical Success Factors• Agreed vision, strategy and prioritisation• Clearly defined governance and funding• Passionate beneficial ownership and well executed change management• Strong clinical leadership• Compelling consumer engagement• Solid commercial relationships with vendors• Interoperability based on standards• Regular, informative reporting
  5. 5. Governance To Drive Change Groups the Board will work with and hold accountable for achieving the plan National Health IT Board Works with: National Information Holds accountable Clinical Leadership Group DHB CEO National Ministry Major NZ Health Patients First Information Group Programmes Projects Group IT Cluster Consumer Local Regional National Panel Invest Sponsor Sponsor Sponsor NZ Telehealth ForumDefine/ Owner Owner OwnerOperate DHB CEOs and CIOs Prog/Proj Prog/Proj Prog/ProjDelivery Manager Manager Manager Health Information Standards (HISO)
  6. 6. Regional Leadership is KeyHealth and Disability Act changes; DHBs to act regionally1.All the regions have different versions of a shared servicesorganisation2.Legal entities are needed at regional level, preferably nota DHB on behalf of the region3.Separating Shareholder and Customer interests inregional shared services organisation delivers benefits4.Regional IT Leaders appointed and IT capacity andcapability regional teams set up-most are distributedHave we made sufficient progress?
  7. 7. District Governance• Regional decision making across multiple DHBs is complex and time consuming • A round of board meetings can take 6 weeks, difficult decisions take 2-3 rounds of board meetings• Important and essential decision process for defining agreed regional strategic direction • Eg. Approval of Regional Service Plans• Impossible process for successful delivery of an agreed programme of work • Need single line of accountability with clearly defined delegated authority and rapid decision making processes
  8. 8. Regional Governance• Need to establish a regional governance framework • With adequate autonomy and single line of accountability for AGREED regional initiatives • Eg. A regional governance group consisting of District Chairs plus an independent Chair • Provided with delegated authority to implement AGREED Regional Service Plans and associated supporting capability (Eg. Regional ICT Plans)• Delegated Authority within agreed on and off ramps and reporting • On ramps: Conditions which must be satisfied to progress • Off ramps: Conditions which if encountered require reference back to parent boards • Reporting: Time, budget, quality and risk
  9. 9. Regional Delivery Organisation• Need a capable and empowered organisation to deliver regional initiatives, including ICT • Using part-time district resource is not efficient or effective • Too many conflicts of interest• Organisation needs to be a legal entity at the regional level to own, contract and/or operate ICT systems and infrastructure • Separate governance structure focussed solely on best practice delivery of outcomes agreed in the Regional ICT Plan • Separation of customer and supplier accountabilities is essential for successful delivery • Customer for each major initiative will be a lead CEO • Customer will be supported by the prime Beneficial Owner if that is not the lead CEO
  10. 10. Programme/Project Governance• CEO of Regional Delivery Organization is accountable for successful delivery of a regional programme of work • Based on the RSP and including the agreed Regional ICT Plan • Reporting to a board focused on best practice delivery• Programme Director is accountable for a specific programme of ICT work within the agreed Regional ICT Plan • Responsible for managing the delivery team and all stakeholders • Direct delivery accountability to lead CEO/ Beneficial Owner • Management of time, budget, quality of outcomes and risks • Management of third party vendor contracts • Report to CEO of Regional Delivery Organisation for performance
  11. 11. Essential Delivery Leadership Skills• Programme/ Project Management • Keeping programmes/projects on time, on budget and to agreed quality • Managing overall programme/project risks • Engaging stakeholders and managing their expectations • Ensuring robust Change Management is implemented • Reporting on progress and risks• Commercial Management • Negotiating contracts with third party suppliers • Managing commercial relationships and associated commercial risk• Systems Integration • Ensuring the end-to-end integrity of the programme/project solution • Ensuring seamless integration with all related systems • Ensuring interoperability of appropriate information
  12. 12. Conclusions• The Health and Disability Act was amended to enable DHBs to act regionally• The Health IT Plan is intended to be implemented on a regional basis • To deliver improved economies of scale and scope• Successful implementation of ICT in such a complex environment requires strong Governance and Leadership • Regional Governance for effective decision making • Regional Delivery Organizations for clear accountability for delivery • Powerful leadership for programme/project management, Commercial management and system integration
  13. 13. Thank you for your attentionAny questions? PREPARED BY
  14. 14. National eHealth Approach Towards 2014 Sadhana Maraj PREPARED BY
  15. 15. National eHealth Approach Towards 2014 Dr. John Morgan Medical Director Midland Health Networks PREPARED BY