Restructuring for Alignment and Value

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A Case Study of the
Auckland District Health Board
Information Management and Technology Service

Johan Vendrig, Chief Information Officer
HINZ Conference Rotorua - October 2007

Published in: Technology, Health & Medicine
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  • Restructuring for Alignment and Value A Case Study of the Auckland District Health Board Information Management and Technology Service Johan Vendrig, Chief Information Officer 30 July 2007 A white paper with the same title as the presentation is available. The individual sections of this white paper provides the narration for each of the slides. About the speaker Johan Vendrig, Chief Information Officer, Auckland District Health Board Johan has been with Auckland District Health Board since December 2002, initially as Manager for Information Services Strategy and Projects and since July 2006 as Chief Information Officer. After completing his masters in Information Management in the Netherlands, Johan started his career as manager patient information services and information management for a medium sized hospital. Since his arrival in New Zealand in 1996, Johan has worked in various account management, sales, marketing and programme management roles for EDS NZ, Telecom NZ esolutions and the Health Funding Authority.
  • Restructuring for Alignment and Value

    1. 1. Restructuring for Alignment and Value A Case Study of the Auckland District Health Board Information Management and Technology Service Johan Vendrig, Chief Information Officer HINZ Conference Rotorua - October 2007
    2. 2. Presentation Overview <ul><li>Context: Auckland District Health Board </li></ul><ul><li>Drivers for change </li></ul><ul><ul><li>Information Management Framework </li></ul></ul><ul><li>IM Strategy informs Structure </li></ul><ul><li>Lessons Learnt </li></ul>You have to jump a Canyon in one jump
    3. 3. Context Auckland District Health Board <ul><li>$1.3B Revenue and 9500+ staff (7,150 FTE) </li></ul><ul><li>Funder for public health services </li></ul><ul><li>Provider of hospital, community and outpatient services </li></ul><ul><ul><li>Over 1M patient contacts </li></ul></ul><ul><ul><li>50% of revenue comes from other districts </li></ul></ul><ul><li>Largest clinical research facility in NZ </li></ul><ul><li>Growing population and service volumes </li></ul><ul><li>Fully computerised (scanned) record – rapid move to EPR </li></ul><ul><li>Continued growth of (clinical) IM & IT investment </li></ul><ul><ul><li>from 2000 to 5700 workstations in 5 years </li></ul></ul>
    4. 4. Drivers for change IM&T support issues <ul><li>Silo mentality </li></ul><ul><li>Culture was systems focussed, not customer focussed </li></ul><ul><li>IT systems designed by IT people </li></ul><ul><li>High reliance on individuals </li></ul><ul><li>Lack of (process) documentation </li></ul><ul><li>Lack of flexibility and scalability of the IT support </li></ul><ul><li>Persistent high demand for more systems </li></ul><ul><li>Ever increasing level of complexity </li></ul><ul><li>Systems have become critical to core clinical process </li></ul><ul><li>Health informatics industry is immature </li></ul>
    5. 5. Drivers for Change ADHB Objectives relevant to Information Management <ul><li>Closer collaboration between health providers. </li></ul><ul><ul><li>Requires information exchange between providers </li></ul></ul><ul><ul><li>Systems that work for clinicians at coalface </li></ul></ul><ul><li>Improvement of productivity and outcomes . </li></ul><ul><ul><li>Requires production planning, business intelligence, data warehousing, coding, costing, clinical audit, data quality </li></ul></ul><ul><li>Compliance with legislation and public accountability </li></ul><ul><ul><li>Requires security, audit and enterprise content management, etc. </li></ul></ul>
    6. 6. Drivers for Change - Information Management Framework Linking Clinical, Financial and Outcome Data
    7. 7. Drivers for Change - Information Management Framework Systems bring clinical and financial data together
    8. 8. Drivers for Change - Information Management Framework “Systemisation of Healthcare” <ul><li>Aggregated data is used to analyse cause and effect </li></ul><ul><li>Guidelines are used to guide/align activities </li></ul><ul><li>Real time data is used to inform clinician at the point of care </li></ul><ul><li>Closing the loop links clinical & financial outcomes </li></ul>
    9. 9. Drivers for Change - Information Management Framework Knowledge Management & Research <ul><li>Capture data at event level </li></ul><ul><li>Integrate data </li></ul><ul><li>Enable analyses & review </li></ul><ul><li>Enable collaboration </li></ul><ul><li>Document knowledge </li></ul><ul><li>Improve access to knowledge </li></ul>
    10. 10. Drivers for Change Objectives for the Restructure <ul><li>Single Accountability for Information Management </li></ul><ul><ul><li>District rather than only secondary provider focus </li></ul></ul><ul><ul><li>Reduce silo mentality – bring IM/IT skill sets together </li></ul></ul><ul><ul><li>(220 FTE Patient Information + 93 FTE Info Systems + 17 FTE Decision Support) </li></ul></ul><ul><li>Implementation of Information Management Framework </li></ul><ul><ul><li>Leadership to integrate clinical and financial information </li></ul></ul><ul><li>Improvement of IM & IT Service Delivery </li></ul><ul><ul><li>Improve focus on users & decisions rather than systems </li></ul></ul><ul><ul><li>Create a professional service team </li></ul></ul><ul><ul><ul><li>Measure & improve performance </li></ul></ul></ul><ul><ul><ul><li>Ability to scale up and down to meet demand </li></ul></ul></ul><ul><ul><li>Enable bench marking (outsourcing or shared service) </li></ul></ul>
    11. 11. Information Management & Technology Service Improve Decisions through better access to information. User Groups Portals Systems Support Structure Content & Config (in-source) TechnicalSupport (in-source, share or outsource)
    12. 12. Information Management & Technology Service Improve Decisions through better access to information. User Groups <ul><li>HIM </li></ul><ul><li>Integrated Clinical Record view </li></ul><ul><li>Information sharing (local & regional) </li></ul><ul><li>BOIM </li></ul><ul><li>“ Concerto Equivalent” for managers & staff </li></ul><ul><li>Business Intelligence </li></ul><ul><li>Enterprise Content Mgt </li></ul><ul><li>ICT </li></ul><ul><ul><li>Reliable Systems </li></ul></ul><ul><ul><li>Measurable & Scalable Process </li></ul></ul>Change is driven by business Key Focus Areas
    13. 13. Growing Pains <ul><li>Confusion around new roles & responsibilities </li></ul><ul><li>Staff turn over higher than expected </li></ul><ul><ul><li>Long serving staff take the opportunity for a change </li></ul></ul><ul><ul><li>Very tight labour market provides opportunities for staff </li></ul></ul><ul><ul><li>Creates support for definition of processes (ITIL) </li></ul></ul><ul><li>Delay in filling some key roles </li></ul><ul><ul><li>Delay in process redesign </li></ul></ul><ul><li>Limited “excitement” at the coalface due to workload </li></ul><ul><li>The pain of a change is quicker than the gain </li></ul>
    14. 14. Gains to date <ul><li>Barriers between the teams are coming down </li></ul><ul><li>The teams are asking the right questions </li></ul><ul><li>Strategy development more shared </li></ul><ul><li>Link with business owners is improving </li></ul><ul><li>Increased focus on business operations enterprise content </li></ul><ul><li>Improved understanding of professional services </li></ul><ul><ul><li>Clarification of roles and responsibilities </li></ul></ul><ul><ul><li>Process reviews in line with ITIL </li></ul></ul><ul><ul><li>Improving visibility of workload </li></ul></ul><ul><ul><li>KPIs under development </li></ul></ul><ul><ul><li>Focus on application performance </li></ul></ul>
    15. 15. Things that worked well <ul><li>Agree drivers with senior executive first </li></ul><ul><li>Involve affected managers in the high level design </li></ul><ul><li>Extensive consultation process </li></ul><ul><ul><li>Many one-on-one meetings </li></ul></ul><ul><ul><li>Be willing to listen and make changes </li></ul></ul><ul><li>Personally present and explain rationale </li></ul><ul><li>Get applicants to commit to values based behaviour </li></ul><ul><li>Involve independent consultant when interviewing </li></ul><ul><li>Select on pro-active attitude and understanding of goals </li></ul><ul><li>Allow people to grow / stretch </li></ul>
    16. 16. The road ahead <ul><li>More focus on team building & values based behaviour </li></ul><ul><li>Prioritisation and workload management </li></ul><ul><li>Investment in IT Service Management </li></ul><ul><li>Ongoing clarification of roles and responsibilities </li></ul><ul><li>Refinement of lower level structures </li></ul><ul><li>Salary banding reviews to stay in sync with market </li></ul><ul><li>Improve internal communication </li></ul><ul><ul><li>ongoing activities, progress and wins </li></ul></ul>
    17. 17. Questions? <ul><li>Papers available </li></ul><ul><ul><li>ADHB information Management Framework v5.2 </li></ul></ul><ul><ul><li>Restructuring for Alignment & Value </li></ul></ul><ul><li>Email [email_address] </li></ul>

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