"I'm here to tell you how annoying the cloud is for me," quipped Director of ICT at University College London Hospitals (UCLH) James Thomas as he opened his keynote address at Cloud Expo Europe, but the CIO 100 leader said that its disruptive influence was complementary to his mobile agenda and was helping drive innovation.

Thomas used his platform to discuss how cloud has underpinned mobility at the six separate hospitals that make up UCLH, improved eLearning facilities and liberated clinical staff.

Voted the leading IT executive in last year's CIO 100 by the CIO UK judging panel for his transformation programmes in the healthcare sector, Thomas also announced that UCLH had just agreed a deal to move its problematic email system to Microsoft Exchange Online.

"We were very focused on taking a cloud solution," Thomas said, "resulting in reduced UCLH management overheads and running costs."

Email headache

The standard mailbox size for staff across the six hospitals was 50MB, meaning they would have to regularly archive their mail – which was also a tough data job for the CIO dealing with 32 million emails a year.

Thomas said that email had been a major headache for the organisation, which was further compounded by the issue of Exchange 2003 support running out in April this year.

While Thomas said that communication via email was a critical application, UCLH believes it will eventually drive down email traffic using social tools.

In October last year, CIO at KPMG Harry Mosely said enterprise social networks at the massive professional services firm had taken over email as the corporate communication tool of choice.

Thomas said Microsoft's Yammer product was being considered. Adoption of Microsoft Exchange Online supports the mobility and bring-your-own device (BYOD) strategy at UCLH, Thomas said.


The drive towards mobility has been a lengthy process, Thomas said. The CIO produced a 2007 vision outlining how he wanted the department to operate in 2017 – with mobility and digital services a large part of that document.

The hospitals needed the ability to support clinicians by having the right data available to them at all times, but only as long as they are accessing the data on a device that reaches the correct standards.

Thomas said that UCLH had traditionally been big users of BlackBerry, but were early users of mobile device management tools with Mobile Iron to migrate over to iPhones, and have recently continued the Apple trend with iPads and iPad Mini tablets from 2013.

"There's lots around that in order to support it," Thomas said. "On our WiFi network we have in excess of 300 BYOD users, but we won't touch Android."

Cloud disruption

Although UCLH has embraced cloud computing, Thomas revealed that it has caused problems. Thomas said that as part of the Standard Financial Instructions at the NHS, he had always had control over all IT spending.

The relevant clause giving the director of ICT purchasing power read: "Purchase of all ICT equipment and systems must be approved by the director of ICT or their delegated officer."

But with cloud being a service and not an ICT system, Thomas said, he lost some control with his first knowledge of outside procurement being a request through the UCLH firewalls.

"But we are dealing with this through education rather than legislation, and education over safety as data," he said.

One of the big cloud success stories was born from the hospital's 'liberating sisters to lead programme', Thomas said.


An internal audit showed that lead sisters, were being detracted from their roles as clinical leaders. The study revealed that lead sisters spent less than 50% of their time on clinical leadership, well below the 75% target.

Thomas said that most of this time was spent on corporate services, or what clinicians might call bureaucracy.

Thomas said the hospital came up with a concierge team to help manage the requests to corporate services from ward sisters, deploying a Microsoft Dynamics CRM system in only three and a half weeks.

The other transformational success came in eLearning, which had previously been hugely restrictive through the NHS Networks tool and which was a crucial component to the education of London's medical students.

"Students were only able to train once they had their pass cards and access to NHS Networks, which was only available when they were in an NHS building," Thomas said.

He said the UCLH borrowed from the blueprint laid down by a number of university institutions, moving all eLearning over to the Moodle open source platform. This enabled students to be able to log in and start their training before they had even officially started and in a much less controlled training regime.

Enabling innovation

Fundamentally, Thomas concluded, the cloud was an enabler and complementary to organisations – it’s real job to liberate time and burdens to focus on innovation, something that should really be the focus in something like the health industry.

He also said that while security in the cloud is a concern and critical to an institution like the NHS, it was not something that should stand in the way when real advancements in culture and practices can be made.

"Security is paramount for us. But we're not paranoid; we wouldn't do BYOD if we were," Thomas said.

"What's important is how can we share data and then ensure it is secure. It`s not how can we secure data that comes first, and then how do we share it."