It's not often a new IT head comes in with the task of transforming an organisation's IT operation from the ground up. Two years ago Paul Kirkpatrick came into St Andrews Healthcare, the UK'S largest provider of mental health services from the charity sector into the NHS, with a history dating back to 1838, to find his team's skills sorely inadequate to support a network of hospitals in the 21st century. The organisation's IT infrastructure reflected the poor expertise within the team and it was only able to manage a network uptime of around 75 per cent.
Kirkpatrick had transferred from British Standards Institute and was used to high expectations in terms of service level guarantees. His first task was to update the network supporting the company's four sites in Northampton, Essex, Mansfield in Nottinghamshire, and Birmingham. St Andrews has 4,000 staff and a £170m per year turnover. Kirkpatrick had a budget of around £3m and a team of 30 to support the business, but the resources he found when he joined in 2008 were inadequate. He began by running an independent audit of the IT systems and his team's ability to run them. This gave him the information he needed to take to the board, but also the credibility to demand from it the changes necessary to keep the company operational.
He found an out-dated Token Ring network architecture being run on current hardware, but with little security in place. Development was chaotic with updates going straight on to the live system with no test environment. There was a large amount of investment in projects, but little implementation. He found 97 open projects in operation, but no process methodology adopted to keep track of the work being done.
Duty of care
In any organisation, this chaotic approach to the IT could do harm to the business, but St Andrews deals with society's most vulnerable patients with a history of mental illness and it had a duty of care to staff that their safety wasn't put at risk by unreliable systems.
The audit gave Kirkpatrick the critical data he needed to be able to push through his demands to the board: He actually managed to triple his overall budget in the last two years and quadruple his capital expenditure. He assessed the strengths of his team – on a one-to-one basis – and those that couldn't be brought up to speed were shown the door. He negotiated an outsource agreement with a third-party networking company to farm out what is essentially a utility function.
More than this though, Kirkpatrick went on to implement an upgrade of the networking systems, to WiFi and to beef up the company's information processing capability. This innovation wouldn't have been possible, he says without the support of the CEO, who wanted to grow the business and the CFO, his first report and IT predecessor, who recognised how vital it was that St Andrews address its spavined systems if it was going to have the foundations for the growth the board wanted to achieve.
Kirkpatrick said: "The CEO saw the need for staff... ...to be issued with one device for all their communication needs. He was concerned with how new patients react when they see staff with lots of gadgets on their belts."
One device would also simplify the way staff get information about patients and the ease of calling for emergency help if they needed it.
Kirkpatrick had previously worked at equipment supplier GE Healthcare, as CIO EMEA and he was aware of the developments in wireless networking specially targeted to healthcare organisations. Up to now, it's a technology that's gained some traction in the US, Ireland and the Nordic countries, Kirkpatrick observes, but he claims he's one of the first in the UK to combine a number of WiFi-based services to deliver so much support for front-line clinical staff.
Access points are positioned throughout the campus and can potentially be used for data streaming, telephony or through the use of triangulation, location tracking of staff and patients.
All of these functions can be supported by a single smartphone handheld device, or in St Andrews' case a fob worn on a lanyard. The company was already using line-of-site infra-red beepers for staff to call for help, but the WiFi connectivity of the new fobs makes them more reliable, gives the user the ability to tailor the call out to the specific need and provides location tracking, so that the caller is easily found by help.
"It means I can start retiring some of the architecture and reducing the multiple devices staff have to carry around," says Kirkpatrick.
The other big project Kirkpatrick has been concerned with focuses on information governance for clinical decisions.
He says: "One of our requirements from the NHS is to conduct care plan assessments. Our income is reliant on showing that our patients are getting better."
He is currently working on linking all the individual core systems into a data warehouse that produces real-time dashboard reporting down to the individual patient. This helps St Andrews provide data to the NHS, to which it owes 98 per cent of its revenue, so that it can plan how long a patient is likely to stay in hospital. Every provider is keen to move patients down the care pathway as quickly as possible so that the beds can be opened up to new patients, but this obviously needs to be tied to outcome reporting and the individual patient needs.
Both of these projects may have had the buy-in from the managers, but Kirkpatrick recognised it was the clinicians who needed to be persuaded too. Without them, neither project would get off the ground, so, in order to create a level of confidence amongst the staff, he set up a live trial of the system in one of the areas where the most emergencies occurred.
He says: "I got them into the IT team, to attend the meetings of our boards. It has to be driven from them. Before, I arrived, IT was seen by clinicians as giving solutions out that were best for the IT. Now we give out the solution that's best for the people working in the hospital."
Kirkpatrick believes the transformation he has achieved has given the organisation a competitive advantage in the private healthcare market. Time to admission is down and the risks to data and staff have been made much smaller.
On top of that, the standing of his team within the organisation has vastly improved. IT has a higher regard amongst clinical staff, who are now proactively coming to them for solutions to their working problems.
For the future, Kirkpatrick is investigating the benefits of cloud computing, just like everyone else. He has a pragmatic attitude towards all IT developments - only choosing approaches that have worked in the real world elsewhere - and the cloud is no different. Working for an organisation that handles highly sensitive patient data, he's concerned that security issues haven't been settled to his satisfaction. Kirkpatrick gives it two or three years before he thinks cloud services will be ready for data of his level of sesitivity.
Standards and Music
Kirkpatrick acknowledges his varied background has helped him in his task of transforming IT services at St Andrews. His two-year stint as global head of IT for products services at British Standards, from 2006-2008, gave him the rigour and systematic approach to identifying the root problems at the company. Before that, his six-year tenure at GE Healthcare, reaching the level of comms and operations director for EMEA, taught him how to get clinicians' support for his efforts. This experience within an IT supplier taught him how to sell his ideas.
His background in electrical engineering and an interest in Midi music systems in the late 1980s introduced him to computing and Kirkpatrick carries this initial interest on in the music label he still runs in his spare time.