South London and Maudsley NHS Foundation Trust CIO Stephen Docherty attributes progress in his latest role to the sense of collaboration at the organisation, coupled with earning a Master's degree that asked why IT leaders struggle to gain professional prominence.
The CIO 100 member outlined why he was brought in to radically overhaul SLaM's approach to IT and mentioned how his experience in the world of gaming set a sturdy foundation for positive change. [Also read: Stephen Docherty CIO 100 video interview - Facilitating external and internal collaboration at South London and Maudsley NHS Foundation Trust]
"The gaming industry showed me that, from an IT perspective, you can be creative, show the art of the possible and keep pushing and pushing, because technology's changing so fast," Docherty said.
Based in Denmark Hill, South London, SLaM has around 100 sites in the capital with 5,000 staff. It is regarded to provide the widest range of services in the UK for those with mental health or addiction problems.
Formerly of Sony Computer Entertainment Europe, EA and Atari, Docherty also completed a specialist Master's that asked: 'why are IT leaders not given more prominence?'. The answer lies, he said, in that IT is often wrongly thought of as a separate department rather than the lifeblood of a complex organisation.
"I was looking at the evolution of the CIO and the evolution of IT since the '50s," Docherty said. "I'd been in technology for 30 years, since I was 18, and I could see how things were changing. I thought, why aren't IT leaders getting a seat at the table? Why are we not developing our next set of CIOs?"
"I think every CIO should try and do a Master's, because it gives them that intellectual background," Docherty added.
Docherty skipped university and instead headed straight into work but later sought and received a scholarship through IBM and City University to study at the Cass Business School. There, he completed a Master's where he said he was "like a sponge in taking all of this information in, because it was the thing that I was lacking".
"If I hadn't had that intellectual background, the learning and the teaching, I probably wouldn't have been able to do as well," he said.
Docherty was then hired by SLaM to reinvigorate and streamline an IT strategy that was "all over the place" and "failing regularly". His background allowed him to bring "different principles and a 'can do' attitude" while he had to "quickly look at an organisation and join up all the dots and see that big picture".
Changing a risk-averse NHS organisation's attitude to IT had to start with the people. All of them, it turns out.
"Bringing about change to the culture was a challenge but everyone in the department had a voice and could see what the vision was and could feel a part of this," Docherty enthused, admitting that there was pushback from the existing IT department, worried that the move to cloud services might put them out of a job. On the contrary, he said that it made them more valuable as they transitioned from managing servers to running a unified service.
"It's the way to go, and I've said for years that it's not IT projects, it's organisational change with elements of IT," he said. The change had to be a shared vision, and one that required the hard work of everyone at SLaM.
"It's been a really great change in the culture," Docherty added. "But if I didn't have a good management team behind me, I wouldn't be able to go out and push for these things."
While rebranding the IT department to 'Digital Services', Docherty successfully transitioned SLaM's IT services over to the Microsoft Azure platform, an important background change that allowed the entire staff to base their workflows completely around Office 365, a move that he believes encourages collaboration.
Noticeably, Docherty doesn't refer to Microsoft as a vendor and is adamant that the word is outdated. Instead he views the business as a partner, which he suggests is much more conducive to progress.
"If it's difficult to get the staff to understand the technology, let's take it to them," he said, explaining how a Service Desk team fielded incoming queries. It wasn't long before staff were comfortable with the new IT setup, a fact confirmed by SLaM's recent Mental Health Global Digital Exemplar status – the only London-based mental health Digital Exemplar of seven nationally.
As a scheme that recognises NHS providers delivering exceptional care and efficiency through its harnessing of digital technology, SLaM can claim via Docherty's leadership, to be moving towards a future vision of healthcare in the UK. The £5 million grant probably helps, too.
"With the Digital Exemplar money, we're going to be able to resource-up and pick up the pace, like how we're piloting digital ward observations on tablets, starting with physical observations. If patients get a certain score, there will be an automated message sent to a consultant to come and see them," Docherty said, pointing towards the holy grail of a paperless NHS, something he envisions for SLaM by 2019.
When Docherty speaks of creating team-level dashboards of live, assured data, it gives the sense of a workforce uniting around an ideal. Not an ideal shaped around IT, but an ideal of better healthcare that is undoubtedly influenced by it. That is largely thanks to Microsoft's Power BI, a business intelligence tool that SLaM is using to put trust back into its patient data.
Docherty saw that the old system had to change, where data was taken and molded to suit the purposes of departments. Not maliciously, but wrongly.
"This had to change," he said. "We took away the layers, and now the data comes straight from the clinical system and into Azure, where we then use Power BI to visualise the data. If it's there, then it's assured - we may not like what the data tells us sometimes but that's what it is."
This simplistic but strict approach to data use is indicative of Docherty's ambition to better integrate emerging technologies into SLAM in the coming years. Of those, he sees wearables as an area with the most potential, one he describes as "the future of healthcare".
Telehealth and wearables
"If you record your moods, your sleep, how you're feeling, alcohol and drug intake, then that's what you class as user-reported data," he explained. "But if you add wearables to that, then that's user generated-data. With two sources of data, you have a powerful source that gives you a longitudinal view of a person."
Pair the use of effective wearable technology in the NHS with AI, and Docherty believes a more efficient form of personalised care will emerge. The user generates data day-to-day, while automated technology helps to work out a course of effective care on a personal level not possible without this type of round-the-clock monitoring.
This is particularly pertinent in mental health, where Docherty sympathises with the drawn-out referral process, one that led a patient to lament to him that they must time their crises to fit in with the system. But with constant monitoring through wearables and AI, a patient could visit a specialist who could view weeks of existing user-generated data – more effective, Docherty asserts, than the current initial consultation process.
With the introduction of newer roles like the CCIO (Chief Clinical Information Officer) and the CNO (Chief Nursing Officer) into the wider NHS, the future adopts a collaborative tone for SLaM. The relationship between these roles is one Docherty describes as a partnership.
"It has to be. You translate for each other. There has to be the clinical perspective and the technological perspective and the business perspective. CIO and CCIO is the way to go, along with CNO," he said, and SLaM has introduced a 'moan and groan' channel for clinical staff to communicate issues with the C-level. Similar to when Docherty introduced cloud services, giving every level of employee a voice is key to these processes of change.
London CIO Council collaboration
This tone of collaboration is strengthened by Docherty's position as Chair of the London CIO Council, a role he says is invaluable.
The meetings, attended by CIOs from the capital's NHS organisations, focus on "how we digitise, how we collaborate, how we do things better," and Docherty believes sharing experience across different fields is vital in order for CIOs to improve their own businesses. With sponsors BT, Atos, Channel 4 and IBM on board, the CIO Council appears an invaluable source of cooperation.
It also invites to its meetings members of the confusingly identically named London CIO Council comprising local government representatives. Gaining perspective from CIOs in other professions goes a long way to helping SLaM contextualise its IT growth.
"It's opening up that whole collaborative network and I think that's the right way to go," Docherty said. Listening to each other's experiences can help CIOs better manage their existing roadblocks. So, did he share any advice with the Council following the WannaCry attack?
"We were absolutely fine. I think some CIOs went into shutdown mode, which is not necessarily the right thing. The CIO Council discussed it, and we really could have had a better mechanism to support and tell each other what was going on, as opposed to looking at the news."
Docherty mentions Will Smart, the head NHS CIO, as someone who recongises that cyber needs to be at board level. This is positive to hear, but notable that such a large, important institution as the NHS is only reaching this point in 2017.
Docherty's progress at SLaM is proof that the NHS is well overdue IT modernisation, but that CIOs of smaller NHS providers are helping to influence change across the whole organisation. Changes like providing prescription instructions in languages other than English are simple enough to introduce, and can be the building blocks of an IT-centric future.
Changing attitudes to IT in the NHS won't happen if everyone shouts at once, but if you give everyone a voice and embrace a can-do attitude, that future becomes a lot clearer.