Great Ormond Street Hospital, formerly the Hospital for Sick Children, is a children's hospital located in the Bloomsbury area of London. It is known internationally for receiving the rights from JM Barrie to his play Peter Pan, or the Boy Who Wouldn't Grow Up in 1929, which have provided significant funding for the institution.

Current IT director Mark Large has worked in the NHS for eight years, but has experience working for global blue chip companies and charitable trusts.

IT leader: Mark Large, Director ICT.

In role since: October 2008.

Reporting line: CFO.

How often does the CIO meet with the CEO: On average, three times a month.

Board level seat: Part of the Management Board, Information Governance Steering Group, Quality and Safety Committee, Capital and Space Planning Group. I am not an Executive Director.

IT budget: £5.9 million revenue, £4.5 million capital expenditure.

IT estate and or number of log on accounts under the control of the IT leader: 3500 users, 98% of the organisation.

IT staff currently employed: 55.

Split between in-house/outsourced staff: 90% in house, 10% outsourced.

IT management team and reporting structure: Three managers – Head of Projects, Head of Service Management and Head of Service Improvement.

Primary technology platforms at the organisation: Patient Administration System is iSoft.

Primary technology suppliers: Cisco, Microsoft, Citrix, Apple.

Significant strategic technology deals struck in the last 12 months: Cardiac MRI system upgrade to put Apple servers into our server rooms and Apple workstations in our theatres and cardiac consultant offices, iPads used for mobility.

Deployment of mobile devices – iPad, iTouch with MobileIron MDM) as a mobility solution, moving towards BYOD with initial help from FutureLabs, on-going deployment with Bock Solutions.

Deployment of Microsoft Federated Identity Manager and ForeFront underway, Lync, Exchange 2010, new licensing deal reached to replace NHS EWA when that ceased.

PACS/RIS replacement with a vendor neutral (XDS) archive (existing system is 10 years old, we now have high-performance web access across the Trust and are future proofing ourselves for data sharing with other organisations using the stated NHS ITK standard).

Cisco/Block Solutions – IP based audio visual capability and TelePresence.

Move from largely analogue to VoIP telephony including wireless handsets – Cisco/Block Solutions.

Percentage of your applications/infrastructure run from the cloud: None yet.

Major technology or transformation project recently completed and how did it transform operations, customer experience or the organisation: Creation of a commoditised IT platform that can soak up the needs of the organisation.

The major component of this is a new Cisco Network Architecture Blueprint local area network with a high density wireless network designed to run asset tracking, and thus able to handle large scale data and voice requirements using mobile devices.

  • The network was unstable and now boasts resilience statistics of >99.999% availability, with a 10GB backbone, 1GB to the desktop.
  • Asset tracking using active RFID tags is to an average accuracy of 2m.
  • Guest wireless installed and being rolled out to patients/parents/visitors.

Leading to:

  • Cisco wireless phones deployed and now in wide use.
  • BlackBerry/smartphone devices are capable of making/receiving calls over wireless using MVS.
  • IP based video conferencing is now available with simple end user call initiation (rather than the old, very complex and unreliable ISDN based technology which is being phased out).
  • Secure, high performance and robust remote access via Microsoft UAG and Cisco Anyconnect for all who need access via Windows or Apple mobile devices.
  • Support of Apple devices on our network and the use of iPads for mobile access to data (electronic prescribing, patient administration etc.).
  • IP based MDT meetings and training delivered worldwide from GOSH offices.

Did the above project reach its cost, timing and transformation objective: All infrastructure projects met or exceeded expectations and were delivered on time and within cost estimates.

Business transformation programme – beyond technology – that the CIO owns or is a major contributor to: Clinical and Corporate Systems Upgrade/Replacements:

  • Replacement PACS system that now provides instant access for those with rights to images from any PC (rather than the old system – circa 10 years old – that could only be accessed by special PACS PCs or very limited web image viewing capability).
  • Upgrade of critical care system for ITU’s – complete renewal including new cot/bed side units in critical care and extending the range of capability available to the clinicians and reducing manual input e.g. more devices being able to be interfaced to the system.
  • New replacement Intranet enabling a complete change in the sharing of information Trust wide.
  • Email migration from Groupwise to Exchange Outlook involving the migration of 2.7 billion messages and providing the significant  new functionality available in Exchange 2010 plus Ironport secure email and much more besides.
  • Deployment of Microsoft Lync for collaboration.

Above all, I am one of the key contributors to the new Information Strategy being written for the Trust which will chart out the path to and delivery of the ‘digital hospital’ future.

The motto of GOSH is ‘The child, first and always’ and I take my part in that very seriously. My role is to take the poor infrastructure and systems that GOSH had and transform them into something that enables all staff at GOSH to be able to operate efficiently; aiming towards The Trust’s strategic aims of no waste, no waits and no harm. I also need to provide the best possible experience for patients and families visiting GOSH for whatever length of stay (e.g. guest wireless, reliable and effective systems that are available and provide the required data on demand and at the bed side). On the staff side, transformation of clinical and corporate systems has been moving at a pace, as per the project list above and below. Two of the most profound transformations have been the replacement PACS system allowing access to images open to staff who need access and the migration from Groupwise to Exchange/Outlook providing massive new functionality and far greater ease of use.

Strategic aim of the CIO and IT operation for the next financial year: Assist the CCIO in the completion of a new Information Strategy leading to a fully electronic and digital Trust. Complete the provision of a mobility platform ahead of the proposed Electronic Patient Record and Electronic Document Management System getting rid of paper medical records so that electronic data is available at the bedside to provide immediate access to information for staff.

Strategy in the use by employees of their own technology, use of mobiles and how social networking is impacting operations, customer experiences or the organisation: Being a children’s hospital, the use of social media is having an increasing impact. We need to meet the demand to communicate with our patients and families in the ways they want to and are used to communicating, but have safe and sustainable ways of achieving this goal. We also have a small IT team here at GOSH, we cannot support all types of mobile device, so BYOD is an important goal. Our aim is for staff to be able to use their own devices given a base rule set which protects the security of patient data, without having to support the devices ourselves. For example, we are a big Citrix user, so a simple strategy would be that users can bring any device that can run the Citrix Receiver application. That way, we can provide a secure service without having to support devices we have no expertise in.

Strategy for dealing with shadow IT and BYOD including influence and engagement with executives, to place the right controls around employee choice: BYOD is a firm part of our plans and we already have part of the infrastructure deployed. Shadow IT is in many ways handled by providing a service that our staff want to consume, thus removing the need to have a shadow IT economy such as bringing Apple technology into our server rooms and making it our mobility solution of choice.

Technologies being considered to enable transformation: iPads now able to be rolled out more widely, session mobility to evade any log on/off delays, EDRMS and associated technologies to reduce the amount of paper dramatically.

We already have implemented a Cisco Network Architecture Blueprint wired and wireless network with average availability >99.999%, and an asset tracking wireless network with average accuracy to 2m, MVS software on our BlackBerry fleet to allow calls to be taken/made over wireless.

Transformational inspiration sources: Our patients can teach us a lot. Being a children’s hospital, we deal with a younger patient set that often is far more used to modern ways of communicating than we are and think nothing of using the internet, social networking and digital sources as a tool. That, coupled with the vision and creativity of our consultants, many of whom are extremely innovative, provides a constant challenge and drive to push the boundaries even further.