University College London Hospitals (UCLH) - comprising of six separate hosptials - is one of the most complex healthcare organisations in London as both a major incident response hospital, a leading treatment hospital for a wide range of care from heart to cancer and wards for maternity and A&E.
Director of ICT, James Thomas, was celebrated at the top of last year's CIO 100 as an example of what the NHS can be in the 21st Century and what a CIO can do for an organisation in terms of sourcing strategy and management, process improvement and being a leader that enables an organisation to think openly and differently about what it can achieve with technology playing a key role. As the NHS faces a new dawn, public sector finances are slashed and the population ages, the panel agreed last year that Thomas shows transformation is the way forward.
Thomas has not slowed down since 2013, and in February this year discussed UCLH's move to the cloud, mobile strategy, eLearning and how the group of six separate London hospitals was trying to liberate clinical staff using technology to improve patient care - and why enabling innovation was still one of the most paramount duties for a modern CIO.
What is your job title?
Director of ICT
When did you start your current role?
Have you completed an MBA?
No, have done Diploma in Management Studies.
Order the following sources of advice/information by value to you:
1. Peer group
Technology strategy and spending
What is the major transformational IT project that has been recently completed, or is underway at your organisation?
The development of iOS mobile apps, to unlock a legacy end of life Patient Administration system. This will overcome the poor UI of the legacy system and extend the usable life of the legacy system. This is leveraging the MDM and BOYD infrastructure that is available.
What impact will it/does it have on the organisation?
This will enable clinical staff to have focused easy access to timely information via a device of their choice (iPad, iPhone). The mobile apps are deployed through an internal apps store and can quickly be updated and deployed.
What new strategic technology deals has your organisation struck and with whom?
We have agreed the comercial profit share and marketing arrangements for the jointly developed with CGI eCarelogic Clinical portal. We have also signed a early adopter agreement for the use of Nexthink across the whole UCLH ICT infrastructure to help optimise the digital experience for the clinical and no clinical staff. This currently looks at all the desktop, network and server infrastructure assessing performance and user experience. This will with a new release be expended into the applications layer for web based applications.
Name your strategic technology suppliers?
CGI, Azzurri, Apple,Extreame, GE, Phillips
If you can’t tell us the IT budget, how much is the IT operational spend compared to the revenue or company turnover as a percentage?
The IT operational spend is lass than 2% of turnover averaging 1.6 to 1.8% over the last 3 years.
What is the strategic aim of the CIO and IT operations for the next financial year?
Developing the ICT strategy for 2017, which will continue the drive for mobility and real time information, provide patients with access to their records, support the drive to improve customer experience. It will also set the direction for clinical systems for the next 5 - 10 years.
Would you describe the CIO role as a transformation leader in your organisation?
I am part of a transformation Team that supports our clinical colleges to evolve the care and services delivered at UCLH.
Describe the transformations you have led / been involved in, how did they transform operations, customer experience or the organisation?
Liberating Ward Sisters is transformation focused on Liberating the time of Ward Sisters from administrative activities to undertaken clinical leadership within the Ward setting. I was part of the original successful bid team and have lead as part of the steering board over the last 12 months.
The introduction of BYOD at UCLH has been as a great success and has pushed the boundaries of the suppliers and the security professionals. This has driven product development by Mobile Iron and driven joint working between Apple CGI and Mobile Iron over the certification and publishing of Mobile apps.
The implementation of Digital ITU (Intensive Treatment Unit) has moved these units from recording all observations from paper to full machine to machine recording of data for 100 ITU beds we are recording approximately 44 million digital observations per year.
Beyond technology, can you describe a business transformation programme that you own or contribute to?
The Customer experience programme, UCLH is working with consultants and patients to define the customer experience that will differentiate UCLH from other healthcare providers in the UK and will help motivate hundreds of admin and clerical staff to see their part in delivering excellent patient care.
The centralisation and rationalisation of paper medical records services across all six UCLH hospitals. This is covering the storage and distribution of 4.4m volumes of clinical notes.
What key technologies are being considered to enable transformation?
The use of Cloud services for, CRM, email, document workflow has been catalysts for transformation.
The deployment of MDM solutions to enable the management trust purchased Apple devices and BYOD devices. This has enabled the creation of an internal apps store.
What percentage of your applications / infrastructure is run from the Cloud?
Less that 10% currently.
How is the use by employees of their own technology, use of mobiles and social networking impacting operations, customer experiences or the organisation at present?
There is a significant impact from the use of Social networks for both staff and patients. The patients are using a variety of social tools and networks to share thier experiences and learn from their peer groups on how to cope with their conditions. With regard to the staff use of social tools we are expanding and supporting the growing use of yammer within UCLH, and we also are piloting specific secure social network tools for Junior Doctors to huddle and communicate.
Do you have a plan in place for how to deal with shadow IT and BYOD. How do you influence and engage executives, place the right controls around employee choice and engage with the organisation on this issue?
We have embraced BYOD, but limit it currently to Apple devices. We currently have over 300 BYOD devices connected. As an organisation we have been focusing on the removal of shadow IT due to the risks of reduced DR capability and inconsistent High Availability. We have over the last 18 months pulled 30 heads together as the clinical systems management team through the amalgamation of Shadow IT.
Where do you seek transformational inspiration from?
I seek my inspiration for different sectors of service and industry outside Healthcare. I regularly use the services of Analysts to guide me to new innovative business models and offerings. I talk with service users in my case doctors and nurses about their needs and what works well in their non work lives.
The CIO role in the business
Who do you report to?
Do you have a seat on the board?
How often do you meet with the CEO?
Does your organisation have a digital leader and what is the difference in their responsibilities to yours?
We have CCIO (Chief Clinical Information Officer), and their responsibility is to drive up the provision of Health informatics and therefore drive the organisation to be move data driven in its provision of clinical care.
What percentage of IT budget do you control and what percentage of IT budget does your digital peer hold?
I have the control over all IT budgets and the Digital Peer (CCIO) has a joint reporting line to me and one of the Trust Medical Directors.
The IT department
How many staff make up the IT team?(What is the split between in-house/outsourced staff)
The IT team (not including Applications management, and programme office) is made up of:
5 internal staff, and 100- 130 Outsourced staff.
40+ internal applications management staff
25+ Project and Programme staff, mix of internal and contract staff
Describe the CIO’s management team, do you have direct reports that develop the relationship and services between the business and IT?
We have an ICT SMT (Senior Management Team). This is made up of the following roles:
Head of Business Solutions (this role is responsible for the relationship management between service users and ICT, there is a dedicated team of Business Engagement Partners.)
Head of Service Delivery and Vendor Management
Head of Project and Programme delivery
Head of Records and Governance
Chief Clinical Information Officer
And how many log-in accounts do you issue across you organisation?
What is the primary technology platform? ( for example ERP, Website, trading system)
.Net based clinical data repository, GE Carecast Patient Administration system, Oracle Financials, SharePoint Intranets,