This week Martin McCormack, director of ICT at Beaumont Hospital, shares his thoughts on technology trends and strategy.
Beaumont Hospital is the largest public hospital in the north Dublin region and the second largest tertiary referral hospital in Ireland. The hospital is a designated cancer centre and the regional treatment centre for ear, nose and throat, as well as gastroenterology. It provides emergency and acute care across 54 medical specialities to a local community of some 290,000 people.
Can you outline the scale of the IT operations at Beaumont Hospital: how many users are there, how big is the network and what are the main applications?
We enable the work of 3,000 staff in Beaumont Hospital and St Joseph’s Raheny. Our network has to be smart enough to carry high-resolution diagnostic images, deliver high-speed laboratory analysis and support patient care, education of our clinical staff and facilitate high-end research.
Ultimately, every part of IT has some element of patient engagement.
How are you using IT to help improve a patient’s time in the hospital?
In a world of Skype, Gmail, iTunes and Kindle, the imperative for disruptive innovation is established and our patients and staff expect on-going change. They want to see a shift from paper-based processes – which are still in place in many hospitals. By contrast, when was the last time anyone booked a holiday by paper?
As an example, we recently won a global award, The Computerworld Honors Laureate Program Award 2012, for innovative use of IT to improve the quality of patient care and the speed of decision making, for our cystic fibrosis electronic patient record delivered through a virtualised desktop.
We’re collaborating on projects with the oncology team, the ED [emergency department] team and the trauma and intensive care teams aimed at improving patient care, supporting evidence-based care and increasing efficiency of resources.
Is your IT budget increased, reduced or the same as last year and how will that affect your priorities?
We’re subject to the same financial constraints as all other organisations in the public sector, so unfortunately we have a reduced budget.
However, two years ago, we joined the Innovation Value Institute in NUI Maynooth and adopted the IT Capability Maturity Framework which aims to show organisations how to measure the business value of IT investments, choose the best IT investment proposals, deliver competitive advantage and manage IT investments for optimal business value.
This has been invaluable. We use the framework to prioritise our investments, to deliver the best value to patients, staff and the organisation. In a nutshell, it’s an intelligent, research-verified way of doing more with less.
Do you see your role primarily as a technical one, making sure all the systems are running and fixing any problems quickly, or do you contribute to strategy and direction at the hospital?
My core background is in clinical services and management so mine is very much a strategic and direction-shaping role.
Beaumont made headlines some years ago by moving to open-source software – but subsequently moved back to Microsoft. What lessons were learned from that project?
The community basis of open source solutions is one of its key strengths. We still use open-source software where it creates helpful solutions. You’re referring to our desktop application of choice: our decision to move back to Microsoft was simply a way to manage value.
What’s your take on cloud computing?
I like to think of cloud computing as the fifth utility. It has many parallels as a service to those used to deliver water, gas, electricity and telephony. It requires architecture for creating clouds with market-oriented resource allocation. It requires management strategies, customer-driven service management and effective risk management to sustain service level agreements.
Clouds will need to be interconnected and we will need cloud exchanges and markets. Within our organisation, we have aligned the development of our private cloud with the hospital strategy, with an architecture that is flexible and sustainable and secure.
How far along are you in developing Beaumont’s cloud strategy?
Phase one of our cloud strategy concentrated on IT production – development, test and IT-owned applications – and lowering IT costs. The benefits realised were simplicity, efficiency and substantial cost reduction, as we virtualised 75pc of our platform.
Phase two concentrated on business production, or mission-critical, applications and improving the quality of service we deliver. This dramatically improved our scalability, availability, protection and security.
We’re in phase three now: managing IT as a service. Our objective is to deliver greater IT agility and preparedness for when we’re allowed as a public sector to avail of public cloud services.
This latter stage is policy-driven; we’re creating an architecture that is fluid and elastic, capable of growing with the addition of new groups of hospitals or users, and is chargeback-capable.
Will it be private, public cloud or a hybrid of both?
At present it is a private cloud.
What are the implications of moving to the cloud for your IT department?
Even if we were to move fully to the cloud there will still be a lot of work to do in managing change, transition and the delivery of services. We will require new skills, certainly, in terms of monitoring service level agreements, closer collaboration with legal services regarding the written contracts with cloud providers and monitoring risk in the cloud environment.
How are you and your team planning to adapt to this trend: will it involve a lot of reskilling?
I believe that it will, but the focus of the department is increasingly on its contribution to the effective delivery of services rather than a purely technical focus, so that process is already under way.
Are there any other technology trends that interest you right now, particularly where they could be applied in a healthcare context?
In healthcare internationally, the evidence is to move to electronic health records as a foundation to manage chronic diseases and provide better outcomes for patients. With that in place, an ecosystem around the patient can develop, that can take advantage of other trends, like the harnessing power of social media.
In Holland, for example, they are using crowdsourcing and open data to keep information on community defibrillators up to date, who is trained and where they are located.
Where do you see some of those trends being applied at Beaumont?
IT professionals in health can deliver value by digitising clinical information, allowing clinicians and patients to view and exchange information; facilitate exchange of information securely between hospitals and primary care teams, using the power of big data to derive value and intelligence from information to improve care quality and outcomes to curb costs. This is essential to a more efficient and effective service and we’re fully engaged in this strategy.
To support this strategy we have begun within our private cloud environment and have virtualised our desktop environment to improve accessibility and productivity for mobile users of clinical applications. We do this securely using two-factor authentication, by controlling information and keeping data off end-point devices. This has driven efficiencies and improved services delivered by IT staff implementing, managing and maintaining clinical systems.