Paperless in 2020? 5 questions with Adrian Byrne

A recent Global Digital Exemplar designee, University Hospital Southampton NHS Foundation serves approximately 1.3 million people in Southampton and South Hampshire. It also offers specialist services such as neurosciences, cardiac services and children’s intensive care to more than 3 million people in central southern England and the Channel Islands. The Trust is also a major center for teaching and research in association with the University of Southampton and partners including the Medical Research Council and Wellcome Trust.

During the recent Healthcare & Higher Education Executive Forum, I had a chance to sit down with Adrian Byrne, University Hospital Southampton’s director of IM&T. Here’s what he had to say:

1. How do you determine your top priorities each year?

Generally speaking, our priorities don’t change year-on-year. We don’t get to the beginning of the financial year and say ‘what are our priorities this year?’ Rather, we have a five-year strategy and our in-year priorities align with how we’re supporting that five-year strategic plan.

To get from where we are to where we want to be, we require a whole lot more information sharing than we what we have had and what we do at the moment. But, in terms of sharing sensitive patient information, there’s a disconnect between knowing what people are allowed to do and what they think they’re allowed to do.

Is it the law or that person’s perception of the law? It’s a growing challenge because of the requirements to share more data. If you look at HIMSS Level 7, it’s all about interoperating with the community and that means sharing data, so we really need to get on top of this whole issue of patient consent and what we do with their data.

I think some of the things we want to do aren’t invented yet. For example, I want to use FHIR and the specifications aren’t yet written for some of the things we want to do. Another example: I want to have an open data platform and the ability to write applications, or the ability to have them written – and not necessarily all by the same vendor. And, I want to have that done in such a way that the people writing those know they can be used in a wide sector of the market and the only way that’ll happen is if there’s a standard interface. If there isn’t a standard interface, and they’re writing an interface just for me, then my costs go up and their level of interest goes down.

2. Are you providing your clinicians a full picture of the patient record?

A full picture – full as in 100 percent? No. It’ll be about three years I think before we’ve largely cracked that.

Do we provide enough? I think most of the time we do. We can work paperlessly in quite a lot of our areas. I think that we require new software. We require better mobility. And, we require software that was written with mobility in mind, which often isn’t the case.

3. So, you’re on target to be paperless by 2020?

If three years from now is as far as you’re looking, then, you’ll probably still see paper. But what you won’t see is our organization managing that paper in an industrial-sized library that holds a million sets of case notes because we’ll have gotten rid of those. So, we’re reasonably positioned, but, 2020 will not be paperless.

Often our challenges aren’t necessarily about IT. Sometimes it’s about things like the building we’re in. The buildings themselves aren’t ideal for things like wireless networks. You can’t just go install network cabling or power. If you’re in a building that was built 30 years ago, it wasn’t built with bedside computing in mind. Nursing workstations weren’t built with the kind of forward-thinking you’d need to install a half-dozen PCs. The old whiteboards that hang on the walls aren’t in areas where you can just replace them with displays.

4. Where do you see ECM going in the next 3 to 5 years?

I see it going is to open data and more sharing, I guess. You can call it sharing. You can call it integration.

People talk about micro-services and platforms – it depends on what kind of language you want to use – but in terms of enterprise content management (ECM), I hope we’re in a situation where you really only have to store information once and all applications will have access to it. And all views of the information will only have one version of the truth and one place where that version of the truth is held. We want to consolidate our supplier relationships and our data platforms down to as few as possible. And, that might mean that not every application that we’ll use will have its own data platform, much like the way some mobile applications use open data now. For example, you can buy an application to look at a bus timetable, but it uses data the transportation authority make available.

5. How do you keep everything moving in the same direction?

It’s important for any organization to have strategic leadership that involves board-level engagement. It also involves senior users, and in a hospital, that means clinicians of all kinds.

When you get down to the project-level, you’ve got different teams involved, and you’ve always got to have that user engagement, but you’ve also got to have some kind of executive sponsor for large projects. Your overall informatic strategy group doesn’t get involved in each individual project, but they’ll champion the overall strategic direction.

Past performance is an indicator future performance, so you’ve got to demonstrate success.  It’s about your track record. If you go to your board and tell them you’re going to do something, they’re going to ask, ‘does this guy deliver?’ They’ll look at the other times you’ve come to them, whether or not you’ve been able to deliver year over year and how often the advice you’d provided was the right advice – or at least has proved not to be the wrong advice.  Credibility is important and while there are a number of accreditations for CIO and CMIOs, you can’t beat demonstrated success.

If you plan to be in London for eHealth week in this May, stop by the OnBase booth, #440 to hear more about how University Hospital Southampton earned its GDE accreditation. While in the UK, Byrne recommends building in some time to take in a few of the area’s attractions, like the London Why and Britain’s national gallery of international modern art, the Tate Modern.

If, like Byrne, you happen to be a fan of craft beer, he suggests heading to the breweries in the Bermondsey area of SE London. And if, like Byrne, you want to finally achieve the goal of getting rid of paper in healthcare, the fact that you’re reading this is a good start.

Julie Fogel

Julie Fogel

A content marketing manager by day, a rock star by night, Julie Fogel joined Hyland, creator of OnBase, in 2011 as a member of the Corporate Communications team. She currently covers healthcare for the Product and Solutions marketing team. As a “content coach,” Julie enjoys making the other members of the content team run laps.

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