Demogene Smith : eHealth Innovation
Mid North Coast Local Health District: eHealth Innovation
eHealth Program Manager for Mid North Coast Local Health District
Can you briefly tell us a bit about your background?
I have been in my current role for two years. Before this, I was working for a small health service in Hamilton, Victoria which was part of a bigger alliance of health services. My roles have included running health orientated projects for the Local Health Districts and the state. Before coming to Australia, I was the director of IT for a regional college in South Africa, which is the equivalent to TAFE here.
What are some of the changes you have observed since taking on this role?
NSW Health and many other areas of the health service are starting to realise how big an impact technology is having on the work they are doing. NSW Health has invested a great deal of money and expertise into making sure health services are effectively tailored for every person. It is actually pretty nice being part of such a big change.
Can you talk about some of the initiatives that are occurring in this region?
For me, technological innovation is not about inventing the next shiny new thing, it is about looking at the problem and picking up the bits and pieces that are lying around you and reforming the puzzle, so that you do things in a much better, smarter way. You don’t necessarily need to go through a massive transformation, because little things can make a big difference.
With that philosophy in mind, some of the things that we have being doing closer to home include being the first Local Health District (LHD) to put up our hand to implement a fully digital Intensive Care Unit (ICU), something that doesn’t exist anywhere else within health in NSW. As a result, we were also the first LHD to come to an understanding of what a digital Health workforce needs to look like.
We have started restructuring all of our systems to better understand the confidence of our clinical workforce. We are also working towards providing a gamificiation perspective for staff to understand their journey to becoming an eNurse or an eClinician and having a fully structured environment to support that. By doing that we have also become one of the first regional health services to investigate the use of artificial subject matter experts to support our workforce, and utilising the products we have around us.
What benefit is there in rolling these out in a regional area rather than a metropolitan area?
One of the challenges for rural and regional areas is not always having a ready access to a wide skills mix. In metropolitan areas you can drive 30kms down the road and you would encounter a lot of innovative and capable individuals and teams that you could leverage from. In the regional areas there is a lot more geography between you and the innovative person, or they may be difficult to identify or find. The geography and regionality make it a very challenging environment to rapidly prototype ideas and to access skills, probably that’s the biggest challenge.
The benefit of being in a regional area is that you have the regional hat culture. People from regional areas have had to face a wide variety of problems so they often have more of a “can do” attitude, wear multiple hats, do multiple things and have a great willingness to learn. With this culture, it is easy to develop high performance teams who can do fantastic things. You find if have a group of people with a mixture of skills and this “can do” attitude, you can get them to do anything with a bit of support.
We find in the regional areas the “can do” attitude that exists combined with a slightly shorter path from the bottom to the top, you can rapidly deploy things where the metros can’t, and that is where we have been finding our successes happen. We have being taking on projects and using our “can do” attitude, coaching a couple people and getting it done quickly. Our project delivery is starting to be testament to this approach and as a result the state is starting to looking at deploying initiatives in regional areas first to test them out. The advantage for us is that it will not take us years but more like months to get an answer to some of the unknowns.
What are some of the roadblocks that could be removed for this process to happen quicker than what it is now?
From my perspective, partnering with some of the incubators would be a start. As this is a state structure a lot of the processes that are imposed make it challenging to engage with the innovative pockets we have being talking about, and partnering up becomes challenging. Often to access innovation you have to go through a fairly lengthy bureaucratic process to be able to do something that may be small, yet has the potential to have a lot of impact.
The biggest challenge is not people’s unwillingness to embrace technology but their limited understanding of what it means in the context of their work. Health has been fairly stable and moved along fairly slowly. That is changing now with the advent of a large amount of consumer technology that is available. If people want to know something they can ask Google or download an app. Health hasn’t caught up yet and as a result it hasn’t cultured the workforce in how technology can be applied. Getting people to understand and then have confidence in simple things like understanding virtual desktops that follow you around or having an app on a clinicians phone to help with decision making have proven difficult.
Can you see a time when incubators are presented with a problem that Health needs solving?
At this point these partnerships with incubators are not happening at a grassroots level, because the connection with understanding the benefit hasn’t happened yet.
If we could tap into the incubators that are specialising or innovating in a particular field and help them understand our problem and use their skills as rapid prototypers, we would have a blossoming marriage and we would be able to do a lot of grassroots things that would facilitate change very quickly.
What is the next step?
A lot of what we are doing now is not the fancy stuff, a lot of it is putting the foundations in to build upon. Then we can enter into using algorithms to improve patient care, creating the apps that can hang off the system as we can connect closer to our consumers and clients in a way that they are used to engaging with other services. A lot of work has taken place in a very short space of time, we are not there yet but we will be in the next two or three years.