How to Apply for an Advertised Job

21st May 2012

In the 35 years since I have left school I have applied for hundreds of jobs. In the last twenty years I have worked in roles where it has been a substantial part of my role, sometimes a challenging part, to review the applications of hopeful job seekers. In this time I have seen and learnt an awful lot about job-hunting, about what works, and what doesn’t; and about what draws my attention when I am looking to employ people. I hope that by sharing some of my experience and observations I can help others to be successful in progressing their own careers.

Advertising for help, reviewing applications and selecting candidates can be a tedious business. However, at the same time, it is critically important to the success of any manager and to the success of any business.

Respect the Employer and Yourself

When applying for a job, no matter where, when or what, there are some attributes of a job seeker that will provide a competitive edge. These include applications that show respect for the employer, understanding of generally accepted protocol, process, and etiquette, and a genuine desire to make a contribution to a team.

There is an old adage that “you are as people perceive you to be” and hence your ability to project confidence, ability, respect, honesty and commitment will not only serve to reinforce others’ image of you but will reinforce your own image and self-worth. Time invested in building and reinforcing your skill in this area will be time well-spent.

In direct conflict with this approach is the thought that any job will do.  By indicating this to an employer you are inferring that your self-confidence is at such low ebb that you don’t believe yourself worthy of even having a choice. The employer is likely to then consider you in that light and to pass you over for someone with more aspiration and belief in their ability to make a contribution. This doesn’t mean you should be dismissive of opportunities that don’t suit you, it means that you should consider, carefully, how accepting a role might give you the opportunity to contribute to your own self-improvement and the business of your employer. If you can articulate this you will be ahead of most of the competition.

The Application Process

I think of the application process as a series of events that begins with your introduction to the employer. This introduction often occurs through an approach by you to an employer who is looking to recruit. It provides a “first impression” to the employer and dependent upon the quality of the first impression, will determine whether or not the employer wants to know some more about you.

Assuming that your first contact is not “in person”, submission of a CV with no attempt to introduce yourself, and to thereby excite the employer’s interest, is probably the worst possible way to approach this step.

A letter that clearly and concisely addresses a need that the employer has (usually expressed in a job advertisement), accompanied by a CV that the employer may read – if they wish to know more – is a good approach.

Once an employer has been introduced to you they may decide to find out some more about you and I often do this by reviewing your CV and perhaps looking up your profile on Linked In. At this point, I may decide that a candidate is someone that might possibly fit the role that has been advertised and that it is worth speaking directly to them, with a colleague, to clarify the information that the candidate has shared and to obtain a second opinion regarding the candidate’s suitability for the role. Interviews will usually be held with more than one candidate so that comparison can be made and the best-fit to the team can be achieved.

Specific Job requirements

There are attributes that an employer looks for in candidates that will be specific to a role, these will reflect how the successful applicant will fit within the team (even if that team is You and the Boss) and the nature of the contribution that they will make to the combined effort of the team.

No manager or leader ever accomplished anything significant, good or bad, which was not directly attributable to the effort, quality and level of commitment of the people who work with them.

A sound manger and leader will clearly understand and articulate the requirements for each of the roles in their team.

When a role is advertised, minimum requirements for the individual who will be successful are usually included in the advertisement. This is an important first step in the recruitment process and companies who are worth investing time and effort in will go to the trouble of advertising roles in a way that ensures no ambiguity and misunderstanding in the application process. The alternative indicates sloppiness, a lack of focus and, perhaps, an implied disregard for the contribution of individuals.

To get through the employment process successfully it is important that, as an applicant, you communicate clearly and effectively with the selection team. Never set out to deceive, especially through omission of key facts. This will eventually be discovered in any good process and will always lead to a negative outcome.

The Interview

There is a lot of information around about how to interview well, but if you cannot get through the selection process to the interview stage then, no matter how charismatic, intelligent and articulate you are, you will not get the job!

Due to the nature of the roles that I recruit for, interviews are often held on the telephone by conference call, or on Skype. In remote locations it is becoming increasingly rare that a face to face interview will be deemed either necessary or cost-effective. Given this, I have some simple advice for approaching interviews.

First, try to relax. If you get to interview stage have already made it through a good proportion of the selection process, tension and stress won’t help now. Relax, be yourself, enjoy and learn from the experience. Listen to the queues from the interviewers. Listen actively and ask questions if you need to, it’s a conversation, not an inquisition, and a successful interview will inform both sides about the role and your suitability.

Think about what you say and the impact it will have on the listener. I have seen the most brilliant applicants blow their chances of ever being employed by to doing something utterly stupid like bringing up the topic of remuneration before the interview even starts. Not clever. Not respectful. Not on. In fact I suggest that, unless the interviewer approaches the subject, the interview is not the place to bring up questions about any topic that does not affect your ability to do the job or to make a contribution to the employer’s enterprise.

Good luck with your job search!

Sustainable Capability in Qatar… My Vision

17th Apr 2012

Sustainability is a buzz word we have become very familiar with in the last decade or so.  It is liberally used by both media and governments to describe the future or point us in the right direction. En mass we became accustomed to it in our day-to-day lives.

But sustainability is so much more than a fancy word – it is a complex concept , a purpose and a way of life.  If implemented successfully, it brings prosperity and long term stability in a well-rounded society. However, so far the most thriving sustainable initiatives have been small-scale. It is therefore commendable that the Qatar government is determined to achieve positive results with their National Vision 2030, which is to encompass the whole country.

Qatar’s Knowledge Economy

Human resources are amongst the most important ones to consider in achieving sustainability so what are the high-level demographics for Qatar?

Qatar is a small state with a population of around 2 million people.

More than half the current population is made up of laborers. These people (mostly men) are brought here, under contract to assist in building projects and development work. Generally they come here because work is scarce in their home countries and, by leaving their families behind, and working for a time in a foreign land, they are able to improve their future opportunities at home.

Of the remainder of the population, around 800,000 people, less than half are native Qataris who hold privileged positions in society and are able to share in the wealth that oil and gas reserves have provided. The remainder are people from all over the world holding jobs that allow them to establish homes, bring up families, educate their children and so on.

Qatar’s National Vision includes, amongst other things, the wise investment in its people (citizens) so that all can participate fully in economic, social, and political life. The National Vision also recognizes the need to balance this investment in its own people by attracting qualified expatriate workers in all fields and thereby making up for shortages of local labor.

Another key-focus of the National Vision, and one which reflects economic planning in many other countries, is the development of “a knowledge based economy characterized by innovation”.

One key industry in a knowledge-economy is the healthcare sector. More than ever this sector is dependent upon information. Good healthcare is supported by good information and improvements in healthcare continue to come from the knowledge that we gain from information well-exploited through effective research.

Most notably for me, this avenue is being pursued in Qatar through the development of the Qatar Foundation, the SIDRA Medical and Research Center, and the investment, statewide, in improving healthcare facilities and resources. These ventures, aligned with a growing higher education and research sector are cornerstones of the Qatari ambition to develop a world-leading, knowledge based economy.

Competing for Scarce Resources

In some fields of endeavor the competition for skills and experience world-wide is intense. It  poses a very real threat to Qatar’s ability to develop a leadership capability in healthcare and healthcare research.  In particular this challenge is evident in the competition for IT and informatics personnel in Qatar.

There are multiple large IT system initiatives currently underway in Qatar.

Each of the biggest IT initiatives is being supported by large multi-national companies and various smaller firms involved in recruitment and short-term staffing.

The problem is that the nature of this support is project-based, which is to say it is focused on fixed-term contracts which will bring skills and talent to Qatar for the term of the contract but which offers no longevity or sustainability guarantee to this nation. It is reasonable to expect that multi-national companies do not have passion about the (development and sustainability) future of Qatar.

The People

In ventures such as these IT initiatives the skills that are needed are those that are scarce and highly in demand in knowledge economies. These skills always include, to a greater degree, people with the talent to make information technology relevant and useful to workers, who are generally not technology oriented but, rather, who are focused more on people then pure technology.

Knowledge-industry undertakings also demand people with skills to work with information. The sort of people who can “drive value” from information, exploit it, and recognize its deficiencies and the remedial action needed to continuously improve the quality and quantity of this resource.

These talents are rare and they are not solely developed through training and education but, rather, through a fortuitous mixture of experience, education and realization of the potential for information and technology to make a difference.

It is true that we have entered the “information-age”. This age is fundamentally different to the industrial-age from whence we came. The winners in this new age will be the stakeholders who recognize the scale and nature of difference and the potential to cater-to and work with it.

Sustainability

For sustainability to become a reality for Qatar we must look at our supply chain for skilled resources and think about how much of the demand could be met from local people through some forethought and planning.

Continuing to “buy” talent from overseas is practical only while the nation is able, and willing, to offer something that these people cannot get at home. At the moment this “something”, in most cases, comes down to money.

True sustainability will come when we no longer buying scarce resources and, instead, grow our own.

There is no shortage of “local” people looking for opportunity, advancement and long-term security. These people often have a stake-holding in the country for other reasons, some are Qataris, some have family here, have been to University here, or simply come from somewhere close by.

These local people include graduates from local universities, children of expatriates looking to start their careers, graduates from other countries, particularly the Asian subcontinent and Africa. Many of them have the raw talent and the drive to achieve. They have the potential to enrich Qatar’s talent pool to support local knowledge sector industries and share their skills with the world. In terms of sustainability, what is the comparative long-term value of people who have a local stake-holding and want to build a life and long-term future here?

The organization I work for, malomatia, has a real, long-term commitment to Qatar and sustainability. My vision, and one we are pursuing at malomatia, is to overcome the dependence on short-term recruitment, to build a pool of talented individuals who share our vision and want to work with us to develop local people who can compete with the best from anywhere in the world.

We also anticipate that local organizations and Qatari companies recognize and support us in a spirit of partnership for Qatar.

It may be a stretch, but if we work together for Qatar; in three to five years we can not only have enough local resource to sustain the various IT and informatics initiatives but we, in Qatar, may be exporting talent to the world.

Qatar could be the source for the best trained and experienced informatics resources anywhere.

Through ventures such as this, ventures that focus on developing and enhancing the human capital in Qatar, the country will continue to thrive and to grow and may very well achieve the vision painted for 2030.

Vacancies at malomatia – Your Chance to Shine in the Sun

18th April 2012

malomatia (Q.S.C.) is a Qatar-based provider of information technology solutions specializing in building a sustainable talent pool in Qatar.

We are currently looking for people who have worked in healthcare and have experience with Cerner Millennium  to join us for our current projects based in Qatar.

These roles will require the successful candidates to move to Qatar for at least two years.  Attractive expatriate conditions including some relocation support are offered for this assignment.

Qatar is a tax free jurisdiction so anything you earn here is paid tax-free.  malomatia will provide assistance with accommodation and return airfares annually. We generally have competitive and attractive packages.

The project is with Hamad Medical Corporation (8 hospitals and about 24 health centers) and we are working in partnership with a large multi-national to support the implementation of a full range of Cerner Millennium functionality. The project will go for between two and five years and will kick off very shortly.

We are looking for people who have worked in a non-IT role in healthcare, and who have also worked on a large project to configure and deploy the application. Some roles require formal Cerner Millennium training.

Available roles that we have available include:

• Application Analyst – Charging / Supply Chain
• Application Analyst – Reporting / Supply Chain
• Application Analyst – Research
• Application Analyst – Emergency Departments
• Application Specialist – Charging / Supply Chain
• Application Specialist – Research
• Application Specialist – Homecare
• Project Manager / Planner

Click here to find out more and apply for these roles.

The Evolution of IT, Informatics, and Sourcing Decisions

IT architects, information managers, applications, and IT operations and infrastructure staff add little, if any, value to most businesses. How has this come about and what do 21st organizations do instead?

Disclaimer: This blog represents the author’s views based on experience working in and managing IT functions in a wide variety of industries over almost thirty years. The reader is advised that the article is based on observation and experience, it is the author’s opinion, not an academic treatise.

I have been a keen observer  and a part of the evolution of IT services over the last 3 decades. My experience took me from being  an IT professional from the late 1970’s in some of the world’s largest companies to managing many large internal service functions, these have usually been IT departments.

In twenty years as a manager and in the fifteen years that preceded them I have seen a clear development in progressive and leading-edge companies in the nature of the IT Department and the relationship that companies have with “IT” as a function. This is not to say that 20th century companies, with 20th century attitudes to their IT functions do not exist today, however these are increasingly in the minority and, like the dinosaurs, either dying out or making a last-ditch effort to keep up with the rest of the world.

This brief essay attempts to describe some of the changes in the relationship between IT and business, the reason that “right-sourcing” decisions must be made by corporate leaders, and how those decisions might influence an enterprise’s future.

The IT Department in 1980 – Competitiveness Through In-house IT

Thirty years ago IT departments in large organisations traditionally provided a full range of “IT services” to companies. To a greater or lesser extent enterprises relied on IT to support their efficient and effective running. In some cases these efficiency initiatives provided companies with a competitive advantage.

Therefore the cost of running the IT Department represented a very real investment decision for the companies involved. Like the book-keeping and clerical functions of the rest of the industrial age, the IT Department was a service provider to the business.

Over the ensuing years; as IT capability evolved rapidly; as the importance of IT to business increased; and as the world careered toward the information age; the nature of the investment decision has changed dramatically.

In the 1970s and 1980s, IT was often considered something of a black-art, managed and delivered by technical boffins, and assiduously avoided by “business” people. In this environment the investment decision was one that revolved around “which particular roles were required to support the company’s IT needs?” and “could we do without them?”.

In those days of few data networks, no wireless or mobile telephones, no automatic teller machines, and Internet (as we know it today); IT was an effective tool used to automate repetitive, often tedious, and otherwise expensive transactional work.

As a result IT offered businesses opportunity to gain a short-term competitive advantage by selectively eliminating costs.

It was sensible, in 1980, to consider building and sustaining a dedicated IT Department, in-house. This gave a business ability to develop a team that  was in tune with the organisation’s operational challenges and able to provide solutions that would make the business more competitive. This advantage was however short-lived, and easily replicated by others.

Companies often employed teams of computer professionals to develop software-based solutions to their business challenges. Over time, they employed, sometimes even larger, teams of people to run the hardware and the systems necessary to deliver these “solutions”.

The situation evolved and, by 1990, the nature of the investment decision had undergone another step change.

The 1990’s – COTS and the rise of Informatics

By the time the 1990’s arrived it had become apparent that automation-challenges were often very similar across a range of companies and even a range of industries. As a result many entrepreneurs became successful by developing solutions which could be used by a whole class of customers, rather than by a single organisation.

Systems that supported common business functions such as payroll, financial management, human resources management, stock control, supply chain management and marketing all became readily available as packages. These were referred to as Commercial Off-The-Shelf  (or COTS) solutions.

In the higher-education sector packages were available to manage student (customer) flows. In healthcare it became possible to manage patient encounters and centralize, electronically, critical information.

Competitive advantage became dependent, not on the IT investment but, on how effective the organisation was in making use of that IT investment.

This was about the time when the ability to align people, processes and technology to improve a business-outcome became a valuable commodity in the IT marketplace. This is the art practiced by informaticists.

The Information Age and the birth of “Right Sourcing”

As attention was drawn to the value-added to the IT investment, those responsible for counting the beans in the corporate machine, and the corporate leadership, started asking themselves some very serious questions.

These questions revolved around the services provided by their IT Departments; in particular “which of these require intimate and specific knowledge of the business?“.

There began to be a recognition that many IT-services are effectively commodities that; like telephone calls, electricity and water; can be purchased as a “service” as and when needed.

Around the year 2000, corresponding broadly with the release of the ITIL 2 framework, organisations which were able to offer a standard set of IT Services began to flourish.  These organisations offered the services involved in controlling and managing computer operations.

Leading enterprises had matured to the point where many companies could express their desire for IT services rather than their need to employ the people who deliver these services.

Whether ITIL, with its disciplines of categorising services and developing service level agreements, was a catalyst for corporate executives to consider outsourcing of IT operations, or otherwise, outsourcing became commonplace.

Through the outsourcing model management had a means of achieving quality of service at a scale-able cost whilst enabling focus on value-added activities involving IT.  This included a focus on informatics for efficiency and data analytics to provide business intelligence.

Right-Sourcing Decisions in 2012

In 2012 some outsourcing decisions are easy ones. Newly set-up companies typically choose to source “core” IT Services from a third party provider. These services include email, data storage, service desk, in fact nearly all back-office IT functions can be sourced from organisations who specialise in providing high quality, high-availability services at low cost.

Often core applications are also sourced from external providers who take on all the responsibility to running, maintaining, and supporting enterprise resource planning (ERP) tools such as the financials, HR, payroll and marketing systems that used to be managed in-house.

The role of the IT Department has fundamentally changed

The information age IT Department has evolved to become an informatics department, closely aligned with the goals and objectives of the business. The model IT Department of 2012 is vastly different to that of 1980.

The IT Department of today anticipates needs, assists in managing, monitoring, and measuring change. IT provides the skills to manage programs and projects of work, manages contracts, service level agreements and vendors to ensure that the business receives the services it desires. The CIO and the IT Director are key to ensuring that the businesses needs and wishes are understood by vendors, that they are specified, ordered and delivered correctly and that services continually increase in value received for money paid.

An IT Department, led by the Chief Information Officer, should have only one goal. This goal is to drive the maximum value from the business’s IT investment.

Achieving this goal is a challenge. Not only must IT put considerable effort into assisting the business to use IT correctly and effectively but, led by an effective CIO, the Department must understand the fundamentals of the business and be prepared to advise on how the information assets can be exploited to maximum effect.

Is Your IT Department an Information-Age Organisation?

In an effort to cut through the hyperbole and to get to the point: Chief Executives don’t need an expensive, jargon spewing, acronym bound consulting firm to work out where their enterprise sits in the spectrum of industrial-age through information-age companies.

CE’s do need to recognise that companies that will be successful in the 21st century will be those that are able to harness and exploit the information that informs their business decisions and their planning.

The following questions will help Chief Executives and their teams to work out if they are ready yet for the information-age:

• Are email, telephony, data storage services, service desk, desktop support and other generic IT functions maintained and supported as in-house services?
• Is the structure of the IT Department reminiscent of some sort of bad science fiction movie, with groups responsible for systems, development, call-centre, servers, operations, and data bases?
• Do conversations with the CIO and IT Director tend to revolve around costs and service quality issues?

If the answer is “yes” to any one of these  questions then it is important to look carefully at the advice which is being received about your IT spend.

Competitive, information-age business however, would be able to answer “yes” to some, if not all, of  the following questions:

• Are all of the computer applications and information technology used by your company provided and supported by third party providers who are managed through well understood service level agreements?
• Is the IT department structured around services such as supply management, change management, information management, business intelligence, project management and IT Service management?
• Is the IT Director or CIO a valued contributor at senior executive meetings and are his/her team key members of all marketing, sales, and other key business meetings across the organization?

Change or Transformation?

1st April 2012

When we talk about transformation in healthcare what exactly do we mean?

The Oxford English Dictionary defines transformation as “a marked change in form, nature, or appearance”. When I picture transformation in nature I have an image of the difference between a caterpillar and butterfly.

One of the most stunning transformations I can think of in the corporate/business world is the transformation that the IBM company made from being a manufacturer and seller of office equipment (typewriters, computers and so) to being one of the world’s biggest suppliers of consulting services. In the past 10 years while IBM hardware sales have hardly changed its consulting and software business have more than tripled in size.

You can be sure that this change within IBM was transformational for the way it ran its business, recruited staff, measured its performance, and approached its customers.

It is also clear that, through transformation, IBM hasn’t lost sight of its roots, instead it has built upon its capability to massively increase the value that it adds to its products through growing its services and software business.

The IBM story is completely analagous to the call-to-arms for healthcare providers. Healthcare transformation is not about stopping what we do now, but it is about transforming the way we do it to add extraordinary levels of value in our endeavors to keep people well, to cure disease, to support care providers and to reduce waste.

There are two key questions for consideration by any healthcare organization who wants to undergo a transformation:

• How does a healthcare provider transform itself from what it is today? and;
• What will “finished” look like?

When deciding the areas where transformation will have the greatest positive impact, it is worthwhile considering what some of the challenges are in healthcare today. I propose the following (in no particular order) are some pressing issues worldwide:

Healthcare providers are often inflexible in their approach to where, when and how services are provided to patients.

This results in an often frustrating and more unpleasant experience for patients who need care than might otherwise be the case.

Demand for service invariably outstrips supply in healthcare and this has often led to a pattern of casual, if not sometimes downright disdainful, treatment of patients.

Clinician decision making could be more-often supported by the complete, current, and timely information that would enable an optimal outcome.

This challenge is multi-faceted and multi-dimensional however it can be simplified to the following:

To treat a patient most effectively there are probably only a few key types of information that a clinician needs, regardless of the clinician’s role in the process (she might be an ambulance officer, a heart surgeon, a nurse, a physiotherapist, or a neurologist). The information needed to provide the optimum care includes:

• an accurate description of the symptoms with which the patient is presenting;
• pertinent details about the patient’s medical history and demographics;
• pertinent details about the patient’s social circumstances and lifestyle; and
• an up-to-date knowledge of appropriate therapies and interventions that might be recommended following a diagnosis.

There is an increasing amount of information regarding research outcomes and evidence-based best-practice in scientific medicine and this body of information continues to grow. As a result it is not unusual for innovation to be overlooked. The result is likely to be a sub-optimal outcome for the patient.

There is also a current legacy of paper-based medical record keeping and un-connected electronic record keeping amongst care providers. If all pertinent information about a patient cannot be accessed whenever and wherever it is needed it poses a risk to optimal care of that patient.

We are developing larger and more sophisticated repositories of information regarding encounters, treatments, incidents, and outcomes. If properly exploited this information may lead to new and better ways to provide care. If the information is allowed to languish, unexploited and unloved it represents a waste of resources and a lost opportunity for improved care.

The providers who, together, comprise a healthcare “system” is disjointed, “gappy” and difficult to navigate, this is compounded by poor information flow between them.

Healthcare systems often appear chaotically disorganized and patients suffer when care providers are not effectively sharing information or working together in a co-ordinated way.

Many significant steps have been taken to improve the flow of information in some jurisdictions (for example: between primary care providers and hospitals) but much remains to be done to include all healthcare “actors” in our attempts to communicate, collaborate and become more inclusive. In this process the optimal outcome will be achieved when prevention, cure, and supporting care providers are in alignment.

Healthcare investment decisions are, too often, driven by technology, technologists, and related services vendors.

Too often, suppliers are selling overpriced and over complex technology solutions into organizations who are not ready, or who are not able to effectively evaluate their real needs and their path to best value.

The resultant extended, expensive programs, promise too much, deliver too little and, perhaps most distressingly, cause the deferment or delay of a range of smaller, more targeted, projects that might have a greater combined impact on a health system’s ambitions.

More often than not the cause of adverse events in our health system are the result of process errors. That is they are caused by someone not doing something that the should have done or doing something that they should not have done. Computer systems and technology can help to support the reduction of such errors but should only ever be considered a a component of a program to improve the process. Not as a solution in themselves.

There is a significant and growing increase in chronic conditions in the Western World.  

The healthcare sector lags behind in adopting and using techniques that would support improved chronic care.

Chronic conditions (for example: type II diabetes, asthma, and many mental health problems) require management and often the participation of a range of actors (such as the patient, family, clinicians and allied health-professionals).

The information management infrastructure of many healthcare providers cannot cope with the complexity of this arrangement and the privacy and security concerns that are implied. While social networking tools continue to have an increasing impact on so many other areas of our lives, there remains little apparent effort to harness this paradigm to support chronic-condition management effectively.

The gap between the haves and the have-nots in healthcare is massive, and increasing, as clinical talent is drawn away from less privileged nations toward those who can afford to pay.

The tyranny of distance today is vastly reduced over that which existed in past centuries. Education, support, or advice could be provided remotely today from almost any point on the world’s surface to any other point.

And yet much healthcare, a quintessentially information driven business, is often still focused around hospitals, health centres, and other physical edifices. This results in inefficiency, expense, exposure to risks related to treatment-caused conditions.

Privacy, confidentiality and secrecy are challenges that face us all in very walk of life today.

However these challenges become all the more difficult when obsolete technologies (paper, other physical media, and pre-internet poorly secured computer systems) are used to store and share valuable information. A challenge that is further compounded when control and management of information is taken out of the hands of those who own it, the patients.

Every one of the above challenges, if addressed effectively would add tremendous value to the healthcare that a provider currently delivers. The basic building blocks of technology to support solutions in every area exist today. The next step for any provider is to agree that the problems represent the priorities and to develop a picture of “finished” and the plans to  move toward the goal.

Some food for thought

If these then are our challenges, then what is it today that we are doing well? and how might we, given the tools and technologies that are available to us, do things differently in the future?

For many roles in our professional working lives, regardless of business sector, we can live and work without going to a central office. We achieve this by communicating through technologies that are appropriate to the purpose.

We collaborate around development of documents, presentations, and even major movies with participants separated by oceans. Job interviews can be conducted over high-quality video conferencing links, pictures, video and audio can be shared without loss of quality between people geographically disbursed across the globe. Some Universities now offer full degree-level education via electronic means.

These activities are a sample of those that require the ability to effectively share information, and to pick up non-verbal cues such as body-language between the participants. We also know that attending a health care facility, particularly a hospital, increases the likelihood that a patient will experience an negative event caused by engaging with the health system.

Why then do we continue to build health-care facilities that assume 100% physical attendance of patients?

We have the ability to offer banking and many other financial transactions in a very secure and safe way to people with no more equipment than a PC at their home or place of work. In the Western world we run much of our lives on-line, paying bills, shopping, looking for work, booking travel and cinema tickets, and banking. We securely share calendars, we hold encrypted conversations using tools like Skype, web-mail, and any one of a hundred conferencing and video services.

Why then are many healthcare organizations unable to support us, as patients, to share our clinical information electronically with those who we believe have a “need to know”?

There are many examples of “peer review” technologies that enable rapid dissemination of information into the public domain as it becomes known or as knowledge about a subject is improved. Wikis are an example of this.

There are limited tools available for sharing best clinical practice locally, nationally or internationally and we need to be more effective about getting the right information in front of the right people at the right time. Despite the efforts of organizations such as the British Medical Journal (BMJ) and Map of Medicine in the UK, we need to be focusing more effort on sponsoring, developing and supporting development of, and access to, tools that support the sharing of best-practice.

The expenditure on information management, enterprise content management and clinical informatics to support decision making at all levels in our healthcare provider organizations must increase. This does not necessarily imply a further investment in technology, it implies an investment in the right people. An investment not in the technologists who were so critical in the 20th century but in the information managers who are becoming so important in the 21st century.

The technology is available TODAY, to share information securely, to link organizations, to support decisions and to find the answers to many of the problems that clinicians, allied health-professionals, patients and their families experience on a day to day basis. These technologies are diverse and many of them are not expensive. In fact the information they provide access to is often inexpensive or already owned by the people who need it most. There is technology and information available that can help us to make progress toward solving almost any problem, clinical or operational, that faces healthcare providers.

If we are to transform the way that healthcare is delivered, we need to recognize that good healthcare and good information management are inseparable.

With the right information extraordinary results can be achieved. We need to focus, not just on better physical buildings, computer systems and equipment which support our core competency, but far more upon effective management, dissemination and exploitation of the information we generate and share.

Reshaping Healthcare Organizations for 21st Century Healthcare; or “If you do what you always did, you will get what you always got”

13th March 2012

The majority of organizations in our modern commercial world are focused on delivering financial profit, they are often called “enterprises”.  How does a healthcare system fit into this framework and can it, too,  be described as an enterprise?

A healthcare system will be comprised of someone who pays for the care (a government, an insurer, or the people who receive care) and a range of providers, healthcare organizations who deliver hospital care, specialist services, or more generalized healthcare services.

A healthcare system, where healthcare is publicly funded, will typically have a strategy focused around the objectives of:

• Keeping patients well longer
• Treating patients more effectively
• Ensuring that patient interaction with the system is as pleasant as possible
• Supporting healthcare workers to perform well, to learn and to build their knowledge to support care based on evidence
• Minimizing waste

Even in a privately funded system these objectives will lead to higher profits and more satisfied stakeholders.

So, in this respect healthcare systems are a form of “enterprise”. And, just as effective leaders actively consider the way that their organizations are structured, led, and managed to meet the challenges identified in their strategies, so must we consider how the “architecture” of the healthcare enterprise will support it to achieve its strategic objectives.

Transformational change and enterprise architecture

There is an old adage that goes something along the lines of “if you do what you always did, you will get what you always got“.  When healthcare enterprises attempt to transition from industrial age organizations to information age enterprises they must consider not just the technology that will be required, but also how their strategy, culture, leadership, people, and organizational structure might support that development.

Often healthcare enterprises have high hopes that, by introducing computerised information systems,  and teaching people to use them, they will rapidly transform the healthcare that they provide.

Too often there is then an expectation that change will be delivered to the enterprise by the technology, the purveyors of the technology, or those entrusted with making the technology work. This expectation is always unmet and there can be a long, and often painful learning curve to the realization that 21st century tools, don’t automatically lead to the knowledge-based organisation that was, perhaps, envisaged.

The issue is much broader and encompasses a range of concepts which are interconnected and interdependent. Understanding of those concepts and ideas are vital in order to achieve successful, and truly transformational, change.

Some questions that governance boards might ask Chief Executives when aspiring to transformational change

Although there are many common threads, each organisation is unique, it’s design, structure and work ethics are affected by a diverse range of local, internal and external influences. Hence there isn’t a one-size-fits-all model for achieving, leading and delivering transformational change. Instead there is a range of issues that might be considered.

• Does the organization’s strategy (including the vision, mission, values, and objectives therein) reflect the degree to which transformation is necessary to deliver it? Is the strategic vision simply a better version of what we do today? Or is it so radically different that stakeholders will know that real change will be required?
• Are the organizations and parties that are engaged in the enterprise ”bought in” to the strategy? (do they feel they own it? was the strategy developed in consultation? does it resonate with the stakeholders who will support its delivery?)
• Do the identified key performance measurements reflect how progress toward achieving the goals of the strategy is being made?
• Are these key performance indicators given the same amount of time and discussion at meetings as purely commercial matters?
• Does the governance and leadership structure of the enterprise work effectively with the governance and leadership of the organizations involved?
• Are the governance and leadership effectively structured to support the transformation agenda?
• Do the enterprise and organizational policies regarding recruitment, remuneration, knowledge retention, and staff development reflect the transformation agenda?
• How is business as usual being managed while transformation is being led? (is the organization expecting too much, too soon, from too few?)
• Is accountability and empowerment appropriately identified from the strategic leadership down through the hierarchy of the enterprise?

Delivering Sustainable Clinical Transformation

8th March 2012

When a clinical information system is introduced to a complex and busy organization such as a large hospital there is no doubt that change will happen.

Sometimes this change can have a devastating effect on the care that patients receive, the experience of dealing with the hospital, or the working lives of health care providers.

In the majority of cases though, the changes that occur as a result of clinical information systems are changes for the “good”. Our aim, at malomatia, is to ensure that change is “transformational”; that it has a sustainable, long-term positive impact on the health, experience and effectiveness of all participants in healthcare systems.

This slide presentation will introduce our approach to transformational change.

Delivering Sustainable Clinical Transformation