CIO's should have ear of CEO: Health IT head

If organisations are to get the best results from their spending on technology, the head of IT mustreport directly to the chief executive or the board of directors, says Hawkes Bay Health CIO Paul Ferguson.

If organisations are to get the best results from their spending on technology, the head of IT mustreport directly to the chief executive or the board of directors, says Hawkes Bay Health CIO Paul Ferguson.

Ferguson joined the district health board last June to help the organisation implement a multimillion-dollar “technology enablement” programme, which aims to improve healthcare through the use of IT.

As part of the programme, Hawkes Bay Health is improving its patient management system by upgrading its Australian-supplied IBA system to a web-enabled version.

Alongside, the board’s Australian-produced Detente pathology system is being switched to New Zealand-made Delphic, in a shared-services agreement with Canterbury Health.

Discharge summaries are being integrated with other systems, the board’s 600 Compaq desktops are being replaced and the organisation is increasing its remote medical programmes for outlying areas.

Ferguson leads 27 IT staffers, and handles an annual IT spend of $2.8 million, plus a further $3 million for the programme. The 50-year-old Australian says he joined the DHB as he found its plan to improve its already extensive technology “exciting”. But just as important for Ferguson was being a member of its executive leadership team.

“Without this direct reporting relationship, you do not get the benefit of your information technologies,” says Ferguson, who previously helped computerise various systems at Brisbane’s Mater Hospital in the 1990s, which included introducing mobile wireless devices into wards. Before joining Hawkes Bay Health he ran a power tools business, and started work in technology in the mid-1980s as a laboratory specialist in pathology at Mater.

“One of the major problems that I have noticed is the difficulty in setting priorities or juggling priorities between technology spend and your health service delivery,” Ferguson says.

“The problem is, you have to deliver — to get the patient better — but to do that you need good technology to get the right information to the right spot to the right people at the right time and to use that technology to minimise the cost of treatment. But most technology is invisible in the sense that it costs a lot and has no emotional content in comparison with, say, a heart monitor. Unless you can argue the real benefits in a forum and at a level where the real decisions are being made, it is sometimes difficult to get that understanding across,” he says.

“It is much easier to get the correct policies across and in place when you are working at that level and these policies can then structure processes. If you don’t have that level of authority or influence, often technology is seen as the answer rather than a process. Because the IS manager implementing the policy doesn’t have any influence at a higher level, the processes that need to change to leverage that technology don’t take place, and the real benefit of that technology isn’t realised,” he says.

Even if IT bosses are not on the company board, it is essential that they at least have some “close alignment with the executive in an advisory capacity”, he says.

All organisations need good, integrated IT systems to succeed, says Ferguson. He says his DHB’s $5.8 million IT spend out of a $120 million total budget shows it has a good understanding of the issues. “The fact that they have embraced the technology enablement programme indicates they understand this.”

Good IT should be efficient and unnoticed, he says.

“To me, IT is like a water tower — mostly invisible, but if it is not there you will know about it,” Ferguson says.

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