Does success in “becoming digital in our workplace” mean we are all techies?” We interview Katie Trott, Chief Nursing Information Officer at the Royal Free Hospital, Uk, fresh before her HIMSS Discussion on 8th June, to see how they do it at her Hospital.
I am sitting in my office – I pick up the phone, and I call Katie’s Hospital, and the Reception immediately connects me, there is a sound of some children in the background, and then I realise – Katie is at home, this is her mobile line.
“I’m sorry”, she says, there is a hint of amusement in her voice “I have the kids at home”. No matter. And so I get straight to the point – you have been responsible for some major large clinical tech initiatives in your past – does this mean you have a technical background?
“No, “ she says immediately. “But I do know how to wire a plug”.
This is all going well.
So we start again, and you could say it gets worse. When Katie started in the NHS as what was then a Nurse Auxiliary, at 16yrs old – there was no discussion of technology per se for people at the front line. Patients were patients and treatments were treatments. Katie’s background is clinical. It just so happened, like so many chance encounters in life, that she was rather good at explaining to patients and colleagues “what was going on”.
This facility to communicate, to bring things back to their essential levels, has been the secret sauce of what – looking back – has been a step by step process over the years, ie, the innate ability to communicate benefits and to lead others into new pastures. As clinical care has inevitably needed more and more clever toys and cool IT, so somebody has to engage with the people who have to make it all work. At the Royal Free, under her direction, they delivered a new EHR in just 11 months.
Katie is self-deprecating; “I was just in the right place at the right time” she says. “We sort of made a decision that we need to do this or that, and then sort of figured it out as we went along”. Clearly this is not true – but what is standout is the motivation to go forward – even though at the time, you might not be sure of what that “forward” can actually deliver.
And it has created some changes in attitudes.
“When I first got into delivering digital or clinical solutions, the mindset was definitely that “big is better”. If we want to do something else, we just got some velcro and stuck on a new module”. But our view now has changed to scaling down, and adopting “best of breed”, a sort of FHIR approach, for the specialist areas that have specific needs.”
Katie continues; “Perhaps I was naive, but I remember when I first started, I thought that fast means better, that you just plug new solutions in. But over time, I discovered the benefit of taking it step by step. That testing and safe empowerment is a process. Sure, we can plug it in, – but everyone needs to be involved before we go play”.
What it seems is that there is a shift in areas of influence. The clinical demands of patient delivery , are becoming the driver of the IT requirement, as opposed to the other way round, And that IT per se, may not understand the clinical needs it is trying to address.
Two things are becoming clear – and that tie in with what we have seen from other NHS Leaders that we have talked to. That success in digital delivery, depends on the individual, and not being scared of appearing to be the idiot. It is a phrase that Katie uses a lot in our discussion – and also the recognition that we are every day in a brave new world, and we have to sort it out.
It is time to end our discussion. We could talk for much longer, but Katie is at home, and there are noises in the background.