Tuesday, July 09, 2013

The intersection between technology and business strategy

    McKinsey recently published an article "The do-or-die questions boards should ask about technology" which highlights the key questions that need to be answered about the role of IT and technology strategy in the strategy of the overall business. Although this is pitched as something that boards should ask executives, it strikes me that it is just as important that technology leaders within the organisation need to know, understand and apply the answers to these questions.

    It may seem obvious that these questions are important, but I have worked in multiple organisations where technology is not considered as a means to achieve competitive advantage, but rather is thought of as a high-risk cost centre which needs to be managed in the style of an unexploded bomb. Such organisations typically have limited understanding of the role of technology amongst top management, and this lack of understanding then pervades the corporate culture. High profile IT programme failures are used as ammunition to justify this approach. What these managers fail to understand is that, unless they happen to be operating in an environment which is totally immune to market forces, if they don't work out how to use technology to enable competitive advantage, another competitor will do. Even worse, a new market entrant without the legacy cost base that existing market participants are saddled with, could totally disrupt the market.

    Conversely organisations that have a deep understanding of how technology strategy is a key enabler for business success are often at the forefront of either delivering market-leading products and services, or leading the way in reconfiguring the economics of the market by using technology to transform ways of working. Most industries have examples of such organisations. Following this approach is not a one-off programme - it needs to be embedded in the corporate culture if the competitive advantage is to be retained.

    The upshot is that technology leaders need to challenge their companies to ensure that the critical questions identified in the McKinsey article have answers that top management are in agreement about and are executing against.

    Friday, April 19, 2013

    Intellect Stream at HC2013

    I had the pleasure of participating in Intellect's stream at HC2013 last Wednesday. The overall event was very well organised, and the Intellect stream in particular had a great set of speakers. Kicking off the stream were several patients, who gave their perspective on the NHS, based on their own experiences of it as service users. A couple of them had previously worked within the NHS so their experiences had been enlightening for them. They all showed immense bravery in sharing their individual experiences around their own conditions; too often the individual is lost in discussions about tariff, technology, resource management, commissioning etc. The lessons they fed back to us were sobering in the modesty of their needs; specifically
    • access to their own records, the degree of access and control varied somewhat across the speakers;
    • treat patients as individuals looking at their overall healthcare status and needs, not as one participant in a series of discrete, disconnected transactions;
    • why do patients have to keep providing the same information?
    • in the case of a type 1 diabetic patient, why can't all of the devices he uses to monitor and control his condition talk to each other, and/or to his smartphone?
    • how can we achieve "no decision about me without me" without a sea change in culture and organisation?
    • as a patient, I see one NHS and expect it to interact with me on that basis, not as a dysfunctional collection (my words not theirs) of organisations grudgingly aware of each other.
    During the subsequent discussion Ewan Davies made the excellent point that objections often made to change (e.g. information governance, less than 100% access to the internet etc), while reasonable should not in themselves be reasons not to change, as is currently the case. Joe McDonald in the last session characterised this as dictatorship by unanimocracy i.e. we are unable to do anything unless everyone agrees 100%.

    I participated in the session on technology platform and architecture. This was really an opportunity to stimulate some discussion around the ideas that Paul Cooper, Jon Lindberg and I pulled together in the Intellect paper "The NHS Information Evolution" launched this week. We were joined in our panel discussion by Phil Birchall from Intersystems and Mark Treleaven from FDB, and the discussion was chaired by Andrew Hartshorn, chair of the Intellect Health and Social Care Council. The discussion was engaging and interesting, ranging from the question of how to create the environment that allows beautifully crafted apps to flourish, to the challenge of how to incentivise a view of healthcare ecosystems that goes beyond the narrow parochial boundaries of the individual healthcare provider organisations. A recurring theme was the need to support mobility; another observation was that clinicians have already started using tools such as Facebook and Google docs to collaborate with other professionals in treating their patients, so we need to move rapidly to provide equivalent functionality which also protects the integrity and security of patient data.

    Moving into the later sessions these themes recurred; the following session involved a number of service developers who talked about some of the challenges they are facing in designing and deploying different kinds of technology services. Gary Shuckford from EMIS talked about his experience, from patient.co.uk, of the kind of information that patients are interested in accessing. He also talked about some of the practical difficulties in ensuring take-up of the service. The final session aimed to pull together various themes that had come up during the day, chaired by Julian David, Director General of Intellect. What was interesting in this session was the degree of consensus, that had been evident throughout the day. There is a clear acceptance that we need to improve how we leverage technology within UK healthcare, and the things that are holding us back are far more people-related than they are technology-related.