I can’t believe I have already been in the Falkland Islands for a month. I am half-way through what I thought would be my original stay here. I say that because I am actually going home in June as planned but coming back in July to complete the project. Hurray! Now those with a good memory may think. ‘Ahhh I remember you saying in a previous blog the definition of success means you don’t come back’. Well thankfully that couldn’t be further from the truth. The truth is that the scope has changed as the project has developed.
I wasn’t going to write much about my work but now is a good time to spend some time reflecting. For the first couple of weeks I did a due diligence exercise and reviewed how much had been completed on the project. I then developed a proposal for both the EPR (electronic patient record) supplier I am working for and the hospital and presented this to the Project Board. Whilst the project manager had done an excellent job before me, I had a few ideas and found a few gaps along with redefining the schedule.
Its been really exciting for me because some of the clinical scenarios I have been involved in are new. I find it’s always exciting to be learning something new. I have deployed ‘millions’ (that may be a slight exaggeration there) of systems and sometimes it feels like I could do it all in my sleep. But this is very different, this is an EPR for an entire country. Incidentally, I don’t think I appreciated that before I came to the Islands, I thought I was going to a small outpost of the United Kingdom. The Falkland Islands is actually a self-sufficient country with a long history, its own currency and unique culture and the people of the Falkland Islands have the right to self-determination, enshrined in international law.
Not only am I deploying a system for an entire country, but is also for most healthcare scenarios which is also quite a unique position to be in. As I understand it, there is only one UK system supplier who can do this at the moment and that is the company I am working for (forgive me if I am wrong with my assumption here). I suspect because of the distance, most suppliers didn’t tender for the work and those that did, didn’t have the system that would be able to cope with the different types of healthcare settings. So what an amazing opportunity for a start up company to prove their worth and what an amazing opportunity for me.
I am dealing with complex healthcare scenarios and as you can imagine I love it. If it was straight-forward it would be far too easy 🙂 Patients may need to see their GP or Dentist, go to A&E, arrive in an ambulance, have a baby in maternity, have some minor surgery, need some physiotherapy, meet with the mental health team, visit the child health team, have a sexual health test, need to see a clinician out of hours, have a stay on the ward, have an x-ray in radiography, have their bloods tested in the laboratory; I am sure that I have forgotten something here. All of these different types of patients will be dealt with differently from within the system and its my job to work out how that all fits together. Also, patients may need to be seen by visiting specialists and/or transported to the UK for specialist treatments. In addition, there is a transient population and a variety of people who will arrive on the Islands under a number of circumstances putting a demand on the hospital resources. British nationals like me who get free healthcare because of a reciprocal arrangement with the UK, the army, foreign tourists on cruise ships, foreign nationals on work-permits who are not entitled to free healthcare and fisherman working in the waters close by. Some patients need to be charged for their care so each consultation or procedure needs to be aligned to an associated cost. Obviously we don’t have to worry so much about that in the NHS in the UK but what is so good is that this system will work for both NHS and private clients which is pretty unique. Usually you would have a range of systems dealing with the different types of patient settings and then systems that just work with NHS or Private healthcare companies. I feel that I have stumbled upon my dream system and suppliers. (Shhhhh don’t tell them that).
So its been a really good month. I have really enjoyed meeting with all of the teams at the hospital. In fact most of the challenges are the same as those that we have in the UK. At each initial meeting, I am establishing how they use their current system and how the patient flows through their service. We are able to work through potential scenarios, set up templates and I am able to offer development solutions. At the same time we are identifying how we can help them improve the healthcare they are delivering by using features and functionality which may be new to them. It is fantastic to be able to influence the development schedule of the system and to be able to give healthcare clinicians the things they need. This is also a very unique position to be in.
So we have done a lot of the preparation work and we are currently in the process of preparing the training documents. Now when it comes to training, most people assume that you only need to train somebody how to use the system. In this case, the system is so intuitive that I don’t believe that much training will be required. But like any system, it is easy to teach somebody to fill information into a box. The key to getting it right is ensuring that we understand enough about how the patient uses the service and how the clinicians need to use the system to support their work. Its not about training someone to use the solution – that’s easy. It about training them to manage their processes and clinical workflow within the system. That’s the hard bit because although generally most teams across the UK and the Falklands do it in the same way there are local anomalies.
So if all that is not enough, I am likely to be leading on the design and development of a bespoke specialsit module to support the core system. I don’t want to tempt fate, so I wont be speaking about this in any detail until the proposal has been approved. But its very exciting and pulls on my experience of system design and development. I do hope that may require a future visit to the Falkland Islands preferably in the summer, the wildlife is much better then 🙂
As you can imagine being 8,000 miles away from the rest of the team has its challenges when it comes to communicating. Not only are we in a different time zone, the internet on the Falklands is extremely slow. Mind you this has not stopped us from having regular stand-ups and communicating on a daily basis. We are using Microsoft Teams and its brilliant. We are all at remote locations and we can send messages to each other for informal questions, share documents and then have regular stand-ups (or sit downs in my case) with them on the conference facility. Even though I am physically far way, I never feel very far away from the team at all.
I really can’t leave this post without mentioning my wonderful assistant. I am not going to name names, but you know who you are! This person is taking on the management of the system when I leave at the end of July and she has been amazing. Only in post for 3 weeks now and already knows more about the system than I do. We have got through a ton of work. The Senior Team at the hospital have also pulled out the stops to make sure that decisions are made quickly. This is a dream project.
Being a solo deployment and working for both the hospital and the suppliers means that it is far from a walk in the park, although I have worked hard over the years and I have the experience to support me which helps. I couldn’t do this without the wonderful support I have from both the supplier who are also working all hours to get this to work and the senior team at the hospital. This isn’t about personal profiles or egos. You need to hear the background story to understand it fully but I really do get it. The suppliers are creating this system to fix an urgent problem with patient record systems in the UK and to save lives.
I always wanted a job where I made a difference and I felt this on Friday when the Chief Nurse who I suspected initially may have had her reservations was telling me what an intuitive system we have and how engaged the teams are. When I saw her ‘almost skpping’ with enthusiam out of my office to her next meeting, I knew then we are getting this right and it feels good.
Some say you make your own opportunities, some say its luck. I don’t know what it is but I think it was meant to be. And to think when I got the message from Lee, I thought it was an April fool!