Portfolio Approach to Digital Transformation The Ministry of … · 2019-05-08 · BC’s Digital Health Transformation Imperative. 6. Portfolio Approach to Digital Transformation

Portfolio Approach to Digital TransformationThe Ministry of Health Experience

PMI-VI 2019 Professional Development Conference

May 6, 2019

The Journey of Digital Transformation – our experience

• Respect the Culture

• Compelling Transformation Imperatives

• Shared and Inspiring Vision

• Tipping to Action

• Collaboration, Collaboration, Collaboration

• Gain credibility

• Build on success

3Portfolio Approach to Digital Transformation | The Ministry of Health Experience

CULTURE EATS STRATEGY FOR

BREAKFAST

- Peter Drucker -

4

Co-Creation with Partnerships (First Round of

Engagement)

Greg’s Wings

http://www.viha.ca/www/

Portfolio Approach to Digital Transformation | The Ministry of Health Experience 5

BC’s Digital Health Transformation Imperative


Of BC residents are

living with two or

more chronic

conditions.

Of the population today

is over 65 years old - over

the next 20 years, the

proportion of seniors

will double.

Siloed

Critical health information locked

in systems or on paper. Making it

difficult for care givers to provide

coordinated end to end patient

care across care continuum.

Disconnected

Patient services are

too often

fragmented,

untimely, and

inefficient.

Misfocused

Health System remains

largely focused on

hospital and not

remaining independent

practices.

Disparate efforts

Lack of coordination across

health system to invest in

improvements is further

fragmenting efforts towards

an integrated system of care.

15% 20%

A year is spent on health

care in BC, nearly 46% of

direct provincial spent;

these rising costs are not

sustainable.

$19b

Digital Health Drivers

• Healthcare delivery is increasingly becoming digitized


BC’s Digital Health Transformation Principles


Patient Experience

We believe that citizens are stewards of

their health information and want choices

on how they engage with the health care

system. Citizens are confident in their

healthcare system and trust the security and

privacy of their data.

Provider Experience

We believe in team-based care that

improves provider and patient

experience and coordination. Provider

experience and collaboration is

supported by digital technology and

literacy.

Cost Efficient & Sustainable

We believe that digital solutions should

maximize value for money in helping

overcome system cost and capacity

constraints. Digital solutions support a

sustainable health system and allow for

optimal allocation of resources.

Accessible & Appropriate

We believe that healthcare must

be accessible and appropriate

regardless of location, culture or

access to technology. There is

equity in its access and use.

Learning & Insight

We believe in a supportive

environment where we can learn,

take appropriate risks and gain

insights to improve the efficiency

and effectiveness of care delivery and

our health system.

Supports Population

Health Outcomes

We believe in creating a

holistic, proactive and

preventative approach to

health to support

a lifetime of wellness.

Privacy & Security

We believe that personal health

information must have the

appropriate controls in place to

ensure authorized access and use of

sensitive information.

Delivering Transformation: The Digital Health Strategy on a page


Optimal health and wellness

for every British ColumbianPatient

EmpowermentEmpower patients as

partners in their care and

wellness

Improved Care Team

ExperienceBuild a culture of trust,

collaboration and joy in

work to support the care

team in delivering quality

health care

Enhanced Decision

SupportProvide timely, accessible,

accurate information and

tools to support clinical and

system planning decisions

Integrated CareCreate an integrated and

comprehensive care

experience for patients and

clinicians

Vision

Strategic Pillars to Digitally Enable Health Transformation

Patient Experience Provider Experience Learning & Insight Accessible & Appropriate Cost-Efficient & Sustainable

Supports Population Health Outcomes Privacy & Security

Goals

Co-create an integrated and sustainable health care system that

delivers improved health outcomes and embraces a culture of

innovation, trust and partnerships

Mission

Digital Health Transformation Principles

Accelerate

Primary &

Community Care

Transformation

Transform Acute

& Hospital based

Care

Advance

Analytics

Capabilities

Enhance

Foundational

Clinical Systems

Infrastructure Policy and Standards Privacy and Security Identity Management

Digital Health Foundation

Architecture

Empower

Patients

1 2 3 4 5

Empower Patients


• Empowerment is essential to enabling citizens to have control

over the management of their care.

• This includes their families and individuals they need to

participate in co-management and shared decision making.

• The widespread adoption of digital health consumer

technologies is transforming how consumers manage their

health and wellness and interact with health care professionals.

What we will accomplish:

• Lead digital efforts to empower citizens to make

informed decisions to improve their health and

wellness.

• Create a secure, convenient and common

experience for patients to access a single view of

their health data and relevant health resources.

• Expand access to virtual visits and improve patient

access to health care, including specialist care.

• Enable personalized health care through increased

integration of consumer health tools.

Accelerate

Primary &

Community Care

Transformation

Transform Acute

& Hospital

based Care

Advance

Analytics

Capabilities

Enhance

Foundational

Clinical Systems


Empower

Patients

1 2 3 4 5

6

Why this is a priority

Accelerate Primary &

Community Care



• Improve ease and consistency of information sharing

between community care providers, patients, families

and caregivers.

• Develop and deploy solutions to facilitate effective

delivery of multidisciplinary team-based primary care.

• Identify, test and co-create innovative solutions for

adoption by primary care and community providers

through Innovation Acceleration Centres.

• Support and optimize care provider workflows and

care delivery through proven technology solutions.

• Develop and deploy a set of common foundational

digital capabilities that can be shared amongst all

primary and community care providers.

Accelerate

Primary &

Community Care

Transformation

Transform Acute

& Hospital

based Care

Advance

Analytics

Capabilities

Enhance

Foundational

Clinical Systems


Empower

Patients

1 2 3 4 5

6

• New methods are required to enable and support the care team

communication and collaboration.

• The vision of multidisciplinary team-based care will be difficult,

if not impossible, to achieve without digitization.

• The technology landscape continues to evolve and provincial

innovation capabilities are needed to stay ahead.

• Supporting PCNs will allow them to deliver faster care closer to

patients’ homes.


Transform Acute &

Hospital Based Care



• Provincial strategy for health authority clinical

information systems that maximizes health system

benefits and contains costs.

• Sector governance and clinical leadership to

identify and pursue clinical workflow, templates and

data standards in alignment with the

implementation of the system transformations.

• Pursue opportunities for collaboration among the

broader Canadian CIS client base, and specifically

those using advanced EHR functionality.

• Strategy and plan to contain costs while ensuring

business applications support the clinical

transformations.

Accelerate

Primary &

Community Care

Transformation

Transform Acute

& Hospital

based Care

Advance

Analytics

Capabilities

Enhance

Foundational

Clinical Systems


Empower

Patients

1 2 3 4 5

6


• The delivery of health services is increasingly complex. Medical

knowledge and digital technologies are maturing and

expanding exponentially.

• Advancement of the EHR is a priority to mitigate risks related to

the fragmentation of care, and enable improvements in quality

and safety; outcomes and experience; and population health

and health system sustainability.

Advance Data Analytics

Capabilities



• Provide capability for analytics to support health

system planning, quality improvement, program

evaluation and planning, operational research and

population health monitoring across distributed

systems of care.

• Develop data collection, data platform and analytic

capabilities to assess clinical programs, guide

technology uptake and enable robust measurement

of outcomes

• Provide mechanisms to implement performance

measurements and metrics defined by clinical,

population health and other business stakeholders

Accelerate

Primary &

Community Care

Transformation

Transform Acute

& Hospital

based Care

Advance

Analytics

Capabilities

Enhance

Foundational

Clinical Systems


Empower

Patients

1 2 3 4 5

6


• Health system planning, quality improvement, program

evaluation and planning, operational research and population

health monitoring can directly influence quality and

effectiveness of care.

• Analytics can drive a near-real-time learning systems by altering

how care is delivered in response to data-driven learnings.

Enhance Foundational

Clinical Systems



14


• Enhance medication management and expand

access to medication information to inform decision

making.

• Develop strategies to enhance clinical processes

through technology, including: delivering report

distribution, end-to-end medication management,

referral management, lab and imaging ordering,

immunization management and image/media

management, amongst others.

• The intent of this focus is to systematically improve

clinical workflows and access to relevant clinical

information by care teams.

Accelerate

Primary &

Community Care

Transformation

Transform Acute

& Hospital

based Care

Advance

Analytics

Capabilities

Enhance

Foundational

Clinical Systems


Empower

Patients

1 2 3 4 5

6


• Access and use of provincial medicine and lab clinical systems

across both community and facility-based providers is essential

to inform decisions and provide quality care.

• This includes results distribution, medication management,

laboratory ordering, medical imaging ordering and image

management.




• Establish a provincial Digital Reference Architecture to

facilitate innovation and investment alignment with the

Digital Health Strategy.

• Support development of policies and standards in the

areas of: privacy and security, data and clinical workflows.

• Develop and deploy foundational digital capabilities to

support DHS Pillars and PCN requirements.

• Advance provincial identity management capabilities to

ensure secure access to health information and minimize

administration.

• Define and develop a provincial infrastructure for secure

sharing of clinical information

• Implement robust and reliable networks, workstations and

hosting services to ensure a secure, scalable, accessible

and well supported foundation for sustainability and

growth.

Accelerate

Primary &

Community Care

Transformation

Transform Acute

& Hospital

based Care

Advance

Analytics

Capabilities

Enhance

Foundational

Clinical Systems


Empower

Patients

1 2 3 4 5

6


• The BC health care system operates in silos and has created

fragmentation, leading to negative impacts on health outcomes.

• We must create an integrated and connected system of care

based on standards and interoperability to behave as an

integrated system.

• System sustainability is at risk due to increasing costs. Disparate

efforts underway in common areas such as portals and virtual

care are further fragmenting our system and not containing

costs.


Creating the Portfolio: Translating Vision to Action


Pillar Outcomes

DHS Goals

Pillar Objectives

Pillar Initiative

Pillar Initiative

Pillar Initiative

Pillar Initiative

The vision and mission set out the overall direction for the DHS. This guides everything else that follows.

Goals articulate specific groups of achievements that the DHS is intended to accomplish and provide direction for DHS Pillars.

Pillar Objectives clearly define the particular subset of goals to be delivered by each transformation Pillar.

Pillar Outcomes answer the question “what does success look like” if Pillar Objectives are achieved.

Pillar initiatives define activities to drive Pillar outcomes and ultimately to support achievement of the DHS vision and mission.

DHS Vision

& Mission

Delivering priorities with Portfolio Management

Key attributes

✓ Partnership - key leaders and influencers in the business, policy and technology.

✓ Empowered - Leadership team be empowered to make decisions within their scope.

✓ Collaborate - With support of DHCO they will coordinate and collaborate within and across the other portfolios

✓ Break down silos - Adaptive governance and networking model; support from DHCO to ensure alignment and engagement throughout the transformation journey.


Portfolio 1

Portfolio Leadership Team and Lead

Project Manager

Project Manager

Portfolio: Business Outcome

Projects: Pillar Initiatives

Portfolio 2

Portfolio Leadership Team and Lead

Project Manager

Project Manager

Strategic Governance

Digital Health Foundation Leadership Team (Architecture

Review Board Role)

Digital Health Collaboration Office

Corporate Portfolio Management Office

Portfolio Governance

Executive Sponsors- Business/Clinical

- Digital/IMIT

Digital/IMIT Leads

Portfolio Lead (Project Director)

Business/ Clinical Leads

PortfolioLeadershipTeam

Accountabilities:• Decisions and alignment to Digital Health

Strategy• Deliver the priorities towards outcome; advice

on engagement and change management• Approve portfolio charter• Approve change requests impacting budget,

roadmap schedule, scope• Champion priorities and consultant/engage

across sector and pillars• Escalate as required

Accountabilities:• Decision and alignment to DHS and

portfolio outcomes• Approve project plans• Approve change requests within

established $$, scope and schedule tolerances

• Champion priorities, consult, engage across projects and portfolios

• Escalate as required

Project Governance

Foundation Team

DHCO and CPMO

Project 1

Sponsors (Business Owner/Digital

Owner)

Project Manager

Team: Clinical, Policy, Digital/IMIT

Project 2


Owner)


Project 3


Owner)


Project Manager

20

DRAFT

Digital Health Initiative Governance Structure – Year 1

21

Deputy Minister

(MOH)

Provincial Digital

Health Board

SC on Performance

Measurement, Analytics

and EvaluationProvincial Clinical

Leadership Committee

Portfolio 1

Empower Patients

Leadership Team

Portfolio 2

Accelerate PCC

Transformation

Leadership Team

Portfolio 3

Transform Hospital-

Based Care

Leadership Team

Portfolio 5

Enhance (Pharma)

Foundational System

Leadership Team

Portfolio 4

Advance Analytics and

System Planning

Leadership Team

Leadership Council

(LC)

Key stakeholder forums to consult and engage, examples:

• Joint Collaborative Committees and the related standing committees, including GPSC

• Patients as Partners

CIO Digital Leadership

Committee

Strategic Governance

Delivery Portfolios

Privacy and Security

WG

Data Standards WG

Digital Health Foundation Leadership Team (Architecture Review Board Role)

MOH Functions - Digital Health Collaboration Office

Digital Health Initiative: Advancing the Digital Health Strategy

Portfolio matters directed as required to CIO/Clinical appropriate committee(s)

Standing Committees or

Functions

Technology Strategy

Standing Committee

MOH Functions - Corporate Portfolio Management Office

Planning at a Portfolio Scale

• Priority Year 1 delivery items were planned out for the entire DHS portfolio, identifying milestones and dependencies across Pillars and specific initiatives


Year 1 priority initiatives organized

according to Portfolio (Business Outcome)

Milestones and dependencies identified and

aligned between initiatives

Estimated timing depicted to

understand volume of work and

resources required

Current Challenges for Project Managers

Portfolio Approach to Digital Transformation | The Ministry of Health Experience

• Executive champion turnover

• Competing/conflicting priorities

• Team capacity and capability

• Unrealistic deadlines• Geographically dispersed

team• Lack of clarity on

accountability for decision making

• Decision making by consensus

• Scope creep – trying to solve all problems in one project

23


Documents

Portfolio Approach to Digital Transformation The Ministry of … · 2019-05-08 · BC’s Digital Health Transformation Imperative. 6. Portfolio Approach to Digital Transformation