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Transforming Healthcare: Reflections from John Ward during his time as Interim CTTO

Since stepping into the interim CTTO role in Technology and Transformation at Health Service Executive, I’ve witnessed and been part of some significant changes. Reflecting on my journey, I’m struck by how much we’ve achieved and the transformative power of technology in healthcare.

Significant Changes in Technology and Transformation

My journey with the HSE began during the COVID-19 pandemic, a period that underscored the importance of modern platforms. One of the most notable changes has been the adoption of cloud technology. This transition was accelerated by the pandemic and a subsequent cyberattack, leading to substantial investment in cloud services. Today, the HSE stands as one of the largest consumers of public cloud in the public sector, a shift that has provided us with incredible agility and responsiveness.

In my role as interim CTTO, the focus has been on developing a long-term strategy. When I started, we were working with the eHealth Strategy for Ireland (2013) and the Knowledge and Information Plan (2015). Since then, we’ve crafted the Digital Health Strategic Implementation Roadmap, a comprehensive plan outlining our vision for the next seven years. This roadmap, developed in collaboration with our stakeholders—including clinical and services colleagues and the Department of Health—will guide our digital health efforts over the next decade. Two key documents will be released this year, setting a clear direction for our digital future, the Department of Health Framework and the HSE Digital Health Strategic Implementation Roadmap.

Evolution of Technology and Patient Care

The HSE’s reliance on technology became apparent during the COVID-19 pandemic and the cyberattack. These events highlighted how crucial technology is for managing health crises and maintaining daily operations. There’s now a stronger demand from our clinical colleagues for digital tools to improve patient care. Ireland’s aging population and physical infrastructure constraints necessitate innovative digital solutions. One such solution is the development of virtual care wards, allowing us to provide acute care at home. This reduces the need for additional physical beds while maintaining high standards of care.

Advancing in a Dynamic Environment

To our dedicated staff, I offer this advice: take pride in the direct impact your work has on patient care. Collaboration with clinical colleagues is essential. They possess deep insights into patient interactions and care needs. By co-creating solutions, we can effectively use both new and existing technologies to enhance patient care in a safer, more efficient manner.

Guidance for Future Leadership

As I pass the baton to Damien McCallion, I am confident he will push the Digital Transformation agenda within Technology and Transformation. Damien’s extensive experience as the Chief Operating Officer at the HSE gives him a deep understanding of patient demands and outcomes. I know he will continue to be clear about our vision and timelines, ensuring that the six principles and 48 initiatives outlined in our roadmap remain the focus to maintain progress in a coordinated, strategic manner.

Memorable Achievements

Reflecting on my tenure, two achievements stand out. Shortly after starting in June 2022, we secured government support for a seven-year cyber transformation programme. This support was crucial for enhancing our cybersecurity posture. The second achievement is the delivery of the Digital Health Strategic Implementation Roadmap. This project involved extensive collaboration with clinical colleagues to identify and agree on what is needed to move forward digitally. Their commitment and collaboration have been both remarkable and rewarding.

Overcoming Challenges

One major challenge was convincing people that our strategy would be implemented effectively. Historically, there has been a number of strategies, and one might ask what is different this time? In my viewpoint, things are different, the COVID-19 pandemic and the cyberattack demonstrated the critical role of technology. Building momentum behind the plan involved close collaboration with the Department of Health and securing their support. Even before the roadmap’s publication, several projects have been initiated, such as the health app and virtual care wards, which demonstrate tangible progress.

Future Developments

Looking ahead, a critical development will be the deployment of electronic health records (EHRs). Our roadmap's core principle is digitally enabled and connected care, with EHRs at the centre. An EHR is a System of Record, and are the cornerstone of a digitally enabled health care system. They facilitate and are essential for building systems of engagement for patients and clinicians. Securing government support, setting up teams, and implementing EHRs across the system are vital steps forward.

Shaping the Future of Healthcare

Technology will continue to make healthcare more accessible and improve patient care. Our systems, guided by the roadmap, will enable clinicians to deliver better services and empower patients to take control of their health.

Surprising Elements of the Role

Building consensus in a large, multifaceted organisation like the HSE has been unexpectedly challenging. Each area has unique needs, and aligning local and regional needs with a national technology capability requires extensive communication and understanding. Ensuring that everyone feels heard and that technology solutions meet their service needs is critical.

As I reflect on my time as interim CTTO, I am proud of the strides we have made. The commitment of  staff and the collaborative spirit of our clinical colleagues have been inspiring. Together, we have laid a strong foundation for the future of digital health in Ireland.


Here you can watch the Interview with John Ward, reflecting on his tenure as Interim CTTO, HSE