639 - The Roadmap to Successful Healthcare Outcomes in WA: Lessons from the Rauland Panel Discussion

0:00Peter Birch: Have you ever heard a term in digital health and just quietly had to Google it later? The Talking Health Tech Glossary has got you covered. We've got hundreds of terms in plain English explanations written for our industry and all free to use. You don't even have to sign up for anything. Just go to talkinghealthtech.com slash glossary.

0:34Peter Birch: Welcome to Talking Health Tech. My name is Peter Birch. We're here in Perth, Western Australia, bringing together healthcare leaders in a live event with Roland Australia. During this event, we had a panel discussion up on stage, which you'll hear me introduce in a moment to make this feature podcast episode today. And then afterwards, we turned the cameras off and we had a session that was a Q &A with clinicians and healthcare executives and the different stakeholders in the room to hear what they really think. Hopefully if you see one of these live sessions that we hold here at Talking Health Tech in the future, you can come along and participate in the conversation.

1:08Peter Birch: And in the meantime, here's the discussion that we had here at the event. Collaboration starts with the conversation team, Health Tech. Let's make it happen. I would like to welcome into the stage Jacqueline Leeds, the CEO of Role in Australia, New Zealand, and we'll get started. Welcome, Jackie. Thanks, Pete. Thank you. Did you want to introduce yourself a bit more, tell us who you are, a bit about Rowland, but also why are we here in Perth? I'll start with a bit about Rowland and then I can probably jump back to a bit about myself. Morning, everyone. Thanks for turning up nice and early. Thankfully, beautiful Perth weather came out for us.

1:47Sharing Rowland indulged me for a few moments. I think telling our story and how we started and where we've got to gives a really great context of actually why we're here this morning. So as a company, more than 30 years ago, we started out and very much were known as a nurse call provider, dedicated the first 20 years of the career of the business very much to bringing a really robust, high quality nurse call system. Certainly what we still today believe is one of the best in class. We iterated and innovated even through that hardware in bringing voice and creating a lifeboat and safety system that then propelled us to do many other things.

2:36And then skip forward 20 years about there and the team started to really innovate and think about, well, what does digital healthcare's future look like? What really is it that we're trying to solve for. And there were a couple of key, key focus points. Firstly, to create an environment where you could unify all the many different systems, whether that's hardware or software, that digital healthcare was starting to embrace. So whether it is your nurse call system, as we were starting to introduce software, bedside engagement systems, whether it was staff duress, more recently into radars and fall detection, let alone how all the communication's working across an entire footprint.

3:23So with a really strong purpose, firstly, to ensure that we were creating a platform that was actually solving for those improved outcomes. And at the same time, there was also a clear purpose. How do you create a quiet environment? With alarm fatigue, a real thing, with measured statistics of its impact, how do you bring together this unified way of working and this communication integration that essentially is quiet, seamless and fully integrated? So there comes to be a platform that we call Concentric Care. It's made up of many different pillars of both hardware and software. But as a platform, it's a very advanced technology, but its true outcomes is to really ensure that the full integration across the hospital system and in aged care environments brings together all those systems.

4:20We sit between, for context, the ICT and the clinical systems layer and we manage all of those notifications and communication that flows and we direct it in the right direction. So, we ensure that everything from, you know, building maintenance through to clinical to small tasks, large tasks, medical emergency, everything in between. How do you direct that communication and those notifications? And it comes back to one key thing, is having also a single device. And that was the other key purpose in designing the platform. By having a single device strategy, you have an opportunity to have a vehicle to manage all of those notifications.

5:06Now, there's a lot of sophisticated technology that sits behind that. We have a great team that is spread across all of the country of Australia and New Zealand with great tertiary hospital as well as aged care and everything in between relationships where we partner with these deployments and we bring to life a lot of this technology. We live and breathe in more than about 420 acute hospitals today, certainly here in WA also, and we've had a really great experience building a great team and they're very much our team, everything from our software engineers, design team and our installation and deployment teams.

5:47They're all Rawland and do a really great job at delivering what we do. In terms of Perth, Well, first and foremost, I'm very pleased to say I am a Perth girl, born and bred. Spent the first 22 years of my life here and then have moved myself over to the east. But I've been in technology for 30 years. I started out my healthcare relationship bidding to government to why take on EMR and the privacy, security and identity factors behind that. So that was my first entree to healthcare many, many years ago. Funny enough, we're still talking EMR today, but it gives some context of my digital and transformation background.

6:31And I've had the pleasure of being with Roland for the last 18 months as CEO.

6:36Peter Birch: Nice one. Hey, last question, Jackie, before we bring up our participants in the panel discussion, what are you expecting will come out of the discussion? And why do you think it's important that we have the people that we've got in the room for this chat? There's no doubt Western Australia is on the brink of a significant transformation. I don't think it's unknown that there has been a slow moving progress in the West, as are some other states of Australia, where we have the digital adoption of digital has been slower than imagined. but this is a game change now. I think the next five to ten years there's some significant movement coming with new hospital builds and also some of the refurb work that we see.

7:25Having been here 17 years we've had experiences, we live in some of these hospital environments and we know them well. I think this is going to be a really exciting time. I hope out of this morning what you importantly take away and particularly with a couple of the guests that are here is how to think digital starts with how you think as an enterprise how do you think of all of the moving parts of a hospital environment and you think about it as one one unified approach not its parts which it is and there's legacy systems but really approach this from the design stage and a few of in the room that are very connected to the new builds, how do you look at it end-to-end and plan and scope it now?

8:12And learn along the way what is single device strategy and why is it important to have a quiet environment and its benefits and then really understand how critical messaging and the role of workflow and communication and all its other parts that's going to make this a really advanced healthcare environment in years to come.

8:33Peter Birch: Amazing. Well, Jackie, some great framing there. Be sure to catch up with Jacqueline and the team from Roland afterwards and maybe there'll be opportunities during the Q &A on stage too, but shall we bring the panellists up on stage? Absolutely. All right, well, please join me in thanking Jacqueline on the stage. So I would like to welcome to the stage for this, the reason we're here, for this discussion, one of the reasons we're here. We've got a late substitute in, but we did, I think we're better off, Tim Lean, Acting Director at the Office for Medical Research and Innovation at WA Health. We've got Claire Lake, Chief Nursing Information Officer from the Sydney Children's Hospital Network, which we'll explain in a second.

9:14Peter Birch: We've got Brad, the Senior Solutions Architect at St John of God Healthcare, and Vicky Knight, the General Manager for Clinical Services at Rowland Australia, New Zealand. Please come up on stage and we'll have the discussion. Hey team, thanks so much for joining. I think it'd be great for each of you to take a couple of minutes to introduce yourselves tell us a bit about who you are the world you operate in and maybe if we'll make the most of the time rather than just reading our bios and things but maybe a project that's I was going to say taken a lot of your time this year but maybe that you've invested a lot of your efforts into this year which might then frame up this discussion that we're having today I'm going to start with you Claire and we'll move down this way.

9:58Peter Birch: Great thanks. Maybe you can explain why you're not from Perth. Yeah sure thanks. Hi everyone so my name's Claire I'm the Chief Nursing Information Officer at the Sydney Children's Hospital Network and as you can tell from my accent I'm not initially from Australia. I came over from England approximately 13 years ago and this is actually my first time visiting Perth. Beautiful from what I've seen so far. So my role across the network is to support implementation and digital initiatives to the end users which are like my nurses. So the network consists of two acute paediatric hospitals. They are, we've got, you know, cardiac patients, oncology patients, emergency departments, intensive cares, but it also covers our hospice, which is pediatric palliative care from 0 to 18 years old, and also our NETS, which is our neonatal and emergency transport services.

11:01And the projects that I've been involved in for the past year, 18 months, is building two new hospitals and deploying the Rawlins Nurse Call at duress and the clinical communication devices. So I'm very happy to talk more to that now. Yep.

11:20Peter Birch: We can come back. And I want to come back to that though. Perfect. But it's, thank you. So yeah, digital health has got a pretty serious acronym problem and we've all got our favourites, but it's a lot, right? And you don't really want to be the person in a meeting that has to ask what something stands for after you've been talking about it for the past couple of weeks. That's why we've built the THT Glossary. It's a free, ever-growing library of digital health terms that we explain in simple language, written for people who actually work in the industry. So that's useful if you're brand new in the space, or you're one of the veterans that just want a refresher before a meeting, or maybe you want to check to make sure we've got everything in there.

12:01Peter Birch: It's all there for you. Have a look at talkinghealthtech.com slash glossary. Bookmark it. Send it to your team. It's the kind of thing that should exist. So we created it. Hope you enjoy. Good context. Tim, thanks so much. Good morning, everybody. This sounded good. I'm day six in my new role. So very, very new to it. So I'm fortunate enough to work as the executive director in the Office of Medical Research and Innovation, which manages the Fiery Fund for Western Australia. And we're very, very fortunate in Western Australia to have the support to back our innovators and researchers. So I'm looking forward to getting my hands on the fund and supporting researchers and innovators all over the country with that and seeing what it does to our patients.

12:47I've been involved in technology. I'm a clinician by background. I'm an ICU nurse by background and have been fortunate to be able to dabble in my day to day work with technology from a very young age and grown and developed from that. I've done various things, commissioning hospital, bringing new tech into hospital, bringing DMRs, EMRs. and various novel factors like artificial intelligence looking at predicting deterioration 12 to 18 hours before it actually happens in a command centre in Royal Perth, which managed a lot of hospitals around the place. So that was really novel. Over the last couple of years, I was the Executive Director of Transformation and Strategy in South Metro, and I worked really a bit about what I saw that was lacking was there was a lot of great innovators like in the room, a lot of great companies but what was happening was it was slow getting the tech and the innovation to the patients so what we really worked on was developing a platform called HealthReady and we've got funding for it now to support getting innovation to patients early and there's lots of drama with it and IP and all that sort of stuff that we need to figure out But what it means for us is we're getting people thinking, people active, people motivating, people asking the question why.

14:06And then for my, I took a little bit of a turn and I took a sabbatical from tech and I became executive director of mental health for South Metro. And I brought all the area mental health services into one. And when you think about mental health and the youth and technology and anxiety and all the other issues that happen, the importance that tech and innovation can bring to that cohort of patients and make a real true difference. I think now coming back after having stepping back into operational land and knowing the challenges that clinicians and everybody face day to day probably will give me a better insight into that.

14:46So I'll stop there. Yeah, 100%.

14:47Peter Birch: No, that point around the challenge, the issue that technology brings around mental health, particularly in youth, as well as the opportunity that the technology has to address some issues. That's a whole other rabbit hole for another day. Vicky, thanks so much for doing. Hi, my name's Vicky. I am a clinician. I'm a registered nurse. And I've been with Roland now for six years. and in a prior life I spent most of my time working in the digital health sphere but from a research perspective so I worked a lot on operational research looking at models of care and the outcomes of those models of care on the patient and on the staff and yeah and in the last year and a bit, I spent a very lot of my time and my clinical team's time working with Claire at Sydney Children's Hospitals Network to set up their really fantastically digitally enabled platforms that they have there.

15:53So, yeah.

15:53Peter Birch: Thank you. And Brad, you've aged a bit since your profile photo there, but can you introduce softly? Yeah. So also I see the world differently to everyone else as the tech guy. So you asked me to speak about something that's recent, that's normally important to people, that's new and fancy. That's not important to me what I've just done, that's important to the people of Western Australia. The story that I want to explain here is St John O 'God asked me to help build a hospital in two years, which my first statement was that's impossible. But now that we've done it, I can come and say how we did it.

16:30And St John and God said that we've got a whole bunch of systems that are amazing. We want you to deliver those. And there's a few things that we can improve on. One of them is digital operating rooms. And my leadership said, we need you to pick one. And I kindly refused because digital operating rooms are very tactile, hands-on. The picture quality has to be seen in person. I can't do that for you. I can't write a specification and buy a system. I have to fly to Sydney. So there was some thought that that was me trying to get a free trip. But honestly, I don't like flying. So I went to Sydney, but I did it for many reasons.

17:06Number one was to buy a digital OR. But the other one is to see what everyone's been doing since we finished the children's hospital. And Rollam was in a lot of the hospitals. So I knew that they were still the real deal is what I call it for nurse call. And I know that all of the companies have evolved and can do so much more. So that's when I started to look into all of the companies that were there, how do they stretch to bridge the gaps that is what you're expecting to learn and hear today. So Roland is definitely one of those partners and we have many others.

17:40Peter Birch: Looking forward to it. Look, exactly what we need to bring to this discussion. Hey, Claire, thinking about, you know, back to the deployments you were talking about before, there was, correct me if I'm wrong, but there's the Randwick Hospital and then the opening up at Westmead or deploying stuff out in Westmead. You know, there may be people in the room that are familiar with deploying technology within one particular health setting, but then if you're trying to do another, and I imagine connect the bits together or have efficiencies of scale and all of that, like, tell me about what changed, what was similar, like, in rolling out a second kind of facility, walk us through that a little bit more.

18:15Yeah, great question. So being part of the network, you want things as aligned and streamlined as much as possible. And that just enables you to have those efficiencies, contingencies. So if it's not working in one space, you can support it in the other space. So when we deployed it at Randwick, very new system, and it didn't quite go as initially planned. And that's not through fault of any one vendor or anything in particular. but we had to hit the ground running really create some quick fixes improve those workflows so as soon as we did deploy it at Westmead it was seamless so we took lessons learned and that's one of the biggest things that you need to do in healthcare we couldn't deploy what we did in our first hospital to our second hospital and hope it worked we knew we had to go real back to basics what's not working, why is it not working, and let's fix this.

19:10So our second hospital had, I guess, a better experience with this deployment. But, you know, lessons learned.

19:22Peter Birch: And Brad, you know, from your side, I imagine you're quite heavily involved in the, you know there's something there's there's a dream that's sold but then there's the implementations oh that's the other end of it but you've got to actually make sure the thing works and the testing elements and all of that like you you strike me as a person that puts a lot of focus on the importance of that piece but there'd be others within any institution that might think well that's just a quick tick the box like what's what are the most important elements of that testing process to actually make sure the thing that's been sold is actually fit for purpose from a technology point, but maybe there's other sides too.

20:01Yeah, I did wonder what I'd be asked and how I would answer it. So it's, yeah. The answer to all of those things is the way we look at the world. So in my career, I've seen lots of really uncomfortable things. So I could be tear-jerking and emotion-evoking, et cetera. On the other hand, I've seen so many amazing things that make me realise, what about if we don't react? So lessons learned are really important. But if we keep reacting, we'll only meet the minimum viable product. We'll only just get there. We'll be good enough. What about if we flip it and we say we're going to optimise everything?

20:43So our lessons learned are what we know and what we should act on. But what if we say, hey, we don't want minimum bar. We want something over and above. right so I find out what that is I never ever compromise I present it to all the leadership and then ask them what they want so we start up here sometimes we might drop back very rarely we do because people can see if we get it right from the start it's not more expensive it's just done properly so this is where I was going with Roland I'm focusing on Roland because they're our partners today, but I do this with all the vendors. So one of the questions that I ask myself and others sort of allude to is how I do it.

21:28Sarah calls it working my magic. It's not magic. It's hard work. And what I do is I create a digital version through data and information of what we're going to build. I do it early. I find it interesting that people think that Western Australia is behind. We're actually very advanced in some areas, but we're secretive. Yeah, because we're out on our own. We're the most remote capital city in the world. So we have to do it our way. Yes. So there's a digital version of Perth Children's Hospital that I helped create, but not just the building, like normally a building model. It's everything. So there's data that explains every decision that I was faced with, that I shared with my colleagues and the output of that into many thousands.

22:17I think we ended up with 100 ,000 objects that we were monitoring and managing at that hospital. And then we proceeded to procure it. I add more data. So this is based on object-orientated programming, by the way. But I added more data and build the models out, and then they can be replicated in other projects. And with the lessons learned, the replication can be optimised each time.

22:38Peter Birch: Do you find that that approach helps with, like, with the decision making side of things like is it reference because like it can be a shame when all this great kind of work happens but then there may already be decisions or direction that's happening at a at an exec level too because it would be such a shame for that work to happen so what happens is the strategy that everyone has in healthcare is to optimize health so it's never misaligned it's mostly just misunderstanding so the if I that's what I'm basically saying if you present all the information as a technologist, the executives will be nodding.

23:14That's exactly what we're trying to achieve. It always works out. Nobody's compromising on healthcare. They just don't know at any one time what the 200 ,000 items, the 100 millions more. No,

23:29Peter Birch: that makes sense. Then I think about the uniqueness of Western Australia. I'll go to Tim. that, you know, we can hear about examples of specific deployments within health systems in a particular hospital. But then if we're trying to think about the... We were talking to someone before earlier today. Geographically, Western Australia pretty much takes up half the country, but then everyone's kind of like down in the bottom... Not everyone, but there's a big chunk of the population down in the bottom left. You want to be able to deliver... You know, the goal, I imagine, sort of to Brad's point, is we want to optimise the delivery of healthcare for everyone.

24:06Peter Birch: We've got a lot of challenges there, a lot of different cultures, experience things. At a system level, how should we start thinking about reconciling all of that? I'll give you the easy question. Thank you for the easy question. Can you fix things, please? I think a couple of things. I think lessons learnt is hugely important in sharing them. And I think we're really good at lessons learnt in our own facilities, and we'll do them well. but I wonder when we see lessons learned from other areas how much notice we take out of them or we've just got our we've just got our focus on what we want to do here and do we really live and breathe somebody else's lessons learned and that's probably something that I would think seeing seeing places and learning from places I probably didn't heed enough.

24:50Western Australia and we're just talking to to somebody from our country colleagues and thinking about all the disparate areas around the place. We've got structural problems. We've got old infrastructure. Some of it good, some of it not so good, but we can't avoid that. I think the advantage we've got is we've got an EMR coming up in the next few years, and that will force us as a community to come together around pathways. And while this is very much tech we're talking about, the patient workflow and what happens at the coalface And when we all disappear after a deployment and it's in the middle of the night, does the tech work?

25:30Does it work for people? Do they revert to normal? That's probably the most important thing is to really understand the workflows, develop the tech around the workflows we're hoping to achieve, and then monitor it and spend more time afterwards monitoring it. So I think for us in WA is we're on a good journey to come together, how we bring the privates in, and how we have that end-to-end solution from the point of patient getting sick to the point keeping the patient well at home. That's probably the key for us. And the challenge is structural. Difference between state and Commonwealth, that's got its own challenges and the transfer of data around it.

26:10So I think we're on the right track, but we're going slowly and we have to do it correctly.

26:16Peter Birch: Well, there's a lot happening in Western Australia at the moment when it comes to systems as well. So it's the right time to have the conversation. Can I jump in for a second? You know what's really interesting? There's massive amounts of amazing tech here in Perth, Tim. The bits that are older and don't work, which is the small bit, cause a whole lot of trouble. It's the bits that we don't follow the full model on. So the nurse call always works. But if we get any little bit off kilter, it's very much highlighted. yeah it has an impact well and Vicky you you've seen it from both sides uh and and right now from the the technology providers point of view but you must still have a lot of flashbacks to your clinical days as well does this kind of resonate from what you've seen and also in the conversations you're having with nurses and clinicians too yeah so one of the first experiences that shaped my journey into digital health research or you know implementation science research was when very long time ago I was working Broken Hill which is far west New South Wales so you know it's not it's remote it's not probably as rural but we also had to service all of the other parts of the far west local health district places like Walgut and Burke and Menindee and Lightning Ridge and we had a lot of FIFO staff, right?

27:44All of our doctors flew in from Sydney. Most of our allied health flew in from somewhere else and we were the poor people who were left holding the patients when everyone else left. And we heard of this thing that was going to change our world and it was called telehealth. And we were like, excellent, that's so cool. and, you know, these people came in with this project and they brought this thing in on a truck. They didn't even fly it in. And it was this massive box that was about the size of that table and they put it into our room, one of the only rooms we had where we did our training. So it now became a clinical space and it had these massive coax cables coming out the back that had a big thing over it so you didn't trip over all the cables.

28:36massive box and we all went, wow, that's amazing. And then we had to use it. And it was completely against everything that we had built in the sector that I worked in. Little did we know, they, I don't think, had spoken to any clinician across the Far West Local Health District. I kid you not. Not only that, they didn't speak to community. And so we started getting our community to come in to use this box and our staff to come in to use the box. And it was a complete failure. The box is probably still hidden in the depths of Broken Hill Hospital somewhere being used, you know, as a prop for spare equipment.

29:18But it was a complete disaster. And I sat back and went, what a waste of money and all the angst that it caused, especially for our community. It caused a big, you know, rift of between health and these people who we said we understood and were partners with us and were stakeholders in their own destiny and then it wasn't. So that's where I started to go, okay, I really like this. I like the idea of technology, but we have to do it properly. We have to make sure that we bring the end users on. And what you were saying, Tim, about the fact that, you know, you have to look at the workflows, you have to look, and I talked about this at Digital Health last time we were here, in Melbourne, you've got to look at all of the workarounds because everyone in health has a workaround because something doesn't work exactly as it should work.

30:13And so you've got to map all the workarounds and do all of that work and make sure that you bring everyone on the journey. And then hopefully you will have these fantastic solutions that actually do achieve, as you said, Brad, achieve what we all want to achieve, which is good outcomes for our patients and good outcomes for our staff.

30:34Peter Birch: We've got about five, ten minutes left of this panel and then we'll open up to the audience for some Q &A for those attending live. But I think you've already given some good kind of key things for healthcare leaders to think about, but I'm keen to get the rest of the panel too because it's, as I understand, an interesting time, important time in Perth at the moment for healthcare technology, you know, with EMRs on the horizon, but also, you know, secret technology, not secret technology, but, you know, a lot of pockets of innovation and potentially some investment too. And I'll go down the line, perhaps starting with Claire too, you know, coming from your perspective as well, from what you've seen, you know, what would you hope that some of the healthcare leaders who are here attending this one or listening in later will take away from this discussion, particularly for Perth in this important time?

31:29bring your end users along on the journey because they are the ones that are using this device or this system or this integration and when it goes wrong at 4am you you need to know that they can they can troubleshoot and they're happy with that implementation and that that is challenging because who are these end users well there are nurses there are doctors they're looking after patients they and they don't always understand tech if i'd have brought my you know initial end users on about nurse call it sounds great it's fantastic but it's not until you get them in the room and they use it they come up with questions that you'd never considered so you then have to go back you go back to the vendors or you go back to your teams and you say this what we thought was going to work it's not going to work so how can we then improve it to make it fit for purpose because at the end of the day it's ensuring that our end users are happy and our patients are cared for safely that's a super important point but it's one that I think you know I think you emphasized it well

32:33Peter Birch: then too because it's what I think if no one in the room is going to disagree with you that hey you need to bring clinicians along with the journey but I think because we say it so much too it's kind of like we feel like we just did it but then also it's a bit of a pain when you're ready to launch something and someone says well this isn't going to work it's like oh well you know maybe they don't know or something like so I think part of that too what I'm hearing is be prepared for that kind of messiness because it's either going to be messy before your deployment or it's going to be messy afterwards and you don't want it to be in front of a patient.

33:01Correct. And it's having the right people as an end user, having those super users, knowing who the voice is within that department or within that integration because they will support you and they will help you. It's better to have that than just ignore those troublesomes and have the wrong person. as part of the end user. Choose your heart.

33:25Peter Birch: That's what I tell my kids anyway. Tim. Thank you. Just to add on two things. First one is communication. And just add on what Claire said is bringing the end users on. And when you think you've got 100 % of your communication and change plan sorted, it's really about 10 % and you need to go back and start again. So the more you communicate, the better. We were just about two weeks before we went live. We wired a whole hospital. We put a remote monitoring service where we're monitoring patient deterioration in wards around the state. And the lead clinician in the project, who'd been on the project two years, came up to me and said a quiet word in my ear.

34:04He says, are we really going live in two weeks? This is pretty scary. And he was involved in it all. But it's just appreciating when you're expecting busy operational people to pay attention to what's most important to you, it might be way down the rank in them. So appreciating that you probably, when you think you're about 100 % communicating, you're only about at 10 % at the most. The other thing for me is when you're implementing something, we give people options. This is the new model of care. This is the new workflow. But the old model of the old workflow still remains. So you've got choices.

34:41Sometimes I think we need to be brave and bold and remove something and limit the options. and that creates a good opportunity of advancing tech. One of the big things for me is, God, I forgot about COVID, but I led East Metro in some of the implementation of a COVID clinic. And one of the main things was the digital component of it. And I remember the day we opened the COVID clinic and everybody, there was reporters outside the door that we were going to go digital with our documentation to link phone numbers and patient data. And the tech failed for an hour before we opened. Everybody was itching us.

35:26The CE was looking at me. The minister was looking at me. Where's the downtime forms? Of course, we forgot to have the downtime forms. And it was the best thing I've ever done in my life. Because if we had paper available, we would have revolved to paper. So we went through a little bit of pain. And you think about all the linkages we were able to manage during COVID. but that was a prototype at that stage. And we allowed ourselves the pain of an hour and a half with no digital to have a new workflow. So really, if we limit the options and we acknowledge and celebrate the past, but then really focus people on the future, that probably is one thing I think we need to be a bit braver on.

36:04Peter Birch: I think that helps with the whole... Because we often talk about the cognitive load and decision fatigue and all of that too, by definition. And if you've got fewer options, It's kind of, this is what we're doing and it's a simplification. But no, that's a great point. Thank you. Vicky, anything else you wanted to add on that? Just probably that I think that when we're setting up these digital transformation projects that we give enough resource and support to the teams that actually need to do it, need to be the people making the decisions, for example. I see in a lot of projects that I'm involved in there's kind of five, six people and nobody really wants to make that decision because it'll come back to bite them if it doesn't work or whatever so I feel like we need to resource we need to make sure that we've got a group of people who are given the role of being the governance creators they're the ones that make the decisions they stand behind their decisions, they're resourced enough so that they can do their research to make the right decisions and then they're the ones that are, you know, they're given the role of making sure that the communication flows and that the clinicians come along the journey.

37:23You can't do that in these big transformation projects with one redevelopment clinician or two. You need the change managers, the super users, the executive on board making the decisions with you, not to make a decision. I feel like that resourcing piece is often left out.

37:44Peter Birch: Yeah. Now that we've got a digital image of what we're seeing, we can amplify it more and then we can use AI technology to detect differences in pixels that humans can't see. So now all of a sudden with our tech, while the surgeon's operating, endoscopy's uptake on this is big. The technology can be like your digital friend checking everything that you didn't see. Same as in medical imaging, it can see, to Tim's point, cancers that are there which a human eye would never detect. So it's about partnering with our technology and our providers who provide that for me. And instead of clinically led, what about just strategically led or just led full stop, the leadership, yeah?

38:27But the other point made before is the followers need to be on board. Yeah. So it sounds a bit cliche, but what about if we all just work together and get it sorted? It's all the good humans. Yeah, good humans.

38:41Peter Birch: It's a recurring theme, 100%. Well, it's all the time we've got for the official podcast recording. You can't go anywhere because for the lucky people in the room, we'll be doing a Q &A session, but we're going to turn off the cameras and you're going to tell us what you really think. So please join me in thanking Claire, Tim, Vicky, Brad.

39:05We hope you enjoyed this episode of Talking Health Tech. Make sure you like and subscribe and share this episode with someone who might find it valuable. For more information and resources about healthcare innovation, visit TalkingHealthTech.com.

39:22Peter Birch: That's it for this episode. I hope you enjoyed it. Make sure you subscribe to our newsletter on TalkingHealthTech.com slash newsletter so you can be across all the things we do at Talking Health Tech above and beyond this humble little podcast. Thanks so much.