Healthcare Quarterly
Abstract
Diane earned a Bachelors degree in mathematics from the University of Waterloo and a Masters in Business Administration from the University of Windsor, and serves on a number of community boards.
You originally went to university to complete a degree in
mathematics. Why did that interest you then, and why the move to
business administration?
My interest in numbers began in pre-school. To keep me out of
mischief, my mom, who was a teacher, taught me to add, subtract and
count by two's, five's and 10's. Having a solid foundation and the
basics well in hand meant that in school math could be fun. My math
degree focused on Actuarial Mathematical Statistics, the more
practical side. Then, during the summers I worked for London Life
and had a chance to experience taking mathematical concepts into a
business application. The first roles I had after graduation were
primarily in the systems field, since the companies I worked for in
insurance and food processing expected that someone from the
University of Waterloo must understand systems. In these roles, I
had the opportunity to learn how the businesses actually operated
in order to build effective solutions using technology. As I
progressed in my career and began to lead teams, there were a great
number of things I wanted to learn about, so an MBA was a natural
transition.
How does your background in business development for
utilities help in the health sector?
In many ways, business acumen, strategic thinking, systems
thinking, building relationships and dealing with people were the
key competencies of my role. As you move into senior roles in the
public sector, these same skills are required.
Why did you decide to move from being chair to becoming the
CIO?
It was a chance to contribute in a way that I couldn't do in the
private sector, but it was a difficult decision, as I had worked
for Union Gas for 19 years and had been given many opportunities
and a variety of experiences. My time as chair of the LHSC board
was just about up when a few key people on the board suggested I
take a serious look at working for the hospitals. I had been on the
board for eight years and developed a passion for healthcare. There
were three things that I think really influenced my decision.
First,as chair of the Joint Committee on restructuring, I bought
into the vision for healthcare in London. It was obvious that if we
continued the way we were, particularly as the baby boom began to
use the healthcare system, the quality of care would be
jeopardized. Second, I learned a lot during that time about
politics, how government works and the way the hospitals operated.
The community leadership and the hospitals worked together to build
a plan for the London hospitals. Third, during that time, I could
compare the impact of enabling technology in the hospitals and in
businesses. Again, it was obvious that although everyone in
hospitals was working hard, there were, and still are, a number of
things to be done to better use our scarce resources. Maybe the
most important influence on my decision was that I met people like
Dr. Charlie Drake and Dr. Ramsay Gunton, who I think are Canadian
heroes.
You're an early electronic health record proponent, an
e-health summit participant and stakeholder participant. You also
gave a talk on plans to integrate a city-wide electronic health
record (EHR). How has Infoway affected your work in creating a
local and regional EHR systems?
It's certainly given me added enthusiasm and resolve, as the wider
recognition and support of the need for the EHR is a real boost.
This also allows a focus on sharing and collaboration from and with
the other provinces and within Ontario, it has reinforced the clear
need to work together. This has strengthened the top-down concepts,
policy, statistics and frameworks, but also worked from the bottom
up in looking at patient needs and local and regional
implementation.
Your organization hosted a technology healthcare showcase of
practical applications - such as robotic surgery, telepsychiatry
and the Southwestern Ontario Telehealth Network linking 40 health
agencies. What are some of the technological priorities that
require infinitely more work?
When I worked for Union Gas and West Coast Energy years ago, we had
a human resource system for all of Canada, with the benefit of
centralized, common information. It was surprising to me that the
hospitals - until a few short years ago - had four or five systems.
As we head into the next fiscal year we have one platform city-wide
and this offers tremendous benefits and economies of scale. We are
just beginning to use the infrastructure/connectivity of Smart
Systems for Health and LARG*net. This connectivity allows for
considerable sharing of information and applications. We are
beginning to work with Thames Valley Hospitals (Middlesex, Oxford
and Elgin County hospitals) to look for opportunities to share
technology platforms for patient care, human resources,
laboratories, financial systems and diagnostic imaging. It really
is exciting to see these all develop into one cohesive system,
using technology as the driver.
One of your previous roles was with SuperBuild, providing
advice on public/private partnerships and privatization. What will
you be doing in your new role of strategic alliances? Does this
imply more private affiliations?
Certainly SuperBuild was an excellent opportunity to learn and
understand how to effectively develop and manage private and public
sector partnerships. At Union Gas, our team was a private sector
partner with many municipalities. Private/public partnerships in
healthcare need to be based on business needs. People and
information are central to providing quality care and it is
generally not advisable to outsource core business.
However, private sector interaction helps generate ideas and, therefore, activities become more productive, and creativity is not only essential, but also prized. We have a small IT shop in comparison to the size of the organizations supported. IT has 150 people servicing eight hospital facilities and three family medical centres, meaning 13,000 employees, 1,500 physicians, 3,500 students and numerous volunteers. In benchmarking with other organizations, our ratio of technical staff to employees is low. We don't develop our own software, so in essence we have "outsourced" that function. We have solid partnerships with Cerner and PeopleSoft and do a lot of project management and support of healthcare providers.
As we looked at the strategic direction for our portfolio, the one area that we have not begun to explore and develop is connecting with the community. With the addition of Strategic Alliances and Networks, we have the capability to work with others in the region to leverage investments and lower costs, but more importantly, help ensure care closer to home and to improve quality and coordination of care.
When you were chair of the LHSC board and celebrating the
fifth anniversary as a merged organization, a co-authored message
with Tony Dagnone (president and CEO) noted,
"We are not simply meeting the standards for teaching hospitals in
Ontario - we are setting many of them. They affirm our reputation
as one of Canada's leading hospitals." Surely every teaching
hospital can say this?
Now in London, there is a high level of integration and
collaboration, with 15 priority programs. Our geography sets us up
to be much more of a hub than some of the teaching hospitals
clustered in Toronto. Recent results of the hospital report cards
and benchmarking data give LHSC above average scores in patient
satisfaction for physician care, nursing care, and overall quality
of care. In all 34 reportable indicators across the four quadrants,
LHSC performed either at or above the teaching hospital group
average. LHSC showed its greatest improvement from last year in
system integration and change, specifically for the innovative ways
in which we use clinical and administrative data, and for the way
in which patient care is coordinated among our many different
caregivers and specialties.
Do you have a particular leadership and management style? I
can't see you being affected by flavour-of-the-month management
theories.
I see management and leadership as a team game much like baseball:
if you don't have the right fielder, you can't win. Everyone has a
key role. For example, the IT help desk is not a function I can do,
but for the hospital to run we need the service staffed with
competent people. We all have to play to win/win. I don't
understand the thinking of those who play win/lose, or if they
can't win, everyone loses. This is not a productive use of energy
or time.
What's the best advice you were ever given? What advice do
you have for new healthcare managers?
The best advice I've received was from Cal Schewry, one of my
mentors at Union Gas. He said, "Look after your people and the
sales and budgets will look after themselves." I have found this to
be true. By working together you're always able to come up with a
creative solution or idea and really contribute to the
organization. The advice I give to others is to listen, support and
don't be afraid to differ; we often miss opportunities and creative
solutions because we jump to looking for what's wrong with ideas
before we understand.
If you could have three people to a dinner party, whom would
you pick?
That's a tough question, but the first person is an easy and
automatic choice - John, my best friend, whom I've been married to
for 27 years and who's always there for me. Having a chance to talk
about leadership and effective teams with some of Canada's notable
people would make for a fun evening. If he were alive, I would want
to invite Charlie Drake, as he was definitely one of my heroes. And
Wayne Gretzky, because he is such a team player and natural leader.
Deputy Premier Elizabeth Witmer, as she epitomizes great leadership
in local and provincial government - she was Minister of Health,
when I was board chair at LHSC and we had some interesting
conversations. Also J. Allyn Taylor, the retired CEO of Canada
Trust, who at 95 is an amazing person and has been a champion for
healthcare in London for many years.
What books are you reading?
A lot at once and I have a stack beside the bed - but mostly I like
to read about people. Right now I'm reading Mitch Albom's
Tuesdays with Morrie and Stuart McLean's Home from the
Vinyl Café. Also, The Set-Up-to-Fail Syndrome: How Good
Managers Cause Great People to Fail, published by Harvard
Business School; Rotman Dean Roger Martin's The Responsibility
Virus; and John Burdett's Leaders Must Lead, a book I
received at a seminar published by Executive Forum in Toronto. And
of course, a couple of golf books - Mike Weir's On Course
with Mike Weir and Lorne Rubinstein's A Season in
Dornoch.
Do you golf for fun or business?
Golf is for relaxation and fun - a four-hour walk in a park with
talk. I've played a lot of "customer golf," too, though - in those
four hours you get pretty good insights into what people are all
about.
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