CIO100 2018 #31-100: Tony Carpinter, New Zealand Blood Service
Tony Carpinter explains that being a Crown agency, the concept of competitive advantage does not apply to New Zealand Blood Service.
The agency is a statutory monopoly for the supply of blood products for New Zealand.
“However, we do need to keep improving our services to meet the needs of donors, patients and hospitals,” says Carpinter.
The NZ Blood Service CIO explains that in their core services, his team works on developments such as as extending the life of platelets and refining the processes for the Massive Transfusion Protocol needed in some clinical emergencies.
“The culture of NZBS lends itself to the ongoing improvements and changes, as new technologies and processes become available,” says Carpinter.
Sam Cliffe, CEO of New Zealand Blood Service, underscores the importance of the technology function led by Carpinter.
“The IS function is absolutely critical to NZBS, and therefore to the safe provision of blood products to the population of New Zealand,” he says.
Cliffee says NZBS uses IT in many different ways. These encompass business systems, automated testing of blood samples, apps for donors and health providers, CCTV, analytics for decision making, sending messages to hospitals, genetic sequencing, building and freezer management, matching organ donors and recipients, running small call centres, tracking the temperature of blood products in transit, checking for bacterial contamination, operating websites for different audiences, and keeping computer viruses at bay.
Carpinter says a recent project implemented by his team is eTraceline, a specialised system supporting the operation of hospital blood banks.
All of the blood banks in New Zealand’s public hospitals now use eTraceline to test blood samples from patients, and issue appropriate blood products for transfusion to patients and other uses, he says.
New Zealand Blood Service operates a “vein to vein” business model, with responsibility for the processes of recruiting blood donors, collecting blood from them, testing donated blood, manufacturing blood products, distributing them and tracking the use of blood products for patients in hospitals and other settings.
All of these functions have been supported by eProgesa, the national blood system, but now the distribution and hospital processes were moving to eTraceline, a new system from the same vendor (MAK-System).
The new eTraceline system offered a number of benefits, he says. These are enabling better compliance with regulatory requirements, improvements in clinical safety and service quality, better support for critical functions such as managing hospital orders for blood products, improving data quality and accessibility by having a single patient database and potential for further improvement, such as smart fridges and checks against patient ID.
The implementation project was well-managed and well-resourced, and included representatives of the different stakeholders, explains Carpinter.
They had a good mix of skilled contractors, mostly with prior experience at the company, and internal resources who were ready to develop new skills and responsibilities.
He says governance for the project was rigourous, and internal and external auditors were involved at key checkpoints.
“The stakeholders were not willing to compromise on the project objectives, and when some unforeseen problems arose, the decision was made to extend the project. This proved to be the correct decision,” says Carpinter.
“The project still had sufficient flexibility to take advantage of tactical opportunities that arose during execution. A number of small improvements were implemented as by-products of the project, such as improved help functionality, dashboards for viewing orders and an up-to-date offline patient database as a contingency for outages.
When the new system went live, the benefits such as improvements in safety could be seen immediately, he says.
“The new system is better able to manage some of the complex situations which occur with blood transfusions. Having easy visibility of orders reduces the risk of missing the dispatch of critical products. Having all patients in one database means that errors involving patient identification are less likely to occur.”
He says operationally, the project was much more complex. It was a significant challenge to implement a system in 20 district health boards, many of which have outsourced laboratory functions to external companies.
Beside the laboratory community, the DHB IS organisations were also affected, since the new system had to be delivered through hospital infrastructure, and also the new system generates messages which are displayed in the DHB Clinical Data Repositories, says Carpinter.
“The project’s success depended on the culture of the laboratory community, which is committed to achieving the best outcomes for patients,” he adds. “The project team ensured that the plans were well communicated, with multiple visits to every site during the project, and many other forms of communication.”
Long gestation innovation
Carpinter says a major innovation project his team is working on is the use of “smart fridges” in hospitals.
The concept is simple, he explains. Remote fridges with blood products should be located close to the point of need, such as operating theatres. The fridges will be integrated with the main blood system (now eTraceline), and the fridge will have controls in place so that only the correct blood products can be issued for individual patients.
“This does not fit the model of a rapidly developed innovation – instead it is having a long gestation,” he says.
The concept has evolved from the idea of a smart fridge to a simpler, modular approach of a smart shelf which can be fitted within a range of fridges. Technology now supports this concept and the capital investment is reduced, he says.
Carpinter says apart from smart fridges, the team has built on their donor app by providing an online donor appointment system which includes a dashboard for donors, and reproduces functionality from the donor app.
The app gives NZBS anonymised analytics from online ads through to booked donor appointments.
He reveals one innovation they considered did not make it to pilot. This was using drones to deliver blood products from Auckland City Hospital to private hospitals in urgent circumstances.
“The aim would be to avoid the vagaries of Auckland motorways.”
He says the project was in line with spirit of the smart fridge concept – finding innovative ways to meet urgent needs. “Unfortunately this use case of drones does not fit within the current regulatory environment.”
Carpinter briefs the board every quarter, and says cybersecurity has been a major area of focus in the last year.
For technology strategy, we have just completed a cloud strategy, using workshops and interviews, he says.
The cloud strategy is necessary as NZBS has cloud-based initiatives underway, such as using Microsoft Azure AD, and SaaS solutions.
“We want to take more advantage of the opportunities available, and we also have to meet the requirement of the Government CDO function to have a formal strategy.”
Creating a positive team
Carpinter says the culture within the technology team is positive, and staff have plenty of autonomy in doing their work.
There are good opportunities for training and development, he says.
“There have been two large implementation projects in the last five years, and these have given us a pipeline of Blood Service staff who have learned new skills from experts and moved into roles in an expanded IS team.”
Carpinter says an area they are also working on is increasing gender diversity.
We do better on other indicators of diversity, he says.
For example, there are 12 staff in our Auckland office, representing nine different nationalities. This has arisen from the realities of the Auckland marketplace, and our willingness to hire new immigrants from time to time, he says.
“At a personal level, I have been prepared to embarrass myself and the audience by attempting Te Reo to acknowledge a member of the team.”
“We are lucky that the work of the company directly helps New Zealanders, so our work is intrinsically important.
“I think that is a factor for both staff recruitment and retention – we attract people who want to contribute to the health of New Zealanders, and they find their work satisfying. Members of our team have been recognised in the company’s awards for staff contributions. “
Carpinter says at this stage in his career, he is becoming more and more conscious of looking after himself and his staff.
“For me looking after myself means not putting too much pressure on myself, not being too self-critical. It means being able to relax and not obsess about problems. It means recognising the human tendency to make up stories about situations, stories that are sometimes darker than the reality.
“Looking after others means accepting diverse motivations and personalities, keeping an eye on what’s going on with other people and being willing to offer support.
“It means advocating for your staff, and helping them reach their potential. The success of others can be very satisfying. We’re in technology but much of working life is about people, people, people.”
“We operate a ‘vein to vein’ business model, with responsibility for the processes of recruiting blood donors, collecting blood from them, testing donated blood, manufacturing blood products, distributing them and tracking the use of blood products for patients in hospitals and other settings.”