Christmas round the corner means one thing- Business Continuity Planning

So, the decorations are going up in the streets, the nights are drawing in and Starbucks have switched to red cups. It can all only mean one thing. Christmas is upon us. However, for those in IT, the other herald of the season is calling for us to brush off our business continuity plans and work out how we keep the wheels turning with skeletal staff.
In the hospitality and leisure industry, the problem is particularly acute as when customers and staff are wanting to party, we need to keep the party going. So, I'm pleased to report that we have closed off our plans. A couple of months of consulting with colleagues, partners and suppliers have come to a close and our arrangements are in place. Scenarios have been identified; systems and processes mapped; contingency plans are written; the control centre has been resourced (with a fancy dress theme- it's not all work work work); and deals have been done with key suppliers.
It's hard to get fired up about Christmas in late summer and it's amazing how many IT companies need to be convinced there's a discussion to be had, but it just goes with the territory and we're all glad now it's done. Now we can look forward to the sound of sleigh bells etc with everyone else. Ok... and maybe a few tweaks to the plan.

Snatched from the jaws of victory

Last week I found myself needing a taxi in the West End of London and I walked for about 15 minutes (or a dozen blocks in US money) before I was finally able to hail one down. Frustratingly, I could see available taxis in the distance, but only long enough to tease me with their yellow lights before they melted round a corner. I had an "Ah ha!" moment, realising the market for an app which could broadcast my geotagged need for a taxi pronto and drivers in the area could swoop to my location. My mind raced with the thrill of seizing upon the opportunity- from writing the business plan through to a glitzy launch.
So, you can imagine my annoyance this week when I found that someone had beaten me to it. Still, perhaps they've executed the idea badly? Perhaps there'll be flaws in their offering? Sadly not. I have to hand it to Hailo, they've done a great job. The "first time use" experience is slick, the app is intuitive, the marketing is simple but effective (it was the sight of a Hailo emblazoned taxi which drew my attention to the app) and it works. Available on the iPhone and Android, I highly recommend Hailo- even if they did beat me to it.

A lesson in healthcare from the game Balderdash(TM)

I was fascinated to learn something new by playing the game Balderdash. In case you've not played the game before, you are basically given a word from a card and need to guess what it means from amongst a selection of options provided by other players and the real answer from the card. I was challenged with Question 4 from the card below:

Frankly, I had no idea.  I was shocked, given my line of work, to hear the answer:

Who would have thought it?

IMT decisions back in the hands of the hospitals

The rules of the game have changed. Since the inception of the National Programme for IT (NPfIT) in 2005, the responsibility for specifying, procuring, configuring and deploying major hospital systems has been centralised and the role of local management had become one largely characterised as facilitation. Now though, following a Department of Health review and the announcement in a ministerial statement that the NPfIT is “no longer required”, executive decisions regarding the full breadth of Information Management & Technology (IMT) need to be back on the agenda of board meetings up and down the NHS in England and Wales.
The announcement is that the centralised approach of NPfIT is no longer relevant and IMT decisions should be local, with more modular systems being selected from a plural system of supply. What is more, the tone set in the white paper is continued- that healthcare provision needs to improve, yet the costs need reduce. So providers quickly need to pick up the mantle and take control of how IMT will enable their organisation to deliver this objective.
This new onus on Trust boards brings the need for them to be more tech savvy than they have previously needed to be. Not only are the decisions and responsibility for system delivery back with them, but a plural market requires significantly more expertise, not only in system selection, but also in architecting how more modular systems will be orchestrated to deliver their digital platform. As the Operating Framework for the NHS in England puts it, the approach is about “connecting all” rather than “replacing all”. Integration is the name of the game and the challenge of making a handful of interoperable systems drive an organisation is exponentially more demanding than merely multiplying up the effort of making a single system work.

Futura font, Passendale cheese and Walter Mossberg, courtesy of Hunch

I arrived at the Hunch.com site with excitement, having read an interview with the founder, Caterina Fake, where she promised to personalise the internet for me. On choosing to sign up using my Facebook account (which saves loads of time and avoids having to remember yet more account details), you are immediately faced with the fairly startling truth that Hunch will only be able to personalise the internet by having access to some very personal information. At least they challenge this head on and you know where they are coming from, and why.
I was then asked to answer a series of question so Hunch can learn more about me. Some of the multiple choice questions were tricky to answer as my life often falls into the "none of the above" category. However, I pressed on and even found myself choosing to answer more questions than considered essential. It was fun and I was optimistic.
So, at the end of the process I was provided with a set of "top 5" recommendations for lots of (seemingly endless) categories- from books to magazines and cars to credit cards. Whilst I found this mildly intriguing it didn't pop up any surprises and, to be really honest, had a slight whiff of product placement (4 Apple product recommendations even though I answered a question saying I was more of a PC user); stating the blooming obvious (who doesn't like "The Wire"?) and simple wrong calls (the site is heavily biased to East Coast US even though my Facebook profile clearly says I'm British and live in the UK). That said, I will be trying Futura font, Passendale cheese and Walter Mossberg (tech writer) at the next available opportunity. The proof of the pudding will be in whether I like these things.
Hopefully in time the dataset being used to drive the collaborative filtering will become richer and provide more insightful suggestions. The range of suggestions needs to grow and become more localised too. However, for that to work they need to encourage me back. To my mind there isn't a sticky enough element to the offering to compel me... but know they now so much about me, I'm sure they'll find a way.

Things to do before I die #67385: Write a good IT Strategy Book

I was recently asked by a client for an example of an "IT Strategy". Although the language, grammar and punctuation all seemed to make sense, the sentence struggled to be processed by my brain. I couldn't, at the time, express in words why this was such a difficult request to satisfy. With the benefit of some time to mull over it and a blog, I will explore this question now.
In short, an IT Strategy is a very difficult thing to nail down. Perhaps this is why there are (by my reckoning) only three books stocked by Amazon on IT Strategy:

• Designing the Future: How to Develop and Implement your IT Strategy
• Align IT: Business Impact through IT, and
• Making IT Count: Strategy, Delivery, Infrastructure

By way of comparison, Amazon stocks thousands of titles about IT Service Management (search for ITIL) and there are at least 11 books which were 'written' by Katie Price alone... I gave up counting (and near enough the will to live) on page 2 when I realised that other authors have seen fit to write about Miss Price too.
Advanced Searches on Google for IT Strategy .doc documents are similarly fruitless, or at least bear largely unpalatable fruit. We can put aside that most such documents are commercially confidential because there are usually enough exceptions in the public sector- or leaks! The results are there (all 6,460 of them) but invariably these 'strategies' are more tactical in nature rather than a strategic framework to support business cases, projects and service management decisions. Frequent bloopers are wish lists of projects and esoteric statements such as "we will buy only Microsoft" (whether or not you drink from the Microsoft fountain this is a dictat which helps in too narrow and exclusive a way). Still, poor examples there may be, but all this criticism is actually neither here nor there if the result is of the highest possible value which the IT function could make to the organisation.
Before I continue, I should explain this is an exploratory article so I welcome any further contributions as to why there are few books on IT Strategy.
First of all, the valuable component of an IT Strategy is not really an object. Yes, there is a document (or all manner of communications media) as a deliverable, but it is the exercise of going through the process of designing, developing, implementing and reviewing IT strategy which provides immeasurable value to an organisation.  You can have a great document, but only with alignment to the business, education and ownership will the organisation use it to great effect.
Any IT Strategy worth its salt intrinsically links to, is guided by and enables the Business Strategy, so often the deliverable is contained within a deliverable of wider scope. This also leads us to conclude there are as many IT strategies as there are unique organisations. Yes, IT strategies often share common themes, but although boilerplate may be a helpful starting point, it will ultimately constrain or miss opportunities for the subject.  What is fit for purpose (in process and deliverable) for one team is not fit for another organisation.
So, this explains why a definitive reference for IT Strategy has not yet emerged. Perhaps we should ask the prolific Jordan to give it a go?

Caught on Google Streetview

On reading the news that almost all of the UK is now covered by Google's Streetview I did the obvious and had a virtual nosey around my own home, my family's homes and various friends' homes. Then I began to wonder whether that car with the contraption on the roof which we saw on holiday last year had anything to do with Google... and it did. Zooming in on the location from memory I was able to see Mr and Mrs Clickrich driving along the A9 in Scotland. I'm pleased to say faces and numberplates were appropriately blurred. Amazing technology! Here's a compilation of the stills of us zooming... ahem, cruising by (these things don't measure speed do they?).

CircleBath. Yes, it's a hospital.

Looking at these photos which I took last week, you'd be forgiven for thinking that I've been hanging around rather swankier bars than normal. However, these are actually from the new CircleBath hospital. ClickRich has been working on this project for the best part of 4 years so it's really exciting to see the vision becoming reality and being so highly acclaimed.
What? You still don't believe it's a hospital? Well, take a look at the much better quality photos on our architect, Foster + Partners', website where you can see real healthcare-shaped things. In that gallery of photos you can glance at one of our state-of-the-art digital operating theatres, but in terms of technology, that was still a fairly simple win really. I look forward to bringing you more news about the tech in due course, including some healthcare firsts.

A whole new battlefield for Apple and Microsoft

For months there has been speculation about Apple announcing an ultra thin tablet computer which has been dubbed the iSlate. Now Microsoft has trumped the announcement (in terms of the timing at least) by presenting 3 slate PCs running Windows 7 from HP, Archos and Pegatron.
It doesn't look like technically the slate PC is anything but an incremental improvement on the tablet PC concept, but the point is that in terms of desirability and utility to the user, slates may be the breed of products which finally establish the tablet as "mass market".
For now, analysts are expecting the slate to stimulate growth of the $950m (£597m) US market for tablets, but I think the impact of the slate will either see it become considered a whole new format distinct from tablets (tablets often still have keyboards), or a redefinition of the tablet. It will also be interesting to see, as the price reduces over the next 5 years, what this does for eReaders such as the Kindle or the Sony. These devices can still boast the strengths of e-ink readability and long battery life, but the gap is closing.

Hypervisor Star Wars

With the technobabble name of Hypervisor, I think that warrants a slightly science fiction post title, don't you?

Server virtualisation, which is achieved using one of the hypervisors on the market, is on the agenda of every CIO or CTO at the moment, whether that is for server consolidation or a grander move towards utility computing and the much vaunted cloud. So, I decided I would rub my twopenneth together and post where my thinking is at on this theme.

When I look at this sort of infrastructure technology I’m looking at the clarity of roadmap. Whatever decision a CIO/CTO makes, they’re going to live with it for probably about 5 years so when I’m reading about the big players (Microsoft Hyper-V, VMWare and Citrix XenServer), I’m not just trying to see who can do what now, but who is demonstrating thought leadership which will put them in good stead for the future.

Now, you don’t even need to go digging very far to analyse Microsoft Hyper-V… you just can’t rule it out. The biggest OS company in the world, and with many $billions sunk into datacentres that they need to start to build revenues off, they simply will not drop the ball on server virtualisation. You might as well value MS shares at mere cents if you do! Interestingly, they probably haven't the greatest feature set right now (they can't do real time migration), but they will architect their product really well so the features will arrive in due course and they will not be killed any time soon. Beyond that you can see how they will develop Hyper-V in the medium term. I can see an interesting triple play emerging with Hyper-V, Azure and all those datacentres.

That triple play brings us to VMWare. It took me far too long to get my head around why EMC bought them because I couldn’t see the synergy. Anyway, a month or two ago they announced a 3-way partnership between Cisco, VMWare and EMC called Acadia and all becomes clearer. This is really exciting. Not only can I buy virtualisation technology, but I can buy myself a private cloud. Aside from that (as if you need it), VMWare have good public domain information about their roadmaps and you can see how a client can go from legacy server infrastructure, through consolidation to private cloud and public cloud. They also have a very mature vision of what separation of logic and hardware can do for you and that sort of quality thinking will keep driving their product development.

Now with Citrix XenServer I see more uncertainty. With a Market Capitalisation of $7bn and profits of $150m, Citrix aren't, in my opinion, big enough or equipped with the right strategic partnerships to ride this wave to the next level. So, they will only exist if they are bought (in fact, I’d have thought that much of their MktCap is acquisition speculation) and until that happens, I wouldn’t make a 5 year investment decision on them. There are acquisition rumours, but it needs to be the right buyer. I don’t think Oracle would be the right buyer for me- I don't see any synergy as potent as that envisioned in Acadia for example. With all that, their tech may well be great but I’m not even going to look until there is that corporate stability.

A great book here is The Big Switch by Nicholas Carr. Treat yourself. It plots the future of utility computing out and takes it to places where really innovative companies are playing- like 3Tera (watch the demo on their website where you just build your infra in a Visio-style GUI). Yes, 3Tera is too bleeding edge for us in midsize corp for now, but it will pay to keep an eye on how their balance sheet develops.

A really exciting future no matter which mast you nail your colours to. The one true lesson we would all agree on is, don't do nothing.

Explaining service oriented architecture using the analogy of local economics

Modern enterprise systems are complex and differences in approach are, perhaps, well described using the analogy of a town’s economy. The traditional approach of buying functionality as packaged systems and configuring the last few features is like the communist approach to town planning where the vendor is the state. The state strictly defines the services in the town from the butcher and the cobbler to the grocer and the taxis. For the system to continue to work, almost all changes (except perhaps the colour of the baker’s walls) must be escalated to the state for review, evaluation and decision. When the state agrees a change is a good thing, it simultaneously makes the change across all towns in its jurisdiction. As the town grows, this approach increasingly restricts further growth until a state of bureaucratic paralysis and economic stagnation is induced- the fact that the town can be any colour is frustratingly irrelevant when all the towns are functionally the same and real differentiation is not possible.

In a system built to service oriented architecture concepts the state’s governance moves to the client side. In our town, the economy is liberalised and trusted to market forces such that individual services can be defined autonomously from state controls. Thus, an ecosystem develops. A service owner can choose to respond to market needs and is free to specialise, compliment someone else’s service or wrapper another service to add value. For example, a taxi driver could encapsulate a cobbler service to create a new “home delivery shoe repair service”. In theory the cobbler service can be modified and as long as the published “service definition” is up to date, the taxi driver can maintain the quality of their overall service without needing detailed information about how the cobbler’s internal operation works. There are few restrictions to even consuming services from other towns. The state still has a responsibility to deliver essential or generic services such as core infrastructure and a directory of the town’s services, but its role is mainly about maintaining the rules of the economy (=standards), rather than trying to deliver value added services. With limited state intervention, growth breeds further growth and the macro economy of the town responds organically to external influence, especially competition.

Tele-Wine Tasting

Cisco, BT and Chief Wine Officer combined some Christmas cheer with a technology demo wonderfully last night. The team used a telepresence room in Cisco's London HQ to host a wine tasting evening from similar kit in BT's New York office. This was a fantastic test of the technology due to the need for it to allow extremely nuanced communication between two groups of people. Only two further things are needed from Cisco to make the wine tasting as good as having everyone in the same room:

1. Object teleportation- removing the need for the wine to be sourced and stored at each location.
2. Time machine- it had to be remembered that it was just 1pm for our valient hosts, who matched us glass for glass (except for the sommelier who diligently spat after each sip).

So, nearly there Cisco. Piece of cake.

Meanwhile, until such tweaks are made, a telepresence room has been set up by Cisco at the Copenhagen Climate Conference (and will stay for about a year thereafter), both to facilitate collaboration and also as a great demonstrator of a technology with the potential to reduce the need for travel.

Jurisdiction and Governance in Force.com

Many thanks to the kind people of Salesforce who hosted a CIO Roundtable at the Andaz hotel in London. More about the hotel later. The event wasn't just about sales pitch. It was a frank discussion about the wider benefits and issues of cloud computing. I think just one person around the table wouldn't agree with the summary that it's not about whether cloud computing should be adopted, but a matter of when and how. The afternoon was studded with some fine examples, but one of my challenges in healthcare is that when it comes to storing NHS patient-identifiable data, we need to store it in England. That's right, Connecting for Health do not even trust the Welsh or the Scots with the data! So, this was something of a damp squibb for the adoption of cloud computing (especially with the salesforce model where all users share a single instance). However, all credit to Tim Barker, who went away and came back to me with a way of residing some data in a specific jurisdiction, but without compromising the user experience of logic in Force.com... such as Swiss Banks might like when they want to physically hold some data within the country. Tagged "cloud data governance", PerspectSys have created ways of running salesforce.com applications in the cloud, storing private and sensitive data at home, under real or perceived control, and retaining all of the rich functionality of the salesforce.com apps.

Lots of Paper is Required to go Paperless

When you are going paperless in your hospital, do not underestimate the amount of time it takes to digitise reference data, lists, protocols, pathways, images, order sets etc. This is just one pile of books I came across to support the complex and lengthy discussions between our IT analysts and front line users.

It is not all about choosing and implementing an Electronic Patient Record product, it is more about making it work for your clinicians through detailed configuration. Sure, some vendors will have some information hard wired into their product and some will provide "out the box" configs, but you need to realise that to do this well in a hospital, or across multiple specialties, the effort can dwarf the equivalent product costs. Your hospital is not "out the box".

I'll go and make a cup of tea then...

What can IT Procurement Learn from the Construction Industry?

A letter by Mike Stranks to the 10th September 2009 edition of Computing Magazine "Overhauling government IT procurement" reminds me of a concept I've long advocated in our organisation, but not posted about yet. Mike looks to the construction industry, which has a much better record of programme success than IT (well, they have had several thousand years to work it out!), and observes that the role of design and construction is split between organisations. Along with a savvy client (often a chartered professional) these three parties create the necessary environment for programme success. In IT, the design and build roles are usually not distinct and are therefore usually awarded to the same company. This is especially true in public IT procurement where, ironically, the public purse want to derisk the delivery by passing that risk on to a prime contractor.

I wholeheartedly agree with Mike. Closing a deal for the design and build before the problem is understood means that the parties are playing with alot of uncertainty. Either the problem will be easier than expected to solve and the client pays more than was necessary, or as is more often the case, the problem is more difficult to solve than expected and the supplier either needs to play a game of "change request charges" to recoup the extra costs or the project fails to deliver.

By seperating the design piece out, the client is able to procure build services with a much better understanding of what they are asking to be done, and the incentives in the 3 way tie up are also more balanced. Classic conflicts between design and build are mediated between organisations which include the client rather than pitch the client against a single supplier who naturally has their own interests at heart.

Mike makes a strong case for chartered engineers in this process. Hooray to that too, but that's a subject for another topic.

Indicating the Way to Quality Care

The NHS Information Centre has published a set of 200 indicators of quality care. This is the result of a piece of work started by Darzi's report 'High Quality Care for All' and you can tell the clinician involvement has been continued into the deliverable with the phrase "assured by clinicians for use by clinicians". The report, downloadable in specific sections, is structured around pathways so that the indicators are clinically relevent. I've not done a count of indicators to see whether the report really has 200 indicators, but I actually find it refreshingly transparent that many sections of the document as described in one way or another as 'to be done'. It has to be said that the mechanics of governance and maintenance have been put in place around the report too so it will continue to evolve. The indicators address Effectiveness, Patient Experience and Safety, and therefore reflects current progressive thinking about what value means in health care (see "War on Waste" by Ali Parsa).

More Money Than Can Be Spent? In a Credit Crunch?

I had a fascinating meeting with a senior officer of the Department of Health today to look at access to innovation funding through the National Institute for Health Research (NIHR) and some of the projects under their mentorship. What was particularly surprising is that we are seemingly conditioned to expect that funds are scarce, but actually fewer innovation grants are allocated than are available. A later check in the NIHR Annual Report confirmed that the organisation has an annual sum to spend and that for almost all categories, the 2008/09 spend is less than the forecast for 2009/10- implying that this year was underspent. This is not a criticism because the organisation rightly sets the quality bar high, but it is still a surprise that we're not generating enough good ideas to qualify for funding. Long live the Government's enthusiasm for innovating our way out of the credit crunch... thinking caps on people!

Leonardo the Inspiration for Robotic Surgery

In the fourth of my posts from the NHS Healthcare Innovation EXPO, I'll share a video I took of a magnificent piece of technology- the Da Vinci surgical robot. Designed so that surgeons could operate remotely on soldiers in the battlefield, the robot is increasingly being used for challenging laproscopic procedures. In this video you can see, briefly, how two surgeons are able to control extremely dextrous instruments in a confined space. At the last count I heard of, there were only a small handful of these robots in use in the UK. Unfortunately, it is hard to imagine what might drive an increase in adoption as it is difficult, if not impossible, for a healthcare provider to be reimbursed more for improved outcomes or for carrying out more complex procedures for which there is no tariff.

Virtual Worlds for Healthcare

The NHS Healthcare Innovation EXPO had an excellent demonstration of a Secondlife simulation- sort of the virtual world of healthcare helping to make the real world of healthcare better. Put together by Imperial College London, the Medical Media and Design Laboratory (MMDL) explores how to use digital media in healthcare. Although created to explore new models of care delivery in the widest sense it seems that the Secondlife simulation fulfils a fairly immediate training need.