For one chief clinical information officer, his state’s digital transformation is more about active listening and empathy, than the technical nuts and bolts.
Dr John Lambert doesn’t speak in the way you would expect a chief clinical information officer for a state health system to talk.
It’s not that he’s not armpit deep in the technicalities of transforming Tasmania’s health system into a modern, digital health-powered entity. But the nuts and bolts are not what keep him awake at night.
“People, people and people,” Dr Lambert said when asked what keeps him awake at night, during a session at the AIDH’s HIC2025 conference in Melbourne this week.
“Will I be able to find the right people in sufficient quantity to do the transformation?
“We’re a small jurisdiction … It’s expensive to move there. It’s a real challenge to get people to move there, even though it’s the most beautiful place on the planet.
“So can I get sufficient quality of people? Will the people of Tasmania really lean in and do the heavy lifting required to transform themselves?
“Will the people of the Department of Health lean in and throw away all their rusted-on biases and entrenched regional differences.”
It’s not the first time Dr Lambert has been in on the ground floor of a statewide digital health transformation. The Northern Territory and NSW have both benefited from his skills, though it’s possible Tasmania will be his most challenging project.
Tasmania’s health department is in the final stages of signing a contract with Epic to be the provider of its digital health transformation.
“Our transformation is about transforming the way all health is delivered in Tasmania,” he said.
“That transformation involves 600,000 people, and all of them have to change from a small amount to a large amount, depending on where they are [in the system].”
Human-centred design is Dr Lambert’s passion.
“It’s all about truly understanding the needs of the people you’re trying to help. And I actually think the skill sets we need enhanced in all of our people are those skill sets to be able to facilitate, to listen, to get people together, to collaborate,” he said.
“So many [EMR rollouts] failed because we didn’t understand all of the stakeholders we should have designed for, and we forget whole groups of people.
“And then they say, ‘well, this doesn’t work for me and why didn’t you talk to me, I could have told you why it doesn’t work, and it’s only a few things you’ve got to change’.
“But we don’t stop and think about who do we need to talk to just to get their views? So again, communication, making the effort to listen to them, teaching people how to listen. It’s kind of a lost skill.”
Dr Lambert has no concerns about the functional aspects of the transformation – that will be Epic’s job, he says, and he’s looking forward to working with them on the implementation of the rollout.
“What I’m worried about is the skill of the 30 facilitators we need for the design working groups,” he said.
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“We’re going to have 50 to 80 groups of 10 to 12 people from diverse backgrounds, and they have to work as one. We have to unify them. We have to get them all collaborating and inspiring each other and not bickering about their different needs.
“That’s all soft skills.
“Every part of our organisation is going to change. If we can’t communicate, understand their fears, listen to them, make them feel heard … people have a minimum right to be heard, I believe.
“Our design model can’t work if people can’t collaborate and communicate and be facilitated.”
Rather than having chairpersons in the state’s design governance framework, Dr Lambert has opted for facilitators with no skin in the game.
“Most of the chairpersons you pick are people like me – people who are privileged, who are senior, who have a strong voice that people respect, and of course, they then over-influence everything in the room,” he said.
“We’ve chosen to go with facilitators instead who have no vested interest in the outcome other than it’s the best outcome, and they don’t have a bias.
“If you look at great design methodologies, the best designers I’ve ever worked with, they’re the lowest ego person in the room, because if you’re a really great designer, you don’t care what the design looks like. You just care that it’s the best design for the people who have to use it.
“And that’s a facilitation, a language skill.”
Ultimately it is the healthcare professionals who must be brought along and persuaded to lean into the transformation.
“We need to learn how to listen to them and translate their needs into language that it can then deliver a solution against,” said Dr Lambert.
“It’s actually about getting better at listening and understanding their needs. And the first principle of great design is empathy, which is understanding what they are feeling when they’re doing their job, so we can build a better solution.”
In the end, says Dr Lambert, a digital transformation in the AI era forces us to think about what it is to be human.
“Each time we take these steps, supposedly forward, it forces us to evaluate the impact on humans,” he said.
“But these [AI tools] are so pervasive and so, in a sense, threatening to what it is to be a human, because they actually start to mimic what we think is intelligence.
“It’s forcing us to evaluate, well, what are the priorities here? What does that mean for us in the future? Where do we want to be? Where do we want to be functioning? How do we want to function in this ecosystem.
“I’m quite excited … the hype is still overwhelming … but I’m increasingly seeing a higher volume of people thinking about, what sort of humans do we want to be in 20 years.”
HIC2025 is on in Melbourne on 18, 19 and 20 August.
