Walking the innovation tightrope

Ask most successful CIOs what it takes to survive and thrive in the position, and it won’t take long before the word innovation is uttered. Going with the flow simply won’t cut it these days. Technology thought leaders have to do just that — lead, by looking for opportunities to carry out information processes across the enterprise in quicker and more economical ways. Improvements for the company and the individual can really only come about by embracing the concept of change.

Those same CIOs will add, however, that while the innovation path can lead to glory, it can also take a downward slope to failure if not trodden with care. To be an innovator is to be a risk-taker, and for many a CIO that can be a scary prospect.

Just ask Judy Middleton, CIO of William Osler Health Centre, which comprises three hospitals in Brampton, Ont. and Toronto. A former nurse who clearly understood the nitty-gritty aspects of what it took to deliver quality health care, Middleton stepped into the CIO role eight years ago with a clear vision for improvement. But implementing that vision meant introducing new concepts — which in turn represented a big risk for her and her career.

“People at the senior level wanted to compare [my ideas] with something else, but much of this was firsts. It doesn’t give them a comfort zone,” says Middleton. “At any one point in time, any piece could have failed, so you have to be strong enough to know that if failure happens, really, that’s the end of your career.”

In the face of such a challenge, however, Middleton meticulously put together a strategic IT plan that she believed would allow clinicians and physicians to access and use data in more effective ways and which would ultimately lead to improved patient care. Eight years on, she’s still the CIO and William Osler is a far different and much more tech-savvy outfit than it was prior to her arrival.


One of the most innovative features of Osler’s improved setup is its use of the Internet to deliver information to those who need it most. A series of Web portals now makes it possible for hospital workers to get access to patient information, from prescription dose data to X-ray images, regardless of where they may be located.

“We are the only [health centre] in Canada that has automated all modalities of cardiology, so a report attached to an image will be presented in the portal,” Middleton says. Most of the newer technology deployed by Osler is appearing first at Brampton Civic Hospital, where “every piece of equipment” is IP-based and running over a Cisco Systems network. Other innovative technologies in use or soon to be in use include: pharmacy robots that automatically dispense medications; a wireless “computer on wheels” device that contains medications for a 24-hour period and associated data; and wireless handhelds for every clinician in the building.

“The biggest hurdle for most hospitals is moving clinicians to electronic documentation and utilizing electronic systems,” Middleton says about her industry. “We’ve done that for years, and now the systems are becoming much easier and more intuitive. The uptake is great. Even the anesthetists in the operating room don’t want to go back to paper; they are doing it all automated.”

To get that kind of buy-in on innovative technologies, however, Middleton stresses that a CIO must have a clear understanding of what users want and need. “They are very comfortable in their workflow practices. You really need to listen to them and engage them in the design and selection.”


For Fred Cook, CIO of North Shore Credit Union in Vancouver, innovative thinking began with a desire to better serve his firm’s customers. The company wanted to better compete with other financial institutions in a crowded environment by creating a sense of greater intimacy with clients.

Thanks to a new customer relationship management system and a Microsoft SQL Server platform, NSCU has been able to cut down on the amount of time customer service representatives have to spend asking customers for their information. A photograph is taken of each new client, which then appears on a teller’s screen whenever that person comes into a branch.

“It protects the organization against fraud and protects the customer from identity theft,” says Cook.

Aside from also tying into NSCU’s phone banking system, the cutting-edge ID system also prevents long-time, high-value customers from being asked for the same information over and over again.

Other ahead-of-the-curve projects rolled out by the credit union include the use of e-signatures for a variety of financial transactions and the opening of an i-Branch. A unique style of banking outlet, the location features “pods” instead of the typical row of wickets and the high walls that separate customer from teller. The goal, according to Cook, was to foster openness and a greater sense of comfort for the client. It isn’t uncommon to see a service rep and a customer looking at a screen shoulder to shoulder.

“Our tellers are encouraged to come out and greet clients, like in a retail setting, so we’ve eliminated the them-and-us type of thinking.”

Over the past six years, four of which Cook has been CIO, the credit union has seen its total managed assets rise from $600 million to $2.3 billion, and that with a customer growth rate of below 3 percent. So how did they do it? Says Cook: “It’s easier to do more business with existing customers once you understand who they are and what their needs are.”

Another contributing factor to the NSCU’s success in a market crowded with bigger players, Cook adds, is an effective leveraging of partner relationships.

“For smaller or medium companies, there is just no way we can build the same infrastructure as our large competitors.…There are a lot of smart people out there who can introduce you to new things that you can bring to your organization, and I would say absolutely talk to them.”


Talking to internal associates is also essential for CIOs looking to drive innovation within their companies, according to Mark Gelsomini, IT operations manager for Genesis Microchip, a manufacturer of liquid crystal display (LCD) chips used in TVs and other screens. His firm recently overhauled an over-capacitated and lumbering storage system with the installation of infrastructure from EMC.

And while communicating those ideas to upper management not similarly immersed in all-day tech talk is a must, Gelsomini stresses that a CIO must stay on top of technology products, news and industry developments in order to speak with a clear voice at the executive boardroom table.

“You need to have a lot of hands-on experience because you want to bring something unique to the organization. If you don’t keep up-to-date you fall behind.… You, as a leader and guiding light, need to keep up on certain technologies.”

The philosophy helped Gelsomini convince upper management that improvements to the firm’s storage setup were needed. With electrical capacity maxed out at the company’s Toronto R&D facility, with backup times averaging between one and a half to two full days, and with engineers drumming their fingers on their desks waiting for slothful data transfers, the time was nigh for an overhaul.

Today, electrical capacity has been increased, backup times have come down to about eight hours, and engineers can access their data in seconds, Gelsomini says. And while the beneficiaries of the storage improvements aren’t exactly sending cards and flowers of thanks, Gelsomini knows they’re happier because, “at the end of the day, no comments are good comments.”


In the case of some outfits, adopting a philosophy of ongoing innovation is necessary not just from a technological improvement standpoint, but also from a human resources one. Take the case of Interior Health Authority, whose medical facilities serve a population of 700,000 in the southeastern portion of British Columbia. While that geography is one of the most beautiful on the planet, soaring mountains and shimmering lakes often aren’t enough to lure the medical staff required to work in the hospitals.

The nursing profession by nature, says Mal Griffin, Interior Health’s CIO, involves long shifts, complex care needs and “lots of stress. Years ago, most women had a career path of either teaching or nursing, but today they have more career choices.”

That reality, along with the lure of working in large urban centres like Vancouver or Calgary, means Interior Health has to do some innovative planning to attract the people it needs. Enter technology.

One of the most significant IT improvements Interior Health made was to update its server infrastructure. Most new applications – the kinds that make it easier for clinical staff to do their jobs and represent the kinds of tools that can go a long way to attracting prospective workers – would require a big boost in server capacity. Add to the situation that the older servers were causing a major drain on cooling, wiring and power requirements, and the organization realized something had to be done.

They chose to consolidate the servers using VMware Infrastructure virtualization technology, thus reducing its server count from 66 to six VMware ESX boxes. One result has been speedier access to information. Without such up-to-date IT infrastructures, organizations like Interior Health would face an uphill battle when it comes to attracting the type of worker it needs to succeed, says Griffin.

“As we have less resources, [we have to ask ourselves], how do we stay competitive? When we talk about attracting staff, we have to look at technology to offset those losses,” he says. “As we become more innovative, people want to work for organizations that are doing great things – particularly young people. They want to make a difference.”

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