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It might sound trite when IT leaders claim their jobs are critical, but in the case of Aaron Powell, chief digital officer (CDO) at NHS Blood and Transplant (NHSBT), the work he does can help make the difference between life and death. It is a high-pressure role that he relishes.
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“I love it,” says Powell. “A lot of what we do is about matching allocation – we match organs and blood from donors to patients who need a transplant or blood transfusion. There are very few jobs where you can go to work every day and know that what you’re doing is having a direct impact on people’s lives.”
Powell says it should be emphasised that three people, on average, still die in the UK every day waiting for a transplant.
Technology can play a crucial role in producing new efficiencies for NHSBT and its patients. To this end, Powell has spent the past two years pushing a digital transformation agenda.
He says the work being undertaken, as in other businesses, is helping change existing processes for the better. “I don’t think Uber set out with a grand plan to disrupt a sector per se – instead, they developed a capability and it worked,” says Powell. “Once they found their capability worked in cars, they looked to extend their offering to Uber Eats.
“The same is true at Amazon – they developed a capability and they saw new opportunities around where that capability could be applied. I think we need to do a similar thing. We need to develop a capability and then think about where that expertise can be used.”
Powell worked in programming after leaving university and then helped to train people at Computer Associates. After a spell in the Middle East, where he worked to digitise government systems, Powell moved into programme management and took a senior post with the United Network for Organ Sharing, the organisation responsible for managing transplants in the US.
“We need to develop a capability and then think about where that expertise can be used”
Aaron Powell, NHS Blood and Transplant
“I loved the role and it was my first insight into the value that organ donation offers in terms of saving lives,” says Powell. On returning to the UK, he joined NHSBT and, after a series of increasingly senior roles, became interim IT director in September 2014 following the appointment of a new chief executive.
“I saw this as my opportunity to demonstrate what technology can really do in terms of the way the organisation works,” he says. During his interim position, Powell delivered a range of improvements to the organisation’s IT infrastructure, including work on the underlying network, a desktop roll-out programme and changes to several core systems. His commitment paid dividends and he became permanent CDO in July 2015.
“I’d developed an increased understanding of the range of technology available and a sense of the positive changes those systems and services could bring to the organisation,” says Powell. “I’ve been fortunate enough to try to bring some of those insights to life.”
Innovative business change
Powell reports to the chief executive at NHSBT, with a seat on the executive board. This elevated position has made it easier for him to find support for his digital transformation agenda. “It means I’m part of the very highest leadership group in the organisation and this means I have an opportunity to set direction,” he says.
“My position as CDO – rather than having the title CIO or IT director – means I have a mandate to do more than simply respond to the rest of the business and their IT requests. My role is to understand what technology can do for the organisation and to reach out and demonstrate the potential for change. So, I’m not a support service. I see my role as driving the improvement of the whole organisation through digital technology.”
Powell points to several key achievements – first, a programme that means the organ allocation scheme now runs on a new cloud platform that supports automation. This initiative will help deliver intelligent allocation schemes in the future.
Another key achievement has been around the focus of the IT team. Rather than focusing on tins and wires, his technology staff concentrate on using the power of technology to improve the organisation’s way of working. “That has required a significant mindset change and has helped us to adopt the benefits of the cloud,” he says.
Powell says this cultural change has been crucial in helping him and his team to demonstrate the power of technology. Like other public sector IT leaders, he manages a constrained budget and must work to demonstrate the value that new systems and services can bring. Thankfully, his executive colleagues have been receptive.
“We have developed a sense at NHSBT that technology is worth investing in,” says Powell. “Like many organisations, we have focused on productivity improvements and cost-efficiencies in the past. It is important that we still do that, but I think the organisation can also see the benefits of an investment in digital transformation.”
Powell says his team has already completed some major investment programmes. The organisation has rolled out a new desktop system, based on Windows 10 and Windows Server 2016. The team has also rolled out Microsoft Office 365 to users and upgraded its Oracle database estates. Internally managed and operated datacentres, meanwhile, have been transitioned to a colocation arrangement.
“When you consider the sensitivities of our operations, we cannot afford our systems to be down because people will die,” says Powell. “We had to make these changes without business impact. We have done a lot of work on the technology side, but the key achievement has been getting the rest of the organisation to see the benefit that technology can deliver.”
Strong digital layer
Powell, therefore, has built a platform for change. He says his priorities going forward include the continual modernisation of the IT estate. The key here will be the introduction of cross-organisation, enterprise application platforms that will allow NHSBT staff to make simple changes to underlying systems of record.
“That is an ongoing journey,” says Powell. “It’s hard work but it’s absolutely right that we focus on that area. We’re also concentrating on the integration layer, so we’re at a place where people in my team understand how we can offer flexible and useful application programming interfaces to people within the organisation and potentially externally.”
Powell says the emphasis will be to build a digital layer that helps parties make use of the organisation’s interoperable application environment. The technology team will create a strategic data platform to help create analytics and intelligence. “We want to be able to offer new services to patients and donors,” he says.
“We’ll be able to do that work around data because we’ve separated the digital services from the underlying back-end systems,” he adds. “We want to get a sense of the capabilities of the organisation regarding technology, so that – as we focus on capability, rather than business processes – we can apply the knowledge in different scenarios.”
The power of information
Powell recognises that achieving his long-term aims will not be straightforward. Legacy systems, and the need to transition safely to modern platforms, always present a challenge, he says, particularly in a high-risk environment like NHSBT.
Talent is also an issue. In a competitive job market, it will be tough to recruit the skilled people the organisation needs to deliver ongoing business change. “As we use more advanced technologies, we put ourselves into increasingly competitive areas in terms of talent,” says Powell.
He says NHSBT must ensure it continues to build a strong understanding of the game-changing nature of insight. For this reason, Powell says his key leadership challenge is to ensure he helps maintain a cross-business vision where the value of data – and the capability that brings that information to life – is clearly articulated.
“People often say data is the new oil,” he says. “Making that sense real in terms of the business case on a day-to-day basis is not as simple as it might seem. Ensuring your organisation understands the power of information is always going to remain a challenge.”
Making real-time decisions
Powell’s work on digital transformation continues. He says success during the next 12 to 18 months will mean most underlying technology systems will have been either updated or replaced. “We’ve done a lot already but we’ve got a lot to do,” he says.
For the first time, the organisation’s strategic plan includes a corporate objective to reduce the number of servers, both physical and virtual, that the IT team controls and manages. Powell says that objective is related to a desire to embrace a cloud-first approach, so the organisation is less concerned about infrastructure and more focused on services.
“We want to create a much more data-driven organisation, where information is everywhere, accessible and can be used by people every day,” he says. “We’re looking at how we can use insights to discover how we access the hard-to-reach groups. As our databases mature, we expect to be able to use patient follow-up data to learn.”
Powell refers to the potential power of innovation. He mentions edge computing, where an increased amount of information is processed at the source of the data. He says several interesting trials are taking place around information, including around the use of predictive analytics and the likely waiting time for an organ.
“The waiting list of today is not the one of tomorrow,” he says. “We want to get away from a static view, and work in almost-real time, so we can learn and make much quicker and better-informed decisions. Those are the kinds of things we’re thinking about, but we’re not there yet.”