Interview: Dr Penny Kechagioglou, CCIO and Deputy Chief Medical Officer at UHCW

For our latest interview here at HTN, we chatted to Doctor Penny Kechagioglou, Chief Clinical Information Officer and Deputy Medical Officer for University Hospitals Coventry and Warwickshire, as well as being a Consultant Clinical Oncologist and Doctor in Business Administration.

Penny joined us to discuss the projects she is currently working on, her experiences with engaging staff in the process of digital transformation, what she would like to see in the future and more.

Here’s what she had to say.

Can you tell us a bit about your background and current role?

My role is to develop and implement the digital strategy at University Hospitals Coventry and Warwickshire, in addition to the implementation of the electronic health record and in collaboration with Coventry and Warwickshire’s integrated care system (ICS).

My passion is around innovation. I’ve completed a doctorate degree with Warwick Business School on leadership and innovation so I feel strongly about digital technology and applying innovation to improve healthcare outcomes.

What sort of projects are you working on at the moment?

The main project I’m leading on is the electronic patient record (EPR) implementation at UHCW, collaborating with the ICS. We’re doing it as a single incidence between the three main acute trusts. It’s a very complex project with multiple stakeholders – I’m engaging with all the directorates in the organisation but also with suppliers, our patients, clinicians and other stakeholders, both internal and external. We are trying to work together not only to apply technology, but also to change the way we work. We want to do some work around population health management, prevention, health promotion – all the aspects of care which are going to enable us to meet the aims of the ICS, which are to improve healthcare quality and care experiences, optimise health and wellbeing for staff and patients and reduce health inequalities in care.

I’m also working with five businesses at the Warwick Innovation District at the moment, trying to identify digital solutions that can solve organisational issues such as patient flow. As we know, as we start to move on from COVID, our wards and emergency departments are full of patients. So it’s very important that we leverage technology to achieve efficiencies whilst improving care quality, both being our Coventry and Warwickshire ICS goals. To give you an example, increasing telecare adoption and remote patient monitoring can improve  patient flow within the organisation.

I’m doing a lot of research projects as well, working collaboratively with other stakeholders within the industry and within the voluntary sector as well. We’re looking at aspects of care such as early warning scores and we are trying to formulate risk scores that predict patients’ outcomes so that we can personalise treatments. Of course, there’s a lot of work that’s happening within the organisation and outside it as well, in the oncology space. There’s our cancer prerehab programme, which we are developing for cancer patients undergoing major surgery, the virtual ward project and many others. So I’m pretty busy!

Can you talk a bit more about how your role ties into developing a digital workforce?

A big part of the work is engagement of the clinical and non-clinical workforce. I do that in multiple ways, such as working with the organisational development team in a hospital. We are trying to engage what we call a ‘change network’, and within that network we employ EPR champions. So developing that network can help to spread the message of why we are driving a digital transformation change, why are we digitising our health records, what does it mean to our staff, patients, our organisation and healthcare system? By doing this, not only does it help to develop people’s skills, it also spreads that vision and that common goal across all tiers of the organisation.

I’m also working really closely with the project management office and the Kaizen promotion office to ensure that any change that happens in our processes, as we transform, follows the quality improvement methodology at UHCW, and that the digital projects that we lead always have a clinical lead to support them along with good project management.

I’m really passionate about developing the future workforce. We also have junior trainee doctors working on our digital projects to ensure that, as they become our future consultant workforce, they have the digital skills to be able to innovate even more. And the same applies to our nurses and allied health professionals.

What are some of the challenges that you’ve faced, and how you’ve faced them?

If I were to break down the challenges, I’d categorise them as technical challenges like legacy systems that we’re trying to solve and bring together and decommission, and infrastructure – how we are going to use our existing infrastructure and build on it, for example so that it can be more efficient for remote working and remote patient monitoring.

Another challenge is the fact that the digital transformation is happening really fast. There is a lot of conflict between transformation and change and ‘business as usual’ because our organisation is very busy at present delivering above and beyond our usual service targets. As a result, change activities often come into conflict with the day-to-day business deliverables and what changes we need to make to support big programmes like the EPR and other digital projects.

There can be a lot of resistance from people. People don’t like change, so we have to deal with the human factor element here. We need to put our teams first and ensure that staff health and wellbeing is optimised, definitely not compromised. We have to make sure we’re looking after them during the process of transformation.

Finally, I would say cyber security is always a challenge. We make choices about systems, clouds, data, data quality – it’s important that cyber security is done right, and that can be a huge challenge.

What would success in your area look like to you?

For me, my vision is that we develop all those technologies and implement them safely, first and foremost. That they are adopted by 100 percent of our staff and end users and we are able to leverage the benefits of those, to create end-to-end seamless patient pathways which are personalised and intuitive. We’d have user data which is standardised and we’d be able to use it to demonstrate those clinical outcomes that we strive to achieve, like reduction in delays for cancer diagnoses, or more efficient movement from diagnosis to treatment. These are some of the benefits that we want to measure and evaluate, and certainly I want to see those materialising.

Success would also be looking beyond single services, looking at the population health level, and using our data to improve the health and wellbeing of our populations in terms of improving quality of life, reducing bad habits like smoking and reversing chronic illness with lifestyle change.

Also, it would mean having a financially sustainable system. I think this is key for the future of our workforce and for our healthcare system as a whole.

Are there any other thoughts you’d like to share?

I’d like to put out a call to action for clinicians. Any large transformation project, like EPR implementation, needs to be clinically led. It’s really important that clinicians at all levels are really immersed into those programmes. The amount of skills out there is immense, and so is the amount of people that we can meet and learn from. Ultimately, by doing this we can develop a future in healthcare that we all own. That would be my message to my colleagues – get involved.

Many thanks to Penny for taking the time to chat to us.