Putting Health Care’s Best Tech Forward

How UHN’s Jim Forbes improved Ontario’s health-care services by outsourcing the day-to-day and focusing on disruptive tech

As the first chief technology officer (CTO) at Ontario-based University Health Network (UHN), Jim Forbes has always known that the value of a CTO is one who thinks beyond the patient’s hospital experience and follows IT trends from other sectors. This philosophy has made Forbes into the leader he is today, and it’s something he’s honed since joining UHN in 1999, becoming CTO in 2006.UHN is the largest teaching research centre in Canada and is a leader in oncology and health-care technology. The IT department outsources much of its day-to-day operations: data centre, server management, data storage, e-mail, help desk, network, device management, and security. This outsourcing allows Forbes and his team to focus strategically on innovation. “That’s an important aspect and explains how we think about IT at UHN,” Forbes says. Systems engineering, mobility, business intelligence, and enterprise architecture are the technology-pushing teams that have stemmed from this focus.

The first critical product and integration layer that Forbes and his team created, in 2003, is called Patient Results Online (PRO). Through the request of Mount Sinai Hospital and UHN, PRO was developed after seeing how physicians were working at both locations and shared numerous patients and services. The PRO project was submitted two years in a row, and in 2003, Forbes and his team became finalists for innovation in the 11th Annual Canadian Information Productivity Awards (CIPA). The following year, they won the CIPA Silver Award of Excellence in the category of Customer Care. In 2005, Forbes received the Canadian Advanced Technology Alliance Innovation Award for Public Sector Leadership, and in 2014 ranked as one of Computerworld’s Premier 100 IT Leaders.

The design principles from PRO propelled UHN’s IT team, and in 2008 it developed its next big project: SIMS sets SAIL. SIMS, which stands for shared information management services, is the department, and SAIL is the technology enterprise service bus. The concept was to build a solution that tied various applications and databases together, allowing clinicians to use retrieved data securely and easily while avoiding the previous practice of copying the data multiple times into multiple databases. The constant copying of data not only complicates the operating environment but also requires more funding and resources to maintain that complexity. SIMS sets SAIL provides mobility and agility for clinicians, who are constantly moving from room to room and floor to floor. Now they can plug in to preexisting interfaces or even work using tablets or smartphones.

The concept of SIMS sets SAIL was taken to the province, where Forbes recognized a fragmentation between many hospitals and community-care service providers and agencies. “Information is an important tool, and the more you can expose the information that you have, the more you can enable innovation,” Forbes says.

Despite the major information-technology contributions that Forbes has made to the Canadian health-care sector, he feels that these triumphs are only the beginning.

“The day you can take an application developed at St. Michael’s [Hospital] and plug it into UHN and Sunnybrook [Health Sciences Centre], and turn it on within one day—and not spend seven months reconfiguring interfaces—that’s the day I’ll be really happy,” Forbes says. That day is planned to come within the next year.

5 Questions with Jim Forbes

How do you innovate on a day-to-day basis?
Always thinking big picture and asking tough questions. Trying to get the organization to see things beyond the work area and understand the health-system perspective.

What does innovation mean to your organization?
Improvement in patient safety and outcomes. That’s the goal. How do we know that when a patient leaves our organization that the service we’ve provided at UHN has delivered the outcomes we expected? Is the patient satisfied when they get home? Does the patient have the knowledge and the network around them to support them in the community?

How do you cultivate innovation within your workforce?
By creating and fostering a learning environment. No idea is bad. Listen, work with people, and help shape their ideas and thinking.

What defines an innovative company in the 21st century?
Foster a learning culture. Think about your ability to adjust to change, or [think about] shifts in the market or demand. We need to be mindful of the time to market and enable that innovation to happen quicker. That’s part of agility, but part of that also helps to minimize the risk of having to do a big deployment.

Is there a technology, trend, or idea that’s driving your company forward?
Our new CEO, Dr. Peter Pisters, often talks about what it means to be a learning institution and a high-reliability organization. I’m happy to hear that term because in my mind it goes beyond patient safety. Higher reliability to me is applying a different degree of engineering to try and get down to eliminating all of your never events so that you don’t have any mishaps. Dr. Pisters is pushing us to the next level.