Everyone faced unprecedented challenges during the COVID-19 pandemic, but imagine those hurdles being amplified working in the healthcare industry in one of the most locked-down places on the planet. Then imagine implementing a company-wide digital transformation while simultaneously saving lives.
Noel Toal describes that situation as “change on steroids”, and few could argue with that.
Toal is the CIO of DPV Health, a community health service across 20 sites in the northern suburbs of Melbourne, Australia. DPV Health offers everything from GP medical services through the whole range of allied health services, mental health services, dental and disability services.
Under Toal’s leadership, DPV Health is using technology to improve the client experience and to improve the ability of its clinicians to deliver excellent care.
Toal’s first senior role was as a regional head of ICT for a large international software development company with clients including the National Australia Bank, JP Morgan, and Swiss Reinsurance.
From there, Toal had something of an epiphany and thought that maybe an ICT leader like himself should have a greater understanding about the world of business, so he studied for an MBA.
“I wanted to understand the language of the business, and I also wanted to understand the difference between managing and leading,” explains Toal.
“Once I had that MBA under my belt then I wanted to understand the practical application, so I went into business, purchasing a cardboard box manufacturing firm. In three years – thanks to my MBA knowledge, board experience and ICT expertise, I was able to turn it around and sell it to a listed company.”
During that period, Toal says he learned a lot about rapidly scaling a business, using ICT to support a new business model, and processes – all of which served him well as he decided to make a move into non profits and healthcare, and eventually to DPV Health.
“I've spent the last four years having a lot of fun in a challenging environment, during the pandemic, but a really interesting time to help deliver excellent healthcare services,” says Toal. “So it's been pretty exciting.”
Toal is not your average CIO. As well as handling the ICT side of DPV Health, he also uses that expertise and experience to manage three teams responsible for client access. These teams handle call centre, interpreting and reception/administration, and Toal puts systems in place to make sure they run as efficiently as possible, while also leveraging technology.
And it’s that approach that really helped DPV health not only survive the pandemic but actually improve the healthcare services it was able to offer its clients, in the most difficult and distressing of times.
“I think we were all shell shocked initially,” admits Toal, “but the organisation grew its revenue by 65%. We had enormous growth, we are very busy, and we've retained most of that because a lot of it was organic – not just related to the pandemic-specific services we were providing.”
Toal joined in August 2019 and as the new CIO his strategy was to roll out a controlled digital transformation – but most of that plan went quickly out of the window with COVID-19. Some of the elements of the plan, such as new equipment and Azure Virtual Desktop, were accelerated to accommodate staff working from home, and DPV Health had to switch to providing telehealth services within two weeks.
With Victoria being the most locked-down state in Australia, and one of the most restricted in the world, it was even harder for people to access vital health services – which placed extra pressure on Toal and his teams.
“We were trying to drive the transformation while supporting all of these extra, urgent demands that were popping up as part of the pandemic response,” recalls Toal.
“We were having to help setup and shift the services, acquire printers, laptops, iPads. A lot of the early part was getting our hands on equipment. We needed to make people more mobile. Luckily we had a good relationship with Microboss and that helped us to get all the equipment that we needed.”
“We also had important partners to help us with the CRM development. Delta Insights were really important for the delivery of that system and then linked to that, we needed
a cloud-based phone system, and that's where RingCentral and NativUC came into the picture.”
We all know that the pandemic accelerated digital transformation and that became in some ways a silver lining to a very dark cloud. Toal admits it was an enabler and helped DPV Health get things done quickly “because we had to”.
And while the pandemic was a period of intense change, there is still more to come. Toal has completed the delivery of the digital transformation and is now working through defining what the new ICT strategy will be, having fixed what he calls “technical debt”.
The new strategy is all about being more engaged with people and leveraging the new systems that have been put in place, such as the new CRM, clinical grade network, cloud systems, omnichannel phone system, hardware, and making sure the company maximises the value of the significant investment from the last four years.
You can almost hear Toal’s MBA switching into action as he explains how he is approaching this new strategy now that he has the platform to build on.
“Someone from another community health organisation said to me the other day, ‘we're three to four years behind you’. That's because we have just done four years of work on digital transformation. You have to do the work, to be ready for the next stage.”
So what is that next stage? Toal immediately, like many tech leaders, turns with caution to artificial intelligence.
“I think one of the risks is that an organisation feels pressured to deliver AI,” says Toal.
“Then they're going to turn it on, think it's intelligent, and use it to search through data and pull together answers for their questions – that's an obvious, real benefit for an organisation. But they're not necessarily going to be prepared for the fact that, historically, they've had really bad practices managing their systems and files.”
“If you unleash AI and haven't segmented and haven't got good internal controls with role-based access, and haven't locked down those documents, and they're not encrypted, you're going to get all sorts of privacy issues.”
Toal’s advice is don't rush into delivering AI without thinking about what the problem is you are trying to solve. He also suggests not using the word AI when working out the problem because it will “just scare people”. Instead, he says just talk about the problem and what you want to do better, and then work out how AI can provide a solution for each element.
DPV Health have built a proof of concept predictive AI model to address the fact that around 25% of clients would fail to attend appointments.
“That’s an instant hit to productivity, and we have massive wait lists because we're publicly funded within a rapidly growing community, to get people in who really need help,” explains Toal. “So if the clinician sits there not servicing someone, that's impacting us and the clients”.
“The model predicts at the time when clients are making the appointment their likelihood of attending. We've tested about 91% accurate on that, so that's been really good, and with a number of other data driven changes those no-shows are now around 14% – or 8% if you exclude mental health appointments – down from 25%.”
DPV Health also utilises AI on some cyber security tooling, and Toal says it’s a great way to make small teams more efficient – “AI is a really powerful way to do some of that leg work for you and just let your people focus”.
Cyber security is also the one thing that Toal says, when asked, what keeps him awake at night.
“It's got to be cyber security, right? That has always been the case but it's been moving towards what I would call drive-by cyber attacks because people can just go on to the dark web and they can download quite sophisticated tooling and run it – but now that tooling is AI enabled.”
“Around 59% of breaches in healthcare come from compromised credentials. They're coming from phishing. You need good internal controls to deal with hackers who use legitimate user credentials. The other element is mistakes. If you look at some of the big breaches that have happened, they are simple mistakes.”
“So how do you deal with mistakes? I think you've got to have really good controls so that when someone does make the inevitable mistake, you pick it up, and you deal with it.”
Toal can rest easy, safe in the knowledge that his extensive skills and experience have not only delivered DPV Health’s digital transformation, but also along the way improved the health services and care for thousands of people.