Former CIO says south west LHIN’s success should be emulated

Tank commanders have a knack for seeing opportunities for engagement and the obstacles that lie in their way more sharply than others. That’s just how Glenn Lanteigne saw things when first graduating from the Royal Military College in Kingston, Ontario as an Armoured Corps officer. But after a budget planning stint at Canadian Forces Headquarters in Ottawa, he rolled into the private sector, healthcare first, with what was GE Medical Systems, becoming a Six Sigma Black Belt.

Those quality control techniques and his leadership skills stood him well through a number of other private sector posts, ending with Senior Director, Healthcare for Telus, based in Toronto. For the past three years, he’s been recognized for his innovative, make-the-best-of-what-you’ve-got-first approach to being the CIO of Ontario’s South West and Waterloo Wellington local health integration network (LHIN).

CHT: Glenn, tell us more of your story.

Lanteigne: In the three years I spent as CIO, I saw a lot of good things happening with e-health in Ontario and across Canada. e-health is seeing some very positive results, and they all deserve visibility. Transparency is always important in the public sector, but I think it’s especially important in e-health because we need that public trust to strengthen confidence and keep e-health moving in the right direction.

CHT: So, what then would you say were your greatest successes over the last three years?

Lanteigne: When I came on the LHIN in London three years ago, the perception of e-health as a “brand”, if you will, was low. Success resulted from a coherent policy framework and a set of operating standards that ensured the most effective use of funds. We leveraged current investments; stakeholders were actively engaged and listened to through a wide variety of channels including social media, and there was open and transparent collaboration with the private sector. The shift from being focused on projects and technology to programs and governance was critical. The situation called for change: transformation and growth as well as a sound e-health strategy supported by good governance. So in this way, and through the efforts of many, we’ve been part of Ontario’s climb back to being recognized as a national leader.

CHT: Tell us about how that good governance worked.

Lanteigne: It was based on the “cluster model” of development, which was created initially to better suit the scale of e-health in Ontario. Having an organized cluster allowed us to leverage our current investments in technology; it enabled us to start innovating the way we delivered and sustained healthcare.

CHT: In that approach, can you give us an example of technologies already invested in that were put to better use? And what roadblocks your team faced in the process?

Lanteigne: Some of the technologies that we built on included ClinicalConnect, as the viewer for cross-continuum patient information; Information Decision Support (IDS) as the data and analytics platform; the South West Interface to Regional EMRs (SPIRE) that enabled download of hospital records to physician EMRs, and eSHIFT, a mobile platform that supports care in the home, as well as thehealthline.ca, a system navigation tool for patients and providers.

In addition to e-health record technologies already developed by the province, one group of technologies we targeted were those that help keep our patients in the home using home sensors. The major hurdle we faced was in getting the healthcare system comfortable with funding technologies for the home.

CHT: One other major hurdle, which I know you’ve spoken about before, is procurement.

Lanteigne: It’s an issue not only in Ontario, but right across Canada. Procurement has been made so difficult it has slowed innovation and delivery. Vendors, for example, who want to engage in the procurement process find it very costly, complicated, and time consuming as a result of healthcare institutions over-managing risk. But that’s changing. Health system leaders are encouraging procurement agents to exercise common sense; procure only when needed; leverage current investments to ensure value for money; and be more open to collaboration with the private sector. Over the past three years, we held numerous private sector engagement and innovation sessions led by the South West LHIN.

CHT: What was it like to be a CIO after the e-health scandal, when LHINs were also getting a fair share of scrutiny? How did you handle the situation?

Lanteigne: It was a challenge, no doubt, championing e-health in a LHIN after the summer of 2009. I think that coming from the private sector and serving as an officer in the military helped me there. With that kind of approach, you conduct a current state assessment; create a strategic plan; set up a framework with operating standards; implement the tactics; create contingencies; form alliances; have good intelligence and communication; and act with integrity, consistency, and fairness. The result was a complete turnaround that produced a sustainable, cultural change and gave us results we could measure against our financial and resource constraints.

CHT: How does leadership and team building come into play here?

Lanteigne: Well you definitely need a team around you if you are going to take that approach. In order to implement a strategic plan, you need people and they need to operate with the esprit de corps of a high performance unit. You also need a sense of purpose and a clear vision of where you’re going. The culture we fostered of a winning, can-do team drove our results.  We were dedicated and committed to delivering on our commitments ensuring that all of us were aligned with the strategy and our mandate.

In e-health, you need to set the tone right from the top and lead the governance as well as be accountable. My approach was also to be very people-focused. I was honoured to be ranked as the #1 leader in the last staff survey conducted before I left.

CHT: What would you say really happened with the Ontario diabetes registry?

Lanteigne: That’s a hot potato, but let me answer it directly. It wasn’t really the diabetes registry itself that was the problem; it was the approach of making it a centrally delivered service. In a province of Ontario’s scale, that’s an unachievable feat, especially without local delivery structures in place. Also, there were a lot of other regional and local technology solutions out there that were already managing diabetes and other chronic diseases. So a large centralized system was obsolete at the outset. It’s a main reason why the project took so long, and in taking so long it lost its vital momentum. When you lose momentum, everyone loses interest.

It is an important lesson however, because the same issues will challenge any provincial initiative that ignores the strength and sustainability of local delivery. I think that the delivery mechanism set up in South Western Ontario to deliver the electronic health record (EHR) and other associated e-health projects should be looked at closely as a new way of implementing provincial initiatives at the local level.