Making Healthy Progress with Digital Transformation

Innovation is not necessarily the first word that springs to mind when you think of state-provided healthcare services. Professor Martin Curley, Director of Digital Transformation and Open Innovation with HSE, Ireland’s health service, is doing his best to transcend that preconception. He talked about how he is managing this in a recent conversation with Forum Podcast host and writer Julian Patterson.

Patterson started by asking why so much of Curley’s talk since entering the healthcare sector has been about business value, technology, innovation and entrepreneurship – arguably not the sort of language one is used to hearing from public sector management.

“We have to recognise that healthcare is about a decade behind other industries with digitalizing,” concedes Curley. “But I believe we’re approaching a Big Bang moment where we’re going to see dramatic change over the next decade. We’re going to see a lot of innovations that are going to drive significant change, and hopefully much better outcomes for patients as well as improved experiences for our clinicians.”


Professor Curley is Director of the Digital Transformation and Open Innovation at the Health Service Executive (HSE), helping enable the digital transformation of Ireland’s health service. Prior to joining the HSE he was Senior Vice President and group head for Global Digital Practice at Mastercard. Previously he was vice president at Intel Corporation and Director/GM of Intel Labs Europe, Intel’s network of more than 50 research labs which he helped grow across the European region. He also served as a senior principal engineer at Intel Labs Europe leading Intel’s research and innovation engagement with the European Commission and the broader European Union research ecosystem. Prior to this Curley was Global Director of IT Innovation and Director of IT Strategy and Technology at Intel. Earlier in his Intel career, he held a number of senior positions for Intel in the United States and Europe. He also worked in research and management positions at GE in Ireland and Philips in the Netherlands.


Professor Curley identifies three Cs that he thinks are at the root of why healthcare transformation is so challenging. “The first is culture, the second is complexity, and the third is capacity,” he explains. “The ‘rule of rescue’ dominates healthcare, with most of our spending and focus on trying to help the sick, and that is noble and the right thing to do. But it detracts from the ability to have a proactive, forward-looking approach to healthcare. We need to be focused on keeping well people well. If you haven’t got a chronic condition, you could be managed best from home. The culture of health systems is designed to minimise variability and to limit change – exactly opposite to the kind of conditions that you need to bring innovation about. You need to be able to take risks, explore prototypes, and so on.”

Secondarily, Curley pinpoints the issue of complexity: “Health care is very complex,” he points out. “When I was at Intel, I saw clearly that common processes can be managed and automated, and that value can be created. Obviously, human beings are a lot more unpredictable than silicon wafers or aeroplanes.”

He also picks up on capacity, in two senses: “First of all, I’m talking about the capacity of people to absorb change, when working in stressful jobs on the frontline,” he says. “In that situation there is limited capacity to adopt change. And the other dimension of capacity is the fact that healthcare systems don’t invest in the capacity needed to actually drive change. Change isn’t free. Sometimes you actually see a slight degradation in performance while you’re undergoing change. Healthcare systems haven’t addressed the need for change capacity to be put in place.”

The pandemic, of course, has been a Big Bang disruptor, knocking a lot of innovation plans for six. But there were, says Curley, examples of innovation being stimulated and accelerated by it: “Necessity is the mother of invention,” he explains. “For example, we developed a solution for the remote monitoring of COVID-19 patients, and we subsequently have thousands of patients being monitored from home. We were able to deploy this nationally, going from an idea to full deployment in 30 acute sites in five weeks. Normally, a deployment of that would have taken about two and a half years. What we need to try and do now is maintain that intensity of desire for innovation so that critical digital innovations can be pushed through and deployed as soon as possible.”

Curley believes that the systems that hospitals and healthcare organisations have in place simply aren’t at the level of operational excellence required: “Certainly they’re not a match for all the wonderful doctors, nurses, physios and pharmacists,” he adds.

He believes that national health services generally suffer from systemic under investment in IT: “In the NHS, for example, the ratio of IT spending to the total budget is somewhere between three and four percent. In Ireland, that ratio is less than one per cent. But one of the good things we’ve done is to split traditional IT from the digital transformation function, according to a model developed by Jamie Ross at MIT. We’re using a methodology called Open Innovation 2.0 where the entire ecosystem is aligned around a shared vision. We have hundreds of partners, both large companies like Dell, Cisco and Microsoft, as well as lots of small companies. That’s given us more resources than are available just internally in the HSE.”

Curley’s plan is to establish a joint fund so the HSE can incubate and accelerate promising digital health companies and innovations into the healthcare ecosystem. An example he cites is the education of clinical professionals in digital technologies, so helping to prepare them for the future: “We’re launching a joint professional diploma with Dell Technologies where we have a thousand clinicians signed up so far. With very low costs, we’ve created a world class curriculum and are on track to become champions of the overall digital change movement in Ireland.”

Next steps will see more work in areas like standards, integration, data sharing, security and the advancement of disruptive technologies: “We’re starting to talk about healthcare 4.0 as a new goal,” he says. “In the tech sector you have Industry 4.0, and we need to look at the equivalent in healthcare. Part of that will be a paradigm shift of focus from clinical care to preclinical care. Tracking a person’s vital signs and using AI to analyse them, we’ll be able to detect the emergence of hypertension, or pre-diabetes before these develop into chronic diseases. We can intervene earlier.”

Good data enables so much, he says, citing the recent case of a senior clinician who used AI for diabetic retinal scanning. “Normally that process takes three to five days to get a result,” he says. “But by implementing machine learning in real time, those three to five days went to three seconds. A retina could be scanned, and with very high confidence a result was actually delivered in three seconds. So this will completely change the process of diabetic retinal scanning.”

The good news, says Curley, is that unlike corporations competing against each other, health systems are more in the business of working together: “We have convened with a plenary session on digital health at the United Nations General Assembly with the goal of sharing and aligning different health systems so we can learn together,” he explains. “We very much want to work with the global healthcare community. The future really is all about collaborating.”


By Guy Matthews, Editor of Innovate! a Business Innovation Leaders Forum publication

Listen to the full interview here on iTunes

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Book of the Month*

The Serendipity Mindset: The Art and Science of Creating Good Luck

By Dr Christian Busch
Serendipity is an aptitude for making desirable discoveries by accident. To other people it looks like “good luck”, but it is more the ability to recognise and seize an opportunity, rather than have good fortune thrust upon one. Finding a wallet stuffed with money on the conference room floor is good luck, whereas holding it up and asking if anyone has lost their wallet might be the beginning of a valuable friendship – that would be serendipity.

Chance encounters, or strokes of fortune, feature in countless stories of business success. This book looks beneath the surface, reveals and teaches the mindset that can transform pure chance into opportunity. The author is director of the Global Economy Program at New York University’s Center for Global Affairs, and a lecturer at the London School of Economics.

Serendipity is an aptitude for making desirable discoveries by accident. To other people it looks like “good luck”, but it is more the ability to recognise and seize an opportunity, rather than have good fortune thrust upon one. Finding a wallet stuffed with money on the conference room floor is good luck, whereas holding it up and asking if anyone has lost their wallet might be the beginning of a valuable friendship – that would be serendipity.

The author says “This is a book about the interactions of coincidence, human ambition and imagination”. In the above example: finding the wallet is the coincidence; ambition is the desire to make something of the discovery; add imagination and you open up a whole menu of possibilities: from spending spree to earning a reputation for honesty – or even making a wealthy friend.

Business is typically forged on human ambition and imagination, but early success often feeds an appetite for control – and “control freaks” can be blind to the opportunities thrown up by the unexpected. They only see chance events as distractions. If plans go awry, they may blame the failure on “bad luck” rather than admit their own inflexible attitude.

The author himself admits to being “a German who is used to planning” and prone to feel anxious when something unexpected happens. That makes him an ideal teacher, because he has worked hard to discover and analyse the mindset that enables one to “connect the dots” and cultivate serendipity. He presents a goldmine of examples from science, business and life where an apparent mishap or failure lead to a breakthrough.

Indeed, studies suggest that around 50% of major scientific breakthroughs emerge as the result of accidents or coincidences. A well-known example is Alexander Fleming’s discovery of penicillin, launching the whole field of antibiotics. Other examples include X-rays, nylon, microwave ovens, rubber, Velcro, Viagra and Post-it Notes – where would we be without these!

The book goes beyond the ability to recognise and respond to opportunities in chaos, but the subtitle – The Art and Science of Creating Good Luck – is actually a bit misleading. True, he does show ways to develop better fortune, but it would be better to call it “inviting” or “encouraging” good luck. For example, he suggests better ways to start a conversation with a stranger – ways that will make it more likely to lead to chance connections or shared interests.

The publishers may have chosen the word “creating” to make the book appeal to the human desire to control – for control freaks are exactly the readership that would benefit the most from this book’s wisdom and practical advice.

For the rest of us, it offers a great way to rediscover the sense of play that is so important in life – and too often lost in business.


“Following the success of The Serendipity Mindset hardback, a paperback edition has also now been launched under the title “Connect the Dots”.

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