This episode of "CIO Confessions" features an interview with Benne Holwerda, the CIO of the Rivas Zorggroep, a Dutch healthcare organisation. Benne discusses his role in navigating the challenges of integrating technology into a human-centric industry, emphasising the importance of process redesign and user-centric design over simply introducing new technologies. He highlights the specific challenges of working in healthcare, where patient data privacy and doctor-led innovation present unique hurdles. Benne also explores the potential of AI in healthcare, outlining both the opportunities and the ethical considerations surrounding its application.

[00:00:16] Jingle: This is the CIO Confessions, a podcast by Devoteam.

[00:00:35] Benne Holwerda: Yeah, that's a good question. Hello everybody. I have been always working on the line between IT and business.

[00:01:09] And I was working there. I was approached with the question, Do you want to work in healthcare? And I let the question sink in and I thought that's it's an area where there's a lot to do and it's interesting and it's really yeah, helping people get better or get a good quality of life in their final stage.

[00:01:34] Gert Jan van Halem: Horkum being in the Netherlands.

[00:01:45] The nursing homes like 17 nursing homes. And we do also care at home for people. So we have a broad variety of of health services in the bigger region.

[00:02:07] What might be different for IT than in other areas?

[00:02:36] People think about in healthcare, so it's really just if you have little children, you have to bathe them and do everything and you're not like where's my app to to put my baby in the bath or something like that. So the focus is not very much on on it. I think a bit more on technology because there's a lot of technology to help you do surgery or.

[00:03:01] Gert Jan van Halem: So is IT seen as a burden for them because they have to do the administration maybe in IT system or maybe it holds them back to do other stuff?

[00:03:17] Okay. Which is for my role. But it it's the big challenge. So how Yeah. How to make work fun also with IT and have it really help you in the things you have to do. And I think one of the main things you said administration, and it's administration for two reasons. Hey, it's the, for the financial, you have to go to the insurance company to to de to get paid.

[00:04:03] Caregivers to, to do their best and what is impacting the, this this results. Yeah.

[00:04:22] Benne Holwerda: Yeah. I think that's a, that's one big part in, in, in the Netherlands.

[00:04:44] So it's it's a wish that is not really coming true. And maybe this is one of the parts where AI or gen AI can be a solution, but then you also have, I have this example lately that if someone in an elderly in a nursing home needs [00:05:00] more care. Then you get into a new level of care and you have to ask the insurance company if that's okay.

[00:05:26] So one of the things I thought we should have a standard text. Just if it's a case, you just push the button and the text goes to the, but the insurance company then says you didn't really look because it's a standard text. So that's like the world we're living in. And then you could say let's use gen AI to make the text every time just a little bit different.

[00:06:00] Gert Jan van Halem: Interesting. And you mentioned the Rivas group does hospitals and also nursing homes.

[00:06:10] Benne Holwerda: Yeah. If you look at a hospital, then there's much more. IT involved if it's for the all the pictures and information of medication and the ECGs and everything that you have to put in the file.

[00:06:47] In this nursing home, you want to just keep it calm, not too much fuss and keep it very easy. Also the people who work there. I'm much more practically educated and not so much into the [00:07:00] sophisticated IT things. If you're a medical profession, you say give me one screen with every information on it and lots of buttons so I can just do it the way I want to myself.

[00:07:15] Gert Jan van Halem: Yeah. Interesting. So if you you've been doing this for, I think four and a half years. So if you look back at that period what are the big projects, maybe the projects that you're most proud of or the biggest change that you make?

[00:07:30] Benne Holwerda: Yeah, but one, one of the biggest problem projects was the our electronic health records the system we use for it, they needed a big upgrade and that's a lot of work and it's throughout the company. So that was a very big project. Which is really like an update of what you're already using.

[00:08:05] So you have a cut like these cameras and alarm buttons and all those type of technologies that we've introduced in these homes. To to enable less people in the night shifts to take care of the people. And with the shortage, we have, we've got the aging problem in Europe.

[00:08:40] How can you do, provide more care with less people,

[00:08:59] Benne Holwerda: That's [00:09:00] right. And that's always the challenge. And for me, it's a lot of the time. If someone asks for technology, it's also the question of why do you I, the example earlier about administrative burden. What you really should be doing is kill the reason for the administration and not introduce technologies to to solve it.

[00:09:39] To the patient records. That will help because you don't have to do it manually. Or if you introduce AI in radiology to to determine if there's something wrong and what it is. That's also something where there's really an advantage of in technology, but there are other areas where it's not so much in a solution.

[00:10:11] Benne Holwerda: Yeah. So what I started with I think a year and a half ago was really introduced design thinking as our method of making change in the right way and have adoption part of the, and then there was really like a culture we do this project, it's about a new process, but in reality, it was about a new application.

[00:10:47] And also increases the dissatisfaction with IT because you've got this new solution and you don't know how it works. You're not into healthcare because you like IT, you're into healthcare because you like to care for people. And that's [00:11:00] why I started to introduce design thinking as a principle and a way of adopting.

[00:11:10] Gert Jan van Halem: yeah. Could you explain for our listeners a little bit of design thinking might not be known for everybody. What do you try to do?

[00:11:23] We'll have to make the adoption in designing what you want. I can explain it with a design sprint that we do. Sometimes it's, we have a problem somewhere in our organization. And then we will ask the people who do that work on a daily basis to come together in a group and in a really structured way.

[00:11:58] Then you will have something [00:12:00] that, that the colleagues will say I wanted to, when can I finally get this improvement instead of, Oh no, not something different again.

[00:12:17] You have all these care people that don't want the tools and somebody has to bridge that.

[00:12:33] And to get them enthusiastic about his way of working. And because the first thing if, for example, if we do a design sprint, they say, I want five of your caregivers to be a week free of everything. And just on this design sprint that's a big problem because there are not enough people. So it's really an effort and a sacrifice to say I will have these, this group of people not doing their regular work, but thinking about how we can improve.

[00:13:13] And so you probably want to drive this, but how do you convince them this is the way to go? This is where we.

[00:13:39] And the opportunity came by to have a subsidized project to introduce it the first time. And that was for me the take to say, okay we have got this problem here. Let's introduce this method and if we like it, we can make it bigger. And if we don't then we had one project and we'll stop afterwards.

[00:14:14] Gert Jan van Halem: Within five?

[00:14:15] Something like that. Okay. So that's you can imagine that it provides some stress with the one and was to move and with the relatives. So we did a redesign with the design sprint of the process where you much more have like different phases of waiting in which you ask someone to prepare, but also to also already provide some information that if you start living with us that we already know more about who you are and you don't expect.

[00:15:08] It doesn't only have to be the professional. So we redesigned the process. And when we did it we started, we went live in one of the nursing home and we got like the order 16 saying, when can I please join? And that was for me the trigger that this way really works. And it also, so very much helps in adoption.

[00:15:38] Benne Holwerda: And I think for me that's somewhere that's the key because I'm not I'm CIO, but I'm not just interested in putting IT everywhere.

[00:16:04] I've had it's a funny example. I've tried to introduce a RPA.

[00:16:09] Benne Holwerda: Those little administrative robots. And what we discovered is an either a partner company that, that would help me introduce it. And everything time they went in to analyze a process where we thought there could be room for an RPA.

[00:16:42] And if your process is better and you can standardize a bit about different parts of the organization, then you've also got the skill to do RPA or Gen AI or all those kinds of technologies. So I think we're much more in the. Process of improving process,

[00:17:02] Yeah. And a bit out of the IT . Yeah. That IT is just, this is the tool that I have to support you, but let's fix your problem.

[00:17:15] And for me, it's like my background.

[00:17:30] Benne Holwerda: And that they want to, a surgeon also wants the right knife to, to perform the operation.

[00:17:38] Gert Jan van Halem: And do you also see that having an effect on your team that it moves more to a process maintenance and then real IT supports. Management mindset.

[00:17:52] Yeah. Yeah. Yeah. It's also still a lot of the regular IT maintenance we have to, and because also our system cannot [00:18:00] go into the cloud. We have our own data centers I've also got a lot of their regular base iT functions. And in place there.

[00:18:09] Yeah. I saw in some research that AI is one of the things that a lot of healthcare providers expect to implement next year in the coming years. Yeah. Any plans at the Rivas group for AI solutions?

[00:18:32] And we are one of the pilot hospitals where we are developing this and it's aimed at if you're coming to the emergency, what is the chance that you will be admitted and for what period of time?

[00:18:46] Benne Holwerda: Yeah. That's that's I think one of the key parts where we're piloting right now.

[00:18:58] Benne Holwerda: Yeah, but if you look at [00:19:00] the situation in the Netherlands, then you see that if the hospital is full, you cannot welcome people at the emergency. Because if they have to go if they need a bed in the hospital, you don't have the room.

[00:19:31] You have to organize and optimize the capacity because there's, we are pretty much booked. So it's a key to optimize. And then it's really important to predict the chances that someone has to be admitted.

[00:19:50] Of course, since what is now two years or so, we're all GenAI , I will solve all our problems. We'll also solve your problems. Peace is coming.

[00:20:09] And that's one of the reasons why I think in general, in the healthcare, we are careful with implementing those kinds, even if it's just in our Microsoft Copilot or whatever. Because you don't really know if the, if all those healthcare data just stays in our health record system or that it's also used somewhere else to be careful.

[00:20:54] Gert Jan van Halem: And then I think it's also for the context of our listeners healthcare data is, I think, the highest level in [00:21:00] the GDPR rules, right? Yes. Yeah, I think. You don't want to take any risks with people's healthcare data.

[00:21:10] Jingle: IT Confessions Box.

[00:21:23] Gert Jan van Halem: And in these years interesting story on, on what and how that's different than somewhere else, but what is your biggest lesson you think that you that you had?

[00:21:51] If you want to If you want to change, or if you want to implement something, then you really have to involve them as [00:22:00] well. Yeah. And that's one of the things I was not aware of before I came into healthcare. So that's one on the, in the area of healthcare. And is

[00:22:13] It's maybe a little bit different than the real caregivers in nursing homes.

[00:22:32] So also to have the conversation also with the doctors about. How can we standardize on some parts to to improve the benefits of technology? That, that's a pretty difficult conversation. And that's why I think we in the Netherlands and all around the world, you have the chief medical information officer, which is like a practicing doctor that, that will for one or two days in a week also be the bridge with those [00:23:00] doctors and IT.

[00:23:04] Benne Holwerda: Yeah. So we work, our counterpart, we work together in, in making technology work.

[00:23:14] Benne Holwerda: Without them, there wouldn't be much operating or exactly.

[00:23:24] Gert Jan van Halem: Yeah.

[00:23:28] Gert Jan van Halem: Yeah. Yeah. And that, that kinds of makes your own role. It's relative to all these big IT projects and ideas, but we're here to help people and we are people to help people.

[00:23:42] Benne Holwerda: And you can also start the whole, I think, don't think it's for this podcast, but you can also start the whole philosophical questions about, if you're old and alone and you've got like a robot kitten or a robot person keeping you company, is that the way you want to live as a human [00:24:00] being?

[00:24:17] Gert Jan van Halem: And it's also what you said about IT in healthcare, probably these robots taking care of people is an idea that we as IT people think might work, but I'm not sure if the healthcare industry is there as well.

[00:24:38] And sometimes it's really, if you've got like a robot cat, people can really get a satisfaction and a feel of companionship out of it. But is it? Is it really how we as humans want to live our lives? And so that's also cares about from people to people. But if you look at the other ways that you can do a lot of it yourself.

[00:25:18] And I think the bit that probably the big tech will be there.

[00:25:32] Benne Holwerda: Almost everybody can use Facebook.

[00:25:41] And maybe with with the younger people getting older, they all know how it works. Of course.

[00:26:04] Gert Jan van Halem: Excuse me.

[00:26:16] Gert Jan van Halem: So just we've been talking for half an hour or so, so we have to come to an end someday. That's too bad. Yeah, but I think interesting question for our listeners maybe is you've done this for four and a half years with Kivos now, but you have a longer experience in the past.

[00:26:43] Benne Holwerda: For me, it's always you have to know the business, cooperate with them, not just align once or twice a year, but really get involved in what is the surface or the process or whatever that's being done at your company.

[00:27:20] Gert Jan van Halem: Very important lesson indeed. So we went from IT to philosophy about humans and robots and how we work together in the future. Yeah. So it's a broad overview. Yeah. Thank you for that. It's very interesting to hear how it works in healthcare. I think it's a bit different than in other industries that I've visited.

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