Interview: James Thomas, IT director, University College London Hospital

With UCLH implementing one of the first large-scale fixed mobile convergence projects in the UK, James Thomas talks Computing through the process

Computing: How is the FMC implementation progressing?

Thomas: We have gone through all the coverage testing and the private mobile radio (PMR) network is in as well. We are now trialling standard mobile devices and smartphones (BlackBerrys and dual-model GSM/WiFi phones) for roaming on public GSM networks.

We want to make sure we are able to use our existing smartphone stock, which at the moment comprises BlackBerries. In the future, we will move away to other smartphones – largely because of infection concerns. [Mobile phone] keyboards are really bad for transmitting infection and holding germs in a hospital environment, whereas you can alcohol-wipe a touchscreen.

We also need to execute a SIM provider change, and we are striking a deal with certain mobile operators to provide us with SIM cards that work on both the PMR and GSM networks. Then we will upgrade 1,000 handsets, which is annoying, but this has to be done.

C: Will UCLH allow staff to use their own mobile devices?

T: I cannot stop the 'bring your own device' (BYOD) trend; in fact, I think we should positively embrace it. If we initiated a BYOD policy tomorrow, staff would bring in 1,000 devices the next day – clinicians love their gizmos. They like their iPads, and I would prefer to work with them to get the apps they need on to the iPad and we will probably need to develop apps specifically for it as a result.

The IT people at Guys and St Thomas’ NHS Foundation Trust already have clinical apps on the iPad, and we could collaborate with them – it would be in the public interest if we collaborated. We just have to make sure we provide open access to core systems.

C: How do you handle security for a BYOD approach?

T: The important areas for us in terms of security are secure email, internal data access and e-procurement. We have a Juniper Networks-based IP virtual private network (VPN) infrastructure using secure socket layer (SSL) technology, so we don't need to worry about policy control on the end user device.

If they bring in their own device, we have the ability to control that device, including remote kill. But if that remote kill does not work properly and kills off some of their personal data, we are responsible.

Interview: James Thomas, IT director, University College London Hospital

With UCLH implementing one of the first large-scale fixed mobile convergence projects in the UK, James Thomas talks Computing through the process

The other approach is to put a container on the device, but that removes some of its flexibility, so what is the point of that? At the moment we are looking to try and avoid going down that route and authenticate in another way.

C: Can device and security management be outsourced? What other ICT services can be delivered by a third party?

T: We genuinely believe we have to get out of managing applications and worry more about services. I feel lucky in that I have both Logica and Azzurri Communications handling security, VPNs and telecoms, but change is the enemy and who knows what challenges we will face in the future. That is the biggest tension we have right now, and we need to work flexibly with our outsourcers to embrace change.

C: What other ICT infrastructure changes have you implemented recently?

T: The rest of the telephony estate took 18 months to upgrade, we took out six private branch exchanges (BPXs) and replaced them with a Mitel IP telephony system. In the last six months we have moved from a four-digit regime which was duplicated at different sites and was a nightmare, so we have renumbered all the telephone numbers to five digits, which sounds simple, but it is a logistical nightmare.

Then we created short-dial codes on the PMR to handle the landline world as well. Azzurri went out and got us 30,000 continuous new London numbers from 02 which is part of the benefit of working with them – they knew the 02 number range was coming out and they went off and pre-bagged 30,000 of them.

C: How does UCLH handle business continuity and application availability?

T: The data centre infrastructure we inherited from the NHS was in the basement of a 120-year-old building under a swimming pool and next to a nursing home, and it was vulnerable to power outages, floods and sewage – an absolute nightmare.

We have since migrated the primary node of our data centre to Docklands and a secondary node to the Trust HQ building itself, which is the old prudential building, so there is geographic separation.

We went through the exercise of virtualising as much as we could, but still managed only 65 per cent of the server base – the clinical apps can't handle virtualised workloads. Some of our software providers have never put their applications in a virtual world before and we are telling them they have to do it – the way it has been set up, it is hugely cost prohibitive to have physical servers in the Docklands data centre – so some of those software providers have had to recode or revalidate their application. Often they just have to test it to make sure it will work in a virtual environment.

C: How big is your IT team and what do they focus on?

T: The team I head up is based around ICT operations. We manage systems, applications and services and it comprises a small team of about 20 people. We have one technical architect, a network infrastructure architect, two contract managers which handle Logica and Azzurri service level agreement (SLA) delivery, three service delivery managers, and a small team for core applications management and patient management systems.

The other side of the ICT team is on the Project Management Office (PMO) side, and includes four program managers and five to six permanent project managers, supplemented by about five to six contract managers. We do a lot of internal development with Logica, but again that is a real challenge because of the complexity of the projects.

C: What is the biggest everyday headache for the UCLH IT department?

T: Storage. We have a very autonomous infrastructure here at the hospital; we have absolute clinical leadership from three medical directors, three medical boards, 15 operating boards and they are almost autonomous in the way they work. They also drive their own agenda in terms of what data they want to store and how they want to store it.

Telling them how they must store data in a particular way will cramp their innovation, so we have to do things the way they want to do them. We need to handle larger and larger medical images from the cancer centre, for example, which can be up to three times the size of an MR scan, meaning storage can run into terabytes and even petabytes at times.