What is the role of Academia in driving Digital Transformation?
As part of an ongoing series of conversations with Digital Transformation Leaders, I was honored to meet with Dr. Rose Clarke Nanyonga, who is the Vice Chancellor of Clarke International University (Formerly, International Health Sciences University)
About Dr. Rose Clarke Nanyonga
Rose Clarke Nanyonga PhD, APRN, FNP is an experienced manager/leader with a demonstrated history of working in the higher education and healthcare industries. Skilled in Healthcare Organizations, Nonprofit Organizations, Nursing Leadership & Education, Epidemiology, Reproductive Health, and Health Promotion. A strong business development professional with a Doctor of Philosophy (PhD) focused in Nursing, Health Policy, and Global Health from Yale University.
Below is a script of the interview that took place on 8th February, 2019.
Give us a brief introduction of yourself and Clarke International University
I am Dr Rose Clarke Nanyonga. I am the sitting Vice Chancellor of CIU, formerly International Health Sciences University. We have been here in the education eco space for 11 years now. The university started as a niche university with a single School of Nursing which formed the initial faculty and then, once we secured the licenses from the National Council for Higher Education, programs were built around that.
The programs were all Health Sciences focused: public health, clinical medicine, laboratory science and of course the degrees in nursing. The majority of the short programs for Continuing Professional Development, also focused within that discipline.
About two years ago we started thinking about what would be a good marriage in terms of university expansion. So not only did we have to change the name – we needed to have a bigger umbrella that would allow us to do a little more than just Health Sciences. With that in mind, we started a School of Business and Applied Technology.
It’s interesting to have this conversation because one of our most successful programs – the Applied ICT in Health and Leadership program – is the program that actually led to us thinking, ok, we need to expand this beyond the small successful program and leverage that success for a bigger program. We now have programs in the school of business and applied technology, including our winning program, and the regular traditional programs, BBA, Bachelors of Computing in Applied Technology, MBA focusing on IT as well as other short courses.
Are you using digital in any way at Clarke International University?
Change is a bit slow when it comes to Academia because there are so many stakeholders involved. Regulations have to move in tandem with the practices that people are implementing in Universities, so often you have to negotiate that space. But there are a few things that have happened at Clarke International University, at least during my tenure.
I came back here from the US after having lived away for nearly 20 years and my experience and tooling as a practitioner is quite different. My exposure to Information Technology and digital resources and the use of that, is fairly ahead from most people who have not had that kind of exposure.
Universities that I have worked for and that I have attended often were ahead of the game, quite transformational in their approach. Digital information was integrated within learning, teaching, and research. Majority of processes and systems have been digitized. I bring a little bit of that experience here. I started looking at: what do we have that we can use to transform (1) the way we engage with our students (2) the way we teach and learn (3) the way we conduct practices and operations.
One of the first things that we instituted was a Student’s Information System. In the past all our processes were paper based. When your numbers are getting to 1000 students you can imagine the registry team will be really overwhelmed with that. This has been an interesting process because of the learning curve; how do we engage, how do we teach, how do we transform the culture around that, the perceptions that people have, and the level of distrust of Information Systems and digital systems.
There is a relationship that people have built with ICT that we really need to address if we need to change anything at all. We do have some early adopters who are excited about the new system but then we have nearly 70% of our people, including the students not signing on, not activating their emails etc. We went through the growing pains initially. We launched the system few years ago; it’s an open source system. Customization is not robust, but it does give us what we need, at least in the interim, and it is responsive to suggestions to change.
What we have done to improve behaviors around it both from the users end and administrators is to have a major meeting every semester. We are bringing the administrators into the room, we are bringing the student representatives into the room, the deans, the teaching faculty, staff, and the registrar as well. We all come together and we go through what has worked, what is not working, what are the sticky points, and what is new in the system. That has been quite transformational.
What the system does was previously for students results but now we are adopting faculties working with the grade book. Instead of faculties keeping students grades in their notebook, when they give a quiz, they can now add that directly onto the system. We are also now using the system to recruit, from the time the student uploads their application from wherever they are, they are then converted to full students after admission, all the way to the moment they graduate. This is an area that we are certainly ahead.
We also have an intranet system. It’s a communication system and can be accessed remotely. Managing Calendars is one area that would make our lives invariably better. We have been trying in the last three years to make sure that the university has a University calendar, that all stakeholders input into this calendar. If I want to book a public lecture, a soccer game etc., I have visibility at my fingertips of what is happening at the university with the main stakeholders. It takes a great deal of work and sensitization.
Would you say that the challenge with adoption is a people and a culture issue?
Well, I think you have to look at this from the mindset, the tool set, and skill set. Off course in terms of tools the technology is there. But what is happening with the skill set and the mindset? Sometimes it's easy to assume that it's a people issue. Just because people have smartphones we assume that they know how to use most of the functions that come with the smartphone.
What I am discovering is that people have smartphones and they will use maybe two functions on it. WhatsApp and perhaps figure out the mobile money app, and off course making calls. Are people oriented to be curious enough to say "What can this phone really do? What can I achieve with this tool?"
Two years ago, we started sensitizing our teaching faculty on Google Suite, how does Google Drive work? How do Google Forms work? how does Google classroom work? And it’s not a single conversation that will change that - its multiple conversations.
I think you need to look at it from: what is the challenge, is it a mindset, is it some behaviors that people have already developed around the digital tools and do we need to change that? And what is going to be the quickest way for you to foster adoption?
Have you seen some additional opportunities that have opened because of adopting some of the digital initiatives at CIU?
I’m particularly passionate about using digital tools to transform the way we do life, how we do relationships, or how we do learning & teaching. Digital is a tool that can be used in almost all transactions be it human transactions or business transactions.
We have had incredible success with the ICT in Health and Leadership program, which was started as bridge program, to help enhance the skills of a college graduate to give them the skills they need to be able to get and succeed at the job. This program has been great and an affirmation and incentive to continue do what we have been doing.
There are many opportunities though, we do teach online – that is a new way to develop knowledge, to teach knowledge, to share knowledge, to disseminate knowledge. But the majority of teaching faculty have never conducted a class online, so when you introduce online learning, while it has a lot of advantages, at the same time you must recognize that you are dealing with established norms and behavior in academia.
You have to recognize that if you are dealing with traditional teaching faculty, professors who have designed content for the last 16 years for classroom delivery, they now must learn new skills to be able to develop and tailor content appropriately for online learning so that you have the level of student engagement that is robust even if those students are not in a classroom setting. Those are opportunities and it is exciting that we have the tools now for us to be able to do that.
A great deal of work needs to happen clearly within universities and the regulatory bodies to recognize that online learning is a legitimate way for us to do learning and development - and to reach a lot of adult learners who are already out of universities, who have a certain level of fatigue when it comes to the traditional mode of learning that traditional universities adhere to.
For example, if you are a mother who has a new born baby, but still wants to learn, you can do this at home on your own time and remain qualified and relevant within your own practice. That’s a wonderful opportunity to explore, not just for new information, new learning, new certifications, but also for continued professional development.
Within the health industry, we have a lot of health care providers working in what we categorize as hard-to-reach areas. The government dispatches these providers to go to Kaberamaido for example. How do we link these health providers to content they will need to continue to tool and re-tool and remain relevant in their practice and use current evidence-based practice or information in their own practice? We have to either transport them from where they are, put them up in hotels so that they can have this CME or we need to find a way to package this information and make it available to them where they are.
That’s a whole space which Universities can go into content development in collaboration with practitioners, manage databases, update databases, and then people can subscribe to those databases.
The other opportunity is in research and registries. Big Data is becoming increasingly important. The country always needs data to make decisions – data-driven decisions - whether in policy or in practice, critically important. Schools of Business together with Schools of Public Health can do prevalence studies or beyond prevalence studies and be able to bring together a whole load of data that we previously didn’t have access to. Data that can then allow us to monitor trends, allow us to be able to make certain decisions about where we put our money, and where are we going to get the most impact in terms of investments.
We are a poor country which means our resource envelope is quite often limited. So, you want data that allow you to address a need where you realize the most impact rather than distributing that resource envelope and getting very little in terms of impact.
What are the positive and negative trends that you see in the education & health sector?
The digital world means you can’t hide a lot of things. There is a vulnerability there. With Social Media today there is an opportunity for institutions to be more transparent, have better standards, better regulations, do student engagement better, do patient engagement better.
Today, a patient can walk into a clinic and if they have a negative experience the next thing you see is a post on social media. This means that health care providers are not as protected because the public, whether well informed or not, are going to react in a certain way. This creates a level of vulnerability for the health care providers.
We must remember that the country doesn’t have enough health care providers and if our response to errors made is going to be a punitive approach then we are losing the opportunity for people to grow and also, we are losing the opportunity for people to be transparent with those errors.
We also must remember that health care providers are human. One of the things that I learned in the USA as a practitioner is that you minimize the errors by reporting those errors because by reporting those errors, by being transparent, it meant that we started asking questions about the why, the when, the how, even before we get to the who.
Exercise a level of appreciative inquiry to understand what is contributing to the error. Is it because we don’t have enough people? Are nurses and doctors overwhelmed? Are patient-provider ratios so high that nurses are not enough time to look after patients? This allows for institutions and organizations to engage in process improvements and quality improvements.
The technology we have can be used as tools to minimize these errors, but people must be able to integrate and realize where the matching point is. How are we going to do this better? How are we going to use technology to foster patient interactions better? How are we going to use digital information to track patients and to make clinical decisions about patients because we now have visibility about what’s going on rather than just looking at one single entity.
Another trend is that some hospitals are now instituting Medical Record Systems which allows clinicians to communicate to each other. With these systems you are not looking at patients in sort of a siloed approach. So, if I am a cardiologist specialist for example, I am only concerned with what is happening in cardiology, cardiovascular diseases etc. Then you have a diabetic specialist who also sees this patient, but if you don’t have access to those notes, you have no idea that what you are prescribing counteracts with what the diabetic specialist is actually saying.
The opportunity there, for hospitals, is to be able to create systems that allow you to have that level of visibility, so you can say, ok, this patient sees a cardiology specialist but also sees oncology because they have comorbidities going on.
The other trend is with application tools that are created to support either patient outcomes or to support patient monitoring. If you are a doctor looking after a patient in critical care at IHK but you happen to be in Gulu, that information can be uploaded securely to the App and you can have visibility of what is happening to this patient in real time. You can then make a critical decision to save this patients life by inputting information into the App and your order is then processed immediately. It’s going to take you 4 hours travel from Gulu to come to Kampala. In the whole of Uganda, as of 2018, we had only 5 critical care specialists. Imagine if you have 11 ICUs in the country how are you going to distribute them?
The other emerging trend in Health Care, as mentioned is Big Data. Once you have that in place you are looking at ten years’ worth of data to try and understand, what are our biggest challenges? What should we be recommending to the Ministry of Health as a health priority area? You have all that data and you can subject them to experiments, interrogations, and to analysis and make sense of these data. A lot of the hospitals mushrooming around the country can capitalize on those opportunities and do a better job in linking health systems together, rather than the health systems remaining so fragmented that there is no way of bringing all those pieces together.
Is linking the health systems the responsibility of Ministry of Health?
The Ministry of Health can lead but it’s better to have an integrated approach that pools resources from the private and public sector. Quite often the Ministry, they are well intentioned, but they will say they don’t have the capacity, or they don’t have the resources.
An integrated approach is therefore much better because it allows you to tap into existing resources within the private sector, then have a more robust approach and plan, rather than coming up with a siloed strategy and then dictating that everybody should adopt that strategy. Majority of the private sector may feel that the strategy doesn’t fit where their business models are going. If you bring the stakeholders together in the same room, they are part of the creation, and then, they are part of the adoption of the strategy.
There is also a huge opportunity to transform curriculum. The curriculum is the main tool that drives delivery of what we teach. Sometimes, it also determines how we teach. Machine Learning for example can be employed as a tool to transform the documents that we develop because we now know better how people learn. We also know that we live in an explosive age when it comes to information. Information that is relevant today is not going to be relevant tomorrow.
The skills and tools that graduates need to have is to understand how to harness the use of this information. How do they get to what they need? What is relevant for today? What is relevant for what they need to achieve? What is relevant for them to compete? We are teaching people, therefore, not necessarily learning information but how to learn that information. We know if they know how to learn the information, if that information changes, they already know how to now learn new information. I think that’s a wonderful opportunity. There are some trends. They may be slow but there is a trend towards that.
What needs to happen then is that a level of skill set within academic institutions that allows them to begin to say: if we are putting together curricula what kind of questions are we asking – where do we start with? Are we starting with the information or are we starting with the product?
At CIU we have adopted the approach of asking: what kind of world are the graduates going to live in? What kind of practice environment? We start there. What do they need to learn? What kind of content do we need to develop for us to be able to produce that kind of graduate? What kind of tools do we need to have to be able to deliver this information effectively? It’s slow going.
We will not change everything in one day or in a month but if there is a recognition that change is important and that it needs to happen now rather than later, then we are on the right path.
Is there a role that the private sector can play to link Academia to industry?
When we designed the MBA and BBA we categorized a percent of our teaching faculty as Professors of Practice not academics. Professors of Practice purely mean that I come to you as an expert in digital transformation. If I am teaching my students about digital transformation and the tools they can use, then I bring you—the expert practitioner into the classroom to teach about that.
We are linking industry not just in the teaching but also before we develop the curriculum. I remember conducting several meetings with about 12 industry representatives when we were building the BBA curricula. We wanted to hear from them: when they hire that graduate what is the expectation and why are universities continuing to produce graduates that are unemployable.
A really innovative design to learning is what we are trying to now experiment with. As long as the National Council of Higher Education allows us to use the Professors of Practice as credible and legitimate instructors of learning, then what that means is that our instruction is rich enough. We are not just talking from theory but we are also bringing those practitioners into the room. It needs the support of the regulatory body though.
If we need to change something we need to have some courage and believe that the technology will work.