A little while ago I posted, venting my frustration at the New Zealand health system. One of my friends at IBM New Zealand saw my post and wondered firstly whether my criticisms were justified and secondly what solutions there are that could solve some of the health system woes. She invited a healthcare specialist from IBM to respond to my post. While the following is unashamedly New Zealand centric, healthcare is something we’ve referred to here on CloudAve a number of times in the past and I though it valid for an international audience. As always we’d be interested in hearing your views on this…
Murray Price is healthcare and life sciences business manager at IBM in New Zealand. The following is his own opinion and should not be taken as IBM company policy.
As much as the New Zealand health system appears to be broken, it is, in fact, still one of the most advanced health systems in the world. Obviously our health system is not perfect, but there aren’t many systems that are any better. There is a general misinformation and lack of understanding in the general public about our health system, including our current international standing and the measures being taken to improve health care.
New Zealand GP’s are some of the most computer literate in the world; over 99% use computers in their practice both to manage patients and to manage their business. The figure in the US is around 30%. This means we can send patient information between clinicians to help improve the treatment process. Our system isn’t perfect, but we are more advanced than most. We deliver better health outcomes for the dollar spent than most countries. We are behind Denmark and literally a handful of others, but ahead of Australia, the UK, and most of Asia, and way ahead of the US. In fact everyone is way ahead of the US despite their leadership in health research.
Our District Health Boards are provided a pool of money to deliver healthcare to their geography within broad guidelines provided by the Ministry. The current bulk funding situation needs to be refined if we are to make improvements to the system, and the health sector needs to make significant changes to reduce costs across the public sector. The initiatives that are underway will make a difference, but they appear to be disjointed.
Our health system can be fixed through a combination of technology, process and governance.
Technology
Technology is easy, it exists today, and it is proven. In fact, advanced technology is being used to improve health systems all over the world, in places like Canada, Denmark, Scotland, Sweden and the US. In Canada, a research hospital is automating the gathering, managing and updating of critical research data and applying analytics to speed childhood cancer research and improve patient care. In Denmark, healthcare providers are using predictive health systems with advanced telemetry to monitor elderly patients in their homes, sharing data instantly. And in the US, a new initiative is enabling individuals and families to store and track their health information and stream data from medical devices.
Technology alone will not solve the problems in our health system; however, one of the essential elements for delivering effective care is developing a fully functioning ‘digital backbone’ to interconnect doctors, hospitals and
patients. A digital backbone will give primary care doctors an essential tool to function in their vital role as the first line of defense against major illness. The ability to exchange information quickly can help reduce medical errors and administrative costs, and improve patient-doctor communication.
The irony today is that we use more advanced technology to listen to music on MP3 players than to keep track of the medical records that save lives. When we need to withdraw cash from our bank accounts, we can use an ATM card anywhere in the world, but when a specialist needs our medical histories, those records are usually tucked away in a paper file in our primary care doctor’s office. Applying technology to our health system provides a clear ROI in lowering costs, and more importantly improving patient safety. And this is achieved when information is unified across a ‘system’ thus allowing the right information, to get to the right person, at the right place, at the right time.
Process
The more difficult question in fixing our health system is process. Do we fit the technology to the process of providing care, or the process to the technology, or redesign the process and the technology together? Delivery of healthcare globally is fundamentally the same with local variations based on population types, density, maturity, and funding. Our processes work for New Zealand and a potential danger is we implement technology that doesn’t fit our process.
There is no ‘one size’ fits all and there is no way we should put up with a ‘one size fits most’ option. But our processes can be improved and we might find technology plays a part in that. We need to keep an open mind and have informed debate to plan the way forward.
Governance
However, the most difficult question facing our health system right now is governance. Who owns the patient record? Who has access to it and for what reason? How do the rights of the individual vs. the clinician vs. the funder vs. the planners inform the overall policy? Again, there is no ‘one size’ fits all and what is ‘right’ overseas may not be right for New Zealand. There is a real danger that the rights of the individual will be decided by others and we need to be very careful this does not happen. It will be almost impossible to get the lid back on Pandora’s Box if we get the governance aspect wrong.
It’s time for healthcare organizations, business and academic institutions to take action toward creating an overall smarter ecosystem for health care delivery. We need a vastly smarter health care system to see improvements in costs, patient outcomes and overall quality of life in New Zealand.
