The Information Revolution …We Are Only At the Start of the Curve…!

Graeme Osborne, General Manager, Information Management and Technology, Statistics New Zealand, was previously with Southern Cross. He presented his observations after 12 months away from the health sector, highlighting three themes throughout his presentation:
   • The "curve".
   • New Zealanders are great adopters of the world’s latest.
   • New Zealand is a very first world poor country - we do not spend much in health care so we must spend wisely.

The "curve" for health care systems is a standard maturity curve that shows that many of the technology based solutions in health care, such as patient management systems, clinical systems and MRI, are in a growth phase and many, such as biotech systems, are at an even earlier stage of maturity. X-ray was the only example given of a mature technology (refer slide 3).

Osborne drew parallels between these health care system examples and the curve for financial services systems, noting that core systems for financial services such as banking and insurance systems and banking transaction standards are at a much more mature stage on the curve. Those items at the early stage of the curve are natural improvements to what is currently used in banking (refer slide 4).

He concluded that medicine is a young science. The IT solutions to support the practice of medicine are in early generations. Standards are still developing. The "value chains" of how we will treat disease in the future are immature and continue to be developed based on the latest research and technology.

Thus, there is a need for care in the way New Zealand invests in technology.

In relation to information management, Osborne proposed that health care leaders should focus on:

With respect to "getting the basics right", he also noted the need for better measurement of improved value or success in order to know which new methods create lasting benefits (refer slide 8).

Referring to the need for joint/national approaches to major health care systems, Osborne noted that the majority of major health care systems implemented in New Zealand over the last 10 years have been first generation and have been very focused on patient administration, some scheduling, and some clinical support or links to clinical support systems.

The problem is that we use more than five different major international systems, each with major risks, reinforcing the concept of New Zealanders as great adopters of the world’s latest.

Osborne presented a figure showing that each introduction of a new IT system maintains New Zealand in a position of high risk (refer slide 11).

In addition, the different major systems have high downstream costs in terms of integration, standards, support, training, future migration and archiving. He noted that the next generation of health care systems are more specialised, incorporating a lot more expert systems (knowledge bases to support clinicians, drug interaction assessments and detailed patient information or patient medical records and involving integration between primary and secondary sectors). Each more specialised system demands more information from the primary care sector.

Osborne made a plea that the interested parties in the health sector not repeat the same mistakes but agree on one or two systems for all of New Zealand and work together on the implementation, integration and support.

With regard to the need to innovate, Osborne noted that integration across the health system should provide cost effective healthcare outcomes. The problem is in identifying which idea will provide the best benefits and thus there is a need to keep trialling. He proposed that the best approach is to use Internet technologies to prototype and trial new ideas, highlighting that the industry needs to continually try new approaches as this is a young science.

Referring to the need to work together, Osborne noted that there are 22 DHBs in New Zealand, each with populations with different health care needs. However, their health care information needs are not very different. He reiterated that New Zealand is a poor, first-world country. We don’t need to spend money on computer systems but on better health care.

Osborne concluded by reviewing the three themes of the presentation. The "curve" demonstrates that medicine is a young science with complex and dynamic value chains. It is too early in the development of health care to put money into lots of different things. He noted that patient management is not the endpoint; population health risk management is closer to that endpoint although not entirely there. New Zealanders, as great adopters of the world’s latest, must learn to work together and to understand that population differences do not mean information differences. He proposes reducing the overall cost of solutions because there are more to come. Again, because New Zealand is a poor, first-world country, all concerned must work together and innovate. We cannot afford to make large mistakes from an information perspective so he suggests making lots of small mistakes - trust is required to do this and to learn from it.
[View Graeme Osborne’s presentation The Information Revolution …We Are Only At the Start of the Curve…!]