Round-up of ITx 2018

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eHealthNews editor Rebecca McBeth

The HiNZ strand of the ITx conference was held in Wellington on 12 July and covered a range of topics from value-based healthcare, to interoperability standards, emerging technologies and design-led thinking.

A private perspective

While the healthcare system purports to be consumer-centric, “we are still incredibly provider-centric”, Mercy Radiology chief operating officer Lloyd McCann told ITx conference attendees.

He said that health providers need to start embracing technology, or new entrants such as Babylon Health, Amazon and Apple “will come in and give the consumer what they want”.

McCann said that while there are good reasons in healthcare to be risk averse, the industry needs to develop some appetite for risk and try different things. Some will potentially go wrong, but lessons can be learned, and everyone moves forward, he added.

McCann also talked about the move towards a value- or outcomes-based approach to delivering care and how this can be enabled through the use of digital health.

He gave an example from MercyAscot where a team of clinicians have been brought together to shorten the patient pathway for people who present to their GP with a neck lump.

He says that by enabling clinicians to work in an integrated team, the patient pathway has been reduced from 8–12 weeks down to one 45-minute appointment, saving both time and cost for patients and the system.

More than 900 patients have been seen by the new service and half are discharged after the first appointment, saving the patients weeks of potential worry, he says.

Other ways his organisation is embracing technology include plans to move to a fully cloud-hosted PAS/EMR system and the use of analytics to improve things like theatre utilisation.

“Private healthcare has a role to play in the digital transformation, we are all part of the same sector and we need to be working in much closer cooperation and sharing learnings from each other’s data and information,” he said.

Hot and cool standards for digital health

HL7 New Zealand chair Peter Jordan spoke at ITx about the need for modern standards to enable digital health and specifically the introduction of HL7 Fast Healthcare Interoperability Resources (FHIR) and Systematized Nomenclature of Medicine – Clinical Terms (SNOMED CT).

He said the goal for healthcare is “semantic interoperability”, which is the ability to exchange data with no loss of meaning.

While HL7 FHIR make it easier to exchange information, “we don’t want to make it easier to pass poor quality data around, so we need things like SNOMED CT,” he said.

This is a comprehensive clinical ontology for use in digital healthcare and relies of clinicians inputting data at the point of care. New Zealand has an edition of SNOMED CT that includes some Māori terms, Jordan told the audience.

He said that good data will drive a lot of changes, including supporting clinicians in their decision making.

Making innovation go faster

Ministry of Health group manager emerging health technologies Jon Herries told the conference his team is working on a number of projects including e-therapies in the mental health space, machine learning, procurement of emerging health technology and intellectual property issues.

He is also looking to develop an ‘incucelerator’ – a cross between an incubator and accelerator – in Wellington where there is a gap in this space and many key agencies are based, such as MoH, ACC, Ministry of Business, Innovation and Employment and Callaghan Innovation.

“People want to do some stuff and are coming to me with ideas and thoughts and we’re likely to be doing something in this space in the next few months,” he said.

“Continuing to do the same things we have always done will not get us to the place we need to be.”

Design-led thinking in mHealth

IBM New Zealand public sector leader, global business services Lori Hand told ITx attendees that mobile health applications can have a huge impact on people living with chronic disease or ageing at home, but they have to be well designed to become an integral part of their lives.

“Designing a mobile health experience is really not about managing a disease, if you think about it like that it misses the point. It should be about developing something that creates an ongoing connection with a human being,” she said.

“We need to develop tools that help them feel valued when they do well and support them when they fail.”

Key to design-led thinking is the need to make something people can use and keep it simple.

“So much artificial intelligence and machine learning can happen behind the scenes of what we are doing, but when you present it to the user it needs to be the simplest thing they have ever seen.”

Hand said the use of AI in consumer applications helps them to become “hyper personalised” and therefore more valued.

The design process for mHealth tools should always start by talking to users in order to define the problem.

“We put user needs lower on the list than technical requirements, but we need to flip that if we want to create a mobile app that people will continue to use,” she said.

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