Industry View: The future is here, so why is it so hard to change?

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Picture: Tony Wai, ProCare CFO and GM corporate services

Guest column by Tony Wai, ProCare

One way the sector can overcome obstacles to change is to partner – rather than compete – with those willing to work together using future-focused guiding principles. 

Delivery day. In the world of Tesla fanboys and girls, this is the name of the day you pick up your new Tesla electric vehicle. Endless clips on YouTube are dedicated to the experience of picking up your new EV for the first time: being in awe of all the controls on just one large screen, auto-pilot, the handling and speed, and of course the knowledge that you have reduced your carbon footprint by no longer needing to pump gas into your car.

Yes, I bought a Tesla. I picked it up this weekend, took it for a spin and loved it! In my short experience of owning an EV, I’m completely hooked. Of course, though, there are sceptics who question whether EVs today are a sensible investment. They warn that the battery won’t last and you might get stuck somewhere if you can't find a charging station and you run out of power. They ask, what if Tesla folds and you can’t get parts, what happens if someone hacks into the system? And so on and on the list of perceived worries and cautions go.

From my limited experience, autopilot really does work, although it’s unnerving. The promise of autonomous driving is near to reality. It’s probably the best car I’ve ever owned and driven and this is despite all the critics and Tesla being one of the most shorted stocks today.

EVs have been around for many years, but it wasn’t until the visionary Elon Musk introduced Tesla to the market that EVs became more mainstream and a real option for travel. Today, the company continues to grow, with demand outstripping supply.

The obstacle to digital services

In our local healthcare system, we have a similar obstacle. A number of the digital services we, as participants, expect to be available for use have not come to market, and we end up being constantly underwhelmed by current offerings. We don’t have enough Elons to pave the way and bring new virtual therapies, PMSs, improved care from use of AI and other systems to market.

Why? Because we have a market size problem. Firstly, the market is too small to develop or bring in systems that can only commercially operate with scale. Secondly, existing providers have not sufficiently enabled standards, good design principles in the architecture of their products and, most importantly, inclusion.

Guiding principles

The UK published a report in October 2018, ‘The future of healthcare: Our vision for digital, data and technology in health and care’, which highlights the issues and solutions. Their vision is “for the use of the best technology available for the health and social care sector”.

The report notes that “to achieve this vision, we have many real challenges to overcome:

• legacy technology and commercial arrangements complex organisational and delivery structures
• a risk-averse culture
• limited resources to invest, and
• a critical need to build and maintain public trust.

At the heart of this vision are four guiding principles we should maintain to make this work:

• user need privacy and security
• interoperability and openness
• inclusion.”

These principles interestingly enough are also somewhat reflected in the Ministry of Health’s new Digital, data, technology services – minimum requirements. This is a great step by our new deputy director-general – data and digital in issuing these, and I'm keen to see how we bring these more to life over time.

What makes it hard to change?

From a public health perspective, there is a view held by some, including myself, that some, but not all, vendors have made it difficult to change, i.e., by not allowing the design of their systems to be interoperable, with underinvestment in APIs, not meeting FIHR standards or by charging unfairly for bespoke integration.

The ‘devil is in the detail’, so to speak – individual contracts and licence agreements for services are kept commercially sensitive and are never able to be discussed or debated. Then there are licences that individual clinicians are agreeing to without proper understanding of the obligations they have signed up to.

We are at a time of incredible systemic change, with issues flagged within the health and disability review interim report quite rightly pointing to a fragmented system with a lack of direction.

I contend that the sector focuses too heavily on risk and failure without the consideration of what the opportunity costs are in not investing in something. The same processes in assessing risk and reward as part of a business case, as well as determining whether there are sufficient capabilities to deliver, should be happening in all organisations – private, public and NGO. If things go badly it needs to be well understood what went wrong to learn from these mistakes.

Partnership not competition

No one has asked the question, why doesn’t the sector feel the need to invest? Are the existing technology solutions too expensive, outmoded or restrictive to deliver for future requirements? I personally would like to see more of these discussions taking place, in order to guide where investment efforts are targeted.

The sector needs to work and partner with those who can and are willing to agree and work with core future guided principles. Why compete when we can partner? We want Elon style entrepreneurs that can partner wherever they may be and we need them now!

Tony Wai is the CFO and GM corporate services for ProCare.

If you want to contact eHealthNews.nz regarding this View, please email the editor Rebecca McBeth.

Read more Views:

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