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CiLN: A passion for using technology to transform healthcare

Tuesday, 25 February 2020  
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Picture: Taranaki DHB child psychiatrist Yariv Doron editor Rebecca McBeth


Yariv Doron is a child psychiatrist at Taranaki DHB and clinical lead for the DHB’s Business Intelligence Group. He sits on the NZ Telehealth Leadership Group, manages medical school students studying psychiatry and finds time to do research for the Taranaki Health Foundation. Originally from Israel, he now lives in New Zealand with his wife and three children.


Yariv Doron first encountered the power of telehealth when he was drafted into the navy in Israel and became a medic.


His home country is advanced in terms of health IT – back in 1982 the boat he was stationed on had a full suite of satellite-encrypted telehealth.


“I remember being supervised from someone on the shore hundreds of miles away from me, seeing what I’m doing in high definition, commenting and helping me out,”  he says.


“We had access to full electronic medical records even on a submarine.”


While attending medical school he also worked as a software developer, so using technology continued to be key to his practice.


In June 2012 he moved to New Zealand with his wife and two children and has since added one more to the family.


“Coming to New Zealand was a bit of a shock to be honest because there’s pockets of really good advancement and then there are pockets where they’re still waiting for advancement to happen.”


After a couple of years familiarising himself with the Kiwi health system and improving his English, Doron dived back into the world of IT.


Developing software


Doron recognised a major issue in the region with regards to ADHD, as there were few paediatricians and they carried the burden of diagnosing the condition.


These doctors relied heavily on psychiatrists to do tests, who were also busy dealing with urgent issues such as abuse, depression and eating disorders.


“So I went to IT and said ‘hey, we need a solution for testing ADHD’, and I described my idea and they said, ‘sure, give us two to three years’,” he says. 


“So one thing led to another and I went back to my laptop and developed my own solution and then brought it back to the IT department and they helped me out with implementation.”


Six years ago Taranaki rolled out the software, which tests children for ADHD in just 20 minutes, and has been carrying out research to ensure its safety and efficacy. Doron hopes the solution will be available to all DHBs for free from next year.


Implementing change


The momentum the ADHD project created led to Doron getting involved in the DHB’s Clinical Business Intelligence Unit, which pulls together project managers, developers and clinical expertise to focus on data, identify trends and make the system more efficient.


One of the cases he tackled early on involved Taranaki being an outlier for postpartum haemorrhage. 


Working with a midwife and gynaecologist, the unit used data to show that, while processes were in place and guidelines were being followed, there were small delays at specific points in the process that were having an adverse effect.


Changes were made and within six months the DHB was back in line with the rest of the country.


Doron describes telehealth as the “next big thing" to roll out across the DHB, using child psychiatry as a case study.


Leading by example


Last year, the only other child psychiatrist in the region retired. The DHB has tried but struggled to recruit a replacement, leaving Doron covering 2.2 FTEs.


He was finding it incredibly difficult dealing with such a massive number of clients, so he started a telehealth clinic, offering appointments by Zoom directly to patients or through a dedicated video conference link at Hawera Hospital.


Doron’s day now includes a mix of in-person and virtual appointments, giving patients much greater flexibility over appointment times.


He says studies have shown telehealth can also reduce congestion around hospitals and reduces fuel and travel costs for families and health providers.


Taranaki DHB’s Clinical Information Reference Group is now pursuing the broader implementation of telehealth across other services.


Doron, who chairs the group, says the key issue to address is culture, as it is not easy to change the way people work and his colleagues need convincing.


He believes it is essential that the roll-out be a clinically lead project. When speaking to clinicians, he likens telehealth to “just another tool” they can use to treat patients and choose to use where appropriate.


A vision of the future


Doron’s passion for using technology to transform healthcare is obvious. His dream is to see “every hospital in New Zealand have a chief medical information officer-type role with dedicated budget and CME”.


He cites the untapped power of data and artificial intelligence as well as home monitoring as just some of the exciting things happening in the world of digital health and has plenty of ideas for how to promote innovation.


“No hospital should rely on a single clinician to drive IT,” he says.


“They should offer a ‘greenhouse’ where clinicians can come with an idea and project managers and developers help them to build it.”


Doron worked at hospitals in Israel with similar ‘greenhouses’ and saw the real benefits in innovation and research that they promoted.


Now committed to New Zealand, he loves the openness of Kiwis and their willingness to contribute to common problems and share ideas.


“HiNZ and CiLN are great because people are genuinely trying to make a difference and I’ve found myself learning so much about New Zealand systems and IT,” he says.


If you would like to provide feedback on the above feature article, please contact the editor Rebecca McBeth.


Read more CiLN features:

CiLN Awards: 2019 winner Rebecca (Becky) George

CiLN Awards 2019 finalist Robyn Whittaker

CiLN Award 2019 finalist David Ryan

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