CIO Interview: Looking back and moving forward

eHealthNews.nz: Covid-19

Monday, 25 January 2021

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VIEW - Lloyd McCann, head of digital health, Healthcare Holdings Ltd

2020 was a memorable year – for good and bad reasons! Our approach to digital and digital health has evolved because of the lessons we learnt last year.

Across the Healthcare Holdings System, we had already embarked on a significant digital evolution – the arrival of Covid-19 had impacts across many of our programmes.

Two of our larger entities in the Healthcare Holdings Ltd portfolio are MercyAscot Hospitals and Mercy Radiology. In 2020, we were able to execute and deliver on many digital programmes that enhanced care, experience and outcomes for our consumers and our team members.

A portfolio approach
At any one time, we have a range of digital health and digital initiatives happening across our organisations. We have become much more deliberate about this approach in recent months. We have found that this allows us to continually build and embed a culture of change across the organisation. There is of course a need to manage tempo with teams, but again, the portfolio approach allows us to spread work across different areas of our organisations.

Some achievements
One of the good things about Covid, as many across the health system experienced, was that we were able to accelerate work in many areas, because we simply had to have digital solutions and channels in place to continue to work.

Using our portfolio approach meant we could push ahead in work that had an impact on our consumers, our staff and our partners.

For our patients, we made significant advances in enabling online bookings for scans / radiological interventions and accessing their own images and reports online through a patient portal. We’ve refined these engagement platforms over the course of the year and we are now getting 350 online bookings and around 250 views of images and reports through the patient portal every week.

We have also established a referrer portal enabling clinicians and their administrative teams to book patients, track the status of patients through our system (e.g. scan booked, scan completed, report pending) and view images and reports through our relevant systems. This self-service approach has received positive feedback as it has enabled more streamlined processes for our partners.

For our own teams, we have expanded our robotic workforce. Our two robotic workers, Matilda and Rob-E are now completing financial processes, HR processes (onboarding), booking processes and we are also looking to use optical character recognition to enable our robotic workforce to ‘read’ referrals. This has freed up time for our human teams to focus on consumer value-add activities.

We have also deployed two AI algorithms that are operating in a second read capacity for our radiologists. The two use-cases are in lung nodules on CT scans and limb fractures on X-ray. The algorithms have improved the quality of our reporting and there has been positive engagement from our clinicians as well. The workflow is not perfect, but at the moment, it is adding value for our human teams.

In perhaps one of our most ambitious initiatives, we went live utilising a remote go-live model for our new PAS. This was a difficult decision to make, however the risk of skills and knowledge fade and the window of decreased activity Covid19 created meant we pushed on with a remotely supported go-live. The go-live was successful and we have bedded the TrakCare PAS in well over the last few months. In addition, the EMR component of the project has also been moving forward with a significant change in a reliance on remote / virtual meetings and processes to drive progress. We are still on track to deliver an integrated PAS/EMR (hosted) with our partners InterSystems and Umbrellar).

Partnerships are important
Our progress despite Covid was significant and the value for our teams and consumers was significant too. We would not have been able to deliver on these initiatives without the support and agility of our partners including (not an exhaustive list!): Aceso, InterSystems, Virtual Blue, Umbrellar and others.

2020 has also changed the way we view our vendor partners and we have put effort into transitioning to building deep strategic relationships with our partners, rather than continuing to operate at a transactional level.

In this space as well, it’s important to call out the work we have done with ACC, Southern Cross Insurance and NIB as funder partners to drive value-based healthcare forward in New Zealand. Much of this work is enabled by digital platforms and processes.

Bionic is the way forward
Combining the best of digital and the best of human is the approach that has led to the successes we have had. Trust has always been critical in healthcare service delivery and the circumstances we worked in over 2020 provided a ‘crucible’ for our teams which necessitated a high-trust environment. This extended to our partners as well. As previously mentioned, our view of embedding change readiness into our workforce has also been an important paradigm shift in terms of our human factors component, as the traditional ‘change management’ approaches and processes were not adequate given the challenges we faced.

Our opportunity
There is more challenge and change on the horizon for our health system. Digital health will no doubt have a critical role to play in driving the pandemic response, improved health outcomes and equity agendas forward across our system.