HINZ Year in Review Webinar

eHealthNews.nz: National Systems & Strategy

Tuesday, 22 February 2022

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FEATURE - Industry Innovation Article - Alcidion

Our Panellists
On Wednesday 8 December 2021, a number of digital health leaders in NZ and Australia came together for the HiNZ ”2021 Year in Review – Lesson in Digital Transformation” Webinar. Sponsored by Alcidion, the panel touched on the events of the past year and the outlook for digital healthcare in New Zealand. Given the impact, there was discussion about the change to the gameplan imposed by COVID for many organisations, bringing to the forefront a number of challenges in 2021.

The panellists were:

Gabe Rijpma, CEO, Aceso Health
Kate Quirke, Group Managing Director, Alcidion
Kate Reid, Director of Digital Health, Consulting, Deloitte | Current NZHIT Chair and Board Director
Kathryn Cook, Te Tumu Whakarae (Chief Executive), Midcentral DHB
Michael Dreyer, GM of National Digital Services, Ministry of Health
Saxon Connor, HBP Surgeon & e-clinical health lead, Canterbury DHB
Stuart Bloomfield, CIO, Waitematā DHB & Counties Manukau Health
Rebecca McBeth, HiNZ News Editor (Webcast Facilitator)

OBSERVATIONS ON THE SECTOR
What are your key observations over the past year?
Stuart Bloomfield CIO at Waitematā DHB & Counties Manukau Health stressed the “importance of clear communication”.

He commented on the huge amount of change commenting, “COVID is the cause and the answer to all of our digital problems. We needed to build or tweak a lot of systems to respond to COVID”. Another silver lining is that COVID has broken down a lot of silos of data sharing”.

Stuart’s role as CIO involves him in digital implementations and he believes it is not often the technical aspects that cause issues, “In these digital implementations, my role is minimum while it’s going well. My main role is sorting out blockages/barriers to progress and when I get involved, occasionally the problem is technical but more often the problem is communication”.

To improve communication, Stuart offers a couple of tips to exclude people who don’t understand:

Less jargon – it limits understanding from outsiders and foreign speakers. COVID has expanded the amount of people using these systems and receiving these communications
Video Conference Meetings – they make it more difficult to read people as there are no verbal cues
Speed of change – Communication has to be close to right the first time. Be clear and concise. plain simple language improves efficiency

Stuart issued a challenge to us all to pause before we hit send on our next email, reread to confirm it is clear and concise and able to be understood by the recipients.

General Manager of National Digital Services at the Ministry of Health, Michael Dreyer contributed to the discussions on digital transformations at a national level. Business led design and the opportunity to iterate on cloud platforms. He noted, “COVID has meant we have had to bring along the rapid delivery of national services’ and given us an opportunity to quickly provide solutions and put them in the hands of the people”. Michael commented that the pandemic has given us an opportunity to get out in the field to glean the basic requirements for process and data which meant rapid turnaround to get solutions in the hands of the end users. With regular feedback and collaborations, you get to systems, processes and services that hit the mark and result in huge buy in from the recipients.

Michael agreed with Stuart that people ‘need regular feedback and communication’ and are key to the success of these solutions as ultimately, we are “building systems – designed by the people, for the people in a modern world with modern techniques and technologies”.

Kate Quirke, Group Managing Director of Alcidion focussed on her observations of how her team has worked across all jurisdictions. One of her major highlights was to see the uptake of virtual care or remote patient monitoring or hospital in the home and telehealth – multiple descriptions for the same model of care. There has been rapid uptake including use of devices by patients in their home and the integration of that data back to their clinician. Kate said, “this has been evident across the spectrum which was rapid and exciting; while it started with COVID it is now expanding to other cohorts, for example, diverticulitis, diabetes, etc". She noted that the pandemic helped to expedite the implementation and adoption which should have long term benefits.

Saxon Connor, Canterbury DHB, HBP Surgeon and e-clinical health lead agrees noting that we should never waste a crisis. He commented that we need to provide people with the tools to optimise the change and embed in clinical workflows. In devolving the locus of control he commented, “Give them the tools and they will come up with the solution”. Saxon commented that relationships are everything and trust takes time in healthcare. The healthcare Industry is ‘under a lot of strain with COVID from frontline to back end – how do we create a sustainable health system? COVID has meant that decision making speeds up’ but we ‘need to go back and fix our systems to increase efficiency and productivity”.

Kate Reid, Director of Digital Health, Consulting, Deloitte and Current NZHIT Chair and Board Director, noted the sense of personal ownership that had emerged. It is a significant and exciting step change in the last twelve months. It is core to the future where consumers are more proactive and take the lead in their healthcare.

CEO at Aceso Health, Gabe Rijpma, sees COVID as ‘kind of a blessing in disguise because it has forced healthcare to think differently around how to do things at scale’. There has been significant change but not always the time to consume and address change appropriately.

ON PROCUREMENT AND INNOVATION
“We’re a small country with pockets of innovation – how do we scale that?”
The conversation quickly turned to how innovation in the New Zealand digital health space is encouraging different ways to tackle health crisis’ but it has not been without it challenges.

Kate Quirke observed how exciting this is for the industry but “How do we harness all of this incredible innovation? There are a lot of providers out there addressing interoperability, access and equity. With so many devices on the market, consistency of guidelines is required without stifling the innovation we have seen. We need to look at different ways of doing things. Take innovation and make it available”.

Gabe is excited by the changes innovation can bring to the healthcare system in New Zealand but has experienced that it is often met with barriers and the excuse that ‘things have always been done this way’. “We’re still procuring software like we do roads. Change that and I think we’ll find a model that’s both fair to taxpayers and the vendors”.

“Our system has never been short on strategies and plans but it’s has sometimes been short on execution” Kathryn Cook, Te Tumu Whakarae (Chief Executive) at Midcentral DHB believes our ‘Business as Usual approach is overwhelming’. The “stickability” of innovation is not always there and the potential is not always realised.

Saxon highlighted that vary rarely is there a budget allocation for an optimisation phase after a program launch – making sure that the technology is working as intended and that stakeholders are gaining the benefit that was intended.

NZ REFORMS (NEW SYSTEM) AND OUR PEOPLE
“This is a workforce that needs to be valued”
Kathryn continued with the importance of involving our patient and clinicians in any changes that we make to the healthcare system in NZ, “People are experts in their own lives…and want to partner with clinicians and have a health system that enables them to do that. We want to make sure that DHBs along with primary care, or shared services agencies and other community-based systems can move into this new system with as little disruption as possible”.

Gabe believes that these reforms are ‘our time to heal’ and offers the chance to “build new models of care that make a difference. This is a ‘once in a lifetime opportunity to really lean in and start making a difference. Not just for digital but our people which ultimately we need to keep hold of as that’s where a lot of the understanding of how the systems we have today work”.

The conversation then shifted to areas that need considerable focus. Stuart s hared his opinion on Interoperability being ‘an area we need significant improvement. Some of the platforms have been set up are going to give us a gateway to progressing that much quicker”. With Kate Quirke believing that “New platforms need to focus on unlocking data”.
Rebecca McBeth, moderator of this session then asked a question that many in the industry have been concerned with - How do we keep good people?

Kathryn thinks “We need to create an environment where there’s hope for the future. That they feel there is something worth staying in the system for. What I’d like to see is our people and consumers having a stronger voice in the design of the new systems”.

Kate Reid believes we need to consider ‘meaningful co-design’, “When we’re designing systems that make people’s jobs harder than we’re adding to the bureaucratic red tape and making their job a lot more difficult and we need to be better than that. That will only happen if we’re collaborating across our systems and our data is being safely shared to enable the workflow to be easier for the workforce”.

Gabe and Stuart reiterated a high priority of the healthcare system in New Zealand at present – the importance of staff already in the healthcare system. Stuart believes “People is the biggest issue that we’ve got. Keeping people in NZ is a priority”. Gabe agrees “Keep your people. We’ll need them as we move to the new system”.

With the dominance of COVID and the introduction of the NZ health reforms, this session recognises that our clinicians and healthcare teams are at risk of serious burnout and could leave the system if we don’t look at ways to improve the environment and find ways to involve clinicians in the design of new systems. Inviting healthcare workers to test, co-design and discuss digital solutions to improve healthcare can foster an innovative environment and create a system that values the health and wellbeing of its workers and not just its patients.

IN SUMMARY . . .
The group were optimistic about the digital health potential and momentum that had been established with some words of caution around scaling, equity, access and workforce challenges. They look forward to applying the lessons learned during the past year to the opportunities that arise in the coming year. They appreciated that there was a more collaborative approach that had developed promoting the sharing of ideas, data and innovation – all boding well for a positive future.