Wait a minute: digital tools will help us crack the health targets

FEATURE - Industry Innovation Article - Orion Health

Four out of five of the new health targets set by the New Zealand government are focused on reducing wait times for medical support. The focus is on faster access to cancer treatment, to specialist assessments, to emergency department care, and to elective treatments.

We know long wait times can be terrible for patients, and the stakes are high when their lives might depend on them. So, of course, these are highly commendable targets. But will they improve population healthcare alone? New efficiencies in a strained health system are desperately needed.

So what can be done, and where do we start?
In my early General Practice days, I remember a referral I had made for a patient sent back to me by the Orthopaedic surgeon with the comment, “Dr X doesn’t do backs.”

I remember thinking, “OK, fine, but who does backs? And how can I connect that specialist with my patient?”

This story highlights a major problem that still persists in the current system: patients and providers can easily end up lost, bouncing inefficiently around while not coming any closer to fixing the specific patient problem.

Solutions
Fortunately, there is an answer, and it lies in the ability to automate the referral process. This provides traceability, accountability, and, of course, efficiency.

Electronic Referral (eReferral) systems enhance communication between providers and specialists, offer a full services directory so patients are not sent to the wrong specialist, and avoid the common problem of lost referrals. Integration and alignment to clinical workflows and existing health information systems are crucial for success.

When healthcare systems are fully connected and information is not locked into silos, any care team member can access data from any point in a patient's journey.

Importantly, generating and monitoring eReferrals is a much simpler task when they are linked to a comprehensive shared care record.

Shared care records save clinicians time by providing easy access to the patient’s history and also help to ensure they are being referred for the best treatment based on their unique profile.

From my position at Orion Health, I have seen this work effectively in Alberta, Canada for example.

While having the right technology is one part of the equation for improving and speeding up access to healthcare, another is in making changes to fundamental business processes. Again, Alberta is a great case study where significant improvements were recorded due to both technology and process improvements.

The experiences I have seen first hand have shown that roughly 40 percent of referrals do not require the patient’s physical presence in the specialist clinic. Removing those patients from the day-to-day work of the clinic significantly shortens the wait time for those patients for whom the specialist has requested their physical presence.

How did they do it?
Traditionally, healthcare providers make referrals to specialists for consultations. However, often, an advice request (referral for advice) that provides clinicians with specialty advice for a non-urgent question is sufficient to manage the patient correctly. This has a huge potential to save both the specialist’s and patient’s time and allow for faster guidance. And in the case of Alberta, that’s exactly what it delivered.

In New Zealand, we have e-referral systems working in Auckland and the South Island. But imagine what waitlist improvements would be possible if this was expanded nationally.

Not only would we gain direct patient benefits with improved referral handling, we would also know what parts of the country are doing well managing patient waiting lists and what parts are not doing as well as they would like.

In other words, we would understand the situation across the country and be able to adjust (for instance, by offering patients who live where the waiting list is long to other parts of the country where the waiting list is not). This was done successfully in the UK under the guise of a project called “Choose and book”.

Of course, the elephant in the room is that for the technology and processes to function to their maximum potential, they rely on high-quality, real-time data. If the information about a patient is incomplete, disconnected, or incorrect, and if the information about where referrals should or can be made is also lacking, then efficiencies will be limited and better health outcomes constrained.

So, while the solutions seem obvious and simple, they are frustratingly difficult to implement.

It is essential we take the time to get the underlying data and information correct and connected in the first place - and ensure it is updated in real-time to be an ongoing reliable source. Only then can the technology and better processes flourish, and a real impact on improved wait times and health outcomes can follow.

Picture: Chris Hobson, Chief Medical Officer, Orion Health

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

Read more FEATURES

Return to  eHealthNews.nz home page