Data and digital staff vital to frontline care

NEWS - eHealthNews.nz editor Rebecca McBeth

Data and digital staff are vital to the health system, both in supporting the frontline of care and improving services, clinical leaders say.

Job cuts have already begun at Health NZ - Te Whatu Ora where commissioner Lester Levy is looking to reverse a reported overspend of $130 million per month.

Levy has promised clinical positions will not be cut and Health Minister Shane Reti has said job cuts at the organisation will not affect the front line.

However, clinical leaders from across the health ecosystem say ‘back office’ staff, such as the data and digital workforce, are essential in maintaining the systems that support day-to-day work on the front line, and enable the flow of data the health system needs to monitor and improve services.

Ashley Bloomfield, former director general of health and professor at Auckland University says:

“A focus first and foremost on the finances... means the executives and those leading the system are spending an undue amount of their time just looking for the next dollar rather than thinking: how do we innovate, how can we be agile? How can we engage our staff in finding solutions to these challenges?

“Where are those staff deployed in the system, and what is it that they need to work effectively? A lot of that actually goes back to so-called back office functions like good data, good information systems, good processes to help them make small changes in service delivery that will really make an impact.”  
(quotes from The Post with approval of Bloomfield)

Ruth Large, emergency doctor and NZ Telehealth Forum chair says:

“By definition 'back office' is non-patient facing administrative work and frontline is reserved for anyone who interacts directly with patients. Unfortunately these terms appear to have become more akin to 'zero' and 'hero' in the post Covid world, the implication being that frontline is more worthy than back office.

“The biggest driver in this argument is fiscal and the unproven assumption that frontline work is the only work that can improve patient outcomes or save money. 

“A healthy health system relies on highly functional teams and the championing of frontline services over back-office feeds into the mistrust of clinicians for managers and vice versa. The result is not an improvement in service delivery, but a closing down of whole of health service improvement discussions. 

“Just as disturbingly are those roles lost in the crossfire, in my experience these have been change management, project management and analyst roles that are vital to improving services and supporting front line.”

Samantha Murton, chair of the Royal NZ College of GPs, says:

“We know that data and digital can be game changer: for example I think having a patient portal is something that should be essential for all patients across the country as it means patients can own their notes. But if we are cutting services, then how do we get a patient portal up and running?” 

“There are multiple areas where data and digital is absolutely essential and needs a lot of work, and if we do not do it, then instead of being a country ahead of the game, we will end up being a country behind the eightball. 

“It would be a shame to look at what the budget is and cut it because of the budget, rather than looking at what the outcome will be and investing because of the outcome.”

Carey Campbell, College of Nurses Aotearoa digital spokesperson, says:

“Healthcare is a team sport and just like our recent Olympic heroes who rely on their ‘behind the scenes’ supporters to be the best they can, nurses and other frontline clinical staff depend heavily on the so called ‘back-office’ staff like those in data and digital roles, so they can focus on what they do best – caring for patients.

“Without the crucial ‘behind the scenes’ tasks that keep things running smoothly, it is more often than not, nurses who find themselves dragged away from their patients to try and sort these things themselves. Not only does this added work take them away from patient care, but also leads to frustration and burnout.”

Becky George - clinical digital health specialist and former HiNZ chair says:

“While we cannot dismiss the logic of reducing workforce costs in a fiscally constrained environment, it begs the question of what will the risk be in doing so?  The staff often labelled as ‘back office’ play a significant role in providing knowledge and skills for the systems in place. 

“These systems, as the workforce emphasises, are vital for enabling their services and providing essential information at the point of care. As more and more systems integrate, the impact of failure exponentially grows. Where the system provides information to the front line it may inform life sustaining decisions or provide timely intervention for preventing deterioration in the community. 

“Health systems will always face financial challenges and competing priorities. The question to answer is, how do we balance the technology efficiencies we are striving for while sustaining and enabling our workforce to deliver their expertise?”

Tony Wai, chief executive of Third Age Health and deputy chair of the Digital Health Association says:

"Our health services are increasingly relying on data and digital technologies to deliver traditional healthcare, such as practitioner consultations and other services, directly to patients. Digital interventions are becoming just as vital on the front line, with mental health apps and patient portals enabling self-directed care and meeting patients' needs more effectively.

“At Third Age Health, where we provide healthcare for older adults in Aged Residential Care homes and general practices across New Zealand, data and digital tools are essential to our frontline services. They enhance operational efficiency, improve patient outcomes, and help us maintain sustainable earnings. 

“However, to fully realise these benefits, our health systems require further investment in digital infrastructure. This will reduce transaction costs and address the challenges posed by a lack of interoperability, which is in essence part of our frontline health capabilities."

Image: Ashley Bloomfield, former director general of health

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