My View - A health system I want to grow old in

VIEW - Brad Porter, CEO, Orion Health

I have found myself increasingly involved in the debate about whether New Zealand’s health system can innovate fast enough to outrun the pressure it is under. Some people have suggested that is driven by self-interest and they are probably right.

By the time New Zealand’s older population reaches its peak, I will be part of it. I am self-interested because I want to grow old in a country where illness is picked up earlier, a clinician can draw on the full picture of my health, and AI can spot patterns a human might miss while giving health professionals more time with patients.

Most of all, I want us to use AI to move healthcare beyond treating people once they become sick and towards keeping them well for longer.

That future is possible. AI is developing quickly and some of it is already being used in healthcare, but New Zealand is not ready to make full use of it. AI needs information that is connected, trusted and available when decisions are made. 

Much of our health information still sits across thousands of applications that do not work well together. Clinicians search for records, repeat processes and piece together patient histories while people navigate disconnected portals, websites, phone lines and services. 

Putting advanced AI into that environment will not repair the fragmentation, it risks carrying the same gaps and inconsistencies into a new generation of technology. We need to get the fundamentals right first.

An ageing country needs a smarter system 
Around 17 per cent of New Zealanders are aged 65 or older. Over the coming decades, that is expected to rise to somewhere between a quarter and a third of the population.

In 2020, there were around 24 people aged 65 and over for every 100 working-age New Zealanders. By 2040, that figure is expected to reach between 33 and 41. 

More of us will live with several conditions at once and need care for longer. We will move between GPs, hospitals, pharmacies, specialists, community providers and aged-care services. Alongside this a proportionately smaller workforce will be available to provide and fund healthcare. 

We cannot meet that challenge by asking already stretched people to work harder, but nor can we keep adding disconnected services and expect them to form a coherent whole.

Make the basics work 
A clinician should be able to see the essential information needed to care for the person in front of them. People should not have to repeat their history each time they enter a different part of the health system.

That information must also appear within the tools clinicians already use. If accessing it requires another portal or password, we have created more work for people who already have too much of it.

Patients need a clearer way into the system too: booking an appointment, checking a result, or working out where to seek help should not require navigating multiple websites, apps and phone numbers. A national digital front door could give people one clear place to begin, while retaining in-person for those who need them.

Underneath this sits less visible but essential work: secure infrastructure, common standards and systems that can exchange information safely.

None of this is especially futuristic, but it is the groundwork that makes the future possible.

I am not going to stop   
When I said I was self-interested, I am sure the fact I lead Orion Health flashed across your mind, so I should say, yes, Orion’s capability can form part the solution if that is the path the country takes. 

But before we can talk about what software to use, I see our role being much more about making sure that the right people know positive change is possible. I see firsthand examples around the world of healthcare systems innovating faster than us in way that reduces ED visits, increases health outcomes and reduces costs.

I worry that too many people think it is impossible to create the healthcare system we all want in New Zealand, so I am going to keep banging on that it is possible. 

The hardest hurdles we have in front of us are not about vendors, they are about leadership, standards, governance, trust and whether successive governments will stay the course.

We released our election manifesto because those of us working in health technology should be solutions-focused, rather than just critical of what is happening now. 

Orion Health is prepared to commit time, people and expertise, and to work alongside clinicians, government, health organisations, researchers, patient groups and other technology providers to help deliver the healthcare system we need. 

The next government must create the conditions for that collective effort to succeed. New Zealand needs a clear national direction, shared standards, systems required to interoperate and accountability for delivery. The work must continue beyond one budget and one election term. 

When I reach my 60s, I do not want to be discussing what AI is doing for healthcare overseas and what it could do here someday, I want it to be the bedrock of the health system I’m happily growing old in.

If you want to contact eHealthNews.nz regarding this View, please email the editor Rebecca McBeth.

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