CIO Interview: Introducing Te Awa

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Picture: Steve Miller

CIO Interview by Steve Miller, chief digital officer MidCentral DHB & Central PHO

In the first of our new series of columns from health CIOs, Steve Miller introduces MidCentral’s new district-wide Digital Strategy, Te Awa. 

The MidCentral District has a vibrant, diverse and growing population of about 170,000 people, covering a geographic area that stretches from the western coast of the Manawatū, Horowhenua and Ōtaki districts to the Tararua district on the eastern coast of the North Island.

MidCentral DHB’s business strategy defines a transformational approach to implementing an Integrated Service Model, known as Te Wao nui a Tāne.

Te Wao nui a Tāne is a healthcare system designed to create stronger connections and care pathways between primary, specialist, community and hospital care in MidCentral’s communities.

To ensure patients and whānau experience healthcare journeys that are as simple and seamless as possible, seven clusters, responsible for integrating planning and delivering services, have been established.

These clusters are acute and elective specialist services; cancer screening, treatment and support; healthy women, children and youth; hauora Māori; healthy ageing and rehabilitation; mental health and addictions; and primary, public and community health.

Key to enabling Te Wao nui a Tāne’s implementation is the consideration of the use of digital capabilities and technologies to further improve the ability for clusters to meet the needs of the people and whānau across the district.

With support from the MidCentral Board, Manawhenua Hauora, Central PHO and the Clinical and Consumer Councils, the development of a district-wide Digital Strategy was commissioned, with my role as chief digital officer for the DHB and PHO being to guide the process to ensure it aligned with the DHB’s strategy of Quality Living, Healthy Lives and Well Communities. 

Co-design from partners

The Digital Strategy, branded to Te Awa, required co-design from all system partners in order to get the appropriate level of buy-in. 

This meant we needed to consult and get as many people involved in the development process as possible.

There are already excellent examples of interagency collaboration in the MidCentral district. For example, Kainga Whānau Ora is an alliance that exists between the DHB, PHO, Palmerston North City Council, Ministry of Education, Police, Corrections and a number of other agencies to address the needs of a cohort of 100 families resident in Palmerston North’s Housing New Zealand properties.

We organised a Regional Hui in Palmerston North and held forums in every locality, such as Horowhenua, Ōtaki, Tararua and Manawatu district, with an open invitation for anyone to attend.

We also extended the invite to our providers and inter-sectoral partners to get them involved, and gave people the opportunity to engage and give feedback online while also holding various meetings with stakeholders.

Through the consultation process, we also sought to define a digital response to the key areas identified through the Locality Planning process, which involved engagement with all localities in the MidCentral region to assess their health needs.

Common themes

Four common themes emerged from this process, which were the need for improved access to healthcare, the need for improved mental health and addiction support, better communication and connection and a desire for well communities where people are supported to have quality living and healthy, active lives.

These themes reinforced the need for MidCentral DHB and its partners in primary and community care to have a more integrated service response to better support the needs of our communities.

The engagement in the strategy consultation was fantastic and, in total, more than 300 people across the district took part in Te Awa’s development. Given the complex nature of this topic, there was a need to take people on a journey around what is digital health, why do we need a digital strategy, where are we today and what the digital future may hold?

We looked around globally and locally at what people are doing in this space and straw-manned the strategy around some draft content and frameworks to test the thinking. We also used the Ministry of Health consumer forum outputs as there was an extensive process nationally as part of the National EHR programme.

The next step was to look at where the District is today in terms of its digital maturity. Subsequently, MidCentral has been chosen by the Ministry of Health to pilot three HiMSS Analytics assessments from March next year. This will help us focus on where to target efficiencies and get a better workforce response, as we further evolve the Digital Strategy.

Overarching vision

Te Awa has an overarching vision, with guiding principles and objectives, and we are taking a portfolio approach to strategic investment.

Rather than having a project-by-project business case approach, we are aiming for a multi-year funding model to allow a more agile approach to execution and better management of the risks inherent in technology projects.

Fundamental to how we are going to give life to Te Awa is our focus on co-design with people and whānau. We want to think big, but start small and rapidly scale. The test for every project as it moves forward will be whether it improves patient experience or workforce satisfaction. And if it’s not delivering value, we will adapt and re-orientate accordingly.

Industry partnerships

Key to the success of Te Awa will be also developing really effective industry partnerships. That’s where the research and development capability is and the where the innovation comes from.

Te Awa has three horizons over five years and a work programme for the first one is being developed, with a range of initiatives underway. Three examples of current initiatives are:

• an enterprise scheduling application which is integrated to the MidCentral Patient Administration System for automating the booking, scheduling and coordination of healthcare resource. This will improve the care experience through appropriately empowering consumers and clinicians with greater online visibility and access to the transfer of care process
• digital Hospital Operations Centre, Patient Flow and Bed Management solution which enables electronic bed requests and a dashboard that provides real-time information about hospital occupancy and demand
• the roll-out of a next generation patient management software system for General Practice.

The final version of Te Awa will be available by the end of the year.

Steve Miller is the chief digital officer for MidCentral DHB & Central PHO.