As the Government begins to roll out its plans for the biggest change to the New Zealand health system since 2001, Greg Thomas says the digital side of Health NZ has the potential to make, or break, the new crown entity.
In July 2022 the Government will press the ignition switch on Health NZ and power up the biggest change to the New Zealand health system since 2001, when the soon-to-disappear DHBs were established.
If the change is to deliver the hoped-for improvement, providing a people-centric, equitable, accessible, and cohesive health and disability system, then information technology and digital transformation will have to underpin the changes.
The underlying principle of making data more readily accessible to both patients and health care professionals needs to be of top priority. This means adopting new systems and ways of working and making it easier for CIOs to access funding.
So how prepared are we? And what should be the priorities?
The new service has lofty goals, and IT has rightly been identified as a critical enabler, but what has yet to be determined are the roles that data, technology and digital solutions will play1.
We know New Zealand doesn’t need 20 different ways of delivering health services, but that doesn’t mean we need to invest in new bespoke systems: bespoke processes and IT systems have largely outlived their usefulness in this respect.
Instead, our health service needs help to standardise IT systems to support easy integration and sharing of information into the future, adopting commodity IT services where it makes sense and using ‘community IT’ services where it doesn’t.
The goal should be to improve access to accurate data in a timely manner in a form that is easily consumed and updated.
Our medical staff should be able to spend their time resolving patients’ health issues, not transposing charts and notes, and patients should be able to access this information equally and freely, with appropriate support and guidance about its interpretation. In 2021, anything less is not acceptable.
And it will help if we approach this not as an enterprise technology project, but as a massive people and process change exercise, focused on equity and underpinned by some technology which, while complex, has interoperability and accessibility at its core.
Making information available and accessible
The Ministry of Health has said that the model for the transformation of New Zealand’s health system prioritises equitable, individual, differentiated and people-driven healthcare.
What’s not clear is the how.
Serious thought needs to be given to how we can enable the health profession to improve its engagement with their customers.
It’s not about just giving nurses and doctors tablets, it’s about making sure the tools, and the data health professionals need to effectively do their job, are readily accessible in a form that can easily be used and managed by them.
Using the wrong tools actually inhibits hospitals from providing effective healthcare services: they are too slow, too cumbersome to use, require more input, or simply do not provide relevant or current data needed for making appropriate decisions.
We can see what the future could be by looking at banking, another heavily regulated industry. Any teller in any branch of your bank (realistically, any call centre operator) has access to every interaction the bank has ever had with you – they know your financial status with them, your contact details, which of their financial packages you have, your transaction history and correspondence with them.
Imagine if the flows of information in the health system were as frictionless as those in banking. Then all your interactions with any doctor, nurse, hospital, or pharmacy would be readily available to all authorised users when, and where, they were needed.
This would represent a huge opportunity to improve the quality of diagnoses and treatment plans, while also saving time.
Thus, one of the fundamental promises underpinning the creation of a unified New Zealand Health Service needs to be better sharing of data across the health system.
It’s important to note that this, in and of itself, will not give the nation a health information system that’s fit for purpose unless it is accompanied by actions that support and effectively address the privacy concerns that accompany such a vast repository of centralised information, and a cultural change that places, at its centre, the person whose information is being discussed and who, today, has limited effective access to that information.
And most importantly, organisational change management is about considering the perspectives of all impacted stakeholders and creating a plan to help them transition to the new way of working and operating.
How to achieve success
To enable the health system to better adopt an agile way of implementing innovative solutions, consider the following approaches, all are based on familiar models:
• Prioritise enabling technologies: The government needs to treat health IT in the same way as it treats Three Waters infrastructure and major roading reforms: as a fundamental enabler.
Given the choice between new clinical tools and a new IT system; hospitals and health professionals will always opt for the clinical tools.
But IT is a fundamental enabler of all clinical activity, so to have it compete for funds with other priorities, all of which have immediate life-saving potential, undermines the long-term health of the health system itself.
• Identify shovel-ready IT projects: Establish a Health CIO group, with a committed budget allocated to modernising the IT infrastructure necessary to support a modern health service. The development and implementation of these systems should be treated as a ‘shovel ready’ digital project with a committed investment stream to support the realisation of this outcome.
• Invest in organisational change management: Health professionals need to be brought along the journey: things do need to change, but they need the time and appropriate support to adapt to the new systems.
This means making a significant investment in organisational change management, coupled with direct on-the-floor support for the period of the roll-out.
It also requires providing smarter and more intelligent interfaces to the applications the health staff use, along with improved, streamlined processes.
This is a once in a generation opportunity. Health NZ requires a bold, brave approach and a commitment to building a foundation which allows IT to positively contribute to a secure, efficient, and quality healthcare system for all New Zealanders for generations to come.
Greg Thomas is a solution executive at Unisys New Zealand and has worked across many different industries and sectors over the past 20 years within the Asia Pacific region. He has designed transformational solutions for application, datacentre, cloud, and end user computing services.
