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International acclaim for EBoP integrated community service


12 February 2014

International acclaim for EBoP integrated community service

Made possible by Minister Tony Ryall’s Better Sooner More Convenient initiative, the Te Whiringa Ora/Care Connections (TWO) service has been internationally recognised asan innovative integrated community service that engages clients and connects providers. In addition, an independent value for money study of TWO has found it is capable of delivering substantial savings to the health sector.

The economic analysis by consultancy Synergia suggests TWO represents excellent value for money, including:

• Projected local net savings of $6.8 million over five years for a community of 50,000 people.

• Potential to break-even within the first 12 months.

• Annual savings of $3,416 per patient and $7,966 for clients with a primary diagnosis of Chronic Obstructive Pulmonary Disease (COPD).

Implemented in February 2011 in the Eastern Bay of Plenty, TWO is a partnership between the Bay of Plenty DHB, the Eastern Bay Primary Health Alliance and Healthcare of New Zealand. TWO targets clients with multiple long-term conditions and those who are high users of hospital services, so that they can remain active in their homes and community. It provides a web of support around clients (and their family/whānau) with chronic conditions like heart disease, diabetes and COPD.

TWO was selected as one of seven international case studies (and the only New Zealand example) on integrated care in the community. Released by the Commonwealth Fund and the King’s Fund, the first in a series of papers provides compelling evidence that integrated care for older people with complex needs can be successfully delivered through incremental improvements to a community provider’s existing services.

Points of interest include the following:

TWO was the only programme where telehealth remote monitoring was deployed.

TWO placed the most emphasis on engaging patients and family/whānau to achieve its goals.

TWO is confirmed as a service that incorporates the right principles in order to achieve success - for both clients and the health system.

“The Bay of Plenty District Health Board and Eastern Bay of Plenty Primary Health Alliance need to be commended for supporting such a transformative approach,” says Peter Hausmann, Chief Executive Officer of Healthcare of New Zealand Holdings Limited.

“Not only is it a locally grown and tested innovation, but the international acclaim proves TWO provides an answer to other countries struggling with increased healthcare costs and unmet demand.”

“I’m also particularly excited that in an earlier Synergia study there were examples of general practice saying that TWO cut their workload in half and freed up the primary sector team to do clinical work. It is our vision that this versatile integrated healthcare model is implemented in communities throughout the country to improve quality of life and health outcomes, as well as further integration of primary care and community support within the New Zealand health system,” says Peter. “TWO is easily replicable for all demographics within every community in New Zealand.”


Notes to editor

• Healthcare of New Zealand Holdings Limited is the parent company of Healthcare of New Zealand Limited and Healthcare Rehabilitation Limited, as well as joint ventures Freedom Medical Alarms and Pharmacy 547.

TWO is a service provided by Healthcare of New Zealand.

TWO provides support over an intervention period of three to six months.

• The initial TWO pilot evaluation involved 250 clients, with an age range of 26-98 years old (the average age is 69 years old). The client group was approximately half Māori.

• Previous analysis by Synergia of TWO found the following:

1. All clients (Māori, non-Māori, male, female and all age groups) experienced a clinically significant increase in their SF-12 scores (a quality of life assessment tool).

2. It improves primary care management of chronic and long-term conditions:

o 10% reduction in bed days for clients

o 47% increase in bed days for the control group

o COPD clients: 22% increase in admission free days

o Diabetes clients: 89% increase in admission free days

o ED presentations: 88% increase in days between events (COPD clients)

o Heart disease clients: stabilisation in admissions to hospital.

• The service also demonstrates broader outcomes aligned to the Ministry of Health’s priorities for health improvement, including:

o Statistically significant increases in health, wellbeing and quality of life.

o Improved access to quality health services.

o Delayed deterioration of conditions.

o A reduction in disparities in health outcomes.

o Improved primary care management of long-term conditions.

• Copies of the Commonwealth Fund’s paper can be accessed at

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