Health NZ Urged To Adopt New Telehealth Model To Alleviate Workforce Crisis

There are calls for the government to adopt a newly proposed, cloud-based, national telehealth programme to help offset the currrent health workforce crisis, reduce burnout and eliminate decades-long inequities in patient care.

Called PASE – the Patient Anywhere Specialist Everywhere project – the system is a centralised telehealth model of care with a nationwide rostering system for specialist doctors, GPs, nurses and health workers, delivering timely care to patients no matter where they live.

The brainchild of the New Zealand Telehealth Forum (NZTF), a White Paper outlining the PASE model of care has been presented to MPs and leading health officials from both Health NZ (Te Whatu Ora) and the Maori Health Authority (Te Aka Whai Ora) in the past few weeks.

The concept relies on a national employer, national booking system and shared health record - a cloud-based, multispecialty health service provider, not reliant on bricks and mortar.

“PASE could help solve elements of the chronic health workforce shortage in Aotearoa New Zealand,” says NZTF Chair and Rural Hospital and ED specialist Dr Ruth Large. “Now that we have a new, centralised health system with Health NZ and the Māori Health Authority, national solutions to nationwide problems such as the PASE model of care can make a real difference to the lives of health professionals, patients and their whānau.”

Dr Large says PASE would be cost-effective to set up, train staff to use and then ultimately run, providing a “win-win’ for both health professionals and patients.

“It would immediately reduce patient travel time and expense by providing care straight to the patient’s home or local healthcare facility no matter where they live. It would reduce inequities of access, reduce waiting times for diagnosis, decrease the risk of misdiagnosis and also meet cultural and disability needs, allowing whānau to be able to speak with a specialist and in-person clinician at the same time.

“Health professionals would receive better collegial, clinical support, especially those working in rural and provincial centres, with PASE providing twenty-four-seven access to a full network of health specialities, helping better manage and coordinate care for patients. While not a panacea for all specialist workforce shortages, PASE would enable more spread of existing services, supporting clinicians to access professional development, continue to work where they live and enable colleagues to work at the top of their scope with specialist support,” says Dr Large.

The PASE model is similar to systems used in other OECD health systems overseas – for the management of hypertentsion, stroke, adult and paediatric emergencies, hospice care, chronic conditions such as asthma, arthritis and congestive heart failure.

New Zealand Telehealth Leadership Group member Andrew Panckhurst says pilot telehealth projects carried out across Aotearoa New Zealand have shown the IT technology and know-how already exist to roll PASE out successfully.

“The PASE model would be an excellent fit for Aotearoa New Zealand, being and relatively simple to set up, train clinicians to use and implement, supporting not just gaps in medical care, but mental health care, palliative and cancer care, even speech therapy and optometry as well.

“We now have the prospect of a further potential health crisis looming in the form of Long Covid, which requires multiple pathological processes and specialty treatment. A PASE system would allow patients anywhere and everywhere to receive the required levels of multi-disciplinary specialist care they need,” says Panckhurst.

The NZTF says a business case is now needed to determine the exact costs and IT infrastructure required to get a PASE system up and running here.

“Its vital that both Health NZ and the Māori Health Authority take a full systems view when considering a a national telehealth care model in order to avoid potential inequities. The true strength of PASE will be seen in a whole of system, whānau, patient implementation approach.”

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