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HiNZ presentations cover interesting array of topics

HiNZ presentations cover interesting array of topics

Date: 23 November 2018

Digital transformation

Healthcare Holdings head of digital health Lloyd McCann told HiNZ 2018 attendees that the single biggest driver for change in the health systems is patients, who are becoming more powerful because of their access to information via the Internet.

“We have been a provider-centric system for decades, we have been talking about patient centric care for decades, but we haven’t transformed at all in my opinion,” he said.

McCann said value-based care is about ensuring that healthcare is improving the outcomes for patients and flipping from asking “what’s the matter with you?” to “what matters to you?”.

He gave examples of transforming the patient experience of Mercy Radiology’s head and neck lump clinic by reducing what was a three to four month process down to a 45 minute appointment.

Pharmacogenetic testing

Pharmacogenetics involves drug doses being tailored to a person’s genetic make-up as everybody processes drugs differently.

Andrew Winnington, managing director Precision Medicine International told HiNZ attendees that the US FDA now recommends genetic testing before prescribing at least 200 medications.

He said medications taken as prescribed kill more people than diabetes and non-Caucasian people are more likely to be adversely affected.

In New Zealand, 28 percent of hospital patients experience one or more medication-related harm. Maori have been shown to be poor metabolisers of many drugs and fast metabolisers of others.

This means many people are “on medications that aren’t working or are doing more harm than good,” he said.

Winnington argued that pharmacogenetic testing can have a significant impact on medication harm and a lead to a reduction in adverse events and healthcare costs.

Death Documents

The Death Documents service has got off to a lively start according to Glyn Wilson and Anne Goodwin from the Ministry of Health. The system digitises what was previously a paper process involving duplicate carbon copy forms and was first delivered as a minimum viable product in March of this year.

Feedback from users informed the next iteration, which allowed funeral directors to access the online system so GPs no longer had to print off the digital forms.

For the past three months the Ministry has been working on APIs to ensure the person using the system has the required qualifications, and to connect to the National Health Index to pre-populate demographic information.

More than 1500 death certificates have now been completed online.

NMDHB's PAS implementation

Nelson Marlborough District Health Board chief executive Peter Bramley gave an interesting update on the implementation of the South Island Patient Information and Care System at the DHB in May this year. The new patient administration system replaced a legacy system that was originally implemented around the time of the fall of the Berlin Wall!

More than 700,000 pieces of patient event information had to be migrated, and super users delivered more than 200 hours of training on the new system before a big bang go-live across the entire organisation.

“It was a huge risk and it went phenomenally well which is testament to team work, partnership, dedication and preparation,” said Bramley.

The system will ultimately be used by all five DHBs across the South Island. Bramley said the South Island Alliance of DHBs working together on IT has not always been an easy journey, but there is a fundamental commitment to finding solutions together.

Clinician burn-out

Canterbury District Health Board clinical IT lead Saxon Connor said technology, if deployed well, can help with clinician burnout, which is “as high as it’s ever been”, and the suicide rate among healthcare professionals, which is also increasing.

International research has shown that the second most common concern among clinical staff is the implementation of electronic medical record systems, which can be hugely stressful and make clinicians’ jobs harder. More than half of EMR roll-outs do not show any return on investment.

“We need to be sure that as we transform we are not alienating and decimating our workforce,” Connor said.

ADHB does e-prescribing

Auckland District Health Board’s Chris Lodge spoke about the implementation of e-prescribing at four re-enablement wards (older person’s care) over 2016 and 2017 and said the implementation has shown both measurable and non-measurable benefits.

However, he warned that it is important to clearly define what is going to be measured pre- and post-pilot and ensure the new processes are embedded before trying to measure outcomes.

“We designed reports before we fully understood the system and what we actually needed, so the post measures required a lot of manual work, but it was still much quicker than paper,” he told the audience.


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