New Zealand, most commonly known for its pristine landscapes and healthy lifestyle, is also leading the way in eHealth as demonstrated at the Global E-Health Forum held in Hamburg on 11-13 October. The National Director of the New Zealand government's Health Board spoke to around 200 delegates from more than 30 countries with other speakers from around the world elaborating on their experiences designing personalised healthcare.
In his presentation to the Forum, New Zealand health system expert Chai Chuah explained how the country has developed health informatics to drive efficiencies: "New Zealand is committed to protecting and improving its health system on a sustainable basis and realises that new approaches are required to increase quality while reining in spending. We are currently focusing on more clinically led innovative models of care; greater involvement of patients and consumers in designing our future health services; and greater integration of investment in IT, workforce and infrastructure," he explained.
With a small, geographically dispersed population and remote locations, New Zealand has strong incentives to develop and implement new approaches to healthcare delivery using innovative health technology.
This focus on innovation has resulted in New Zealand's health sector being recognised internationally as a provider of high quality and cost effective services. For example, a 2009 Commonwealth Fund survey ranks New Zealand first for advanced electronic health information capacity among primary care physicians and second for use of electronic medical records.(1) And, a 2010 Commonwealth Fund study ranks New Zealand first in overall quality of care, coordinated care and patient-centred care.(2) This is despite the fact that the average spend on health per head of population in New Zealand is about 16% less than the UK.
New Zealand enjoys a culture of strong collaboration between scientists, engineers, entrepreneurs and medical professionals. Researchers and product developers work closely with clinicians and the health sector to identify medical needs, areas for improvement and potential technology development.
This approach is exemplified in New Zealand's eHealth patient portal, described by Mr Chuah in his presentation. "The current phase of this project has provided us with the opportunity to design personalised healthcare and make important medical information (such as medication, allergies, etc.) available for individuals and providers," he said. "It is these kinds of initiatives that keep New Zealand at the forefront of eHealth innovation and encourage other countries to look on the country as a test bed for their own future their families, driven and controlled by them."
Because the UK's health system has a similar structure to that of New Zealand, the UK has been able to view the smaller country's experiences as "pilots" before implementing similar changes itself. Technology solutions from world-leading New Zealand e-health company Orion Health helped the NHS Greater Glasgow and Clyde Health Board, the largest health board in the UK, to create a near paperless hospital environment by providing a clinician friendly view of information from multiple information sources. Now a clinical portal is being used across the region to create a shared health record. There are currently 10,000 registered users and more than 140,000 patient results are viewed via the system every week.
Another New Zealand company delivering innovative optimisation technology in Europe is award-winning Optima, a leading operations research company that delivers simulation software solutions for the emergency services, using advanced mathematically based technology. In Denmark, Optima predict helped the government to remodel its ambulance service by determining how many ambulances to use and where to place them to get the same approximate response times throughout the region. Four years later, regional emergency medical services performance data has validated Optima predict performance metrics.
Another example of New Zealand technology applied in the UK is evident at Bedford Hospital and Northampton General Hospital NHS Trusts. Both have made cost savings by implementing CapPlan capacity planning and bed management systems, from New Zealand company Emendo. This improves operational performance by using predictive analysis to accurately match resources with demand for services. Bedford Hospital saved £110k (€127k) over the first four months of implementation, and to date is averaging savings of approximately £600k (€690k) per annum in Inpatient areas alone. At Northampton General Hospital, CapPlan identified potential efficiency savings of approximately £690k (€794k) in its first year of operation.
Atlantis Healthcare is another New Zealand company having an impact in Europe with offices in Germany, Spain and the UK. The company designs and implements patient support adherence programmes improving patient outcomes and saving health expenditure. Atlantis Healthcare has deployed over 70 of these programmes across 43 disease states. With a new office now open in Frankfurt the company is implementing a significant programme that supports caregivers of Alzheimer's patients.
New Zealand's achievement in cost effective provision of healthcare is based on many factors, not least its cultural resilience and self reliance stemming from the country's geographical isolation. However, it is clear that innovative and prudent investment in technology has played a significant role, driven by a local IT industry that has sought to pioneer new approaches and drive innovation in collaboration with local health provider organisations.
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About Chai Chuah
Chai Chuah is National Director of the National Health Board Business Unit of the New Zealand Ministry of Health.
The NHB Business Unit is central to the new model for planning and funding of health services and changes that will have an emphasis on:
Before joining the Ministry, Chai was Chief Executive of Hutt Valley District Health Board - a position he held since 2002.
1. C. Schoen, R. Osborn, D. Squires, J. Peugh, and S. Applebaum, Perspectives on Care, Costs and Experiences: A Survey of Primary Care Physicians in 11 Countries, 2009
2. K.Davis, C.Schoen and K.Stremikis, Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally 2010 Update, The Commonwealth Fund, June 2010.