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SmartHealth, opportunity not threat: Nigel Murray

Waikato DHB Chief Executive Dr Nigel Murray

By Comment for nzDoctor.co.nz
Friday 16 December 2016

Waikato DHB chief executive Nigel Murray asked for the opportunity to explain what his DHB is doing with virtual health services Healthcare globally, and more recently in New Zealand, is being transformed.

New models of care enabled by technology are disrupting the custom and practice of the past, just as many other industries – airlines, banks, taxis, travel services and retail shopping have been disrupted through online platforms providing greatly enhanced quality, access and service choice.

Healthcare lags way behind these customer-focused industries, and we simply have to place greater value on our patients’ needs and expectations. These technologies have the power to fundamentally change the way we work in hospitals, primary care, and in the community and NGO services.

The most exciting aspect of these new frontiers is the democratisation of healthcare, where the people of our communities have the power of health information at their fingertips and can make informed decisions with their health professionals.

Monopoly on knowledge disappearing

It’s a time like never before, where the monopoly on medical and health knowledge is beginning to move from the health professionals to patients and their communities.

For example, in general practice and hospital outpatients we have much to modernise.

Once, the only choice for patients was to take many hours out of their day to sit in a busy waiting area, being exposed to airborne infections from fellow patients.

Now they can consult with a doctor over their smartphone, tablet or home computer from the comfort of their home.

Kiwis already sourcing healthcare online overseas

These changes have arrived and we must respond as our patients have already embraced the modernisation as evidenced by many Kiwis sourcing healthcare overseas using online platforms.

For example, HealthTap can see the location of its users and around 400,000 Kiwis have accessed the American version of the app.

Health leaders must embrace and stimulate the transformation and shape it to our needs in New Zealand.

At the Waikato DHB we have started that journey with the introduction of our SmartHealth service, an app-based platform that provides a range of services for patients and health professionals.

These changes that shake up the status quo can be challenging and at times frustrating. Like all industry transformations they are open to misinformation and misinterpretation. This is a natural part of change.

But this doesn’t mean we should stop modernising our health system to better suit the needs of our patients and our workforce.

Misinformation about SmartHealth

And there’s a fair bit of misinformation and misinterpretation out there right now about Waikato DHB’s new SmartHealth initiative. Put simply, SmartHealth gives patients an opportunity to have their hospital consultant outpatient appointments at home and gives them DHB and doctor-approved health information online.

It also lets them talk to an online doctor on evenings and weekends for free, before making a decision to drive to an in person out-of-hours service, for example, an A&M clinic or hospital emergency department.

Many of our GPs are now also considering offering “virtual services” to their registered patients using SmartHealth, where usual practice charges will apply.

Healthcare professionals including GPs who sign up to SmartHealth can also create clinical networks with their primary and secondary colleagues enabling a closer connection through chat messaging.

Some of these quick and easy conversations will reduce unnecessary referrals to our hospitals.

Breaking down barriers to access

Many of our patients tell us transport and financial issues are barriers to accessing care. This is particularly felt by our rural and Maori populations.

If people don’t access healthcare because it is hard to afford or it’s not available when and where they want it, they are at risk of waiting until they becoming seriously unwell before accessing care.

Unsurprisingly, our board think that’s unacceptable.

SmartHealth is not a GP practice management system – but it does need to talk to all the PMS systems in our district. That’s why we’ve made SmartHealth interoperable with other systems so that we have a shared health record that is created around the patient.

We already have nearly 4000 patients signed up to SmartHealth, powered by the HealthTap app, and 1000 Waikato-based doctors, nurses and allied health professionals registered on the system, who are busy creating New Zealand content for our health information.

GPs should not see SmartHealth as a threat – but as a great opportunity to not only modernise the service they offer their registered patients but also to create clinical networks, access specialists for advice, and carry our peer review or CME.

Not a silver bullet

Virtual health services are never going to be a silver bullet for every clinical scenario. Patients who need to be physically examined and who need special tests and investigations will need to see someone in person.

SmartHealth is less about which technology platforms we choose to use, but more about how we use these platforms to change how we deliver services.

Innovative solutions are the only way we are all going to meet the huge healthcare demands of the future.

But more importantly our patients are demanding we do things differently. We must empower our people to live healthy lives and make sure everyone has access to our services no matter who they are or where they live

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