I’m writing this post from my room at the Westin Lighter Quay in Auckland, New Zealand. The hotel is directly across the street from our Microsoft offices in Auckland. My room is so close to Microsoft that I don’t need to rely on the Westin’s broadband. I can connect directly to our corporate network from the wireless signal emanating from our building.
I serve as Microsoft’s executive health industry sponsor for the region. I’m at the beginning of a full week’s tour in New Zealand and Australia that will take us to 5 different cities in 5 days. This is my 5th trip in as many years. Over the course of the week I’ll be speaking at industry events and meeting with customers, partners, health executives, clinicians and government officials.
World travelers know that you can learn a lot about what is currently going on in a country by engaging local taxi drivers in a conversation. On the way from the airport to my hotel, I got an earful about the current economic climate in New Zealand. The government has been making some big infrastructure investments—new freeways, bridges and such. In part, this is due to the World Rugby Cup that will bring more than 60,000 visitors from around the world to Auckland in September of 2011. According to my taxi driver (who was East Indian but had lived in Auckland for 20 years), New Zealand is suffering from too much immigration. “There are far too many people on the dole”, he said. Making matters worse, the country has lost a large number of manufacturing jobs that have been outsourced to places like China and India. Thus, unemployment is much higher than usual, the government is running large deficits, and taxes are high (sound familiar?). My driver stated that up until 2 years ago, he was making good wages in a manufacturing plant. Then the factory closed when the jobs went to China. In order to stay afloat, he took out a loan and bought a hybrid Toyota (with a government incentive) that he is now driving as a cab.
The economic scenario really isn’t all that different from what we are experiencing in America, or for that matter, around much of the developed world. And just like America, healthcare spending is very high on the government radar. But unlike the US, virtually 100 percent of New Zealand docs are already using electronic medical records . However, that doesn’t mean all those records and the information they hold are connected. So now, the government has set out on an ambitious National Health IT program to connect health information and aggregate it around the citizen/patient. The vision of the program is:
“To achieve high-quality health care and improve patient safety, by 2014 New Zealanders will have a core set of personal health information available electronically to them and their treatment providers regardless of the setting as they access health services.”
Among other things, the program calls for all hospitals to operate on a common platform. The desired outcome: easy access to health information, transfer of health information between health care organisations, capture of clinical event information into a regional clinical data repository, improvement of primary health care practice management systems, consolidation of the systems used in secondary and tertiary settings into regional or national platforms, improvements in the quality of information used for population health, and replacement of systems managing patient, practitioner and organisation identity.
A second and equally important goal is to develop a shared care capability. This covers not only the sharing of core components of the ambulatory patient record, but development of multidisciplinary care plans aided by decision support tools to support the optimal delivery of care. The program will be deemed a success when:
New Zealanders can understand, support and trust how their electronic health information is recorded,managed and accessed and can access a core set of their personal health information to share with their health practitioner(s) And Clinicians, can access the most commonly held health information electronically at the point of care, and can use information systems to enhance the effectiveness of their health care practice.
New Zealanders can understand, support and trust how their electronic health information is recorded,managed and accessed and can access a core set of their personal health information to share with their health practitioner(s)
And Clinicians, can access the most commonly held health information electronically at the point of care, and can use information systems to enhance the effectiveness of their health care practice.
So, my visit should be quite interesting as we explore some of the steps and technologies that will be needed to get from where things are today in New Zealand, to where the country’s National Health IT program calls for things to be within the next 5 years.
On the other hand, maybe I’ll just take a “sabbatical” and steal myself away on this lovely yacht that is docked in the harbor next to my hotel. Oh…. so tempting. And it’s for sale. Any buyers?
Bill Crounse, MD Senior Director, Worldwide Health Microsoft
With saturation of the EMR via PMS systems within NZ this is a good platform to build on connecting Health care providers together to share key patient vital information, build virtual clinical teams, monitor business financial health and research into workforce issues facing the sector. It is not however a platform that is useful to the patient in management of their health information or places it within an environment for them to share in a controlled manner. A common platform needs to be implemented to enable the multitude of health applications and devices to interact with users in an easy, seamless and beneficial way.
Thanks Chris and I completely agree that the citizen/patient needs to be at the center. That was very much a topic of discussion in my meetings with officials in New Zealand. In particular I advocated a model in which health data is aggregated around the patient with the patient in control of the data and who he or she wishes to share that data with - be it clinicians, caregivers, family members or others. It is the only scalable (and affordable) model that I've seen actually working in other countries. Microsoft HealthVault is one such example.
Bill Crounse, MD
HealthVault did come to mind Bill, but seems to be a concept that most people don't seem to be able to grab. If you are ever in Rotorua would be keen to connect. Our organisation has managed to move all of our member practices into a fully hosted infrastructure and we are working on a number of clinical projects using this platform, www.raphs.org.nz