Speech to the Data Health AssociationHealth
It’s a pleasure to join you here at Parliament this evening for the Digital Health Association’s 20th anniversary. Congratulations, and thank you for two decades of work.
Digital innovation is central to unlocking the full potential of our reformed health system, and I welcome this opportunity to be with you today.
While there is no doubt our health system faces many challenges, this is also an exciting time to be in the health sector in Aotearoa New Zealand.
It might be a time of challenge, but it is also a time of great opportunity.
The COVID-19 pandemic has highlighted the power and potential of digital technologies for our health system and has provided the impetus for innovation.
Now we must use the momentum built up over the past two years to make our health system fairer and more effective.
The influence of pandemic
In the 21st century, people should be able to access health information, support and services close to home – even in their own homes. Our changes to the health system will let this happen.
The COVID-19 pandemic was a catalyst for a significant shift in the way data and digital capability is used to support the health of New Zealanders.
The health sector needed to move quickly to deliver critical – and often long-distance - new services.
Digital technology was the answer, taking enormous pressure off the sector and making sure people who needed help got it, even when we were in lockdowns.
Health professionals started offering services remotely – through telehealth, which can include anything from a conversation on a phone to using video images to make an initial diagnosis or a second opinion.
And the practice of e-prescribing grew enormously, from 415 GP practices in March 2020 to 1038 by March this year.
The number of eScripts issued over that time went from 624,300 to more than one-and-a-half million (1,559.427).
This virtual care developed for the pandemic gives us a foundation for the future, and I – and, I am sure, most people using health services – expect digital services to continue to be available.
To get better, in fact, giving people more ways to get safe, high-quality and convenient health care.
Technology also gives us the opportunity to make our health system fairer, something we are now legally required to do under the Pae Ora Act which brought the changes to the health system into effect.
Expanding digital prescribing
As I said, one of the positive consequences of the pandemic was many more GPs moving to e-prescriptions.
This is a good system, in which a prescriber such as a GP generates a prescription and sends it through a secure channel to the New Zealand ePrescription Service, an electronic health information exchange broker operated by the Ministry of Health.
From here, it can be securely downloaded at a community pharmacy.
The impetus for shifting to e-prescribing came from the need to limit personal contact to stop the spread of COVID-19.
But there are other advantages too. E-prescriptions are more convenient for GPs, pharmacists and patients, and better for record-keeping. It’s also faster and more secure than using hard-copy prescriptions.
That’s why today, I am pleased to announce we are expanding New Zealand’s e-prescription service to include controlled-drug medicines, and making other changes to make electronic prescribing easier.
No longer will prescriptions for controlled drugs have to be in a hard copy, with a physical signature.
We will - finally - be able to say goodbye to fax machines.
And for chronic conditions like ADHD, prescribers will also be able to increase the period of time covered by a single prescription when they prescribe electronically, reducing the number of times patients need to visit a GP for repeat prescriptions.
Clearly, this will benefit rural and low-income people especially, for whom the cost or inconvenience - including travel – involved in visiting a doctor is often a real barrier to getting the medicines that can make their lives better.
Other benefits of electronic prescriptions include reduced costs for GP practices, increased flexibility, fewer delays, and, importantly, reducing the chance of error.
More detail about these changes will be released shortly, and I expect them to be in place by the end of the year.
Reforms and reconnecting
Health technologies are changing all the time. We need to think about how we can use them to work smarter to help all New Zealanders get the healthcare they need.
That’s what our reforms of the health system are all about and digital technology is central to these reforms.
In Timaru a couple of weeks ago I saw a really good example of the way in which cutting-edge technology is helping patients.
Patients there are part of a Te Whatu Ora – Health New Zealand trial of BioStickers, a wearable device that lets clinicians remotely monitor important things like heart rates.
It’s based on Bluetooth technology working through a smart phone. The data goes back to the hospital clinical team, and will also be picked up by any family member who has the app and has been granted permissions by the patient.
Medical-grade data, such as skin temperature, heart and respiratory rates, body position, activity level and gait analysis, is gathered.
The data is monitored by the clinical team at the South Canterbury Hub at the hospital, and anything that is outside pre-determined parameters generates an alert notification for a nurse to contact the patient to assess whether anything needs to be done.
If an in-person visit is warranted, this can be arranged with a nurse at the Hub, or if the patient is some distance away, with another suitable health professional nearby.
That means patients who might otherwise be in hospital can be at home, safe in the knowledge their health is being monitored.
It’s early days yet, but the patients I spoke to - and the medical professionals caring for them – are enthusiastic about the devices’ potential.
This is the type of technology that can really get to the heart of modern healthcare – caring for people, as much as possible, where they live.
Obviously, it’s of great benefit to the patients who don’t have to be in hospital longer than necessary, but it also frees up precious health resources so we can ensure access for more people.
Another example is the trial of a new chest pain testing pathway I saw in Christchurch last week.
Thanks to a new digital device, results from a blood sample taken from patients with suspected cardiac events can be evaluated in minutes instead of hours, and the results directly recorded into the patients’ electronic notes.
Because of this technology, many patients can go home instead of being kept in hospital for observation, saving Christchurch Hospital 5000 hours of ED time and half a million dollars a year.
From November, it will be introduced for all patients presenting with chest pain and discussions are under way to see how the technology can be rolled out across the country.
And that’s a good thing, because healthcare is enormously expensive.
It’s a fifth of all Government spending, and with a growing and ageing population to look after, we have to make sure the resources we put into it go as far as possible.
This does mean some change is needed. We need the infrastructure and the people to use it if we are going to transform our health services.
Under the system today we have, for the first time, a national organisation, Te Whatu Ora – Health New Zealand, that is responsible for national, regional and local digital and data systems.
It is patently ridiculous that the records of a person from one part of the country are not available to the health professionals treating them when they are in another part of the country, but that’s the system we inherited.
Mechanisms such as stronger adoption of standards will be established to ensure coherence at the system level, and we will modernise and simplify our digital environment - replacing old technology and consolidating systems to remove unnecessary duplication or variation.
This isn’t just talk. In Budget 2022 we provided significant investment - $320 million over four years, building on the $385 million provided in Budget 2021 to increase data and digital capability.
Key elements of the investment are:
- Improving data and system intelligence for decision making at all levels of the transformed health system through better use of data and analytics.
- Supporting the development of innovative and equity-focussed digital care, including making sure the nine prototype localities have the technology they need. (Locality networks are the way in which communities, including iwi, can have a say on what health services are provided for them and how they are provided. The prototypes were announced in April, and one of the things they are working on is the mechanisms used to join-up care through provider networks.
- Fixing the historic under-investment in the sector to reduce the current risks to system resilience caused by out-of-support and end-of-life systems and technology infrastructure.
- Using investments such as Hira – the programme to join up data across the health sector into a national information platform - to give better access to information, improve equity and give consumers and their families the ability to better manage their own health and wellbeing.
Some of our key investments from Budget 2022 include:
- Data and digital infrastructure for the new Dunedin hospital.
- Data and digital foundations and innovation, aligned to the broader draft New Zealand Health Plan Te Pae Tata.
- Population health and disease management digital capability so we can make sure we retain and use the infrastructure developed for the COVID-19 pandemic response – especially for building a basis for future population health and disease management.
- The National Public Health Service data and digital platform – a common platform to support the delivery of core Public Health Unit functions across a single national service.
We can’t do this alone – and we don’t want to. You’ve told us that we need to change the way we engage with the digital health sector, and we agree.
Te Whatu Ora – Health New Zealand will work with the sector. Where it makes sense, it will move from transactional to strategic relationships.
We want to foster a thriving digital health sector based on consistently applied commercial principles
All commercial engagements will have a common thread: demonstrable value for health consumers.
We are always interested in technology that will help deliver better health and wellbeing for all New Zealanders: Our Hira programme will support a vibrant market for health technology providers, while giving consumers better access to their own health information.
We will be looking for partners who want to work with us to find innovative ways of dealing with existing challenges, as well as future opportunities.
We will know we have been successful when we can point to a thriving New Zealand digital health sector supplying seamless end-to-end services.
This is a once-in-a-generation opportunity to build a transformational, truly national health system that improves the wellbeing of all New Zealanders. No matter who they are, or where they live.
We’ve made significant progress in the past few years, and demonstrated the power, and desire, to create health services underpinned by innovative technology.
Change will not be without challenge, but I know we have the momentum and we have capable people like yourselves.
I look forward to working with the Digital Health Association and our wider supplier community to change the way we deliver care, value, and health to New Zealanders