New Zealand has overcome many of the barriers to developing a truly integrated healthcare service by strategically viewing health care as a continuum, from patient to the care provider and community, and employing a range of new approaches and electronic health technologies.
The White Paper "Better Information for Better Care - New Zealand's Approach to Efficient and Affordable Care", commissioned by New Zealand Trade and Enterprise, invites European health sector professionals to explore how New Zealand has combined policy, system design and information technology to transform its healthcare system.
Malcolm Pollock, Director of the National Institute for Health Innovation and author of the White Paper, commented: "New Zealand's size has enabled a highly responsive approach to the development of sustainable healthcare systems. The country has pioneered advances in many areas of healthcare, ranging from medical devices and bio-pharmaceutical products to cost-saving IT solutions."
New Zealand's focus on innovation has resulted in its health sector being recognised internationally as a provider of high quality and cost effective services, as can be gauged by these independent rankings:
- New Zealand is ranked 1st in overall quality care delivery, including 1st in coordinated care and patient centred care delivery
- 1st in practices routinely sending patients reminders for preventive or follow-up care (97% - same as the UK)
- Highest ratio of using a computerised system for patient reminders for follow-up care (92%) rather than manual procedures (76% in UK)
- 1st in practices with advanced electronic health information capacity (92%), followed by UK (89%)
- New Zealand, together with Norway displays the highest physician satisfaction rate (over 75%) with practicing medicine
- 2nd in doctors' use of electronic patient medical records (97%), following the Netherlands (99%).
At the same time, the per capita cost of healthcare in New Zealand is less than in many other developed countries. According to the OECD, in 2009 New Zealand per capita health expenditure was US$2,983 versus US$4,348 in Denmark, US$4,218 in Germany, US$3,978 in France, US$3,487 in the United Kingdom and US$7,960 in the United States.
New Zealand has achieved these advances through far-sighted strategies, the leadership provided by the National Health IT Board, by the long term investment over more than 20 years in health IT, and the country’s single tier of governance.
"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," said Chai Chuah, National Director of the National Health Board, the New Zealand Ministry of Health. "New Zealand is committed to improving its health system on a sustainable basis and realises that new approaches are required to increase quality cost effectively. We are currently focusing on more clinically-led innovative models of care; wider involvement of patients and consumers in designing our future health services and greater integration of investment in IT, workforce and infrastructure."
New Zealand was among the first countries in the world to establish an electronic Population Health Index, a secure system that features nearly 20 years of health encounters and is now supplemented by a Health Practitioner Index. Beyond informing public policy decisions, these indices have enabled development of rich data sets.
Significant eHealth initiatives underway in New Zealand at present include opening online access between hospitals and primary care for emergency care, the roll out of nationwide eReferrals and eDischarges, early work in transferring records between GPs, and eMedication in hospitals and primary care.
This approach is exemplified in New Zealand's eHealth patient portal, described by Mr Chuah: "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 could be of interest to European countries who share the same challenges as New Zealand. The phase focuses on capturing broader information from patients and their families, information that is driven and controlled by them."
Many of New Zealand's world-class health technology companies operate in Europe, providing sophisticated healthcare solutions. The White Paper suggests that European deployment of New Zealand approaches to health IT can help streamline procedures, generate higher efficiencies and cost savings.
Dr Stephan H Schug, MD MPH, Chief Medical Officer, EHTEL (European Health Telematics Association), said: "Delivery models of European healthcare and welfare must fundamentally change to better support the needs of persons with chronic conditions. New strategies and processes are needed. The recent White Paper "Better Information for Better Care - New Zealand's Approach to Efficient and Affordable Care" provides an impressive example how clinical IT systems can support integrated care across primary, secondary and community settings and enable shared care across the continuum of care. New Zealand thus becomes an interesting laboratory where European healthcare systems may find significant inspiration for necessary changes."
Jeremy Nettle, Chair, Intellect Healthcare Council said: "Intellect Healthcare UK congratulates the New Zealand Government in its Healthcare initiatives enabling Clinicians, policy makers, researchers and technicians to deliver the challenges of a modern healthcare with the active support and participation of New Zealand's local yet internationally recognised, health technology companies." This success said Jeremy "has been demonstrated through Case studies that illustrate how IT contributes to the quality of New Zealand's clinical care now recognised as among the best in the world. The White Paper also summarises, for comparative purposes, the IT strategies and progress in a number of European countries."
New Zealand Trade and Enterprise (NZTE) is New Zealand's economic development and trade promotion agency. Our role is to help New Zealand businesses build strategic alliances and develop commercial relationships internationally. Through our global network of 45 offices, we connect New Zealand businesses with opportunities around the world, sharing knowledge, experience and networks.
New Zealand creates world leading innovations and solutions for key markets, backed by science and technology, and NZTE works to promote these throughout the world. We help investors identify New Zealand-based opportunities and gain access to government and private sector contacts. We connect international buyers and investors to industries in which New Zealand has a long-term sustainable advantage and to businesses with high-growth potential. These connections are, for example, in value-added food and beverages; knowledge-intensive manufacturing and services (such as marine, aviation, health IT); and with businesses demonstrating high-growth potential.
NZTE focuses on international opportunities that match New Zealand's business capability and provide significant, sustained economic benefit to New Zealand. For more information please visit www.newzealand.com/business
About Malcolm Pollock
Malcolm Pollock is Director of the National Institute for Health Innovation (NIHI), New Zealand’s research and educational centre focused on health informatics and applied technology and part of Auckland University. He was co-founder, and is currently a Board member, of Health Informatics New Zealand (HINZ), the leading health informatics organisation in New Zealand. He is also Interim Chair of the New Zealand Telehealth Forum and past Chair of the New Zealand Health IT Cluster. Malcolm is a spokesperson for New Zealand Trade and Enterprise on New Zealand health technologies.
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. Mirror, Mirror on the wall: how the performance of the U.S. healthcare system compares internationally, 2010 update, The Commonwealth Fund, retrieved from: http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2010/Jun/Mirror-Mirror-Update.aspx?page=all
2. 2009 International health policy survey of primary care physicians in eleven countries, the Commonwealth Fund, retrieved from: http://www.commonwealthfund.org/~/media/Files/Publications/In%20the%20Literature/2009/Nov/PDF_Schoen_2009_Commonwealth_Fund_11country_intl_survey_chartpack_white_bkgd_PF.pdf
3. Electronic medical record adoption in New Zealand primary care physician offices, August 2010, The Commonwealth Fund, retrieved from:http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2010/Aug/1434_Protti_electronic_med_record_adoption_New_Zealand_intl_brief.pdf
4. See Footnote 3
5. See Footnote 3
6. OECD Health Data 2010, Country notes and press release – Canada, retrieved from: http://www.oecd.org/dataoecd/46/33/38979719.pdf