In these austere times, when the NHS is charged with delivering efficiency challenges of £120 billion, the adoption of an integrated, IT-driven healthcare system is seen as an important move, enabling the introduction of new services, saving time (and money) and providing more efficient operations and better informed decision making.
Dr Nigel Millar (Chief Medical Officer for the Canterbury District Health Board) visits the UK and Germany in March as a Health Ambassador, sharing the New Zealand experience in tackling issues such as developing an integrated healthcare system (and how this has helped in co-ordinating the response of Christchurch's healthcare system following the devastating earthquake in 2011). New Zealand has capitalised on its small, geographically dispersed population to develop and implement new approaches to healthcare delivery using innovative technology. These innovative approaches are widely seen as models for larger countries.
A Whole of System Approach
New Zealand is no stranger to paperless healthcare systems. It was among the first countries in the world to establish an electronic Population Health Index, a comprehensive database containing nearly 20 years of health data. In Christchurch, it has been the development of an electronic, cloud-based patient record system that helped to get local healthcare provision back on its feet so quickly
following the 2011 earthquake.
The Canterbury District Health Board (CDHB) was already some way towards developing its Shared Care Record View (eSCRV) when disaster struck in February 2011. In the immediate aftermath of the earthquake, the CDHB faced a big struggle to get general practice back on track. With many GP surgeries and hospitals damaged and people leaving Christchurch to stay with relatives, eSCRV provided access to essential patient health information at the point of care - wherever that might have been (e.g. A&E, hospitals, community nurses, the GP and pharmacists). Dr Millar doesn't go so far as recommending a natural disaster to test the foundations of an integrated healthcare system, but coping with that emergency was a good test for their innovative healthcare models and systems. "In under 24 hours after the earthquake, our systems had identified the most vulnerable people living at home and assessed them in order of risk", he said.
"We have worked with Christchurch-based global ehealth firm, Orion Health, to establish an online information portal to streamline information flows within facilities, organisations and across regions. As a result we are now able to provide clinicians with widespread access to patient medical records, integrated with their existing IT systems, resulting in improved quality of care and reduced costs. Right now, we are rolling out this system to include community nursing and community pharmacy records too."
Where there's a will, there's a way
Rather than derail their reform plans, the earthquakes actually accelerated the pace of change in Christchurch. According to Dr Millar, "we found that the disaster boosted the use of innovative healthcare models and systems to provide better care to the community. Clinicians, policy makers, researchers and technicians rose to the challenge with the active support and participation of health technology companies. The collaborations have improved clinical practice and other aspects of the health system in novel ways."
Looking ahead
Canterbury's earthquakes brought many challenges, but also provided new opportunities to work with the wider community on aspects that impact on health, such as housing, immunisation and alcohol abuse.
Canterbury Health Board's achievement in the cost effective provision of healthcare is based on many factors, not least a cultural resilience and self reliance stemming from its 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 through collaboration.
About Dr Nigel Millar
Dr Millar has been the Chief Medical Officer at the Canterbury District Health Board for the last
10 years. During this time, he has participated in a transformational change to an integrated and
connected health system. A Geriatrician and Internal Medicine Physician by training - Newcastle UK
- he came to Christchurch in 1992.
Nigel has led from the front in championing the implementation of clinical information systems - most lately a common shared record across the health service. The need for which was highlighted after the 2011 Christchurch earthquake.
Nigel is a member of the National Health IT Board, an advisor to the Health Quality and Safety Commission. He is also the InterRAI Fellow for New Zealand.
Dr Millar has been visiting the UK and Germany during March on a Health Ambassador mission. He presented at the Healthcare Innovation Expo(London) on March 13th and at the Electronic Document Management Conference (London) on March 14th.
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