Exploring by Topic: health IT

New Zealand has been given Number 1 ranking in the level of cross-sector health information exchange by The Commonwealth Fund in its 2012 survey of eleven countries.  Previous Commonwealth Fund studies have given New Zealand high rankings in various surveys but this is the first one that has focused directly on the level of Health Information Exchange (HIE).

It is interesting to note that countries such as the US, Canada and even Australia are still well behind New Zealand in terms of HIE.  Twenty years of concerted effort has placed us narrowly ahead of Sweden, The Netherlands and Switzerland.  You can access the charts from The Commonwealth Fund’s 2012 survey here.

What this survey did not reveal is the extent of information exchange taking place.  Not only can New Zealand’s practices exchange information with a few other parties (as now happens in most other countries), they can exchange information with almost anyone they choose.  Currently the average New Zealand general practice exchanges information with over 70 other parties in any given month (see graph below).

Most of this communication uses the messaging systems that HealthLink has now had in place for many years but increasingly practices are beginning to use online referrals, eLab and similar online services which have now been installed in approximately 50% of New Zealand’s general practices over the past two years.

If you would like to know more about what HealthLink is doing with its new range of online services or about ways in which electronic messaging can be utilised to streamline healthcare delivery, please feel free to contact me.

The New Zealand health sector has one of the highest levels of clinical messaging in the world – by my estimation we are second behind Denmark.  Clinical messaging has a wide range of uses, predominantly it is used for the exchange of pathology and radiology reports, specialist letters, discharge summaries and to send information to and from a range of databases.

Growth in Electronic Clinical Messaging in the New Zealand and Australian Health Sectors

As you can see from the graph above, clinical messaging is growing steadily each year in both New Zealand and Australia.  Approximately 70 million messages are sent annually between more than 9,000 healthcare organisations, spread across both countries.  Key to this growth is the realisation by clinicians that electronic communication is a simple, reliable, low cost way to replace paper with a far more efficient communications medium.

The Average General Practice Exchanges Information Electronically with More than 50 Other Healthcare Organisations Each Month

Today the average New Zealand general practice exchanges information electronically with more than 50 other healthcare provider organisations every month.  This means that the amount of paper being sent from one practice to another has reduced markedly.  The growth in electronic communications combined with better and better electronic medical records is having a very beneficial effect on the New Zealand health system, which is acknowledged as being one of the world’s most efficient.

If you would like to know more about what HealthLink is doing with its new range of online services or about ways in which electronic messaging can be utilised to streamline healthcare delivery, please don’t hesitate to contact me. 

A recent article on the Computerworld website has caused quite a stir. Randal Jackson interviewed me to find out more about my open letter to the health sector which was addressed to Dr Murray Horn and Mr Graeme Osborne and copied to the Minister for Health, the Hon Tony Ryall. Click here to read the article.

I wrote the letter in response to the controversial decision over the eReferrals tender for the Nelson-Marlborough DHB, in which the contract was awarded to the worst scoring and most expensive vendor. In the article I propose that instead of funding and running specific projects, the MOH use the same funding to apply incentives to stimulate innovation amongst competing providers. Such an approach is working around the world. I also advocate interoperability standards rather than proprietary solutions. How much use will it be if the Nelson and Wellington eReferral systems cannot communicate with each other? Currently they won’t.

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Photo by Simon Clark/FarmerClark.com

It certainly seems a long time since I was a young Telecom exec,  setting up HealthLink as a specialised Telecom service!  We are now doing rather a lot of healthcare sector integration, delivering over 65 million items of clinical information per year, across New Zealand, Australia and now Canada.  With our recent expansion into Canada and growing demand in Australasia, the future looks bright.  But our key focus is still on service quality rather than service expansion.

You can read more about HealthLink’s origin and history in this week’s NZ Herald article, as well as learn about our three newest services, CareConnect eReferrals, CareInsight and eLab.

If you are interested in learning more about healthcare IT, consider attending HINZ 2011, 23-25 November.  With leading speakers from around the world, this year’s conference looks certain to be as interesting and useful as its predecessors.

• Come and hear about the US’ “Meaningful Use” – from David Blumenthal, the man who designed the strategy
• Learn about the Australian Personally Controlled Electronic Health Record (PCEHR) – due to go live in July 2012 – from Andrew Howard, the man in charge of it
• Study Sweden’s plans to integrate its health and social services information with Professor Sabine Koch, the woman who is driving the initiative.

Every year the HINZ conference is where the health IT industry gathers to discuss the latest advances and to discuss and debate the direction of this very important field of endeavour.

Make sure you also drop by the HealthLink stand and enter our competition to win an iPad 2!

You can find further details and register at the HINZ conference and exhibition 2011 page.

There have been a number of brave efforts to establish ways to use information technology within healthcare.  In 1998 the British government committed to spend six billion pounds to develop a national programme for healthcare information technology. In 2010 the US Government’s ‘Meaningful Use Programme’ allocated an even larger sum of money for the implementation of information technology within the US health sector.

What is behind these decisions is an urgent need to reduce the cost of healthcare delivery.  All around the world countries are finding the cost of delivering healthcare to aging populations is enormous and they (we) are scrambling to find solutions to this problem.  Use of information technology is seen as one way in which healthcare costs can be lowered.

A 2005 report produced by the highly influential US based RAND Corporation entitled, “Can HIT Lower Costs and Improve Quality?” , said the following:

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