by Divina Paredes

New Zealand’s first virtual health service goes live

May 13, 2016
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‘Today most people expect to be able to do their banking and shopping online, using smart phones and tablets, and people are already using Google to look for health information. Patients want services delivered in different ways, and we want to treat them like customers and provide them with services that are convenient and health information they can trust.’

“Over 60 per cent of people in our district live in rural locations and all too often patients are travelling long distances for a short consultation,” says Waikato District Health Board CEO Dr Nigel Murray. “Offering patients the option of a virtual visit via video or text will help to give everyone access to our services no matter who they are or where they live.”

Murray says this was the driver behind the DHB’s launch this week of a virtual health service.

“We want to put patients in control of their healthcare and give them a greater say in their own care, how it’s organised and when and where it’s delivered,” adds Murray.

Offering patients the option of a virtual visit via video or text will help to give everyone access to our services no matter who they are or where they live.Dr Nigel Murray, Waikato DHB

The service lets patients talk to their hospital doctor over their smartphone from home rather than having to travel to an appointment.

The Virtual DHB, powered by HealthTap, also has a wealth of health information available on an app, all approved by doctors. It means people can check out symptoms, conditions and treatments and get health information on their smart phone, tablet or desktop computer.

The DHB is signing up doctors from all its services across its five hospital sites, and is talking to GPs and other community organisations about opportunities this service can offer their patients too.

The Virtual DHB supports thegovernment’s recently launched NZ Health Strategy with its themes of people-powered healthcare, care delivered closer to home and using emerging technologies to deliver better results and revolutionise the way we work.

“We already have clinicians from dermatology on board, cardiology and renal are next and we will working with all our other services to implement this initiative where appropriate, this year,” says Murray. “If your doctor is registered on the system and they deem it appropriate for your particular treatment, it means you can choose to have a video conference call or text chat with the doctor via the app from your home or work rather than travelling to hospital.”

Patients will also be able to use the app to book an appointment with their specialist, share a medical photo with them, send a direct message to their doctor like a text, and view their health record on the app. A multidisciplinary team of professionals who are caring for the patient will all have access to the shared care plan and can discuss the patient’s care with each other.

Patients can access health information, tips and the latest research to help them manage their own health effectively.

Using the app, people can ask a question and receive an answer from a database of millions of responses all approved by doctors registered on the system.

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Residents can sign up to the service from 1 June by taking photo ID along to the enquiry desk at Waikato Hospital or to the DHB’s other hospitals at Thames, Te Kuiti, Tokoroa or Taumarunui. To be eligible, people need to be over the age of 18 and be covered by the Waikato District Health Board services.

Murray explains: “Obviously patient safety and security is really important to us, so initially we are going to have to see people’s photo ID in person at one of our hospitals. But we are working on setting up a secure online sign up process that will be more convenient for people in the near future.”

The program builds on previous investments in the use of technologies like telehealth to reach more people, he states. Telehealth provides safe videoconferencing between patients and specialists, thus making healthcare accessible to people in the rural communities and for those who have difficulty traveling.

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“The citizen focused, patient based clinical record is a very new paradigm…You can see it is needed because people are taking it up and using it.”Darrin Hackett, Waikato District Health Board

The Waikato DHB has listed telehealth as one of the top projects for the ICT team in this year’s CIO100, the annual report on the top ICT using organisations in New Zealand.

The DHB recognises the changing demands on healthcare and the need to invest in virtual healthcare, with a comprehensive program aiming to remove the boundaries of ‘bricks and mortar’ to address an ageing population and workforce through the use of technology, according to CIO Geoff King.

“The key change is moving away from bricks and mortar healthcare system, to a more flexible working environment, which we support from a virtual perspective and also [through] mobility [systems] for clinicians,” says King.

Object lessons

“The citizen focused, patient based clinical record is a very new paradigm,” says Darrin Hackett, executive director virtual care and innovation at the Waikato DHB. “You can see it is needed because people are taking it up and using it.”

So what are key insights they can share with other organisations?

Hackett and King say what worked well with the rollout was the team’s approach to working and designing the service with the users.

“Our direct customers are our clinicians, but it is much broader than that,” explains King. “Our patients are our customers too. Everything we do is focused on improving the quality of care for our customers.”

Hackett points out: “What we don’t want to do is say, ‘this is how it works and this is how you might use it’. Rather, we say, ‘This is the opportunity, this is how some of your colleagues in other areas are using it.’”

Hackett says the team ocused around “co-designing” the service with the clinicians, the public and the patients.

This allowed the team to know the pain points and problems of the users and work with it, he adds.

“It is a co-design evolving process rather than the normal waterfall approach…It is a very creative, agile DevOps approach.”

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The key change is moving away from a bricks and mortar healthcare system, to a more flexible working environment.Geoff King, Waikato District Health Board

Global and local partners

The DHB worked with Spark to connect the rural communities through telehealth.

“There is enormous opportunity for technology to play a really useful role in delivering expert healthcare to more New Zealanders, says Spark Digital CEO Tim Miles. “We are really proud to be unleashing this world leading healthcare innovation, supporting people across the Waikato.

“With the very strong regional presence of Spark’s fast 4G mobile services and our peerless wireless broadband becoming commonplace, we’re confident that the Virtual DHB will deliver a really impressive, personalised experience for people ready to give it a go.”

The Virtual DHB is powered by global mobile technology company HealthTap that has more than 100,000 doctors around the world signed on to their system. Many Kiwis are already using HealthTap’s global system, but Waikato DHB has ensured the Virtual DHB is customised and responsive to local needs.

Waikato DHB has been at the forefront of innovation in virtual health and has already been using telehealth to connect patients to doctors virtually.

The Virtual DHB initiative and the appointment of Dr Ruth Large as Clinical Director of Virtual Care, Dr Damian Tomic as Clinical Director of Primary and Integrated Care and Chief Virtualisation Officer Darrin Hackett, strengthens the DHB’s strategic commitment to virtual health.

“Telehealth has enabled doctors and allied health professionals from Waikato Hospital to carry out outpatient clinics and inpatient rounds with many patients in other hospitals over a video link,” says Dr Large. “But with the Virtual DHB, once patients are discharged from hospital many won’t have to come back for their follow up appointment, they can talk to their specialist or other health provider from wherever they are.

“In some cases an examination will still be required, but if it isn’t then an appointment from home may be offered. This is ideal for people who live far from hospital, don’t have transport or have to stay home to care for children or the elderly. With this initiative, clinicians can make home visits without physically travelling anywhere and reduce the number of outpatient visits to the hospital. It’s making health more accessible for everyone.

She says the DHB can also supply some home monitoring equipment which can link via bluetooth, like blood pressure cuffs, weighing scales and a pulse oximeter, and the data can be fed back to medical staff remotely.

The DHB is working with US universities, tertiary institutions including the University of Waikato and Wintec and the National Institute for Health Innovation, to conduct research during the trial, focusing on how patients and clinicians use the service, changes in patient’s health, and how to drive lifestyle change.

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