Mike Keyworth Healthcare New Zealand

1. HEALTHCARE NEW ZEALAND
How Healthcare of New Zealand is
taking advantage of computing
and communications technology
to improve its delivery of services
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Introduction
• …a range of innovative systems and services has
become available to assist care providers to look
after patients in their communities
• How Healthcare of New Zealand is taking advantage
of computing and communications technology to
improve its delivery of services

2. HEALTHCARE NEW ZEALAND
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Outline
• About Healthcare of New Zealand Ltd
• Client Management Systems (CMS)
• Digital Pen Project
• Wound Laser Device
• Assessments
• Mobile Workforce
• Challenges for Healthcare
• The Future
• Conclusion
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About Healthcare of
New Zealand Ltd

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Workforce Comparison
• Wairarapa DHB – 350
– http://www.wairarapa.dhb.org.nz/wdhb/aboutwdhb/faqs.asp
• Mid Central DHB - 2,100 (FTE)
– http://www.midcentral.co.nz/MDHB/MDHB-Info.htm
• Capital & Coast DHB – 3,500
– From 2006 Annual Report
• NZ Army – 4,583
– http://www.nzdf.mil.nz/at-a-glance/personnel-composition.htm
• Healthcare of New Zealand – 6,000
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Healthcare of NZ Ltd

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Healthcare of NZ Ltd
• Community Services;
– 5,000 support workers
– 16 - 18,000 clients each month
• NZCare Group;
– 700 support workers
– 530 clients in 90 community homes / 8 facilities
• Wellcare Education
• Freedom Medical Alarms
• Management / Admin / Support
– 400 staff
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Healthcare of NZ Ltd
400 ICT Users in 50 Locations
• Between Auckland and Invercargill:
– Ranging from the Christchurch office with 90 users
– To the Wairoa satellite office with 1 part time user
• Business Improvement & Support Team = 5.5 FTE:
– 1.0 ICT Manager
– 1.0 ICT Support
– 2.75 Client Management System (CMS) Support
– 0.75 Business Analyst

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Improving Delivery
• So, how is Healthcare of New Zealand taking
advantage of computing and communications
technology to improve its delivery of
services?
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Information Systems
• Effective use of information systems to enable better
care management
• More informed decision making
• Flexible systems to cater for differing demands
• Entered once; through to payroll and invoicing
• Linkages to other technology enablers…

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GoldCare - Client
Management System
Modules include;
• Enhanced Community Support – Home Care
• Health Care Records – Nursing
• Assessment Information Manager (AIM) – Assessment
• Care Anywhere – Off Network
• Enterprise Web Services Manager – Web Access
• Mobile PDA – Access via Mobile Phone
• Telephony – Support Worker Timesheeting
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Digital Pen Project
Any sufficiently advanced
technology is indistinguishable
from magic.
~Arthur C. Clarke

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Project objectives
1. Demonstrate improved
clinical health outcomes
2. Demonstrate improved
productivity
3. Demonstrate the feasibility of
the solution
4. Understand user acceptability
5. Understand the economics
for development of a
business case
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Practical Issues
• 70 Nursing staff operating out of the
Christchurch office leading to:
• Issues with facilities;
– space
– parking
– availability of PC’s
• Poor utilisation of resources;
– duplication of work
– unnecessary travelling time

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Digital Pen Project
• Pilot with 6 nurses / one form
• Issued RFP to 3 Digital Pen providers
• Selected Destiny Wireless (Australia)
• Partnership with Vodafone
• Designed initial form / XML outputs
• Created GoldCare CMS interface
• Pilot ran from 4 Dec 06 to 23 Feb 07
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Digital Pen Technology

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Client Visit Record
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Benefits
• Reduced duplication in home clinical record (96%)
• Less time documenting at office (100%)
• No need to return to base
• Improved work satisfaction (87%%)
• Information available immediately in GoldCare (CMS)
• Instant e-mailing of data to GP’s and other parties
• Contract compliance; we leave a copy in the client’s home
• Reduction in costs
• Allowing Nurses to nurse and administrators to administer

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Wound Laser Device
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Wound Laser Device
• Special Project out of our
Christchurch Office
– Laser technology
– Accurate and quick
recording of ulcers and
other dermatological
conditions
– Measures area and depth
www.aranz.com/#medical
– Compare healing process
over time

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Wound Laser Device
• The scanner consists of a device containing two
lasers and a camera. This palm-sized scanner
interfaces to a PDA.
• Software calculates the surface area and depth
profile of the ulcer / wound.
• Documentation is organized into a patient file
containing clinical photos, graphs showing changes
in ulcer surface area and depth over time, together
with clinical notes.
• Comprehensive reports can be generated from the
data stored on the PDA.
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Assessments
• GoldCare
• Assessments:
– ACC SRA
– InterRAI
– Target etc
• Technology:
– Notebook on/offline
– PDA
– Paper (digital?)

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Mobile Workforce
Computing on the job?
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Mobile Workforce
• Access to Client Management Systems:
– Change appointments
– View Client Information
– Timesheet Information
• Access to e-mail
• Out of Hours service
• Technologies:
– Mobile PDA (GoldCare)
– Notebook on/offline

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Mobile Workforce
Support worker monitoring / timesheeting:
• Fixed line phone with PIN
• Mobile phone with Voice Recognition
• Mobile phone with bar code reader
• Mobile phone with RFID
• Mobile with Digital Pen / paper
• Implanted chip for GPS tracking ONLY JOKING!!
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Challenges for Healthcare
Aging population with Chronic Diseases
• “In developed countries, the epidemiological shift
in disease burden from acute to chronic diseases
over the past 50 years has rendered acute care
models of health service delivery inadequate to
address the health needs of the population.”
» Adherence to Long-Term Therapies – Evidence for Action
World Health Organisation, 2003, ISBN 92 4 154599 2
• People over 65 make up around 16% of the
population but this group:
– Account for 43% of NHS Budget (2003/04)
– Occupy 65% of acute hospital beds
» A Recipe for Care - Not a single Ingredient UK DoH
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/
PublicationsPolicyAndGuidance/DH_065224

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Challenges for Healthcare
Workforce issues
– What workforce?
• “The New Zealand Institute
of Economic Research
predicts that by 2011 the
compounding affect of the
aging population will mean
that the demand for health
care workers will outstrip
the number of workers
available.”
– Taranaki DHB - District Annual Plan 2006-2007
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Telecare / Telehealth
• Various flavours
– Alarms to remote monitoring of vital signs
& (much) more
• Tried and tested – It works!
• Proven benefits
• Savings $$$
• Reduction in demand for (skilled?) Workforce

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Information Requirements
• Multiple demands
– Professionals
– Patients
– Families
• Channels?
• Joined up?
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Digital TV
NHS Direct Interactive –
Freeview Ch108
• FAQ’s, Hot Topics,
Healthy Living, Guide to
the NHS, Advice on;
diabetes, diet, asthma etc
• Includes photo’s,
illustrations and video
clips

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Conclusion
• We are improving the delivery of services with smart
use of technology
• Technology enables more efficiencies
– we are a commercial entity so it has to!
• Healthcare of New Zealand is able to offer better / more
flexible range of services using technology as the
facilitator
• We are looking to the future in order to reduce demand
for scarce resources while maintaining effective face to
face delivery (where required)
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Final Thought
• Computers let you make more mistakes faster
then any invention in human history with the
possible exception of hand guns and tequila
- Mitch Ratcliffe

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Any Questions?
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Contact
Mike Keyworth
Manager, Business Improvement
Healthcare of New Zealand Ltd
phone: 04 802 0934
email: mike.keyworth@healthcarenz.co.nz
website: www.healthcarenz.co.nz

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