While there are major differences in the way health care is provided in Canada and New Zealand, both countries see a similar role for e-health in providing more effective services to their citizens.
A group of New Zealand health experts has toured Canada and other countries looking at how they employ information technology in health care. In an interview with CIO Government Review, they said e-health was an important strategy to counter the shared problems of aging populations, long waiting times and shortages of medical professionals.
"The infrastructure for e-health needs to be developed as quickly as possible to get the most benefit," explained Debbie Chin, deputy director-general of Health for New Zealand.
A vital step was the introduction of e-health records so the health care system knows each patient's history, she said. "Electronic is the way to go; it's the best way to deliver quality information on patients to doctors and hospitals."
Chai Chuah, who runs the Hutt Valley District Health Board, said IT could assist the system in dealing with a growing patient load and the shortage of professionals. "We have to frame development projects to help deal with these issues." Better information will enable doctors to determine what treatments are required.
When it comes to deciding how to approach the adoption of IT systems, health care should emulate the success other sectors have had in employing IT as a vehicle for better service delivery, he continued. There is no need to invent a new system from scratch.
New Zealand is a unitary country so it doesn't get caught up in Canadian-style wrangling between the federal and provincial governments over health care funding. As well, the private sector already plays a significant role in New Zealand health care in areas such as the provision of elective surgery.
Chuah says most New Zealanders pay part of the cost of medical care. "So we have a different culture about using health care. Government funding is much more targeted."
Ken Leech, CIO for ProCare Health Ltd., a major private care provider, says IT can also play a key role in managing change in health care. "There are many independent units in the system and managing change through all of them will be difficult without an integrated information system."
Rising health care costs are a challenge in many countries and IT offers ways to get better results from strained health care budgets. Leech said New Zealand had used e-health to deliver a cardiovascular risk management program.
"Heart disease is the biggest killer in the world. IT enables us to deliver risk management information to doctors so they can prescribe the best kind of treatment for patients. We can demonstrate the benefit of reducing cardiovascular risk, which is a significant saving for the health care system."
Leech also called for increased funding for developing technology that can be used as a screening tool for family physicians before they decide that a patient should be referred to a specialist.
Chuah added that e-health could generate better quality service for patients, more service or both. "We can fast-track referrals to specialists and cut down the waiting time for appointments with them."
So what do these experts prescribe for Canada? Chin said a national e-health network should be rolled out as fast as possible. "If not, your health care system will be fragile. You need to build the delivery platform, focus on patient identification and networking."
Leech added that a national system doesn't require a central e-health registry. New Zealand uses a regional-based network in which the patient identifier works across the country in terms of providing an individual's information to the health care system.
Chuah noted that New Zealand tries to keep a tight lid on its health care spending. "We look at what works well and how we can extract information from our electronic records. Ours would be considered a hybrid approach - using existing systems as much as we can, rather than bringing in something brand new."
While New Zealand doesn't share Canada's geographical challenges, there's no doubt that its experience provides valuable insight to the Canadian health community as it develops an e-health system for the country.
Alex Binkley is a freelance journalist based in Ottawa. He can be reached atalex.binkley@sympatico.ca
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