THE 12 THEMES BEFORE CHRISTMAS
December 21, 2020
THE 12 THEMES BEFORE CHRISTMAS
I had the privilege of being the keynote speaker at the NZ Health IT (NZHIT) AGM on the 9th of December. Given it was close to Christmas I thought about presenting a “12 days of Christmas” presentation. However, as there was actually 17 days until Christmas Day, I got creative and focused on the “12 themes of 2020” to reflect on and looking ahead to 2021.
Firstly, I would like to acknowledge the great work of outgoing CEO Scott Arrol who has done a tremendous job of leading NZHIT for the last 6 years. I wish you well for the next step in your career. Secondly, I want to acknowledge all the members of NZHIT – it has been a very challenging and rewarding year with technology as an enabler being a key outcome of responding to the pandemic.
Now to my 12 themes and “shout-outs” to highlight examples where people and tech have made a difference….
1. Covid19 – disruption and innovation
Every industry has been affected by the pandemic and as a result there has been significant disruption and innovation. What we have learnt is that healthcare can be agile, fast and safe in deploying new technologies. We were all united by a single purpose and that resulted in greater collaboration across the whole health and technology sectors including some of the greatest advances in digital and data.
We have been challenged by the Director General of Health to “lock in the advances”. From my perspective that also means locking in the different procurement and decision-making processes, the industry collaborations, and the power of being united by a single purpose.
Innovation – a big shout-out to the Ministry of Health team for their leadership in the development of the Covid contact tracing app that now is Bluetooth enabled. Another shout-out to the industry collaboration that went into the development of the Awhina app, well done Streamliners and Webtools Health.
Disruption - the use of platforms for various responses to the pandemic such as the MIQ facilities and the rise of consumer choice. Patients no longer want traditional methods of engaging with the healthcare system, they want solutions that are designed around them.
2. New models of care
Technology has enabled new service delivery and new models of care across many domains of the health system. In primary care we have seen the launch of new online services such as Tend and new ways of data sharing to improve access to data such as the MedTech Global Alliance.
In community care there has been significant advances made by aged residential care (ARC) services when it comes to their capability and engagement with residents. For example, let’s shout-out Spritely who deployed a vulnerable person response to Covid19 for ARC residents using an iOS platform.
In the areas of mental health and wellbeing, and public health the use of avatars, digital humans and chatbots have come to the fore. Big shout-outs to Mentemia, Clearhead and Soul Machines in this respect.
Hospitals have rapidly increased the use of virtual/telehealth enabled services and recognised that services do not need to be always clinic or hospital based. In this regard there’s shout-outs due to Orion Health with their patient portal and platform response which was hugely successful outside of NZ; and to Rauland for their ICU remote monitors that allowed clinical staff to better manage ICU Covid19 patients.
3. Future of work
As we all had to move to supporting an increased number of people working from home, we learnt that there is no going back. We now need to have the ability to support a “hybrid” working environment that enables people to work anywhere on any device.
This will mean that we need to be using platforms that can support multiple business functions such as recruitment, people management, finance and supply chains. This places an emphasis on collaboration, teamwork and patient care. We also need to improve our automation capability to reduce variation and improve security, reliability and speed.
Shout-outs to Orion Health and Microsoft for their collaboration in integrating MS Teams and the South Island Patient Information System.
Firstly, I must acknowledge NZHIT’s leadership of the charter for interoperability. But that was 4 years ago – hello people, what are you waiting for??!
It is time to understand that interoperability is not a nice to have, it is a must have. This is particularly so in our environment where we are not swallowing enterprise solutions whole but using a best-of-breed approach.
We need to understand the role of the platform players versus the niche operators. We must have published APIs that meet HISO standards. We must establish robust data sharing and stewardship, and we need to look for the innovation. I recently learnt about “Super Apps” that are currently emanating out of the retail space. What might be the Healthcare Super App?
Collaboration is the key to innovation!
It needs to be cross-disciplinary that brings together clinicians, technologists, vendor partners, providers, and service users. Co-design and user experience are the key to successful technology adoption so building something in your R&D environment without input from end-users is a recipe for disaster!
It needs to be cross-sector and cross-industry. For example, what can be learnt from MTANZ and AgriTech? In Christchurch we are learning how important industry collaboration is with ChristchurchNZ identifying four Super Nodes. One of which is “Healthcare and Resilient Communities” but all of them call on technology skills that are common across them all such as security, DevOps, automation, etc.
Webtools is an example I am aware of as they have clients in many different sectors. This meant when the pandemic hit they were able to utilise capability within the broader company to support their health response.
The recently released report indicates that NZ needs more tech not less stating that “it matters not only for productivity but also wellbeing”. The recommendations include the need to update regulations to remove barriers to technology and promote worker wellbeing.
Are we clear on what this means for healthcare?
Also recommended is the need for ICT/digital companies and providers to focus on user experience, data access and workflow.
Additionally, the “Health Insights” report identified health technology as a high growth industry anchored by a few key large companies and there were plenty of opportunities for smaller scale players to operate in this space as well. These reports will be important to be reflected in the upcoming NZ HealthTech Opportunities Report.
7. Technology – it does matter
While I always focus on the outcome that technology enables, I do want to highlight the importance of being up-to-date in terms of the underlying technology capability. I have been somewhat frustrated recently by the lack of NZ health tech company’s readiness for cloud. I stress that you do not want to have your Kodak moment because you blinked too many times and let the cloud opportunity pass you by.
So please invest in understanding the whole gambit of cloud, AI, blockchain, IOT, analytics, the super convergence of biotech and compute power plus many more on the horizon and not even seen yet. How will they affect you, the services you provide and what are you doing to keep looking ahead?
This is fundamental for success in any environment. It has been identified in the Simpson Report and recently reinforced by Shayne Hunter (Deputy Director General, Data and Digital, MOH) in his eHealthNews opinion piece.
In my view, this is all our collective challenge.
For what it is worth the type of leaders I think we need are those that have an inspiring clear vision and strategy, clarity of purpose, decision-making based on trust and empathy, courage to do the right thing for our community and a fierce focus on the execution of the strategy.
There is a clear need to invest differently for the transformation at scale we need to achieve. We need to think about how technology solutions are procured and then spread, rather than repeatedly re-selecting capability because we are bound by old procurement thinking.
We need to leverage cross-government investment rather than thinking “health is special”. Take identity as an example, surely for a digital public service this could be delivered once and applied to all?
We need to have more “D” in our R&D. We must look at how we can support companies to gain access to services and support. NZHIT may be best placed to work with agencies such as MBIE, Callaghan, NZTE and others to ensure health technology companies can thrive. In return, these agencies need to reciprocate and collaborate for the benefit of the country.
10. Capability and Capacity
There are significant challenges in maintaining and growing health technology skills across the system. Let’s look at just a few -
Privacy Act 2020 – are you ready for this? A shout-out to Celo who are demonstrating that secure messaging is increasingly important in our mobile world!
Cybersecurity – we know that this requires attention across the whole system, and we are competing with many other sectors. A shout-out to Datacom, Unitech, and Ara who are working collaboratively to address the workforce capacity issues relating to security of our health data.
Digital literacy – to me this is a public health and health promotion opportunity. How do we get this taught in schools? Shout-outs to the Clinical Informatics Leadership Network for their leadership in improving digital literacy of our clinical community as well as to Mind Lab and Tech Futures Lab
The productivity report also highlighted the need to build core tech skills at scale for NZ’s digital future and that the training needs to more flexible. What role does NZHIT and HINZ play here?
A climate emergency has been declared by our government. What does this mean for health tech companies and the health system? We know tech has a significant impact on our carbon emissions and many of the global multinationals are responding with “circular economy” initiatives to ensure they are demonstrating their contribution to environmental sustainability.
11. Government Priorities
We are aware of the Simpson Report and implementation planning for data and digital in the health and disability system. How does NZHIT ensure members can best respond effectively to this?
We also know investment is planned for the National Health Information Platform (nHIP), or its next generation, based on what has been achieved through the Covid19 response. It is essential that this investment must be driven by our models of care.
The Simpson Report also highlighted the importance of data and digital literacy at the governance level – this will also help to speed up innovation adoption.
Other government priorities include child poverty, climate change and equity of access and outcomes. Therefore we need to be thinking about how technology can be an enabler to support these priorities. How do we ensure it is whole of system (including health and disability services, rural and urban localities, Maori leadership and participation, citizen engagement and co-design)?
The Digital Council Aotearoa has highlighted four areas for nurturing in 2021, 1) ensuring everyone is included, 2) understanding the emergent picture, 3) building government for the digital age and, 4) enabling a thriving tech sector. I think these are all areas we can focus on nurturing too.
12. Call to Action
So, in summary, I encourage you to be Bold! Be ambitious! Be Collaborate! And Evolve! Remember you don’t want to be the next Kodak! Together we can build the digital prescription for our health system.
Thank you and best wishes for 2021!