We have been conspicuously silent on #nz-forum about the blooming pandemic (according to everyone except the WHO). As we are the intersection of the clinical and IT worlds, we need to step up.
This post in the CCIO forum (note we can look at it but not comment at the moment) highlights some of the good stuff going on out there, and the digital challenge: Edit - the thread has now been moved to the #open-forum, so now we can all reply
Well it’s an opportunity to get Telehealth and video consults/assessment into business as usual across the country. Much better to conduct a video assessment with someone at home than on the phone to them in the car park.
Oh - looks like it’s a private page, I can’t see it. But yes, the pandemic - are we allowed to call it that now? - presents some challenges and perhaps opportunities for technology in both the clinical and the non-clinical spheres.
In particular, the use of technology to substitute for in-person meetings or attendances promises to be one of the options open to both clinical and non-clinical users and staff. Working from home certainly is being looked at by many organisations - including possibly some DHBs - for staff who do not need to be onsite to achieve their work functions.
ZOOM seems to be the main player in DHB video communication. If Doctors or organisations have a professional licence with security as per Health Alliance for Auckland Metro and Northland , patients would just need a free download to enable secure video consultation. I see Medtech are re advertising their video consultation module but presumably at a cost to practices. Is this not an opportune time to fund secure ZOOM licences out to all Primary Care as part of DHB response and facilitate this methodology of remote triage and consultation. Also as has been mentioned will drag us all into the comfort space of utilising these tools for improved access and reduced inequity for our patients. Many follow up outpatient appointments do not require A face to face physical consult . Certainly my recent health challenge has helped me reflect on this aspect of our care . A personal experience today was receiving an appointment for specialist review on one day requiring 4 hours travel return as preliminary to receiving an “hour long” infusion on immediate next day , a further 4 hours Travel . 2 days loss time plus travel for 1 hour infusion. Remote consult likely could have managed the prelim meeting as part of ongoing care . Luckily I was able to have conversation and reschedule appointments on same day.
There are a variety of VC tools of which zoom is certainly a good one. The NZTLG are working on a statement and for what it is worth I have been spamming our MOH friends
Auckland Regional Public Health notification - currently you still have to fax all notifications - ok let’s get that electronic in Northern Region
Monitor patients - currently in an excel spreadsheet - rapid prototype later - thanks Brian, Tina and Nate - we have a care pathway form we are happy to share - that has - admission to the coronovirus pathway, ongoing monitoring tasks, discharge task
Qlik dashboard over that - in progress as we start to pull these threads together - we have an amazing team with Delwyn, Monique and Sharon working on this one
amazing how many eOrder forms needed a question / advice slipped in - well done Health Information Group in WDHB
Our stance is (thanks Nate)
We have been doing a rapid development process – it is an ongoing and rapidly developing situation
We have started off with keeping it simple – a minimum viable product that is extensible and regional
How many DHBs now have an alert possible to put onto the Patient Administration System? and for those that do - what have you chosen?
We’ve sent message to ou patients on ManageMyHealth and updated our website. Clealry a LOT of interset in video consults, which we offer. Medtech promoting it.
I think the tech missing is a decent online symptom checker. NHS online has put one up https://111.nhs.uk/service/COVID-19/
Healthline MIA on this. Given they are at 10% service level you’d think this would be up and running
We need an international one (with a better UI than that one). I’ll ask about it on the #open-forum as I bet the author of that one is one there (or their boss).
Yes I have used this to push notifications via e e-referals, after I saw the advice from Public health to FAX - almost fell over. I especially pushing this to help with Public health informatics - where traditionally falls over and cant cope tracking the 80% who are mild and we only find out afterwards with serological studies.
I really like the potent we could extend to cover suspect cases sent home - and when testing stops as well if start getting that busy. ( which is usually the case)
Zoom is free for anyone to use in auck north region. It is just getting the idea in heads that we need a service to be on call via it. Hopefully will change some who refuse to change - people default to what they know in crisis, so need lots of support.
I have been doing the not sign paperless scripts and it is amazing. Delivery great but many people prefer to pick up believe it or not. But will not work for the 10% who need support but not full hospital bed.
I think we need to plan to have hubs , or fever clinics - with some low dependency beds, like china did. Reading report from WHO it was big part of population triage and once set up barely any Health worker infections.
A small comment on zoom. Point to point delivery from local pharmacies is way more reliable and safe than an out of town delivery via courier. Your local pharmacist will ensure the medication gets to their own patient and is able to complement their healthcare with a myriad of local commissioned services. Zoom has its place but it’s not the be all solution and has it’s own risks . Pretty much all NZ local pharmacies can or will delivery directly where needed and patients will prefer and trust their local. It’s not the face to face the patients necessarily want - it’s the security in their local that they know their history and will be able to provide continuity of care and go over and above when needed. The other aspect is that courier itself is not as secure as point to point delivery.
Lots of organisations on Office 365. Teams comes free with that. Tu Ora PHO using teams for video now. Given the whole of govt deal with microsoft why spend $$ on zoom?
Hi - lots of great ideas here (most of them I know about through various sources).
I am holding the bag at the ministry (for Shayne) around how data and digital can help in managing this. At this point we know about a number of opportuntities, but I am focused yesterday and today on getting the problems defined.
One thing thing we are keen to avoid is half-baking something because it is cool (ie. if it fails or has unintended consequences we are in the situation of SmartHealth). This means we need to balance the time taken to make good decisions with the urgency you all have identified.
If you want, feel free to email me (jon.herries@health.govt.nz) or keep going here and I will check in regularly.
MahiTahi Hauora the new PHE in Northland on 365 and teams activated but seems not actively used. Northern Health Alliance have done all the back office security for ZOOM and all Northland rural practices have a professional licence currently funded through Rural SLAT. Same security. Is the Microsoft teams video privacy compliant if used for patient consultation ? I see that there is some discussion amongst GP’s about use of Doxy.me which I thought had been explored previously and because resident in cloud offshore was deemed a significant risk. People seem to be just getting on board as a response to need to manage remote consultation. Unsure if safe decision. Would appreciate feedback so I might pass on to those contemplating
Grahame
