Health Forum NZ - where to from here?

NathanK · 30 July 2020 21:00

What on earth should we do with ?

Most of you know that Health Forum NZ is a Discourse Forum (like this one) that was spooled up in response to the need for private and rapid national multidisciplinary communication early in the COVID-19 crisis. This is led by me with a whole lot of help from many @nz-ciln members, is entirely volunteer, and HiNZ pays for the (modest) costs incurred.

It took off like a ship driven before a storm, but once lockdown was announced the wind eased significantly. With the return of ‘normal’ life, this driving force has eased further to the point that Health Forum is now essentially drifting in the doldrums.

Especially in view of a possible COVID-19 resurgence such as in Melbourne, I believe that there remains a need for a digital tool for ongoing joined-up private national collaboration and communication, such as:

smaller special interest groups (10s - e.g. Paediatric Anaesthesia Leadership, OT clinical leadership)
within whole clinical disciplines (100s - e.g. Anaesthesia, CiLN)
across disciplines (1000s to 10000s - e.g. everyone)

There have been some pockets of enthusiasm (all driven by @nz-ciln members), but transforming this into success has proven elusive. Ongoing discussions have been held with the MoH about how HFNZ could work with their needs, but they understandably aren’t in a position to embrace it unless it becomes well established. Other organisations are in a similar position and appear have a bit of a siege mentality due to immense financial pressure and change fatigue. Individuals state that they are still recovering from the IT storm.

So what do we do? Please do reply with comments / thoughts.

Call it a day and wrap it up
Carry on and be patient - they will come
Open it up - go public (at least partially)
Explore making HFNZ a formal CiLN/HiNZ project and relaunch it

0 voters

alex · 30 July 2020 21:08

Nathan a good discussion. I wonder if what is needed more than clinical discipline specific - which can be well supported by professional bodies - is a space to bed down to areas we know the health system is moving to - community/ wellness/ prevention focused, interprofessional practise and rural generalism, rapid discharge, and on a more detailed level different new models of care - fsa by allied health, wait list to intervention list, etc? Change up how is structured ? I do like the macro/meso/micro structure though

grahame.jelley · 30 July 2020 22:01

Thanks @NathanK

You know I have posed the same question a couple times but Indonbelieve we need to persist and recognise it may take time to build the small communities of interest. There is an interest in the structure we are developing in GP space and I am getting some interest in subgroups of GP interests

Tortoise not the hare . Covid drove the hare at the start but long term vision I feel tortoise will win the race

We as clinical informatician need to stay the course

My 2 cents

Grahame

PamJ · 2 August 2020 03:26

Nathan

Great work!

I believe there is a need for health discourse in NZ as I see a gap for our issues to be discussed among professionals. Lived experience is important, the anecdote to illustrate a cause has great merit. We don’t need to have cancer to be an oncologist, to have a uterus to be an obstetrician, so surely our common interest in the health of NZ is commonality enough. Diversity brings great strength - and that encompasses our professional diversity also.

I agree there is a need for such a digital tool to solve this, or facilitate discussion just where the right place for this to sit - I am not sure.

There are many advantages to a forum that is moderated over facebook. The negativity of FB in my view, is counterproductive - but it seems it is where people hang out. I struggle to cut through the dross to the real discussions and interesting, informed or learned opinion. I have tried the FB covid doctors page, but find I don’t read much on it because of the noise.

Engagement remains the challenge.

I don’t live my life in FB - and I do keep work and private/social life separate - so I don’t like the mix that others do. I keep my notifications to “pull mode” rather than “push” so I can focus on one thing at a time - and get things done without interruption. I have allocated time for pulling my FB stream - and sometimes I just don’t. I know - how can I leave FB unchecked?

I live in my emails - so I like the Health Forum’s weekly updates - I can jump into the Forum if I would like (easy enough to delete the email if I don’t, or park in my to do later folder). This could work more seamlessly with some clever IT ninjas like you Nathan, on the case.

There will always be tension with small groups, professional groups or silos - and true multidisciplinary discourse.

The first is easiest and safest and where people gravitate to and hold dear - or defend the purpose (sometimes to the detriment of conversation). We were brought up in medical school to be like this, and it gets more definitive as we specialize, then amasses a steroid boost when we are working in the professional sub-type we have chosen (Public health, pathology, GP, surgeon etc). This is fueled by constant need to prove our choice is worthy, but also because we have to fight for funding - so we defend our patch vigorously.

The latter - multi-disciplinary discourse - is harder - but in my view where we have a gap, where the conversations can have some transformative change for health in NZ.

I would love to be able to bring up issues with Paediatricians - and all of the subgroups of paediatricians as there are now. I would also love to discuss issues of primary care with GPs. Recently I have been interested in our Public Health and Occupational Health issues as Covid-19 is here. There are other parts of health that I am also keenly interested in - maybe I have not heard of them, or have no time for them, or I don’t even know what I am missing.

I am interested in the Cannabis referendum, the end of life bill, and the recent decision to take women’s health and psychology out of the medical curriculum in 2023 (Otago University Chch campus). I would invite discussion from those not only in my small silo - but the broader range of medical professionals that brings a perspective I may not have considered - or perhaps have shelved in my busy paediatric space.

Instead I see interesting discussions around these issues that are going to shape the future of NZ’s health system with little input from the professions that understand them best. The NZMA were sidelined by the PM when they raised the issues relating to General Practice within the Covid-19 response - so where and how do we get our voice? A place for discourse would perhaps enable us to look at evidence, gather up opinion, fire up our interest, ask questions, think …

I attended the RACP webinar yesterday from occupational health - the first speaker was eloquent as she went through the scientific evidence on PPE - and the mistakes being made as we are being fed political ideology not supported by science around the high rate of infection of healthcare workers that is attributed to community spread when they are working in a hospital with Covid-19. Another example of how we need to disseminate to ourselves good quality information from well trained and respected academics, and not fall victim to believing the rhetoric we are fed from the media. It is frightening as there is a lot of it!

Just imagine if we could solve issues by collaboration without re-inventing the wheel? What if a clinical conundrum could be posed to the forum to ask the collective wisdom for advice?

So - it would be good if Health forum could be a space to facilitate the three aspects you outline.

These are my thoughts.

Pam.

Mat · 2 August 2020 23:38

I think the current place for NZ health forum is one targeted to motivated users with specific passions to drive specific issues. I say this because motivated users will use the forum, and if they use and demonstrate benefit, they will attract other users.
Given that junior docs are generally more IT literate and motivated, is this the likely best place to create a space for them?
So - my vote is to keep going, but to try and identify potential target audiences - any other suggestions

KarenDay · 3 August 2020 00:10

Hi @PamJ. I like your description of how you like to roam through conversations. This is typical of a high functioning social media forum and long may it continue.

One pattern that continues to impress me is that someone will throw a comment, question, observation into Discourse and a few people catch it, discuss it, and then take it offline to take the collaboration further. It would be great if they had the time to give a brief update once they’ve resolved their issue but this isn’t typical human behaviour and if anyone wants to know what’s happened there’s nothing to stop them asking.

There are lots of people who feel shy about saying anything in this kind of forum. I’m interested in how we can get to hear their voices too.

PamJ · 3 August 2020 01:21

Dear Karen

I agree - the negativity of feedback inhibits a lot of freedom of discussion - a nice open place to facilitate this is welcome - a strength of the forum over FB.

Pam

karenshaw · 3 August 2020 04:28

HI Nathan,

I definitely think there is a place for HFNZ and an important one. Speaking from a nursing perspective many of my colleagues are still using Facebook groups as there is a significant lack if understanding about privacy and the basics of how social media works. HFNZ is a vital tool for us to have professional discussions in a safe place with the ability for like minded groups of nurses (and other specialities of course) to break off and collaborate, share and discuss important topics. I did try to get NZNO interested but I think my timing was out as it was during COVID and they were clearly up to their ears in professional help for nurses (as they should be). I would be really keen to help get this out to nursing as they are a BIG group in health and one that needs this. I was only thinking yesterday that it might be an idea to try and get an article promoting HFNZ in Kai Tiaki the NZNO monthly magazine. Many of my colleagues still read it. With backing from HInZ or/and CILN too, we look to “legitimise” HFNZ publicly, for healthcare professionals and promote all three organisations/forums together.

Finally, please don’t get disheartened, post-COVID was always going to be hard, coming down from the intense ‘high’ of lockdown has left many a bit flat. Things will pick up, we just need to get out there with a good reason for them to join!

Karen S.

NathanK · 6 August 2020 13:38

Thank you all; I really appreciate your thoughts and advice.

Yes, this is my passion too; we have reasonable single discipline communications already, via a kaleidoscope of non-integrated platforms. What you suggest is the point of the multidisciplinary area(s), and sub-areas can be created if the need develops.

Yes, it will. COVID-19 / lockdown gave us delightfully quiet streets and an appetite for IT related change. Alas, both were short lived!

Every time I venture into Facebook I am reminded of this. But how to convince the hordes? You are right, good moderation is vitally important and will remain so.

They didn’t really rise to the challenge early on (rather flocked to Facebook), and I didn’t target them with marketing and the like. But yes, they are a group that is not well catered for and without a natural community. Anyone got any good RDA contacts? @liz?

I’d love to know how to make that less scary. I recall my pounding heart before posting on the #open-forum the first time. Setting the tone with the culture and displays of gentleness and warm welcome are likely to go far but not easy to implement.

We are fortunate that this backing already exists. We have to decide if it is worth throwing CiLN and HFNZ in together to maximally leverage the benefits of this for each body. Personally, I’m all for simplicity and clarity.