A Canterbury Tale
In 2013 the King’s Fund in the UK published a case study about Canterbury in New Zealand and the region’s quest for integrated health and social care. The entire study makes for interesting reading, but the key point to note is that Canterbury has proven that it is possible to provide better care for patients, reduce demand on acute and primary care, and reduce demand generally across health and social care by improved integration – particularly around the interface between the hospital, primary care and community services.
From the early 2000s, the Canterbury District Health Board, New Zealand’s second largest DHB, devised a vision for an integrated health system that would keep people healthy and well in their own homes. In 2007, an electronic shared care record, coined HealthOne, was commissioned by a partner alliance involving the Canterbury DHB, PHO Pegasus Health, and Orion Health. Pegasus Health hosts the General Practice, Pharmacy and Community Care Databases, taking the primary care information from the various systems to a central repository, to be viewed as a ‘single-source’ of up-to-date patient information. Additionally, many pharmacists across Canterbury using the two main pharmacy systems in New Zealand (LOTS and Toniq) have contributed pharmacy data to the patient record.
HealthOne consolidates the GP record, community pharmacy dispensing information, and community care coordination referrals into a centralised store. The patient’s healthcare providers in the hospital and a number of community providers can access a summary of their patient’s demographics, medications, encounters, allergies, alerts and observations. They can also view past visits, admission data and discharge information, (unless the patient has opted out of the system) and edit or change the information seen in there.
The results HealthOne has had a significant impact on the workflow of primary and community healthcare providers, giving them access to up-to-date and relevant information, allowing timely, safe and more informed decision-making.
As of April 2016, there were some excellent adoption results:
- More than 57 million patient data items (e.g. a diagnoses, a prescribing, a dispensing) are contained within HealthOne, with more than 1.7m new items received every month.
- The rollout to community pharmacies began in February 2012 and now more than 450 pharmacy staff have HealthOne access.
- The first 12 General Practice sites were rolled out as a pilot in June 2012. As of July 2016, nearly 1500 General Practice doctors, nurses and practice staff across three health districts have access.
To deliver integrated care in a health system that has evolved enough for EMRs to be commonplace (as in Australia and New Zealand), the next critical step is to support care coordination – addressing the underlying system problems that create silos, gaps in care and patient exclusion, is the ultimate goal.
Orion Health is investing heavily in an IT solution that delivers to the needs of a healthcare system – not just a single healthcare provider or insurer. Our offering for integrated care and population health management delivers an end-to-end solution with seamless data integration and visualisation, built on a massively scalable open platform – the Amadeus platform. Amadeus is able to integrate with multiple data sources across both health and social providers and insurers generating a centralised, complete view of a patient’s record so clinicians need only log in once to see the longitudinal patient record, perform analytics queries over huge data sets, and turn insights into clinical workflow, from individual care plans to customised care pathways.
Systems can take advantage of this rich data and manage individual patients and entire populations more effectively using the Orion Health Coordinate solution. A virtual multidisciplinary care team approach enables a true patient centric view and way of working – making sure that social, behavioral and genetic data are considered when creating care plans or considering interventions. This model supports proactively addressing the social determinants of health in conjunction with immediate health needs. It also supports prioritising resources across care settings and most importantly, prioritising the needs of the patient.
For more on integrated care, please download our white paper, "Navigating the Journey to Integrated Care"