I believe that New Zealand has a unique opportunity to leapfrog the rest of the world with healthcare IT breakthroughs that show the rest of us what is possible from a 4.5 million person learning lab.
Why?
The perfect storm for innovation requires alignment of technology, psychology, and implementation.
New Zealand is divided into 20 District Health Boards which improve the health of their populations by delivering high quality and accessible health care.
The District Health Boards remind me of the County Council system in Sweden, which in my opinion is the best healthcare delivery model on the planet. Although District Health Boards are funded by the central government, they have flexibility to innovate and there is complete alignment between investment and outcomes. If District Health Boards spend $1 on healthcare IT and save $1.50 in care costs, they keep the surplus. Historically, in the US, if I spent $1 on IT and reduced costs by $1.50, the private insurers would benefit, not the provider organizations. Countries with socialized medicine and local implementation organizations align costs, benefits, and regional awareness of the key problems to be solved.
I met with leading IT thinkers, innovators and folks at the highest levels of government (photo below is the "Bee Hive" Parliament). The executive and legislative branches are completely comfortable with the idea of creating a countrywide database that incorporates clinical data, financial data, social determinants of health, genomic data, social service data, and judicial system data. Instead of sending 5 cars to a person’s driveway to deliver services from 5 different government agencies, every government official wants a coordinated program of service delivery based on bringing well being to families.
New Zealand has many advantages - a national healthcare identifier, a common privacy policy, a robust economy, a relatively small population, and a geography that can be traveled by air from tip to to tip in 2 hours.
The people of New Zealand are remarkable - they are friendly and approachable in ways that are subtle. For example, I walked into the airport and to my gate without a boarding pass. The folks at the gate happily printed my paperwork without question. The level of anxiety/fear is low and the political climate is such that the liberal and conservative extremes are not that far apart.
The infrastructure for internet connectivity is good and the number of local developers/tech experts is high.
New Zealand has the technology for data capture/exchange, a desire to maximize quality/safety/efficiency and District Health Boards to implement it. District Health Boards operate hospitals and fund primary care in each area so there is a single point of accountability and authority per region. I met with District Health Board leaders in Auckland, Wellington, and Christchurch, so I can confirm they are dynamic, motivated, and well informed.
The next year in the United States is likely to be politically challenging and lacking enablers such as a single healthcare identifier to execute any bold national program of big data aggregation. Finally, every person in New Zealand I spoke with felt that individual privacy, although important, was not an impediment to building a large database for societal good.
So watch New Zealand. 2017 is the year they can lead the world. With government, industry, and stakeholder alignment they can set an example for us all.
Sounds a lot like Iceland - except for lack of incentives... I have a few colleagues who have specialized in emergency medicine in NZ, they've all come back very happy.
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