Technology supports new models of care for long-term conditions

The inaugural Australasian Long-Term Conditions Conference, which was held in Auckland in 2011, made it obvious that technology is a crucial enabler in a health system that strives to meet 21st century demands.

Three years later, the 2nd Australasian Long-Term Conditions Conference will reveal how that is already happening. Also being staged in Auckland, at the Waipuna Hotel and Conference Centre on July 29 and 30, the conference will feature speakers including the creators of technological innovations, experts in models of long-term care, and those who manage complex health organisations.

In the past 50 years, demand for healthcare has undergone a profound change. We not only want more healthcare, but we want different healthcare. However, our longer life expectancy comes with hooks attached: people are living for years, even decades, with conditions such as diabetes, heart failure, and chronic obstructive pulmonary disease.

The cost of long-term conditions now accounts for 70-78 per cent of all healthcare spending in New Zealand, according to the National Health Committee Report on Chronic Conditions 2007.

The episodic model of healthcare – someone gets sick, is treated, gets better and then goes home – has to change. We now need a planned, proactive model of healthcare which reflects a reality that people with long-term conditions go home and continue to manage their condition.

And they often do so in partnership with multiple health professionals: a GP, endocrinologist, podiatrist and ophthalmologist are all likely at some stage to be involved in the care of a person with diabetes, for example.

All this is placing an unprecedented demand on the people and physical resources that comprise our health system, but that health system is facing demographic pressures of its own. Figures from the New Zealand Nursing Council and Medical Council show that in 2011 both professions had roughly 12-13 per cent of their active workforce aged over 60 and an average age of 45.

Clearly, the answer cannot simply be to recruit more health professionals – there aren’t enough young people to recruit.

As delegates at the 2nd Australasian Long-Term Conditions Conference will hear, the health system is already creating some new models of care.

Many, if not most, of them involve increasing use of technology, and increasing partnerships with patients. They aim to use all available tools to help patients manage their own conditions without always needing health sector personnel, or physical resources, to do it for them.

For example, mobile technology is helping patients to take ownership of their own wellness, and make the changes needed to enhance it. These tools range from mobile apps that help you to choose healthier food when shopping (, to managed programs such as diabetes support and smoking cessation.

Technology is also providing the answers to logistical issues of caring for people with long-term conditions: shared care plans improve continuity of care when multiple health professionals are involved; patient portals give access to their health carers at a time and place that suits patients; and telemedicine is bringing specialist care to patients in outlying areas.

Technology is also providing ways to improve medication management, reach across cultural divides and reduce duplication and waste.

Delegates will also have access to health technology vendors, not only to find out what is already available, but also to suggest challenges for which technology may develop answers. And futurist Ross Dawson will encourage us to be bold and think of technology as business as usual, not as a special program.

Because while health care is in a state of rapid, and complex, change the goal – enhanced patient welfare and improved patient experience – remains unchanged.

For more on long-term conditions and the conference, see the conference website, hosted by Health Navigator New Zealand.

Gayl Humphrey is a researcher at the National Institute for Health Innovation (NIHI) and a member of the organising committee for the 2nd Australasian Long-Term Conditions Conference.

Posted in New Zealand eHealth

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