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Photo: Getty
Photo: Getty

BusinessJanuary 30, 2019

The app will see you now: how technology is improving access to healthcare

Photo: Getty
Photo: Getty

What role can technology play in our overburdened, underfunded health system? Jihee Junn spoke to some of the innovators working to ease the pressure on healthcare in New Zealand.

Health has become a major focal point for the tech industry in recent years and nowhere has this been more apparent than at CES, the annual Consumer Electronics Show which held its most recent iteration earlier this month. From breathalysers that detect diabetes to head impact monitoring mouthguards, health tech proved to have just as much of a presence at CES this year as the voice assistants and TV screens that physically dominated the showroom floor.

But health tech isn’t all about fancy wearables that poke and prod your body in various semi-invasive ways. At its essence, it’s about improving the delivery or consumption of healthcare for others. ‘Charlie’, for instance, which also showcased at CES this year, is a fully autonomous medical robot designed to accompany and comfort sick patients. Not only is Charlie able to respond to any questions and anxieties that patients might have, but it’s also able to connect them to medical staff if needed. In turn, this reduces stress levels not just for patients, but for nurses, doctors and caregivers as well.

Another company providing small but efficient tech-based efficiency improvements is Emergency Q, a software developed by Auckland-based company Healthcare Applications. Emergency Q’s main goal is to help reduce wait times in hospital emergency departments (EDs). Its founder, Morris Pita, says the idea came about after his own personal experience taking his son for treatment at a local ED.

“We got there and we realised we didn’t know how long it was going to take. It’s information that would’ve been really good to know,” he says. It’s an experience that’s vastly different to that of something like ordering a pizza online, because an emergency room, by contrast, is like an “information blackout”. Wait times can vary anywhere between 30 minutes to seven hours, and unless medical staff are on hand to give you an estimate directly, there’s really no way of knowing how long it’ll be.

Founder of Emergency Q, Morris Pita (Photo: supplied).

Last year, it was estimated that one in every four patients who turned up at Auckland City Hospital ED were forced to wait for more than six hours. At the same time, staff shortages have made things worse with doctor numbers falling so drastically that there simply aren’t enough to “safely run the department”. Then there are those who use EDs “like a GP”, clogging them up with non-emergencies and exacerbating problems with congestion.

Our public health system needs to desperately be better. It’s not just EDs plagued with excruciating wait times: access to elective surgeries, cancer treatments, GP appointments, and mental health services still leave a lot to be desired. And while throwing public money at the problem certainly helps, it’s not the only solution either. Apps like Emergency Q are proof that simple advancements in technology can go a long way in helping to alleviate pressure on our healthcare system. Vensa Health, for example, is another case of technology being used in a way that simplifies access to primary care. Patients and professionals can use its online portal to book appointments, request prescriptions, view lab results, and get reminders for things like screenings and immunisations.

Then there are those services that allow you to check on your health in a way that’s easier to access remotely. As Haimona Gray pointed out back in 2017, often the biggest barriers to accessing health care in New Zealand are geographic and financial – barriers that could be lifted by a greater of acceptance of “distance health services” for low-risk issues.

Firstcheck, which is an app that allows you to access expert opinions on skin lesions, is one example of a start-up that’s managed to do this. Instead of having to physically visit your doctor to check if a spot or mole is okay, Firstcheck allows you to do this remotely in a quicker, more accessible way than having to book an appointment with your GP. Another example of this is oDocs, an innovative technology company that’s made eye care more accessible to areas lacking ophthalmic services.

Emergency Q

Good things can happen when private and public come together in a way that works. In its first 10 months, Emergency Q was able to save patients more than 21,600 hours of waiting, as well as reduce patient volumes by 12%. Today, the app has more than 12,000 users and is now fully operational at both North Shore and Middlemore hospitals.

“These results are proof that the technology works”, says Kiwibank business manager Deborah Lagdon. Having worked with Healthcare Applications since its launch back in 2016, Lagdon’s been with the business since the very beginning. She helped find financial support for the app’s release and development – another example of private and public working together to improve the health system.

“I’ve known Morris for four years now having worked with him on a previous business and when he showed me how the app worked, I was really impressed…. I even suggested they approach Callaghan for a research and development (R&D) grant which they were successful in getting.”

Emergency Q is designed to be a win-win solution for both patients and medical staff. For the former, it eliminates time wasted in waiting rooms and puts “the power to make informed decisions” into the hands of the patient themselves. For doctors and nurses, it enables them to focus on the most urgent cases, relieving pressure on beds and other physical assets as well as delaying the need to spend more taxpayer dollars.

An Emergency Q poster in a hospital ED (Image: supplied).

There’s no doubt that New Zealand’s healthcare system is world class, particularly compared to a lot of other nations. But that doesn’t mean there isn’t room for improvement. Our doctors are overworked, our nurses are underpaid, and our hospitals are crumbling before our very eyes. We need more funding (that much is obvious) but it’s time we start looking at all our options on the table. Any small efficiency has the potential to make a huge difference – one that could very well mean life or death.

This content was created in paid partnership with Kiwibank. Learn more about our partnerships here.

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BusinessJanuary 30, 2019

If one of NZ’s big Aussie-owned banks goes belly up, who pays the price?

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The exposure of New Zealand banking to the whims of the Australian owners of our four biggest banks are well known. But if one of those NZ banks fails, Australian taxpayers could find themselves cleaning up the mess, write Matthew Greenwood-Nimmo and Timothy Jackson of the University of Melbourne

Australian banks have been under enormous scrutiny during the financial services royal commission, which reports on Friday. But one thing that hasn’t dominated the headlines is their relationships with their subsidiaries in New Zealand.

Each of Australia’s big four banks owns one of the New Zealand big four.

This has important practical implications, a fact acknowledged by New Zealand’s Financial Markets Authority and the Reserve Bank of New Zealand when they completed their own review into the conduct and culture of New Zealand’s banks in November.

Too big to fail?

If a systemically important bank gets into difficulties, the host country government usually intervenes with a rescue package and looks after depositors.

This (implicit) guarantee gives those banks a “too big to fail” status. It allows them to borrow funds more cheaply than their smaller competitors because lenders believe the government will come to their rescue if they get into trouble. It also allows them to take greater risks, knowing that, thanks to taxpayers, they will survive regardless.

New Zealand is trying to end that guarantee.

Not in New Zealand

Simply put, if a New Zealand bank fails, the Open Banking Resolution states that the cost will be faced primarily by the bank’s shareholders and creditors rather than by taxpayers.

Households that deposit with it could lose some of their savings.

Suppose a financial crisis hits both countries at the same time – a plausible scenario given the economies of Australia and New Zealand are exposed to similar risks.

The New Zealand bank at risk of failure would not receive a taxpayer-funded bailout. It would turn to its financially-stretched Australian parent for help.

If that help placed the Australian parent at risk, Australian taxpayers might have to come to the rescue.

Australian taxpayers might find themselves supporting the New Zealand banking system.

No easy way out

There are problems with each of the obvious solutions.

One would be for New Zealand to legislate deposit insurance and rescind its declaration that its banks will not be bailed out.

From New Zealand’s perspective, it would be unfair: the Australian owners would collect profits from their New Zealand subsidiaries in good times, while relying on New Zealand taxpayers to foot the bill in the bad.

New Zealand regulators would also wear the burden of having to making sure the Australian owners didn’t take excessive risks in New Zealand.

Another solution would be for Australia to follow New Zealand’s lead and declare that it too would stand firm and not bail out important Australian banks.

Such a policy might not be credible. The political cost of allowing households to lose their savings would be hard for elected officials to bear. The government would face considerable pressure to renege on its commitment.

A third, intriguing, possibility is that governments around the world could act together and formalise the “too big to fail” guarantee, knowing that other governments would do the same. To offset the burden facing taxpayers, governments could charge those important banks for being too big to fail.

The imminent report of the royal commission would be a good time for Australians to work out what to do.The Conversation

Matthew Greenwood-Nimmo is senior lecturer in economics, University of Melbourne and Timothy Jackson is a PhD student, University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.