I am delighted to announce that Carol Bennett, who has only just started her new job as CEO of the Hunter Medicare Local in NSW, after leading the Consumers Health Forum for five years, is in the chair at @WePublicHealth this week.
It will be an opportunity to hear her thoughts on primary healthcare reform and where it should be heading, as well as to learn about some of the initiatives that the Hunter Medicare Local is pursuing.
Thanks to Scott White, Communication Manager for the Hunter ML, for this overview of a new initiative in the Hunter region that aims to drive improvements in healthcare by bringing together some of the major players involved.
The Hunter Alliance: an example of regionally-driven health reform?
Scott White writes:
Many Croakey readers would be aware of the HealthPathways program. For those unaware, HealthPathways is an online health information portal for primary care clinicians to be used at the point of care.
It provides information on how to assess and manage medical conditions. It also outlines how to best refer patients to local specialists and services in the most timely way. The site is not public, but interested clinicians can obtain access information by emailing the author swhiteAThunterml.com.au
In its recent submission to the government’s Medicare Local Review, the Australian Health Care Reform Alliance, AHCRA, (LINK) cited the program as a positive example of achievements by MLs.
However, HealthPathways is much more than the development of care specific pathways as described in the AHCRA submission.
In the Hunter, where the first trial of the program began, we see the program as much more than an online tool to help guide GPs in their difficult, information‐varied referral role. Whilst there is no doubt that HealthPathways does this, and does it very well, it is much more than that.
Dr Lee Fong, one of the GP clinical directors with Hunter Medicare Local, describes HealthPathways as a reconnection between the primary and tertiary care sectors – a connection that was somehow lost over the years and is now being rediscovered.
And in the Hunter there are many other clinicians and health care managers who, like Lee, recognise the huge potential that improving communication and relationships between the two sectors has for improving health outcomes.
In the Hunter, clinicians and managers from three of the major healthcare organisations – Hunter Medicare Local, Calvary Health and Hunter New England Local Health District – have been meeting to pool their knowledge about the health care needs in our region.
In these meetings we have discussed examples of everyday people facing unacceptable experiences of our healthcare system:
- An elderly man who had over twenty aged care assessments ordered by a variety of different doctors, nurses and allied health professionals, all of which produced the same results. The Health system has evolved into a complex beast that brings together funding and programs from the Federal, State and Non-Government spheres. Better coordination and communication between service providers across these settings can only benefit the patient by reducing duplication and confusion. Ultimately, if the system is simplified, unnecessary costs are reduced.
- A women in her 70s who underwent a procedure and three months later her GP still hadn’t received the results of the procedure or any instructions to manage her ongoing care. The GP is the one constant in a patient’s health journey. GPs need to know about the key events in that journey to provide the right care. Delays such as this could have resulted in the patient missing out on important follow-up medications or tests and may even have resulted in unnecessary repetition of investigations and with that, unnecessary costs.
These stories illustrate many of the problems in our system – gaps in care, duplication and waste of precious resources.
Emerging from these often-difficult conversations, and driven by a need to make a real difference, we agreed on a proposal to work as a single system, to work together in tangible ways, to share responsibility and not shift the blame.
All three organisations have now signed a formal agreement, known as The Hunter Alliance (http//.ouralliance.healthpathways.org.au). We will now act as one system to improve care for people with diabetes, chronic lung disease and for people in their last year of life.
A key to the Alliance has been the strong history of successful collaboration between the Health District and the Medicare Local (and its former incarnation as a Division of General Practice). This collaboration has meant that we had already had wins with programs such as GP Access After Hours and the Connecting Care program, both of which have been successful in reducing strain on the hospital system.
Of course, we recognise that getting the Alliance together is only the first step in a major larger project. Dr Tracey Tay, who is an anaesthetist and consultant with the Agency for Clinical Innovation and a key driver of both the HealthPathways program and the Hunter Alliance, continues to remind us, it’s much easier to describe the problem than to fix it.
In explaining how we will tackle this enormous challenge, Tracey likes to quote the work of US surgeon and author, Dr Atul Gawande, who suggests that a great healthcare system needs to act like a racing car driver’s “pit crew”, a well-trained team that works together to support the driver to win the race.
To commence this process, we are starting from the ground up, seeking the views of both clinicians and consumers from across the Hunter.
Initially we are conducting an online survey, a copy of which can be found at, http://ouralliance.healthpathways.org.au/ and from there we will move to staff our pit crew.
We understand some may expect a faster pace but we are preparing for the Bathurst 1000 not the Melbourne Grand Prix. If you would like to keep updated about the program complete the online survey and you will go onto our mailing list.